Getting 2 Zero - what is it about?

The world would be a better place if all animals in shelters and pounds could find the right home.

What are you up to next week? I will be attending the bi-annual Getting 2 Zero summit on the Gold Coast. Getting 2 Zero aims to achieve zero euthanasia of healthy and treatable dogs and cats in shelters and pounds around Australia.

This year the program includes speakers from around the country as well as international guests, who will share their expertise and bring their skills, research and hacks to the discussion. It’s about reducing the length of stay of animals in shelters, increasing rehoming, increasing reclaiming, and ultimately improving the lives of animals.

It’s also about improving the quality of life of shelter animals, and preventing infectious diseases like parvovirus. There will also be talks about keeping animals out of shelters in the first place. Its a brilliant space for those working with animals to rethink the systems in which we work, evaluate the evidence and introduce strategies that save - and improve the quality of - lives.

Whether you’re free for the day or the whole week, there’s still time to register. Check out the program here.

Declaration: I will be speaking at and MC’ing this event (and I'm very much looking forward to it).

Getting to zero in shelters, keeping pets cool, and an introduction to medical ethics

Better shelter management has improved the outlook for healthy kittens like these (happily rehomed). We can still do more.

The welfare of animals in shelters in Australia has improved by leaps and bounds since I graduated. The influx of animals, once overwhelming, is now being stemmed thanks to better shelter management, increased education of staff in animal welfare, behaviour and enrichment, an understanding and determination to be proactive about combating compassion fatigue and a groundswell of motivation to do something to prevent the destruction of healthy animals. There is still a way to go.

Getting to Zero is a model aimed at achieving ZERO killing of healthy or treatable cats and dogs – that more than 90 per cent of the intake of shelters. Every two years, G2Z hosts a conference, drawing on expertise from around the world.

This year I will be attending the Getting 2 Zero 2017conference. Save the date!

Meantime this has been an incredibly busy week. The current heatwave is playing havoc with companion animals. One of the most common things I’m seeing is late presentation of unwell animals, with owners reporting that they noticed their pet was a bit off colour, or perhaps less interested in food, but thought it was just the heat. It’s understandable – this heat is knocking everyone around, and causing behaviours like lethargy, panting, increased thirst and inappetence that are also seen with illness. But this is also problematic as it means that signs of illness are easily dismissed.

Undoubtedly its preaching to the converted, but please ensure pets have access to a cool environment and if you think they’re a bit off colour, best to get them checked out. More tips on keeping animals cool here. It looks like this hot weather is set to continue.

Finally, Dr Gwen Adshead, who treats people, gave a great lecture about medical ethics which raises some issues faced not only by doctors, but veterinarians. This article provides a beautiful summary of the key schools of thought in medical moral decision making. Read it here.

The science of shelters: interview with Nell Thompson and Cindy Karsten

Cindy, Trish and Nell - helping shelters help everyone.

When I grew up, animal shelters were chaotic, overcrowded, feared destinations from which animals were unlikely to return. That has changed rapidly. Shelters are transforming into adoption centres, pro-actively promoting animal welfare and increasingly analysing data to improve their performance. Two people who have been influential in this field are Nell Thompson and Dr Cindy Karsten.

Nell  was appointed as Coordinator of the national Getting 2 Zero program in July 2012. Nell has worked in the animal welfare, care and veterinary sectors for over 20 years and was the Victorian G2Z representative since the development of the G2Z program. Her background in shelter operations and management and animal health is a great resource for Councils, shelters and all groups and individuals involved in the program. Nell is passionate about improving outcomes for pets who enter the shelter and pound systems and strongly believes that the best results occur when animal welfare and animal management are working together towards the same goals.

Cynthia (Cindy) Karsten, DVM graduated from the University of Wisconsin School of Veterinary Medicine in 2010 and went on to complete a shelter medicine internship at Colorado State University.  She finished her Shelter Medicine Residency at UC Davis in 2014 and is now the Outreach Veterinarian with the UC Davis Koret Shelter Medicine Program.  Her main areas of interest include infectious disease control, population management, intake diversion/pet retention programs and community medicine. She has participated in numerous game-changing shelter consultations at both rural and urban, national and international animal care facilities, where she has identified far-reaching solutions in the face of limited resources.

