Groundbreaking Work for the Future of Shelter Medicine

by Julie Mazzola | Oct 31, 2012

Maddie’s Fund, Purdue University College of Veterinary Medicine and PAWS Chicago are working together to develop the next generation of shelter veterinarians and shelter medicine protocols

I. Training Veterinary Leaders

The new field of shelter medicine has established itself as a career path. In fact, shelter medicine has now been recognized as a specialty by the American Board of Veterinary Practitioners. 

Hands-on shelter learning opportunities for veterinary students are an essential component of training future leadership. As shelter medicine continues to gain esteem, shelter medicine specialists will be in greater demand across the country. 

With a grant from Maddie’s Fund in 2008, Purdue University and PAWS Chicago have joined forces to educate and train veterinary professionals and leaders of the future in shelter medicine, animal behavior, population health and companion animal welfare. Veterinary students from Purdue are given an opportunity to gain hands-on clinical experience at PAWS Chicago’s Rescue & Recovery Center and Lurie Spay/ Neuter Clinic. 

This Maddie’s Shelter Medicine Program is designed to give veterinary and Certified Veterinary Technician students exposure to the many facets of working in a high-volume spay/ neuter clinic and a No Kill shelter environment so that more lives can be saved. This invaluable experience is laying the groundwork so that proactive life-saving medical practices in shelter medicine can be integrated into a growing number of sheltering programs across the country. “PAWS Chicago has enabled the Purdue Maddie’s Shelter Medicine Program to educate and train future leaders in the field of shelter medicine in an adoption-guarantee environment,” said Purdue Veterinary Professor and Maddie’s Shelter Medicine Program Director, Dr. Annette Litster. 

Shelter Medicine Fellowships for Veterinarians 

This Maddie’s Post-DVM Fellowship in Shelter Medicine is a year-long opportunity for veterinarians that place fellowship trainees with the team of shelter veterinarians in the state of-the-art facilities at PAWS Chicago. This advanced clinical training in shelter medicine focuses on areas of population medicine, infectious disease, animal welfare, preventative medicine, high volume spay/neuter and animal behavior. The Maddie’s post-DVM Fellow will also pursue an important issue related to shelter medicine, which will be published in a national peer-reviewed veterinary journal.

Shelter Medicine Externships 

Fourth year veterinary students from Purdue University School of Veterinary Medicine are able to study a 1-6 week clinical rotation in shelter medicine at PAWS Chicago or the Humane Society of Indianapolis. Veterinary technology students are also given externship opportunities. 

During clinical rotation, students participate in the full spectrum of shelter medicine services, from intake to adoption. Students work alongside experienced shelter veterinarians to learn about population medicine, infectious disease care and control, preventative medicine, spay/neuter anesthesia and surgery, animal welfare, behavior and environmental enrichment and client interaction and education.

II. Humane Shelter Medicine Research

With a grant from the Maddie’s Fund Shelter Medicine Program, Purdue University is conducting cutting edge studies at PAWS Chicago, aimed to improve the quality of care for pets living in shelters. This humane research and application of evidence-based methods of veterinary health care and preventative medicine is transforming the way shelters medically care for their pets. “Information from the practical shelter medicine studies conducted at PAWS has moved the science of shelter medicine forward so that shelters all over the USA and beyond can constantly improve the health and welfare of the shelter pets in their care,” said Dr. Litster.

Published Studies

1) This two-part study on parvovirus and distemper in dogs: i) investigated diagnostic accuracy of a test’s ability to segregate lowrisk from high-risk in a population; and ii) determined existing antibody and assessed protective immunity following vaccination. Published 2012. 

Medical description Part I – Accuracy of a point-ofcare ELISA test kit for predicting presence of protective canine parvovirus and canine distemper virus antibody concentrations in dogs. This study investigated the diagnostic accuracy of the Synbiotic TiterChek CDV/CPV, an in-clinic ELISA test kit used to measure serum antibody titers against CPV and CDV in dogs. 

Impact to Shelter Medicine Part I – The results of this study have transformed shelter medicine by validating that the Synbiotic Test works in a shelter environment. This enables PAWS Chicago to save more lives by clearing puppies for adoption faster and improving treatment protocol when disease is detected by determining who is at the highest risk.

Medical description Part II – Prevalence of positive antibody test results for canine parvovirus (CPV) and canine distemper virus (CDV) and response to modified live vaccination against CPV and CDV in dogs entering animal shelters. This study determined antibody titers against canine parvovirus and canine distemper virus in dogs entering shelters in Chicago and Indianapolis and response to modified live vaccinations over the following two weeks. 

