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Breaking down care barriers

Getting veterinary services to where they're most needed

From Animal Sheltering magazine May/June 2015

Access to basic medical careis considered a fundamental human right in many nations. In any community, it has a major impact on quality of life. This goes not only for humans, but for their companion animals as well. Most of us know that if we wake up with a sore throat, we can drive to a doctor. Similarly, when our pets are unwell, we can take them to a veterinarian and get the treatment to help make them healthy.

That’s not always the case in less affluent communities, where geographical distance and lack of resources create major barriers for people who love their animals but may be barely eking out a life for themselves. An unexpected veterinary bill is no joy for anyone’s wallet, but for many, it’s a potential crisis. A sick and reluctant cat is difficult enough to get to a veterinarian when you have a carrier and a car. Without those elements in place, it becomes a more serious challenge.

Animal welfare organizations are increasingly recognizing these realities, and in an exciting trend across the country, they are moving outside the walls of the shelter and working with animals and their owners in communities that most need them. Shelters are now implementing medical intervention programs that help loving pet owners keep their animals and improve animal welfare as a whole. Sometimes this requires provision of significant services, but many times, minor assistance is enough to help a beloved furry family member from becoming another shelter statistic.

What sorts of services and through what means might your organization be able to meet community veterinary care needs? Spay/neuter facilities, vaccine clinics and fairs, shelter events and mobile veterinary services are amazing opportunities. As more animal welfare groups consider reaching out with help that keeps animals from ever needing a shelter, it’s worth considering what exactly is meant by “basic medical care.”

As with many things in the relatively new field of shelter medicine, the more established human medical arena provides a helpful reference. In human medicine, basic care goes beyond just vaccinations and includes periodic medical exams, provision of first aid and medications to relieve pain and suffering and treat uncomplicated conditions such as infections. It includes basic diagnostic procedures such as radiographs, dental care, reproductive control and in some cases, surgery. Information on nutrition, behavior and end-of-life care should also be available.

Further research is needed to understand the perfect constellation of “basic care” that will maximally impact animal welfare in our communities, but the sidebar on pp. 43-44 contains a list of basic veterinary services every pet owner needs access to. As we work to get shelter intake and euthanasia numbers down, it’s worth considering how providing some of these services may enable us to help people and animals we’ve never previously reached.

How can these services be provided?

Almost unequivocally when the topic of affordable veterinary care is broached, it stirs up heated debate about the impact on private veterinary practice. The rising cost of veterinary care and the difficulties small businesses face are issues without simple resolution. Rather than becoming stuck in divisive disputes, communities must work creatively and collaboratively to provide access to basic care for at-risk animals before they reach the shelter. Skilled veterinarians are critical to the success of community intervention programs. Here are a few ways various groups might get involved in meeting these needs.

Outreach to local veterinarians to encourage volunteer clinic work, seek discounts for clients who need them, build professional relationships and calm fears of lost income: Behind every well-run vaccine clinic or spay/neuter event—whether held in a shelter facility, parking lot or other venue—there should be licensed, experienced veterinarians, technicians and trained volunteers performing examinations, administering vaccines, prescribing parasite control and maintaining operations. Animal welfare groups should collaborate with local veterinarians and veterinary associations, seek their assistance and let them know that the services being offered will have minimal impact on private practice income. Research has shown that many of the people in less affluent communities who are contacted by outreach programs have never before brought their animal to a veterinarian, and most of them will continue to experience life circumstances that will make such expenses an ongoing challenge. Animal welfare groups that help these clients are not taking customers away from veterinarians in private practice.

Full- or part-time clinic work out of the shelter facility: Many shelters provide veterinary services to the less affluent people in their community directly from their facilities. From spay/neuter only to full veterinary clinics with after-hours emergency care, the level of services varies.

Transportation services and mobile clinics: In some areas, just being able to get to the vet is a primary barrier for people who need to access care. Some organizations provide transportation for pets in need. Emergency pet ambulances are available in some regions, and transportation just for spay/neuter in others. The services themselves are mobile in still other places.

