The Rapid Rise of Shelter Medicine

2009 by Laurie Peek, DVM

Audience: Executive Leadership, Foster Caregivers, Public, Shelter/Rescue Staff & Volunteers, Veterinary Team

In the 1970s, most animals were killed within hours or days of arriving at shelters. The field of shelter medicine simply didn't exist, because the animals didn't stay long enough to justify it.

As the number of pets entering shelters dropped in the 1980s, this changed. Shelters held animals for longer time periods, and some facilities started to employ local veterinarians to provide pet care.

Although longer hold periods meant more adoptions, they also meant more potential for the spread of disease within the shelter. And in the face of outbreaks in their animal populations, shelters had few available responses beyond killing all the exposed animals. In fact, such killing, or "depopulation," was the commonly accepted practice during outbreaks of infectious disease.

Complicating this was the public image of shelter animals as poorly behaved and/or diseased. Veterinarians usually didn't encourage clients to adopt animals from shelters because of this. In addition, many veterinarians viewed employment at an animal shelter as a depressing and second-class position. There was a general feeling that shelter veterinarians weren't good enough to make it in private practice.

By the time I went to veterinary school in the early 1990s, there was still no such thing as shelter medicine training. Many veterinary colleges did have partnerships with area shelters to give students an opportunity to perform a spay or neuter, but there was no special training for the overall management and care of animals in a shelter. If a shelter did employ a veterinarian, most of their time was consumed with spaying and neutering and not caring for the health of the population.

Nonetheless, with more veterinarians working in shelters there came the understanding that there was a need for better health management practices. I started volunteering at a shelter in Wisconsin in 1998. This shelter had a part-time staff veterinarian, but the individual was hired primarily to perform spaying and neutering. Since there was only one surgery room (in a renovated garage), I elected to help with examining individual animals (something I was good at coming from private practice).

I was amazed at the variety of diseases exhibited by animals in the shelter and the ways in which they were being treated and managed. Animals with highly contagious infectious diseases were being housed right along side healthy animals. Diseases that I would consider easily treated in private practice were reasons for euthanasia in the shelter. Strangely, the people overseeing this practice didn't see a problem with it.

But veterinarians working in shelters such as the ASPCA in New York City saw things differently. In 1999, the ASPCA contacted Cornell University Professor of Epidemiology, Jan Scarlett DVM, and veterinarians at these venerable institutions launched the very first shelter medicine course, "Issues and Preventative Medicine in Animal Shelters."

At the same time, Maddie's Fund designed our first guidelines for veterinary colleges seeking grant funding for shelter medicine training. Initially most of the veterinary colleges were only interested in spay/neuter funding, but our interest was on improving medical management of animals in shelters. In 2001 the University of California at Davis applied for the first ever comprehensive grant for shelter medicine training that included a residency program in epidemiology and preventative medicine. UC Davis graduate Dr. Kate Hurley became the first resident in shelter medicine at the school.

The Maddie's® Shelter Medicine Program at UC Davis enlightened the veterinary college world to the medical needs of shelters, such as veterinarians trained in "herd health" and population management subjects previously taught only with reference to livestock such as cattle and pigs. Small animal training had always been oriented towards individual animal care. The UC Davis program ignited the effort to educate veterinary students in this new field of shelter medicine, with its focus on group animal health for small animals. Out of this emerging practice the American Association of Shelter Veterinarians was started.

Maddie's Fund continued to support shelter medicine with grants to Western University (2002), Iowa State University (2003) and a second comprehensive program with residency training at Auburn University (2004).

After 2004, the field of shelter medicine started to solidify. Efforts were being made to make shelter medicine a board specialty of its own, the image of shelter veterinarians was on the rise, and shelter medicine was becoming a recognized and respected field of veterinary medicine. By 2004, additional shelter medicine programs had been started by Colorado State, Ohio State, and the University of Florida. Several universities had started to broaden their partnerships with area shelters with for-credit externships in shelter medicine, which included individual animal care as well as spay and neuter programs.