How did you get together and end up collaborating?

I was looking for a speaker to present on shelter med issues for the 6^th National G2Z Summit (a biennial nationalconference on companion animal welfare and management issues) and contacted Dr Kate Hurley of the UC DavisKoret Shelter Medicine program. Kate presented for us in 2011 and suggested Dr Cynthia Karsten would be a good match for our needs and audience. Needless to say Cindy was a huge success and we invited her and Trish McMillan Loehr to visit an Australian shelter with us to do a shelter consultation.

The combination of the shelter med and behaviour perspectives was identified as being extremely valuable and covered the spectrum of shelter issues and challenges very nicely providing holistic solutions and recommendations. This visit was so successful that we decided to offer the Australian shelter, rescue and pound community the opportunity to tap into this expert resource and we have just completed a 3-week road trip covering two states and visiting 7 organisations. The feedback has once again been fantastic and we are looking forward to travelling to other states next year to spread the progressive sheltering word!

Why, in the age of huge awareness about responsible pet ownership, do we still find so many companion animals in shelters?

“Responsible pet ownership” means many different things to different people. I think we need to be clearer on what we (in the sector) need this to mean to people i.e. Desex, Identify, Train and Keep Safe. We also need to empower people to do this by employing supportive, non-judgemental and non-enforcement means.

Basic vet care (i.e. desexing surgeries, vaccination, microchips) is out of the reach of many pet owners. Just as basic health care would be out of their reach if we didn’t have Medicare. Perhaps we should be considering spending the enormous amount of money, spent by not-for-profit and Local Government each year on housing and disposing of stray and unwanted pets, on preventive strategies such as low/no cost desexing, low/no cost pet training classes and a myriad of other supportive measures.

The topic of ‘responsible pet ownership’ has been a very common topic for discussion lately and was actually a special session at the recent 2016 HSUS Animal Care Expo in Las Vegas.  A recent HSUS blog post discusses an important way to consider‘responsible pet ownership’.

How can the numbers of animals in shelters be reduced?

Most pets end up in pounds and shelters as strays and many of these are microchipped but the details are often not up to date making contacting the owner difficult, if not impossible. This is a message we have not successfully integrated into the community. Are we furnishing newly adopted and reclaimed pets with a good ole fashioned collar and tag? The research shows this works best when physically placed onto the pet at the time of release. [Ed. Definitely very helpful - often means that animals are returned to owners within minutes, if not hours, of being lost].

Cats are still the main issue when it comes to overpopulation, we need to ut more resources into low/no cost desexing while also considering changes to management of cats by shelters and pounds in general.

Educating and training veterinarians on paediatric desexing of cats is extremely important as cats can be ready to breed by4 months of age. The data shows that >90%of owned cats are desexed but this is unfortunately taken from the information relating to registered cats. There are many people who still do not register their cats (for a variety of reasons) so this is giving a false impression of the numbers of pet cats that are desexed. It also does not take into account those cats that were desexed after they had an “oops” litter which is happening commonly with cats. Desexing them after they have bred is great but it would be better to have done it before the horse left the stable in the first place. The three main reasons why people do not desex are: lack of knowledge (didn’t realise siblings can breed, didn’t realise cats can breed so young etc.), lack of resources (money, etc.) and access to affordable services. You can live in the suburbs but if you do not have a car or someone to drive you, a cat carrier and the spare money it can all get too hard really quickly.

The other major driver of pets into pounds and shelters is the lack of pet friendly accommodation. The HSUS is taking this on with their new initiative Pets Are Welcome.

Some shelters talk about resurrender of animals following a “honeymoon period”. What is the honeymoon period?

Not sure about this one so can’t comment.  I’ve never really heard shelters talk about this but I do always talk with shelters how the adoption is the start of a relationship with folks in the community and not the end of the relationship with the animal.  Let folks know that the shelter is there to support the new owner and the pet in any way that they can.  However, if it is not working out, no pressure, the animal is also always welcomed back or support them in rehoming the pet on their own.