Raising funds to support clients in need: Shelters and rescues have often developed grants or funding pools to help adoptable animals. What about funds to help a pet who’s already in a loving home? Subsidizing medical care for pets whose owners can’t afford it can prevent those same animals from ending up in shelters or rescues. This can be a direct way to collaborate with willing veterinarians in the community, who are either seeing clients unable to pursue needed treatments, or are willing to receive special cases with appropriate funding.

One core skill required to implement any of these services sustainably is successful relationship building. Quite simply, we need to connect with each other and understand each other’s needs in order to improve the quality of life for animals and the people who care for them.

The ASPCA Cares Program is an example of a program that focuses on relationship building in targeted communities. This program launched in 2012 and is based on The HSUS’s Pets for Life program. ASPCA community advocates provide basic services and supplies for pets and host regular events within the targeted neighborhoods. This program recognizes that many of the most serious animal homelessness and health crises arise in neighborhoods with limited access to veterinary care and other pet care resources.

Jocelyn Kessler, the ASPCA’s director of spay/neuter operations, shared this recent story that illustrates how trust and education are important components of creating change.

“We met Jamal K. at our June 2014 vaccine event in Brooklyn. Jamal is an animal lover, but he was staunchly opposed to spay/neuter when we first met. He rescued his pit bull-mix Moet from a home where she was being abused. He also has two cats, China and Passion, whom he saved from the streets. As our staff spent time with Jamal at his home over the next few months, we saw firsthand the love he has for his pets. We built a relationship with Jamal so he would trust us to help his animals and eventually come around to the idea of spay/neuter. Our medical staff took the time to consult with Jamal on Moet’s skin condition and never pressured him to spay her.

Eventually Jamal decided to have his cats spayed, and when China wasn’t able to undergo surgery due to illness, we scheduled an appointment for her to be seen at a partner veterinary hospital in Queens. China’s infection cleared up, and she was spayed on our mobile clinic shortly after. Moet became pregnant and had a litter of four puppies in November, but we are delighted to report that Jamal has now decided to spay Moet and the puppies and find them loving homes. He even brought two of them to the mobile clinic in the middle of a snowstorm! It was amazing to see his dedication to his pets, and the way his views have evolved regarding the best way to keep them healthy and happy.”

Clearly this work is impactful, and the type most animal welfare advocates and shelter veterinarians want to do more of. It is an exciting time to be in shelter medicine and assist in providing these services. Even more exciting? Imagine what might change at your shelter in the future if your community’s animals’ basic care needs are met!

Veterinary Care Basics

Vaccines

What: No matter an animal’s age or lifestyle, vaccines are critical for protection against life-threatening diseases like feline panleukopenia and canine parvovirus, and also for keeping levels of disease low in the community. Minimally, cats should be up to date on FVRCP vaccines, and dogs should be up to date on Da2PP vaccines. Vaccination against rabies virus is a legal requirement for dogs in all states and recommended for cats even when not required by law because of the zoonotic and fatal nature of this disease. There are other vaccines that may be recommended based on animals’ lifestyle and risk of infection. In many places, because of the legal requirement and serious zoonotic nature of rabies, public rabies vaccine clinics are scheduled. Shelters and communities should consider the benefit of providing opportunities for Da2PP and FVRCP vaccines on a regular basis as well. Panleukopenia, canine parvovirus and canine distemper are serious diseases that still threaten animals everywhere in this country. Spay/neuter facilities, vaccine clinics and fairs, shelter events and mobile veterinary services can provide wonderful opportunities to serve the critical need of provision of regular core vaccination services to those who would otherwise not have access.

When: Typically, in both owned dogs and cats, vaccines can begin around 6 weeks of age (in most states, a rabies vaccine is only valid when given by a veterinarian after 12-16 weeks of age). Any animal 6 weeks or older should be on a regular vaccination schedule.

