This document provides guidance on how to provide medical care to animals in a shelter or rescue on a limited budget. It discusses legal requirements, intake procedures, spay/neuter protocols, vaccination schedules, common injuries and illnesses seen, and approaches to treatment. For injuries and illnesses, it outlines treatment plans and estimated costs for various case studies. It emphasizes treating all salvageable animals regardless of condition and focusing on quality of life rather than euthanasia. Hospice and palliative care are discussed as options for aging or critically ill pets.
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Medical 101: How to save lives on a shoe-string budget
1. Medical 101: How to save
lives on a shoe-string
Ellen Jefferson, DVM
Austin Pets Alive!
www.austinpetsalive.org
2. Legal Requirements
Check your state laws
We recommend you buy and read “Shelter
Medicine for Veterinarians and Staff” by
Miller and Zawistowski to learn more
about the legal intricacies of running a
shelter.
Rabies testing in all bite cases or death
from neuro disease with course less than
10 days. Law and morally correct thing to
do.
4. The Basics - Spay/Neuter
Drugs
◦ Induction-
Dogs-
Ketamine/Acepromazine
IV
Cats- ketamine/Valium
IV
◦ Maintenance
Isoflourane gas
◦ Pain Control
3 prong: morphine,
metacam, lidocaine
Performance
Measure
◦ Animals don’t wait
longer than 24 hours
from adoption to home
(best practice)
Staffing
◦ 1 doctor- 30-40 per
day
◦ 2-3 techs
◦ Follow high volume
spay/neuter clinic
structure
5. Wellness Schedule
Vaccines every 2
weeks (between 4
weeks and 4
months)
Adults: 2 vaccines
Deworm every 14-
30 days
Frontline every 30
days
Ivomec- sarcoptes
prevention
6. Traditional Thought Process at
Shelters for incoming ill/injured
animals
Treat just enough to
stay alive for stray
hold
Euthanize
immediately due to
“suffering”
7. How is Medical Care Different in
a No Kill City?
The goal is to save all
salvageable animals, no
matter the problem
◦ Treat as if will live
◦ Systemizing
treatments makes it
easier
◦ Get them out!
Saves
space, money, time
Treat
to
live
Euthanasia is not an option
8. Euthanasia vs. Kill
Definition of Euthanasia:
◦ The deliberate ending of a life suffering
from an incurable, painful, deadly
condition
For reasons of mercy because without
euthanasia, natural death would be preceded
by extreme suffering
Definition of Kill
◦ The deliberate ending of a life NOT
suffering from an
incurable, painful, deadly condition
9. Reasons animals are justifiably
Euthanized at No Kill Shelters
Ideally
Dying from Trauma upon arrival or after initial treatment
◦ White gums, shocky,
◦ Body will not be functional again even with medical help
◦ Broken spine, severely maimed
Dying from Illness upon arrival or after initial treatment
◦ Flat out –white gums, cold
Chronic condition that will result in pet’s death
eventually, painfully even with help
◦ Bad arthritis, cachexia
Untreatable aggression as diagnosed by a behaviorist
10. 2 options for “herd health” in a
shelter that is trying to become No
Kill
1. Spread funds over all
animals by
incrementally giving the
most basic care until all
are saved
◦ APA’s choice
2. Save some high
dollar animals but not all
who are salvageable
due to limited funds
◦ Most No Kill Shelter’s
choice
11. Triage
Scarce Resource
Management =
Conservation of Life
Saving Resources
◦ Being flexible with
drug choice
◦ Following protocols for
efficiency
◦ Elevating only the
conditions that have
the highest potential
for life long problems
to the most expensive
resources
12. Medical Reasons Animals are
Killed in Traditional Shelters
Trauma
◦ Injuries
◦ Hit By Car or other
major trauma
◦ Broken bones
◦ Head trauma
◦ Wounds, burns, lace
rations
Too young
Diseases
◦ Infections
◦ Chronic diseases
that are difficult even
for good owners to
manage
◦ Old age diseases
◦ Diseases caught at
the shelter
13. How do we save money?
Treat what we see
No expensive tests unless
really critical to treatment
What happens if the result
is negative?
James Herriot Medicine
◦ Nature is your biggest ally
Use what you have
◦ Don’t order expensive drugs
unless there is truly no
alternative
There almost always is
14. How do we save money?
Ask for donations and help
◦ Tangible supplies
◦ Chip ins
◦ Fosters/adopters
Accept all donations
Volunteer help
Break up tubes/bottles to share with out
contamination
◦ Frontline
◦ Eye meds
Find alternatives to expensive meds
◦ Eye meds, antibiotics
Foster homes!