Veterinary colleges also started to see the value of sending their students to shelters. Since most teaching hospitals see mainly second and third opinion cases, shelter rotations gave students the opportunity to see first opinion cases, providing exposure to the types of cases a new graduate might see following graduation rather than the specialist referral cases presented to most university teaching hospitals.

Maddie's Fund awarded seed money to Cornell University's Jan Scarlett to direct a comprehensive shelter medicine program with residency training in 2004. Two years later, the program received $700,000 in endowed funding for resident training, and in 2007 it received a $2 million endowment for a shelter medicine clinician, the first endowment for training in the field of shelter medicine.

With the support of Maddie's Fund, disease management in shelters has undergone a sea change in both practice and approach. What was once a field staffed largely by well-meaning, well-intentioned people without the systems or structures in place that would allow them to help the animals most in need of their help became a model for progressive animal care and disease prevention.

"The focus on shelter medicine has benefited animals in a number of ways," said Maddie's Fund President Rich Avanzino. "It's resulted in lower disease rates and fewer illness-related deaths in the shelters themselves. And more veterinarians are entering shelter medicine practice, due to its increased status and greater visibility. And that means better preventive care and treatment for animals in shelters."

Because shelters are now saving lives instead of having to fall back on "depopulation" to control disease, many animals that were once processed through or killed are being kept healthy until they can be adopted. Where diseases were once considered impossible to treat or prevent, now there are established protocols for care and management that include isolation and treatment. Shelter veterinarians are being trained not just to treat disease, but to control and prevent diseases within the challenging and dynamic environment of a shelter.

Maddie's Fund's support of shelter medicine has grown to include comprehensive funding for programs at the University of Florida, directed by Julie Levy, DVM, PhD; Purdue University, directed by Annette Litster, BVSc, PhD; and Iowa State University directed by Claudia Baldwin, DVM. An additional grant was made to Dr. Christine Petersen, DVM, PhD at Iowa State University to publish "Maddie's® Infection Control Manual for Animal Shelters," recently released to great acclaim.

In fact, of the twenty-eight veterinary colleges in the United States, twenty-four of them now offer some kind of training in shelter medicine. Maddie's Fund funds fourteen of them. Out of six colleges with a comprehensive shelter medicine program that includes residency training, Maddie's Fund funds all but one of them.

"Our commitment to shelter medicine continues to grow," said Maddie's Fund Board Chairman Amy Zeifang. "We've invested nearly $8 million into shelter medicine programs to date, and are the largest charity to offer grants in shelter medicine in the country."

This success has created new challenges. Now that shelters are realizing that they don't have to depopulate for any or all disease outbreaks, they want to know how to control and prevent instead. Veterinarians involved in shelter medicine, including the experts we have helped fund at numerous universities, are being inundated with requests for assistance and guidance. The need is great, but the infrastructure and co-ordination to deliver the necessary personalized knowledge and guidance across the nation is weak. Even with six comprehensive shelter medicine training programs, the number of trained shelter medicine experts cannot keep up with the need.

The question has become this: can shelter medicine training keep up with the challenges of the future, and the growing demand among shelters and shelter veterinarians for better systems, more information, and increased knowledge?

Maddie's Fund is formulating new strategies to remain on the cutting edge of this revolution in veterinary medicine and animal care.

Laurie Peek, DVM

Dr. Peek graduated from Cornell University College of Veterinary Medicine in 1996. She has been involved with Maddie's Fund® since its inception. As Maddie's Fund Director of Veterinary Programs, she has guided decisions on veterinary school grants and guidelines and advised on veterinary related issues. As Director of Maddie's InstituteSM, she has launched a series of live and on-demand webcasts on various shelter medicine topics designed to help shelter personnel address medical and behavioral problems in shelter dogs and cats, thereby helping them save more lives. Dr. Peek has also practiced small animal medicine and surgery and provides spay/neuter and adoption assistance to several animal welfare organizations in her community. She has been a foster parent to many kittens over the years.

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