Shelter medicine is a rapidly growing and newly recognized specialty area of veterinary medicine that has gathered a lot of interest in the last several years. Although not yet formally recognized by the AVMA as a specialty, veterinarians who work with or for shelters are increasingly aware and appreciative of the special knowledge and skills required to design a successful shelter health care program.
The AVMA does acknowledge shelter medicine as an emerging field, and the AVMA recognizes the Association of Shelter Veterinarians (ASV) as the professional organization representing shelter veterinarians.
Characteristics of the Shelter Environment
While veterinary colleges have traditionally taught general herd health management for large animals, they have not routinely taught veterinarians how to manage the health of companion animals housed in a herd setting. With the constant introduction of animals into shelters with unknown histories and vague backgrounds of disease exposure, it can be a nightmare for the average veterinarian who is not trained in population management and medicine to help shelters solve their problems.
Many of the problems that shelter veterinarians deal with on a daily basis are unique to shelters, despite the surface similarities to kennels, veterinary hospitals, breeding facilities, laboratories etc. It requires an integrated approach utilizing almost all the disciplines of veterinary medicine in order to successfully meet the challenge.
Shelter medicine is not the practice of small animal veterinary medicine in a shelter. Shelter medicine is production medicine. The goal is to prevent disease rather than treat it. Shelters are not hospitals; treatment is time consuming, costly and often results in prolonged animal pain and suffering.
Shelters have different missions and goals, budgets and resources from hospitals, kennels, laboratories or breeding facilities for which most small animal herd health management protocols were developed. They may be open admission shelters, meaning they must receive all animals, resulting in high turnover and population density problems not faced by other facilities that can limit admission.
In addition to basic veterinary health care protocols, shelter programs that should have veterinary input to operate successfully include stray animal capture/care/control; lost and found; breed identification; animal placement/matching/counseling; owner surrender; humane education; volunteer programs; partnership with other shelters, auxiliary and rescue groups; foster care; wildlife rehabilitation; animal law enforcement (nuisance, rabies, licensing laws); cruelty investigations; disaster relief; euthanasia; behavior evaluations/modification/ training/enrichment; low-cost veterinary services; spay/neuter programs; including trap neuter release programs for free roaming and feral cats; counseling; chemical capture for free roaming animals, microchipping, etc.
The veterinary medical program must evaluate disease risk and develop programs that increase and maintain the health and well being of a variety of animals. Such programs will incorporate elements of proper husbandry, shelter design, stress reduction and sanitation with vaccination, deworming, and disease testing protocols that are applied in a non-traditional manner.
Shelters pose additional challenges for veterinarians, who must deal with conditions not faced by veterinarians working with kennels, pet stores, breeders, etc. Some of these challenges include:
One of the most frustrating challenges for shelter veterinarians is dealing with internal dissension amongst staff and failure to follow the veterinarian’s professional advice. It must be remembered that despite the implementation of a comprehensive health care program, some disease may be inevitable because of the interplay between host, environmental and agent factors, and agency limitations.
Decisions made by veterinarians working with shelters have far reaching consequences for thousands of animals and humans. Health care, medical and ethical issues have become much more complex. In addition to examining, vaccinating, diagnosing, treating, neutering, performing behavior evaluations and even euthanizing animals, shelter veterinarians are intimately involved in the design of management protocols that ensure sanitary, healthy, enriched and safe conditions for both staff and animals. Their advice about zoonosis, etc. is critical in dealing with liability issues.
In recognition of the complexity of practicing veterinary medicine in shelters, there have been many exciting developments in recent years in the veterinary profession:
Shelter veterinarians must be strong, independent thinkers. While it was common for many decisions to be made without research or informed advice from textbooks or colleagues, shelters now have a variety of organizations, universities and written resources to turn to when seeking advice about their programs.
Shelter veterinarians are often at odds with their veterinary colleagues who criticize them for performing pediatric neutering or for using different vaccination protocols, for example, but there is now research to support these practices. But creative diagnostic and treatment regimens must often be utilized because of the lack of access to conventional methods.
The ability to be innovative is a prerequisite character trait for working in a shelter, and should be encouraged rather than discounted as incompetence or ignorance. The custom of obtaining a second opinion from an informed source should also be encouraged, just as second opinions are valued in private practice settings.
The situations encountered by shelter veterinarians are not found in any other area of veterinary medicine. Shelter medicine is no longer a place where retired veterinarians end a career or new veterinarians start one. Shelter medicine represents a new and rewarding lifetime career option that is destined to grow as more humane alternatives and options are sought for the world's homeless animals.Lila Miller, DVM, is Vice President of ASPCA Veterinary Outreach.