15. Don’t skimp on:
Pain medicine
Cleaning up wounds
Proactive treatment on things that will
probably get worse
◦ Anorexic cats
◦ Eyes
◦ Baby illness
18. Injuries
Hit By Car
◦ Most injuries that
you see immediately
after an
accident, will
improve with time
Within 24-72 hours
Pain management
Hydration, treat the
obvious
Re-evaluate
Somewhat
unreliable
Indicators of the
future right after
the accident:
◦ Head trauma
◦ Spinal reflexes
◦ Blindness
◦ Mobility
◦ Incontinence
◦ Biting due to pain
Must be willing to deal with it if worse
than you thought
19. Supportive Care for Trauma
Watch for 24 hours
◦ Comfy bed
◦ Pain meds
Support broken
bones
◦ Splint, sling
◦ Padding
◦ Bubble wrap
Common Pain
Killers
◦ Tramadol- not
controlled
Common Anti-
Inflammatories
◦ NSAIDS
As long as well
hydrated and eating
◦ Prednisone – don’t
use in shelter, most
likely infectious
20. Case Study- Coda
Found by a dumpster
Semicomatose
Couldn’t stand or see
R/O for swollen head
in a Chihuahua
◦ Hydrocephalus- poor px
◦ Head trauma- good px
Gave him 72 hours
◦ antiinflammatories
Cost $15
22. Bone Fractures
Surgery or no surgery?
◦ Decision making process at
APA
Splint/sling- Immobilization
Theory
Time
Amputation:
Open wounds where bone has
popped through
Limb is not functioning AND it is
mutilated
Not used instead of fixation for long
bone fractures
Bone Surgery (pins or plates or
FHO)
Only if joint is effected and size
matters
23. Benefits and Risks of Bone
Fracture Policy
Benefits
◦ Saves more lives
because more
money can be
spread amongst
more animals
◦ Costs less
◦ Decreases
transportation needs
to and from vet
Risks
◦ May heal in weird
way or incorrectly
◦ Longer to heal
◦ May not heal at all
◦ Regular vets can get
angry if not clearly
explained why in
notes
◦ Adopters can get
angry if not
educated
26. Note from Honey Biscuit Foster
to new foster for another hurt
kitty
She was a total sweetheart and so easy to treat, also
hit by a car, with a broken jaw and blind. As soon as
her story was posted on the APA blog, she had enough
donations to cover her surgery costs (within the first
couple of hours!) and an amazing family to adopt her!
I would take this little boy in a heartbeat, it was such a
rewarding experience to see Biscuit mend and find a
great home, however I have a medical foster kitty
already who needs to be syringe fed due to liver issues
LOL
I am happy to help anyone who does take Lincoln with
advice, supplies, etc, Hope you can give him a chance
:)
30. Case Study- Honey and Mr Z
Burns all over body
Leg contracted
Costs: $300
All four feet effected
Burns on back will heal
Feet will contract –use wet
bandages
3 months of bandages
31. Case Study- Chico
Bitten by bigger
dog
Will heal but
surgery is best
Should not be
euthed for this
Cost $170
33. Case Study- Snake Bite Dog
Big open wound
Dog is stable
otherwise
Long term
antibiotics, salve, b
andages if possible
Surgery to close
edges preferred
but not essential
Cost $50
34. Case Study- Eye popped out
Nonpainful
because damage
was done long
before she came to
the shelter
Needed to be
removed
People will
contribute to this
$150-300
35. If the pet is still fighting….
Eating = will to live
Even if something
looks horrific, if pet
is eating, that is a
good prognostic
sign
May not eat
immediately with
trauma
37. Sarcoptic Mange Treatment
Sarcoptic
◦ Hard to find foster
◦ Control sarcoptes in shelter
population
Treat all dogs weekly
0.15/ 10lbs orally Ivomec
Prevention
◦ Not contagious as soon as
not itchy anymore (2 weeks)
◦ 6 weeks treatment with
ivermectin
OR revolution every 2-3 weeks x
3 treatments
◦ Pinna test
◦ Cost <$50
Demodex
◦ Easy to find foster
◦ Have to be careful about how
long they are in foster if large
breed puppies
◦ Will relapse when stressed
◦ 6 weeks+ ivermectin
treatment depending on
severity
◦ Can buy Promeris at
Maak4pets.com
◦ Usually not itchy, don’t have
to keep retesting as long as
treatment is long enough
◦ $60
38. Mild to Moderate Generalized
Demodex
Promeris x 2-3
doses
◦ Recommend
use for life
Cephalexin x 2
weeks
Deworm
Adopt as is
39. Severe Demodex – life
threatening
Check for swelling in feet, will loose
protein
◦ Check PCV/TP
◦ Need refractometer and centrifuge only
◦ No lab work needed
Continue to treat mange
◦ Ivomec or Promeris,
◦ Painmeds? Crusty, bleeding skin?
◦ antibiotics
41. HOSPICE AND PALLIATIVE
CARE
Austin Pets Alive! defines palliative care as the care of patients with a life-limiting illness that is
not responsive to curative treatment or where curative treatment is not available or not applicable
due to concurrent medical conditions, age, and other risk factors. Control of pain, and other
symptoms, and frequent measuring of quality of life (appetite, activity, interaction with family
members, pain assessment, hygiene) is paramount to optimal care. The goal of palliative care is
achievement of the best quality of life for individual patients. Palliative treatment can be long
term, for months or years and is also utilized for hospice patients.
