Street medicine

Free clinics, charitable funds are lifelines for pets of the homeless
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It was a fairly common sight that first piqued Dr. Jon Geller’s interest in the plight of pets living on the street with their owners. Crossing a bridge in Nashville, Tennessee, he saw a homeless man panhandling with his pit bull–type dog.

“There was something about the obvious intensity of their bond and the surprisingly robust appearance of the dog, in comparison to the owner, that struck me to explore this issue further,” he said.

The encounter eventually led Dr. Geller to found a volunteer organization, The Street Dog Coalition, in Fort Collins, Colorado.

Genevieve Frederick had a similar epiphany while visiting New York City. On the website of Pets of the Homeless, which she later founded, she tells of seeing a homeless man panhandling beside a “beautiful healthy, mixed breed dog” that was obviously devoted to the man.

The National Law Center on Homelessness and Poverty estimates that 3.5 million people, 1.35 million of them children, are likely to experience homelessness in any given year. Estimates are that 5 to 10 percent of homeless people have dogs or cats.

Homless dog
(Courtesy of Pets of the Homeless/photo by Tim Hulsizer)

“Veterinary medicine has made progress in providing care for pets of low-income owners, but pets of the homeless fall out of the safety net,” said Dr. Geller, an emergency care veterinarian at Fort Collins Veterinary Emergency & Rehabilitation Hospital.

The Street Dog Coalition is helping bridge the gap by providing medical care for pets of the homeless. The all-volunteer group pitches tents for its free clinics at shelters for homeless people and other places where they congregate. The first clinic was this past May in Fort Collins. The team of five veterinarians, four veterinary technicians, and three veterinary students saw 25 dogs and five cats. Vouchers are given to cover the cost of spaying and neutering, and any additional care needed, at a local veterinary hospital.

Dr. Geller has seen no shortage of volunteers or of local and national companies willing to donate supplies. The coalition is developing a model for a street clinic that could be used at other locations. Next year, he hopes to expand the clinics to Albuquerque, New Mexico, and San Diego.

Frederick said Pets of the Homeless is the only national program of its kind. At first, she called it Feeding Pets of the Homeless and started donation sites across the country, listed on the website, where veterinary clinics and others could take pet food for distribution to food banks and shelters that serve homeless people.

Today POTH’s mission is feeding and providing “basic emergency veterinary care” to pets of the homeless. It partners with veterinarians to provide free wellness clinics in their communities at locations that already serve the homeless. The veterinarians and veterinary technicians donate their time, and POTH underwrites the cost of medical supplies and shares its know-how. The clinics offer examinations, vaccinations, minor treatment and medications, nail trimming, and ear cleaning, and give vouchers for spaying or neutering.

“The doctors who do it get hooked,” Frederick said.

If a pet examined at a wellness clinic requires extensive treatment, the owner is referred to POTH’s emergency care program.

“When we have an emergency case such as vomiting or mange, we call a clinic we’ve been working with. We ask only for a 25 percent discount. If a hospital calls us with an emergency and it’s not a hospital we’re working with, we ask the doctor for the diagnosis and prognosis and a cost estimate,” she said.

Frederick hopes more veterinarians will partner with POTH on free wellness clinics for their areas.

Dr. Geller told attendees at his session on “The Indigent Client” July 13 at the AVMA Annual Convention in Boston, “We need to take our medicine to the streets. Is street medicine a lost art?”

Dr. Geller and vet student Margo
Dr. Jon Geller and Colorado State University veterinary student Margo Hennet draw blood for a heartworm test during a free clinic run by The Street Dog Coalition for pets of homeless owners. (Courtesy of the Coloradoan/photo by Austin Humphrey)

It involves maximizing one’s clinical skills, being resourceful, and relying on less technology, he said. It’s about using simple blood tests and free-catch urine dipsticks for diagnostic testing, for example, and treating with over-the-counter medications, $4 prescriptions, and splints made from newspaper and other materials.

His hope is to collaborate with other practitioners interested in this work and to compile a handbook on street medicine.