What can be done to reduce resurrender of animals?

We can try to make the best match that we can at the time of the adoption and then support, support, support! What do we need to do to help keep that pet in the home?

If a pet is resurrendered after a recent adoption, then we need to take the opportunity to learn more about how that pet was in the home so that we can find a new home that is more suitable or help that pet through rehabilitation if required. We can also try to find a more suitable pet for that adopter rather than push them away which will mean pushing them towards a pet shop or online purchase.

This goes for pets being surrendered in the first place as well as strays being reclaimed by their owners. Are they having problems with behaviour? Fencing issues? Affording food and/or medical care?  It will be less expensive for us in the long run if we can meet people where they are at and work with them to keep their own pet.

One criticism of the “adopt-don’t-shop” model is that many suitable pet owners are not deemed suitable as adopters by shelters. Is this a recognised problem?

Looking at the prohibitive messages that many shelters and rescues have on their websites, before the potential adopter has even got in front of the pets in their care I would say yes. Add to this some of the less than flattering descriptions and write ups commonly seen on cage cards and internet profiles it’s not surprising that many people are still sourcing their pets from online sources and pet stores.

Requirements such as home visits, landlord checks, no kids under whatever age, etc., etc. are just putting barriers in the way of potential adopters. Add to that the cost of adopting a pet and it’s enough to tip people over the edge. While it is still possible to obtain a kitten free to good home in the community we cannot afford to be putting excessive adoption fees on our pets (particularly cats). Fee waived does not mean care waived. We can still use our regular adoption processes (as long as they are reasonable!) but ask for a donation at the time of adoption rather than a required fee. It’s not reducing the value of the pet in the adopter’s eyes, there is plenty of research around this that shows these pets are just as valued as thosepurchased elsewhere for higher amounts.

It’s also not impulse buying. Once again research shows that these pets are remaining with their adoptive owners as long as other pets sourced from other providers. One of the activities that we ran during our recent shelter visits was a "“stand up sit down” game using common adoption requirements. In one of the sessions, none of us, including all the staff, would have been allowed to adopt a pet! We could hear the minds blowing that afternoon…

What can be done about it? 

We have to trust, support and enable the community to do the “right” thing. Just hanging onto these pets in our shelters is not the answer. They don’t get “better” being incarcerated. It’s not even the answer in a foster home as we need to make way for the next one needing our help.

We hear about puppy factories and see footage in the news of ghastly, squalid conditions. Surely this can’t be that common in Australia?

It is fairly common in Australia, they are often located in rural areas and out of the way so many people do not realise how many there are. People may also not pick up their new pet from the actual location it was bred in (i.e. purchasing online, pet store or meeting at a pick up location) so they do not realise where the pet originated. Many of these dogs are sold on-line and thus buyers do not have a clear picture of where the dogs are coming from and the lack of welfare afforded to them.

What can be done about puppy factories?

It is certainly an animal welfare issue due to the conditions these animals live in but it is probably not the greatest contributor to our companion animal welfare and management issues. We need to encourage legislation such as Breeder Permit legislation which requires an inspection using best practice (not minimum standard) compulsory standards and the breeder using a traceable permit number when advertising their offspring. This way the consumer can trace the origins of the pet, be confident it was bred and raised in the very best of conditions and the welfare of all animals involved is assured.

What could we do to make the world better for non-human animals?

In terms of our stray and unwanted companion animals we need to look at our data. This sector has not been great at collecting and reviewing relevant data. We need to do this in order to develop and implement strategies to solve the issues facing the sector. Who are the animals coming in to our facilities? Where are they coming from? What are the barriers facing them in regards to leaving these facilities healthy and happy?

A good place to start is ensuring that all pet owners have access to affordable (to them) pet care and food/supplies needed for their pet.  Supporting all pet owners to allow them to care for their pets to the best of their capacity will keep both pets and people happy together.

Any advice you’d like to share with veterinarians and future veterinarians?

Learn more about Shelter Medicine! It’s not just about desexing, vaccinating and euthanizing. It’s the science behind good shelter and pound management, the whole story.