Parasite control

What: Companion animals can host a variety of internal and external parasites, most of which strain the immune system of their host, some of which are uncomfortable, and a few of which are contagious to humans. Part of good preventive care involves examining regularly for common parasites that require treatment. It is probably not feasible to test or treat for all parasites; parasite prevalence differs by region. But pet owners should aim for regular exams for internal and external parasites, and heartworm testing and preventive medication in dogs.

When: Dogs and cats should be tested annually for internal parasites with a fecal examination, or more frequently if animals are symptomatic (losing weight or experiencing gastrointestinal upset). Heartworm testing should happen annually for all dogs along with a prescription for preventive medication (which can also prophylactically treat common zoonotic parasites). Owners can learn to examine their pets’ coats and external ear canals for signs of parasites during regular grooming, so that when they notice flea “dirt” (excrement), tapeworm segments or ticks or fleas, they’ll know to seek treatment.

Spay/neuter services

What: Spaying and neutering not only provide behavior and health benefits for individual animals, but also help combat pet homelessness. Different models for this service have been developed around the country, many of them targeting underserved communities and their pets.

When: Kittens and puppies as young as 8 weeks can be safely spayed or neutered. In animal shelters, surgery is often performed at this age so that animals can be placed for adoption with the surgery completed. Many veterinarians find the surgery to be less stressful and the recovery more rapid for young animals. It may also be less expensive to have the surgery performed when an animal is smaller and younger. With owned animals, it is advisable to perform spay/neuter before the age of 6 months, as this is the time that reproductive capability typically begins. Most animals should be fully vaccinated by 4 months, and this can be ideal surgery timing to ensure protection from infectious diseases while in the hospital.

Emergency care

What: Anyone who has ever owned an animal knows that emergencies typically happen when least expected. Having a plan in place ahead of time can help when difficult decisions must be made and emotions run high. Owners should know where to go for 24-hour care and understand the requirements for payment ahead of time. Shelters and rescue groups that provide medical services such as spay/neuter should make sure that clients know where to go if a complication occurs, and how payment will be discounted or covered.

When: You can help owners be prepared by providing the names, addresses and phone numbers of emergency care providers.

End-of-life services

What: Many shelters focus solely on life-saving services, and may be missing a critical need of clients whose pets are nearing the ends of their lives. There is perhaps nothing more difficult than facing the decisions that come when companion animals are suffering, ill or otherwise nearing the end of their lives; this is magnified when the client doesn’t know about or can’t afford euthanasia. Resources to call on for advice, euthanasia services and grief counseling can be incredibly helpful in minimizing human and animal distress.

In Los Angeles County, the ASPCA’s Safety Net Program managers, who are stationed at two county shelters, often meet residents who intend to relinquish animals they cannot afford to euthanize. In late 2014, Bernice Osorto, the Safety Net manager at Los Angeles County’s Downey shelter, prevented the surrender of Mimis, an 11-year-old Chihuahua who was suffering from an enlarged heart.

Mimis was having difficulty eating and walking, and her stomach was swollen. Her entire family accompanied her to the shelter to relinquish her and say goodbye. Osorto provided an ASPCA voucher to a local veterinary clinic, where Mimis was medically evaluated. The vet recommended euthanasia, and Mimis was humanely euthanized that same day, sparing her the stress of entering a shelter and allowing her to spend her last hours with her family.

“Providing end-of-life services for an older or very sick animal is as important as providing medical care,” says Allison Cardona, senior director at the ASPCA, who oversees the organization’s Safety Net Program. “It also allows pet owners to be with their beloved animal during the euthanasia process, providing comfort and closure for the pet as well as the person or family who cared for it.”

Although it may seem that a service that ultimately ends a life is finite, often the impact is far-reaching. This can be especially true when children are included appropriately in the grieving process and when compassionate and connected services are offered by animal shelters and others in a community. Often, a circle of caring begins, and these families will turn to the shelter again in the future, perhaps even to save a life through adoption.

About the Author

Miranda Spindel, D.V.M., M.S. is senior director of shelter medicine and development at the ASPCA.