Austin Pets Alive! supports hospice care as a means to provide support and care for patients in
the last phases of incurable disease, or at the end of life. Hospice incorporates all of palliative
care. A hospice case is expected to have a shortened lifespan and may only have a few weeks
or months to live.
In both of these categories, heroic measures such as extensive hospitalization, advanced
imaging, specialist referrals, and invasive surgery would not be pursued. Minimal laboratory or
other diagnostic tests may be warranted. Pain medication and other available
supplements, prescription diets, or other medications to treat chronic conditions would be
utilized. These pets can be adopted as hospice or palliative patients with full disclosure of the
medical condition and expected prognosis. The focus for these patients is on quality of life.
One of the last groups we saved
42. die in a home and
with love
Goal – to save
animals from dying
in a shelter with no
care or
compassion. Part of
the last 15%
How – educate your
fosters, no
heroics, focus on
QOL
Who –
felv, old, thin, possi
ble
cancer, congestive
heart failure
Joe - foot injuries, chronic
diarrhea, geriatric
43. Viral Infection: Parvovirus
Major problem
◦ ~400 per year at AAC
◦ Killed instantly along with littermates
Contagious
High fear
Arguments against treating:
◦ Disease Control
◦ Cost
44. Parvo Treatment Ward
Why Treat?
◦ People want
puppies
◦ Better in about 7
days
◦ No lasting effects
Ward is covered in
other presentation
◦ Disease control is
essential
Breaking ground in
shelter treatment of
Parvo
45. HEARTWORMS
179 cases seen in 2013
◦ Very prevalent in Austin
5.8% of intake
◦ 99% success rate with treatment
◦ ~$50-250 to treat
◦ Post Adoption treatment
$0 adoption fee
$150 treatment fee
Reserve for most adoptable dogs
46. Heartworm Treatment
Pre treat-
Doxycycline x 3 weeks
Ensure over URI (don’t treat too
quickly)
Prednisone – start 24 hours before
injections
No x-rays/bloodwork
Waiver
Foster for at least 30 days
Back to back injections - 2
Ok to be adopted (or fostered by
new owner until treatment) and then
treated
Fundraising Campaigns help!
47. GI Parasites
Why are these puppies and kittens with diarrhea
put down at shelters if not parvo?
◦ Still could be parvo, distemper, parasites are
contagious too
Treatment Plan
◦ Control diarrhea
Panacur
Marquis (weekly)
Kaolin
Yogurt/bland diet
◦ Ensure hydration
Vomiting? Eating?
Sq fluids, anti vomiting meds, injectable meds
Parvo test
◦ Needs to be better in 24 hours or more action
taken
◦ Faster, more aggressive treatment for little babies
Sq treatment
49. Felv + Cats
Serum testing!
Kittens often
seroconvert
Live 6 months-2
years
Ward/Sanctuary
Retest --Referring
shelter often shows
a different result
Specialized foster
or adopter
◦ No cats
Lifelong care
Sell as “short term
commitment”
50. Contagious diseases caught at
the shelter
Distemper
◦ Kennel Cough
URI in cats
Stress
◦ Hepatic Lipidosis
Ringworm
GI Parasites
51. Cat URI
Vaccines prevent
severe cases
◦ Nebulizing
◦ Force feeding
◦ Amoxi if mild
◦ zithro or baytril if
severe
◦ Eye meds
Idoxuridine
Gentamicin
Make your own!
◦ Foster
52. Ringworm Cats
The problem:
◦ Zoonotic
◦ Stigma
◦ Very contagious to other
cats in the shelter
Treatment:
◦ Terbinafine or Itraconazole
Check ALT if refill after 3
weeks or if showing signs of
illness – not eating?!
◦ Lyme Sulfur Dips
◦ Black light to affirm
diagnosis
Ringworm unless proven
otherwise
Strategies:
◦ Cattery entrance check list
◦ Adoption Events:
Adopt a Fun Guy!
Fun in Fungus!
Free Fun (gus)
◦ Display them
Winter months
◦ Ward
Volunteers
53. Ringworm caught at shelter
Can take days
to weeks to
show up
Always look for
it on intake and
before adoption
and exposing
other cats
Lyme Dip?
54. Fat Cat Anorexia
Force feed in
medical foster
ASAP
Weigh daily
Observe in
individual cage as
opposed to habitat
Appetite stimulants
SQ fluids
55. How do you set priorities when
you are trying to save all?
Pull
◦ Acute problems
Trauma, fractures, lacer
ations
Short term diseases
that are treatable
Give body time to heal
◦ Chronic problems
That are not associated
with incontinence
◦ Chip Ins
Think before pulling
◦ 2 or more legs
unusable
Reason to pull: if acute
injury
◦ Excessive drinking
◦ Chronic weight loss
◦ Incontinence- more
than just from acute
trauma
(acute:<48hours)
◦ Chronic diarrhea in an
adult
◦ Severe Arthritis
Maybe 1-2 cases at
a time