Learn to desex paediatrics and take those skills into your new job. If your bosses are not comfortable doing it ask them if you can offer that service. Learn about companion animal behaviour, and human behaviour!

And remember why you went into this profession in the first place.  When you can be anything, be kind.  

Thank you Nell and Cindy. Its great to see these kind of initiatives empowering shelters. For more info check out the Getting 2 Zero site here. 

What disinfectants should be used when cleaning up after animals?

Dishwashers need to operate at 60 degrees C to kill most pathogens - especially if they incorporate an extra "rinse" cycle.

What disinfectant do you use to clean up after animals? What is the best disinfectant for vet practices to use? It seems like a simple question, but disinfectants have a LOT of work to do. We rely on them to control infectious diseases. 

According to a panel of feline experts, “the cornerstone of good hygiene is effective disinfection” (Addie et al, 2015). 

Appropriate disinfection, as part of a good cleaning regime, will save lives. 

They’ve just published guidelines on disinfectant choices for feline environments – but the guidelines can be applied to dogs also.

In nature animals are more spread out so there is usually less density of bugs. In households, shelters and vet hospitals, animals are closer together, exposing them to unnaturally high levels of pathogens.

The hardest bugs to kill include parvoviruses (that includes feline parvovirus or panleukopenia virus), protozoal oocysts, mycobacteria, bacterial spores and prions. The best way to kill these is heat, under pressure, which is fine for autoclaving surgical equipment but not appropriate for human hands or animals.

A very important consideration when it comes to choosing an appropriate feline disinfectant is that they are susceptible to toxic effects not necessarily seen in other species. For those who want the detail, cats lack the enzyme UDP-glucuonosyl transferase, which is used by other species to detoxify agents like phenols. It is believed that because cats are true carnivores they’ve not been historically exposed to plant toxins and thus have lost the ability to metabolise these via glucuronidation (the use-it-or-lose-it approach to evolution). This is one reason why essential oils should not be used in cats.

Another quirk of cats is that they spend 5-25 per cent of their time grooming so tend to orally ingest just about anything in the environment if they walk, sit or lie on it. 

Hero grooms his little paws.

So while it is important to choose a detergent that blows bugs out of existence, it needs to be safe to animals and humans.

Other key points are:

• Dishwashers and washing machines should operate at a temperature of 60 degrees Celsius to eliminate spores and viruses;
• Alcohol, especially ethanol, is very good at killing enveloped viruses and is not easily contaminated – but it’s not so good at killing the non-enveloped viruses;
• Bleach is very effective and very safe IF it is not inactivated by organic material, heavy metal ions, biofilms, low temperature, low pH or UV radiation. In other words bleach needs to be applied to a clean surface (this applies to most disinfectants really);
• Chlorhexidine which is commonly used as a skin scrub is easily contaminated and not as effective as alcohols;
• Quaternary ammonium compounds such as benzalkonium chloride are not recommended. While they are effective against some pathogens there is increasing documentation of resistance, and not just to these products but a cross-resistance can develop to antibiotics including drugs like chloramphenicol;
• No single disinfectant will kill everything we want it to, so it’s important to do an inventory of the cleaning products in your hospital, shelter or home. As antibiotic resistance is an increasing issue, we will be relying more on disinfectants.

According to the authors, we may be seeing an increased use in UV radiation and products containing silver being used for disinfection in the future. They recommend cardboard litter trays in outbreak situations and this seems like a very good idea in a veterinary hospital context, bearing in mind the waste that may be created. Of course there are other important things we can do to reduce the risk of infectious diseases - isolating unwell animals, avoiding over-stocking or over-crowding (which is not just bad for the physical but also the emotional and mental health of animals, as it is for people) and appropriate vaccination.

You can download and read the guidelines here. You can also subscribe to the guidelines at the website.