Impact to Shelter Medicine Part II – The study showed that older and sterilized dogs are more likely to have protection and the sooner that you can vaccinate, the sooner you start building protective titers (or immunity to disease). 75% of the dogs had titers for parvo at intake, 85% after 6-8 days from 1st vaccination, 100% after 13 -15 days from the 2nd vaccination. 36% of the dogs had titers for distemper at intake, 60% after 6 -8 days from the 1st vaccination, 98% after 13 – 15 days from the 2nd vaccination. The average age of the dogs in the study were 1 year.

2) Identify which puppies and kittens were most likely to be delayed by medical illness after shelter intake and investigate how management practices can reduce these delays. Published 2011. 

Medical description – Risk factors for delays between intake and veterinary approval for adoption on medical grounds in shelter puppies and kittens. 

Impact to the Shelter Medicine – This study showed that if puppies and kittens are placed on antibiotics within 24 hours of the first signs of upper respiratory infection, they will recover seven to 10 days sooner than if you delay treatment until the signs worsen.

3) Determine the best antibiotic treatment for cats with upper respirator disease. Published 2012.

Medical description – Comparison of the efficacy of amoxicillin-clavulanic acid, cefovecin, and doxycycline in the treatment of upper respiratory tract infections in cats housed in an animal shelter. This randomized prospective study identified the respiratory pathogens in Chicago cats and compared their response to three different antibiotic treatments. 

Impact to Shelter Medicine – This study showed that doxycycline was more effective than amoxycillian/clavulanate (clavamox) or cefovecin (convenia) in reducing clinical signs of upper respiratory tract infection, such as sneezing and eye discharge. This standardized PAWS Chicago antibiotic protocol for the treatment of upper respiratory and shortened cure time.

Studies submitted to journals, currently under review 

1) Randomized masked controlled clinical trial to compare 7-day and 14-day course length of doxycycline in the treatment of Mycoplasma felis infection in shelter cats. This randomized, blinded placebo–controlled trial compared oneweek and two-week course lengths for doxycycline treatment of shelter cats infected with Mycoplasma felis and showing signs of upper respiratory tract disease by tracking response using clinical scoring and PCR results over a two-week period. 

2) Epidemiology of feline panleukopenia virus (FPV) in an animal shelter. In a traditional shelter, panleukopenia exposure results in death. This disease is highly contagious and deadly. This study described 145 cats that were exposed to FPV, dividing them into 3 groups – those that did not show signs of disease, those that showed signs of disease but survived and those that did not survive, so that comparisons could be made between the groups. This study will show that euthanasia is not the remedy for panleukemia.

Manuscript in process from completed study 

Feline immunodeficiency virus (FIV) transmission did not occur in long-term cohabiting FIV-positive and FIV-negative cats. This study investigated serial FIV test results in 45 FIVnegative and 5 FIV-positive cohabiting spayed/neutered cats with completely unrestricted access to one another over a period of up to 8 years. During this period, FIV transmission did not occur, despite the fact that each FIV-negative cat was exposed to FIV infected cats for an average accumulated time of 11.98 years.

Studies In Progress 

1) Use of Ponazuril as a first line treatment for coccidiosis in a shelter environment. Many shelter veterinarians and private practitioners are currently using ponazuril (Marquis paste) to treat coccidiosis, an intestinal infection, with very favorable results, but there is no uniform dose schedule. This randomized blinded controlled study compares the results of ponazuril treatment at three different dose rates in dogs and cats with coccidiosis, to determine the most costeffective and efficacious dose. 

2) Clinical trial to determine the efficacy of famciclovir as part of intake protocol for shelter cats. Previous studies conducted at PAWS have confirmed that approximately 90% of cats entering PAWS Chicago are infected with feline herpesvirus (FHV). Oral famciclovir has been used successfully to treat shelter cats with FHV, but an effective clinical dose rate has not yet been established. This randomized, blinded, placebo-controlled clinical trial will determine if famciclovir can reduce clinical signs of upper respiratory tract infection if used as part of the shelter intake protocol. 

3) The Purdue FIV Study. This prospective study is the first to produce evidence regarding the clinical effects of FIV infection by following 89 naturally-infected cats and age, sex, and location–matched FIVnegative control cats over a five year period. The study currently is in Year Three and is yielding a diverse range of important and practically–relevant findings.

Dr. Barbara Kompare, DVM PAWS Chicago Shelter Medicine Veterinarian 

2010 Maddie’s Post-DVM Fellowship in Shelter Medicine through Purdue University at PAWS Chicago 2009 Maddie’s Post-DVM Fellowship in Shelter Medicine through Purdue University at PAWS Chicago

Dr. Kompare was instrumental in the study that focused on comparing the efficacy of certain antibiotics in the treatment of upper respiratory infections in shelter cats.

“I went into shelter medicine to help those who do not have a voice and who cannot help themselves. Shelter medicine is designed to protect the health and welfare of shelter pets. By focusing on the challenges that directly relate to animal health such as housing, sanitation, population management, enrichment, and others, we can work toward a greater impact on the physical and mental health of our homeless pets. Shelter medicine has become the practice of monitoring both the health and welfare of the population as well as the individual. It is simply not one or the other.” 