“This is the most challenging group needing help, but they’re probably more bonded to their pet than any other group,” he said. “In addition, pets of the homeless are at higher risk for disease because they live outside full time.”

Frederick once wondered why anyone living on the street would even have a pet. She learned most shelters don’t allow pets unless they are a service animal, and many owners will not abandon a pet if they become homeless. POTH offers free crates to shelters that will allow a pet to stay with its owner. Frederick is looking at options for putting pet housing within shelters.

“A lot of domestic violence victims will become homeless; they are in a Catch-22 because they can’t go into a shelter with their pet, so they stay on the streets. For women on the street, pets serve a purpose. Even if it’s a little dog, it can alert the woman that a person is coming too close,” she said.

Sometimes, a stray dog will see a homeless person and be attracted to the person, Frederick said. There are many ways a homeless person comes to own a pet, but the pet offers companionship, comfort, and security.

“The dogs get 24/7 attention. Every day is an adventure for them. Usually they are very social,” she said.

Many veterinary hospitals offer financing plans to low-income clients or those facing hardship, but Dr. Geller notes that in-hospital financing plans have high default rates, and people living on the poverty line don’t qualify for third-party payment plans. Some don’t even have home addresses. Many practices have “angel funds” to assist needy clients or potentially pets of homeless individuals. He knows of hospitals that invite clients to round up their bill to the next dollar, with the funds used for the pets of indigent owners in the area.

Some regional emergency animal hospitals have funds to help the indigent. DoveLewis in Portland, Oregon, has a Velvet Assistance Fund for emergency patients with a fair to good prognosis. It covers up to $750 per case. The fund has a $19,000 average monthly cap to ensure viability.

Mercer Clinic for Pets of the Homeless in Sacramento, California, not far from the University of California-Davis, is an example of a nonprofit that brings together volunteer veterinarians, veterinary and undergraduate students, company sponsors, and others to provide free care for animal companions of the homeless.

The American Animal Hospital Association’s Helping Pets Fund was a national program that provided grants for treatment of pets whose owners were facing financial hardship and for treatment of abandoned pets. The fund awarded more than $1 million in grants and assisted some 4,000 pets from 2005 until its funds were depleted in 2012. Donations had decreased while demand increased.

This past summer, the American Veterinary Medical Foundation launched a fund that takes a different approach. The AVMF Veterinary Care Charitable Fund requires that AVMA members register their clinics on the website to be eligible to receive and track donations. There is no enrollment fee for AVMA members. The AVMF accepts donations from an enrolled clinic’s clients and disburses payments directly to the clinic for charitable care it provides. Donations are tax-deductible, an advantage over the angel funds at many practices. In addition, any donor can contribute to the general AVMF Veterinary Care Charitable Fund, without directing the gift to a particular clinic.

New AVMF Executive Director Debborah Harp said it’s at the discretion of the practice owner whether the hospital’s individual VCCF fund can be used for homeless pet owners. Harp said 90 clinics are currently enrolled in the VCCF. One hundred donors had contributed $38,000 as of November, including a $10,000 donation from Merial that helped launch the fund.

Alpine Animal Hospital in Chubbuck, Idaho, is enrolled with the AVMF Veterinary Care Charitable Fund. Dr. Rena Carlson-Lammers, a hospital co-founder and AVMA District XI board member, said the after-hours emergency calls Alpine’s veterinarians and veterinary technicians take are not always from regular clients, and some need financial help.

“There is only so much our clinic can subsidize. Sometimes we’re scrambling just to get the emergency fee,” she said. “We’re looking at how to use our funds.”

They have been building their fund through fundraisers such as a yard sale advertised to clients as benefiting the charitable fund and a $20 first-aid class geared toward their many outdoorsy clients.

Frederick said, “I’m a middle-class white lady, and working the wellness clinics myself has really enlightened me. Most Americans are a paycheck away (from homelessness). All it takes is one catastrophic medical bill, a divorce, a lost job.

“Yeah, a lot are mentally or physically disabled and are probably the chronic homeless, but sometimes they are just happy with their situation and having their pet. And that’s OK.”

Related JAVMA content:

Searching for shelter (Dec. 1, 2015)