Reference

Addie DD, Boucraut-Baralon C, Egberink H, Frymus T, Gruffyd-Jones T, Hartmann K, Horzinek MC, Hosie MJ, Lloret A, Lutz H, Marsilio F, Grazia Pennisi M, Radford AD, Thiry E, Truyen U, Mostl K (2015) Disinfectant choices in veterinary practices, shelters and households: ABCD guidelines on safe and effective disinfection for feline environments. Journal of Feline Medicine and Surgery 17:594-605.

Muggsy the rescue dog

Muggsy was lucky to have a second chance with Molly and her family when they adopted her from a shelter.

We recently had the pleasure of meeting Molly, who at twelve-years-old is an animal lover. She rescued Muggsy, from the Animal Care and Control shelter in her home-town in the USA.

“I’m not sure how she got there, but I was looking at the website and found her. When I first saw her she was named Lorna and her fur was all messy.”

Molly’s family took Lorna – who became Muggsy – in and she had a fantastic life (and a decent hair cut from the look of these photos).

“She loved to play and snuggle with us but was protective of us and would bark at people and dogs."

Have you ever taken a chance on a rescue dog? That reminds me of one of my favourite YouTube videos of all time, made in an animal shelter complete with singing staff! (check it here).

And by the way if you’ve ever done anything nice for an animal – like adopting someone from a shelter – you may be eligible to enter our Shark Girl DVD Giveaway. Check out the details here.

Interview with Dr Lila Miller on shelter medicine and getting to zero

Dr Miller examines a young patient.

Dr Lila Miller is best known internationally as co-author of Shelter Medicine For Veterinarians and Staff (you can check out the second edition and download an exerpt from Wiley here) and more recently Infectious Disease Management in Animal Shelters (order a copy or download exerpts from here). She was also the first African American woman to graduate from Cornell's veterinary program and has witnessed massive diversification of the profession.

Dr Miller has more than 30 year experience working in animal shelters for the ASPCA and is Vice President of the organisation's Veterinary Outreach. She taught the first course in shelter medicine in the US, co-founded the Association of Shelter Veterinarians and has recieved a swag of awards in what many consider the toughest field in vet-land.

One of the most fascinating things about Dr Miller is that she almost quit vetting. She spoke candidly with SAT on the eve of her visit to Australia this month to speak at the 5th National Getting to Zero Summit (you can register here - the program looks amazing and its running next week, 10-14 September). 

[NB Dr Miller was apologetic that she writes "like she talks - a lot"...but I think you will agree that this interview needs to be run in full].

Tell us about yourself.

I have a bachelor’s degree in animal science and a veterinary degree. I grew up in Harlem, New York, where I still reside. My father worked in a clothing store as a tailor and pressing clothes and my mother sold tokens in the subway. I went to Cornell University as an undergraduate majoring in animal science and then went onto the veterinary school, where I graduated in 1977. To give you an idea of the times, I was the first African American woman to graduate from Cornell’s veterinary college, and was a member of the first class to admit more than just a handful of women! (How things have changed!) 

At the urging of my mentor,   Dr.  Joseph Tait, who was providing veterinary oversight of the shelter system in New York, I went to work at the ASPCA right after graduation to help the organization develop a health care program for the shelter animals. The ASPCA had the contract for animal control for New York City, operating 5 shelters that were open 24 hours a day, 7 days a week. The vast majority of the animals were euthanized by lethal injection or decompression chamber.

After helping convert to all euthanasia by injection, setting up health care and spay neuter protocols and helping implement adoption criteria, working both hands on and supervising the program for about 5 years, I became director of a clinic that provided low cost veterinary care to the community as well as the shelter animals. The clinic underwent several physical and staff expansions to meet the demand, but after 15 years, when the ASPCA finally decided that operating a municipal animal control program did not fit the mission of a national animal welfare organization, the clinic was closed by the agency that took over animal control. 

I then went on to teach shelter medicine at Cornell and write about what I had learned about caring for shelter animals. I then became director, senior director and vice president of the ASPCA’s Veterinary Outreach department, which had a staff of 3 other veterinarians dedicated to teaching shelter medicine to veterinary and shelter professionals, providing consultations and grants to shelters to help improve the lives of shelter animals, decrease euthanasia and increase the live release rate. My current job is vice president of shelter medicine, where I continue to focus on teaching and training veterinary and shelter professionals about shelter medicine. I also lecture extensively to veterinarians about their role in handling animal abuse, whether through education or participating in investigations and prosecutions.