Dr. Jamieson Nichols, DVM PAWS Chicago Shelter Medicine Relief Veterinarian

2009 Maddie’s Post-DVM Fellowship in Shelter Medicine through Purdue University at PAWS Chicago

During her fellowship, Dr. Nichols was involved with the Purdue FIV Study to produce evidence regarding the clinical effects of FIV infection, and a study that looked at vaccination response times in shelter animals.

“Learning to look at the shelter as its own patient is the area I have learned the most about at PAWS Chicago. In veterinary school, particularly in small animal medicine, you focus on the individual patient exclusively whereas in a shelter setting there is the individual patient but also the entire shelter population that has to be viewed as one patient as well. In keeping with that mindset, having to adopt a population management mentality and awareness while keeping an individual patient focus was an initial challenge. A shelter medicine presence is important for the obvious reason that a healthy shelter population increases the rate of movement of cats and dogs through the system (intake, preventive care, adoption) and on to their forever home which in turn makes room available for other animals to be taken into the system. But overall, shelter medicine helps to serve as another means by which we can improve and enrich the lives of animals within the sheltering system today and help the dedicated people involved in the No Kill movement create and implement new ideas and solutions to end the homeless pet problem that we face.”

 

Letter from An Extern

Dear PAWS Chicago, 

As a former veterinary student who participated in an externship experience at PAWS Chicago, I would like to share a few things about how that experience impacted me then and now. I was raised in Hendricks County, Indiana, and since the age of 16, took an interest in how our local animal control and shelter was run. Back then, I thought the main way I could help was to participate in functions that raised money for the shelter. I was exposed a little bit to the politics of everything at that time, but I didn’t truly know what it all meant and assumed everyone was working in similar ways toward the same end goal. 

Through undergrad and veterinary school, I learned more about spay/ neuter programs across the country and about pet overpopulation. This was still just skimming the surface of what rescue and shelter organization really is all about, though. It wasn’t until Purdue/PAWS Chicago/Maddie’s Fund provided me with the opportunity to immerse myself in a shelter for a few weeks that I really learned how complicated everything can be. I learned it isn’t just veterinarians and animal scientists out there trying to solve this huge problem; in fact, it’s your average animal lover and dedicated social activist who is driving change in animal welfare in this country. I learned that as a veterinarian, I need to be involved in this process in order to help prevent the unnecessary spread of disease and subsequent euthanasia’s. I learned that operating a good shelter is like operating a business, and that a mixture of dedicated volunteers and paid staff are necessary to run a successful shelter system. And I learned that it is ok to have multiple paths leading to a common goal, and that shelter organizations need to work together in order to make the biggest and most positive change. 

I am now two years out of veterinary school. For a year and a half, I kept my eyes open for opportunities to make my own change in Hendricks County (I went back home to work in private practice). The political climate of Hendricks County’s animal welfare group has been stifling, but finally a group came along with a message of working together in order to save the most lives. I immediately started supporting this group, Misty Eyes Animal Shelter and Learning Center. I was soon asked to be on the board of directors, serving as the Veterinary Medical Director. It is now part of my responsibility to help this organization develop protocols and plans for Hendricks County’s first No Kill shelter.

None of this would have been possible without my experience at PAWS during my senior year of veterinary school. I would not have known what kind of group I wanted to be part of. I wouldn’t have the wealth of information that has been provided to me. So much of that experience has proven to be invaluable to me, and I hope that this ultimately translates to saving lives in Hendricks County, to making Hendricks County a No Kill county, and to making an impact on greater Indianapolis. 

Thank you, thank you, thank you! 

Matt Cantrell

 

Real World Impact

Determine Who is At Risk in a Parvo Outbreak 

Parvovirus is a deadly puppy disease that many shelters will immediately euthanize for to avoid it spreading through the population. PAWS Chicago has a 96% survival rate because of treatment protocols and immediate response. 

This study verified that in the event of a parvo outbreak, PAWS Chicago can test the population to see who is at risk. In April 2012, parvo struck PAWS Chicago and 43 puppies were exposed. By using the Synbiotic Test, PAWS veterinarians determined who was our high risk and needed intense medical treatment and who was low risk. Sixteen of the puppies had protection and went into foster homes, freeing up medical team time to focus on the puppies who most needed care. All the puppies survived and are living in loving homes today. 

Puppies are Cleared for Adoption Faster 

PAWS Chicago can now “fast track” puppies over the age of five months by using the Synbiotic Test. If a puppy has protective titers to parvo and distemper, they can be spayed or neutered and immediately transferred to the Adoption Center. Puppies without protective titers go into a foster home for two weeks to ensure they are protected from disease before being cleared for adoption and being exposed to other dogs.