Shelter medicine: A budding field that is helping to raise the standard of care in animal shelters

 On Dr. Kate Hurley's first day as veterinarian at the Dane County Humane Society in Madison, Wis., the shelter was in the middle of a ringworm outbreak. 

Though ringworm is easy to treat in private practice, Dr. Hurley said, she soon learned it is difficult to control—and often fatal—in a shelter setting. Her training hadn't prepared her for the small animal herd health situations shelter veterinarians face, she said.

The trend is helping to raise the quality of veterinary care at animal shelters across the country, an important step to stopping dog and cat overpopulation and improving adoption rates, according to humane organizations.

"There's so much passion and emotion in shelters, it's good to have veterinarians coming in, to bring science into it," Dr. Hurley said.

The Association of Shelter Veterinarians, formed three years ago, has grown to 420 members—320 veterinarians, 52 nonveterinarians, and 48 students. There are student chapters of the Association of Shelter Veterinarians at UC-Davis and Colorado State University. A growing number of members are private practitioners who work with shelters in their communities. The association is focused on elevating the standards of care for shelter animals by disseminating information, providing a venue for networking, and promoting educational opportunities, said president, Dr. Julie D. Dinnage.

Dr. Dinnage, who left private practice in 1998 and now works for the Massachusetts Society for the Prevention of Cruelty to Animals, said the image of shelter medicine has improved in recent years.

"Shelters are going farther above and beyond to try and help animals through foster care and veterinary care," she said.

Dr. Dinnage said fracture repairs and full medical workups, for example, are happening in more shelters. Some shelters have state-of-the-art facilities and surgical suites, said Dr. Hurley, who is on the Association of Shelter Veterinarians' board of directors.

Though standards for veterinary care in shelters are rising, shelters require a different kind of care than other types of practice.

"As much as we still deal with the individual animal, we cannot divorce ourselves from the entire group dynamics," Dr. Dinnage said. For example, shelter veterinarians often use different vaccine protocols and treatment strategies than private practitioners.

Shelter veterinarians often work for a board of individuals who may not have medical backgrounds. They also have special budgetary constraints. Dr. Hurley explained treatments that cost just a few dollars for an owner, can cost thousands for a shelter that has hundreds of animals in its care.

Dr. Mary Blinn, a shelter veterinarian at the Charlotte-Mecklenburg Animal Control Bureau, said she frequently deals with cruelty and neglect cases, such as dogs with ingrown collars, or emaciated animals. She has learned how to conduct forensic investigations on the job, using human forensic techniques. On a few occasions, she has testified in court.

Shelters that offer veterinary services, such as vaccinations and spay and neuter surgeries, have been criticized by some private practitioners who feel it's unfair competition. But Dr. Dinnage said shelters have a responsibility to provide appropriate medical care for animals in their facilities. As fewer shelters euthanatize for treatable conditions and as longer-term housing options become available, there is a need for veterinary care during an animal's stay in a shelter. Disease prevention protocols, such as vaccinations, are part of that care.

"We're trying to make successful adoptions happen. That's our goal—a great match," Dr. Dinnage said. She said shelters encourage adopters to seek lifetime veterinary care for their pets; owners who do so are less likely to relinquish them.

Dr. Blinn said it's important for shelter veterinarians to be active in their local communities to answer questions from practitioners. She has served as president of her local VMA and been an active member.

"When I explain what I'm doing and why, most veterinarians are responsive," Dr. Blinn said.

Teaching herd health
Many veterinary schools are adding shelter medicine to their curriculums to prepare students for the demands of shelter medicine. According to Dr. Hurley, Cornell University introduced the first course on shelter medicine in the fall of 1999; now, many schools offer some instruction in shelter medicine.

Several schools offer externships, rotations, and postgraduate residencies in shelter medicine.

The University of Florida College of Veterinary Medicine recently hired Dr. Natalie Isaza to serve as an assistant professor of shelter medicine, a newly created position. She will oversee an optional, two-week shelter rotation for veterinary students. Western University also has a shelter medicine rotation. Other schools and colleges offer volunteer opportunities to work with shelters.

The University of California-Davis was the first school to offer a residency, Dr. Hurley said, a program launched in 2000 with a $2.2 million grant from Maddie's Fund. Dr. Hurley was the program's first resident and is now the director of the program. The program works with several regional animal shelters, and provides hands-on training for veterinary students. Iowa State University also received a Maddie's Fund grant for its classroom-based shelter medicine program. Maddie's Fund has agreed to fund a shelter medicine program at Auburn University, and hopes to fund another at Cornell University.

Rich Avanzino, the president of Maddie's Fund, a non-profit organization that funds shelter programs, said that the organization has committed $5.5 million to funding shelter medicine education as part of its "no-kill nation" initiative. Currently, the goal of the initiative is to stop the euthanasia of healthy animals in shelters.

"We think it's important to have veterinarians and technicians working in every shelter," Avanzino said.

The first textbook on shelter medicine, Shelter Medicine for Veterinarians and Staff, is due out this year, according to the book's editor Dr. Lila Miller. Dr. Lila Miller is the senior director and veterinary adviser at the American Society for the Prevention of Cruelty to Animals and has taught shelter medicine at Cornell. Several shelter veterinarians contributed chapters to the book on topics including epidemiology, sanitation, shelter design, cruelty investigations, and euthanasia.

Dr. Miller, who began working in shelter medicine in 1977, said the development of the book has paralleled an explosion of information in the field of shelter medicine.

"(Previously,) we had no standards and guidelines, and people were out there on their own," she said. "We hope that the book will elevate the status of veterinary medicine in the field of shelter medicine."

She also hopes the book will help all veterinarians understand shelter medicine and boost collegiality between shelter veterinarians and the rest of the veterinary community.

"We need to get all veterinarians, not just shelter veterinarians, cognizant about what's going on in shelters," she said.

Humane organizations and veterinary conferences are offering more continuing education opportunities in shelter medicine. American Humane, formerly the American Humane Association, has a shelter veterinarian track at its National Humane Conference. The track, which started in 1992, was one of the first of its kind, and helped launch the Association of Shelter Veterinarians, Dr. Dinnage said. The association now holds its annual meeting in conjunction with the conference. The North American Veterinary Conference also has a shelter medicine CE track. The Humane Society of the United States' annual Animal Care Expo offers shelter medicine CE for veterinarians.

Growing demand
Many in the sheltering community believe there will be increasing demand for veterinarians and veterinary technicians in shelters, as the public insists on a higher quality of care and shelters try to move away from euthanasia of healthy animals, Dr. Dinnage said.

"I think the need is huge," Avanzino said. He estimates there are more than 3,000 animal shelters across the country and fewer than a quarter of them have veterinary services. The ASPCA National Shelter Outreach Program estimates there are 4,000 to 6,000 animal shelters.

Shelters, which can range from small, home-based operations to municipal shelters and large nonprofits with multimillion-dollar budgets, offer many job opportunities for veterinarians and veterinary technicians, Dr. Dinnage said. Some have full-time or part-time veterinarians and technicians; others hire private practitioners as consultants.

Salaries for full-time shelter veterinarians are generally comparable to salaries for associates in private practice, Dr. Hurley said. Municipal facilities also may offer generous benefits and paid vacation, she said. An added benefit is a regular, 40-hour workweek.

"I think (the demand for shelter veterinarians) is going to explode in the next 10 years," Dr. Dinnage said.