In addition to co-editing the three shelter medicine textbooks, I co-founded the Association of Shelter Veterinarians and have been actively involved in veterinary regulatory medicine. I was a member of the New York State board that regulates veterinary medicine and on the National Board of Veterinary Medical Examiners that creates veterinary examinations for licensing boards.

What motivated you to become a veterinarian?

I always wanted to be a veterinarian from the age of about 5. I don’t recall what my initial motivation was, but as I got older I never wavered from it. I liked animals but wasn’t overly involved with them-I had a dog, parakeet and hamster over the years as a young child-and as I got older I found I liked biology so it seemed like a good match. All my education through high school was focused on attaining that goal.

Shelter medicine is a tough area to work in. What attracted you to this area and what sustains you in it?

I was never “attracted “to shelter medicine. It didn’t exist when I was in veterinary school or even after I graduated. As a student, I disliked visiting the shelter with Dr. Tait, thinking it was a depressing place and that I would never work there. But Cornell was very grueling and when I graduated I was drained and didn’t feel qualified to go into private practice and didn’t want to undergo the rigors of an internship either.  In fact, I wasn’t even sure I wanted to be a veterinarian any more. 

Adult dogs with parvovirus, a common affliction in unvaccinated populations.

When Dr. Tait  asked me to work at the shelter  and help him improve conditions for the animals I hesitated but thought it would be a good place to get hands on experience with animals for a couple of years without the pressure of private practice.  I also saw it as an opportunity to make a big difference in the lives of hundreds of homeless animals who didn’t seem to get much attention from veterinarians, and realized the impact of any improvements I could make would be far greater than I could make for the individual animals I would treat in private practice. 

I thought I’d stay at the ASPCA just long enough to help set up a program and train staff. After about 5 years, when the program was established and running well, I was asked to run a clinic in an underserved area of New York as well as continue to oversee the shelter program.  I saw another opportunity to help animals who would otherwise be neglected because their owners could not afford the cost of care. When the clinic closed, I was offered the opportunity to help teach others what I had learned over the years and it was another chance to make a difference. So what started out as a short term commitment borne of uncertainty about my future turned out to be my life’s work.

How have shelters changed since you graduated?

Shelters have changed dramatically over the last 30 years. When I started working in New York City, animals were essentially warehoused and most were killed after being held for a few days, sometimes only 48 hours.  All animals were admitted to the shelter regardless of their medical condition or conditions in the shelter, often leading to overcrowded conditions and some long term stays that sometimes lasted for months for legal and cruelty cases. The influx of animals far exceeded the adoption and return to owner rate. The focus was on animal control and nuisance complaints, not animal welfare.  But as the human animal bond increased and more was and is being learned about animal behavior and emotions, the focus has been shifting to rejecting euthanasia as the primary method of animal control.

Other ways shelters have changed?

Providing for quality of life, reducing euthanasia and increasing the live release rate have become an increasingly important goal for shelters. In addition to paying more attention to the physical health and behavioral needs of shelter animals, shelters are engaging the community in the struggle to end euthanasia of healthy but unwanted pets. Foster care, rescue groups and volunteer programs are much more common than 30 years ago.

Shelter staff are becoming more professional, receiving training in animal behavior and handling, and research is being conducted to debunk the myths surrounding adoptions and determine the best ways to get more animals into loving, long lasting homes. Research is showing that fee waived adoptions, adoptions as gifts and during holidays can result in good, long lasting placements. Behavior assessments are being used to match an animal’s behavior  to the lifestyle of potential adopters, and to make their stay in the shelter while awaiting adoption less stressful.

Early age desexing and high quality,  high volume sterilization techniques and protocols were pioneered by shelter veterinarians in an effort to decrease the births of unwanted litters that were finding their way into the shelters, swelling population numbers and making the job so much more difficult.  

Early-age desexing is a safe and effective means of controlling the number of unwanted animals.

