A specialty whose time has come

Dramatic advances in the science and practice of shelter veterinary medicine have occurred since the first courses on shelter animal health were taught in veterinary colleges in the 1990s.

In less than two decades, shelter medicine has evolved into a distinct field of veterinary practice drawing on a wide range of disciplines, from design and oversight of preventive health care protocols to veterinary forensics, all aimed at ensuring shelter animal well-being while protecting public health.

Training in shelter medicine is now offered at almost every veterinary college in North America along with several postgraduate internships and residencies, while hundreds of hours of continuing education on the subject are presented at veterinary conferences every year. The Association of Shelter Veterinarians, which began as a grass-roots movement in 2001, today claims more than a thousand members, including some 700 veterinarians, and has student chapters in 22 veterinary colleges.

So it was no surprise when the AVMA Executive Board on April 11 voted unanimously in favor of granting provisional recognition to the Shelter Medicine Practice specialty within the American Board of Veterinary Practitioners, on a recommendation from the AVMA’s American Board of Veterinary Specialties. Shelter medicine was one of two veterinary specialties recognized by the AVMA board this April (see article).

“This group has been passionate about elevating the level of medicine provided to shelter animals, and their effort has paid off. I am very happy for them and what this will mean for the animals that find themselves in shelters,” ABVP President Amy Vogt told JAVMA News.

Dr. Kate Hurley oversees the shelter medicine program at the University of California-Davis School of Veterinary Medicine. She is amazed at how quickly the field of shelter medicine has evolved, from its fragmented and marginalized beginnings to recognition by the American Board of Veterinary Specialties. “I remember when shelter medicine as a veterinary specialty wasn’t even a twinkle in anyone’s eye. ABVS recognition certainly came much sooner than I expected,” Dr. Hurley acknowledged.

Shortly after receiving her veterinary degree from UC-Davis in 1999, Dr. Hurley was working at an animal shelter when parvovirus struck. She felt overwhelmed and unprepared. “I had one veterinarian telling me vaccinating dogs on intake wouldn’t work, and another colleague telling me the test wasn’t reliable, and I had animals with bloody diarrhea and 150 dogs at risk,” she recalled.

“I had to make a decision,” Dr. Hurley continued, “and it was going to have far-reaching consequences for the animals in my shelter, our reputation in the community, and potentially for pet animal health if I let animals go out of my shelter sick. That’s when I realized we need to think about animal shelters as a whole system, much the same as we think about herd health.”

Dr. Hurley returned to UC-Davis in 2001 to start the world’s first residency in shelter medicine. “I was the first person crazy enough to undertake a residency in shelter medicine when there was no clear path for what that would mean,” she noted.

I realized we need to think about animal shelters as a whole system, much the same as we think about herd health.

-Dr. Kate Hurley, shelter medicine program director, University of California-Davis School of Veterinary Medicine

That path would eventually lead Dr. Hurley to co-chairing the committee that in 2012 would formally petition the ABVS for recognition of shelter medicine as a veterinary specialty. Her co-chair, Dr. Brenda Griffin, said that, unlike conventional small animal practice and its focus on individual patients, shelter medicine must address the well-being of entire populations of captive dogs and cats in the context of unique shelter environments.

“Shelter medicine is a very, very unique blend of population and individual health care,” said Dr. Griffin, a professor of shelter medicine at the University of Florida College of Veterinary Medicine. “Our endpoint is to be able to release physically and behaviorally healthy animals into the community for a lifetime of care from practitioners in the community.”

Most communities are home to at least one animal shelter, which may be a public or private institution, a small sanctuary providing lifetime care, or a large facility that admits thousands of animals annually. Demand for long-term shelter of homeless animals has increased in recent years, Dr. Griffin explained, putting these populations at greater risk of contracting infectious disease, developing problem behaviors, and having their welfare compromised.

The role of veterinary medicine within the animal shelter community has historically been limited to neutering animals and treating the ill. One of the new veterinary specialty’s goals is to increase veterinary guidance within the animal shelter community and provide science-based recommendations that protect the health and welfare of millions of homeless animals.

The skills and knowledge a veterinarian needs to work effectively within the animal shelter context go beyond medical and surgical skills, according to Dr. Stephanie Janeczko, ASV president and senior director of community outreach shelter medicine programs for the American Society for the Prevention of Cruelty to Animals.

“Shelter medicine practice encompasses all aspects of veterinary medicine that are relevant to the management of shelter animal populations, including many skills beyond medical and surgical care,” Dr. Janeczko said. “As shelter veterinarians, we must take a broad approach to the physical and behavioral health of the animals that addresses community-level concerns and protects public health. This includes a thorough understanding of epidemiology, immunology, infectious diseases, and animal behavior; educating and managing staff; facilitating spay-neuter and adoption programs; and addressing cases of animal cruelty.

“It really is a distinct area of practice, and it requires a distinct set of skills and application of knowledge.”

A distinguishing characteristic of a board-certified shelter veterinarian will be a knowledge base and skill set applicable to the wide variety of shelter types. “A veterinarian can become an expert on their own shelter, but no two shelters are alike,” Dr. Hurley noted. A shelter medicine specialist will be able to optimize shelter animals’ physical health; enhance shelter animal behavioral health; protect community and public health; alleviate companion animal homelessness; address animal cruelty, abuse, and neglect; facilitate animal shelter management; serve as a resource on animals and public policy; and advance the practice of shelter medicine.

Shelter medicine diplomates will likely be found working in municipal and nonprofit shelters as medical or executive directors, in academia, for nongovernmental organizations, in federal and state departments or agencies, and as consultants. “We’re seeing an incredible amount of excitement because shelter medicine has traditionally been overlooked as a veterinary practice area,” Dr. Griffin said.

The inaugural examination for specialty certification in shelter medicine is scheduled for November 2015. The application deadline is September 2014, and the credentialing deadline is January 2015. Click here for more information about the examination or the Association of Shelter Veterinarians.