Shelters are being retrofitted and designed with the welfare of the animal in mind, and as inviting, cheerful destinations for the family to visit to acquire a pet.

Shelters are also seeking alternative and more innovative ways to deal with free roaming cats, instead of the traditional method of just trapping and/or killing them.

Shelters are also starting to work together collaboratively, transporting animals at risk of euthanasia to areas of the country where they can be rehomed due to shortages. In some communities, shelters with greater resources are working with shelters with lesser means to save the lives of adoptable animals who would otherwise be euthanized because of minor health problems or overcrowding.

How do you think shelters need to improve?

One of the biggest areas we need to work on is the management of cats. The number of free roaming cats is unknown but estimates are over 50 million in the US alone.  Bringing healthy cats into the shelter ends up often being a death trap for them-so much so that some shelter professionals are recommending not bringing them to the shelter at all, and redesigning cat housing to meet their needs when they must be brought in. We need to improve getting the message out to the public about desexing, humane care and responsible pet ownership. We also need to improve customer service and outreach.

Shelter cats need our help!

You’ve written extensively about infectious disease control in shelters. Why is the shelter context different?

Disease control in shelters is problematic for a number of reasons. Shelters are often underfunded, understaffed and overcrowded, which creates a perfect storm for disease transmission. 

This puppy is suffering from parvovirus. Affected dogs are extremely flat and depressed, and display gastrointestinal signs including vomiting and haemorrhagic diarrhoea. It is treatable but requires intensive care.

Animals are admitted from varying sources with all types of disease exposure that the shelter has no history about. Mandatory holding of animals who may appear healthy but are incubating disease results in disease spread. Shelters are inherently stressful, which contributes to disease transmission. Many shelters were not originally designed to house animals so poor ventilation and porous housing materials that are difficult to disinfect may be used, contributing to disease spread. Many shelters are unable to provide ongoing staff training and the very sanitation protocols designed to prevent disease spread may inadvertently contribute to it. When disease does occur, many shelters cannot afford diagnostic testing and don’t have proper isolation and quarantine facilities for appropriate management. The list could go on and on as to why it is more difficult to control disease in shelters. 

Can you tell us about any non-human companions you share your life with?

I have a 10 year old tortoise shell cat named Miss Coco. I found her as a stray outside my building when she was about 6 months of age.  I had planned to turn her into the shelter, but she was very friendly and insisted on rubbing and endearing herself to me and my mother, who insisted on keeping her.  As my mother can no longer care for her she has been living with me for about 6 years now.

Burnout and carer’s fatigue are commonly associated with many areas in veterinary medicine, including shelter work. What are your strategies for dealing with these?

I don’t really have any strategy for dealing with burn out. I have certainly experienced it over the last 35 years but when I ask myself what else I could be doing that would have the same impact, I draw a blank and feel renewed.

Do you have any favourite resources that you can share on shelter medicine?

My favorite resources are www.aspcapro.org, www.shelter medicine.com, the shelter medicine and forensics on- line courses offered by U of Florida’s shelter medicine program, Maddies fund webinars, Humane Society of the US (HSUS) Animal Sheltering magazine and  the shelter medicine textbooks I edited with Stephen Zawistowski and Kate Hurley. The Veterinary Information Network (VIN) has a shelter medicine page, but the membership fee is expensive. Of course, one to the best resources is the Association  of Shelter Veterinarians (ASV) member’s list serve.

Dr Miller with a puppy.

Any tips for veterinary students or veterinarians seeking to work in shelter medicine?

Veterinary professionals who wish to work in shelter medicine should try to familiarize themselves with the resources that are available and join ASV. The practice of veterinary medicine in a shelter is very different from typical private practice. Failure to understand the differences often results in unsatisfactory interactions between veterinarians and shelters. Students should select a veterinary college with shelter medicine training available-there are several in the US- join the student chapter of ASV and try to do a supervised externship program at a shelter.

What does “getting to zero” mean to you?

To me “Getting to zero” would mean society had finally met its obligations to the animals it domesticated and no more healthy adoptable animals would be euthanized for lack of a home.