shelter medicine 101 - Petfinder

SHELTER MEDICINE 101 Karen Dashfield DVM [email protected]

Shelter Medicine

Shelter Medicine

TEAMWORK

It takes teamwork to keep the animals in our care healthy • • • •

Front Desk Shelter Workers Volunteers Sending facilities/ organizations

• • • •

Receiving facilities/ organizations Veterinary Technicians Veterinarians And……the public

Intake- Best Practices

Intake- Best Practices Physical exam Preventative Medicine Intake processing Animal Flow and Housing within the shelter

Physical Exam- Procedure 1. Visual inspection • • •

Observe the overall behavior and appearance of the animal Note any odors, discharges, odd behaviors Is the animal “normal” or “abnormal” on visual exam

Physical Exam- Procedure 2. Weight • •

Weigh the animal in grams, kilograms or pounds. (Grams and Kilograms allows for easy calculation of fluid needs) Categorize the animal based on appearance as overweight, good weight, underweight, or emaciated (severely underweight)

Physical Exam- Procedure 3. Check for hydration • •

Look for sunken eyes Check skin tent- should be 3 seconds or less.

Physical Exam- Procedure 4. Eyes • • • • •

Are they bright and clear Discharge Squinting Injuries Sunken

Physical Exam- Procedure 5. Ears • • •

Discharge Uneven carriage Wounds

Physical Exam- Procedure 6.

Mouth

• • • • • • • •

Odor Infection Teeth Discharge Wounds/ injuries Check beak on birds Closes properly Jaws match up

Physical Exam- Procedure 6.

Mouth

• • • • • • • •

Odor Infection Teeth Discharge Wounds/ injuries Check beak on birds Closes properly Jaws match up

Physical Exam- Procedure 7. Nose • • •

Discharge Wounds Breathing sounds

Physical Exam- Procedure 8. Skin • • • • •

Hair / feather condition Parasites Infections Wounds Bruising

Physical Exam- Procedure 8. Skin • • • • •

Hair / feather condition Parasites Infections Wounds Bruising

Physical Exam- Procedure 9. Skeleton • • • • • • •

Pain on palpation Obvious deformities Crepitus on palpation Exposed bone, tendons Obvious fractures Abnormal joint motion Check Feet

Physical Exam- Procedure 10. Temperature •

Rectal Temperature should between 100 and 102 in most species of mammals

Physical Exam- Procedure 11. Respiratory Tract • • •

Breathing rate Breathing effort Noises heard when breathing

Physical Exam- Procedure 12. Digestive tract • • • • •

Palpate abdomen Observe stool Observe appetite Palpate crop in birds Check rectum/ vent for discharge and swellings

Physical Exam- Procedure 13. Nervous system • • • •

Withdraws feet when toes pinched Walks normally for age Anal tone Head tilts

Intake- Preventative Medicine

FLEA BATH Washes off external “germs” so minimizes risk of animal breaking with disease, and minimizes risk of passive transfer.

VACCINES Vaccines can be effective within 2-3 days. Vaccinate immediately to get the vaccine in play

WORMER Immediate worming on intake will minimize the risk of parasite egg shed into your environment.

Vaccinations- Dogs •DAPP •Rabies •Bordatella

Preventative Medicine Vaccinations- Cats •FVRCP •Rabies •Bordatella?

Vaccinations Canine influenza vaccines are not core vaccines. If you have confirmed (H3N8) flu the vaccine is necessary to control the disease. Scientists doubt that the current vaccine is effective against H3N2 flu.

Vaccinations Spending $100 to PCR test several dogs with URI can be a money saver. By knowing what your endemic germs are, you can develop a better vaccine strategy.

Flu- the current PCR tests will come back negative for H3N2 flu. A quick flu test can be run to diagnose an Influenza A infection, but is not specific as to which flu the dog has

Blood levels can be run to diagnose H3N8 Canine Influenza, however 2 samples 2 weeks apart are needed before an animal can be diagnosed as actively positive or negative. An early positive may be previous exposure. An initial negative may mean immune system hasn’t had time to respond yet.

Vaccinations If you handle small numbers of animals, cheaper just to vaccinate for likely disease, but with larger numbers, targeting the diseases you actually see will save you money.

Vaccinations Shelter staff can legally administer all vaccines except the rabies vaccination.

Core vaccines cost between $4 and $7 each if administer by staff.

https://www.aaha.org/professional/resources/canine_vaccine.aspx#gsc.tab=0

http://www.catvets.com/guidelines/practice-guidelines/feline-vaccination-guidelines

BY VACCINATING ALL ANIMALS THE RISK OF OUTBREAK IS MINIMIZED DUE TO A GENERAL “HERD” IMMUNITY

= VACCINATED ANIMALS

THERE WILL STILL BE OCCASIONAL SICK ANIMALS BUT SPREAD OF DISEASE WILL BE MINIMAL WITHIN YOUR POPULATION

= VACCINATED ANIMALS = SICK ANIMALS

= VACCINATED ANIMALS

= UNVACCINATED ANIMALS

= VACCINATED ADULT ANIMALS = VACCINATED ANIMALS UNDER 4 MOS

= UNVACCINATED ANIMALS = VACCINATED ADULT ANIMALS = VACCINATED ANIMALS UNDER 4 MOS

= UNVACCINATED ANIMALS

= VACCINATED ADULT ANIMALS = VACCINATED ANIMALS UNDER 4 MOS

NO VACCINES

IMMUNITY FROM MATERNAL ANTIBODIES

NO IMMUNITY AFTER MATERNAL ANTIBODIES WEAR OFF

VACCINES DISCONTINUED TOO EARLY


NO IMMUNITY AFTER MATERNAL ANTIBODIES WEAR OFF

PROPER VACCINATION SERIES


WINDOW OF OPPORTUNITY FOR INFECTION DESPITE VACCINATION

VACCINE INDUCED IMMUNITY

LONG INTERVALS IN VACCINATION SERIES


WINDOW OF OPPORTUNITY FOR INFECTION DESPITE VACCINATION

VACCINE INDUCED IMMUNITY

WE CAN’T PREDICT HOW LONG MATERNAL ANTIBODIES WILL LAST 2 WEEKS??? 8 WEEKS?? 16 WEEKS??


WINDOW OF OPPORTUNITY FOR INFECTION DESPITE VACCINATION VACCINE INDUCED IMMUNITY



A “virtual” room can be created in a number of ways: 1- space 2- barriers 3- procedures

1- Space Leave empty runs or cages around the sick animal or animals to create a “void"

1- Space

Panleukopenia doe not spread between cats in cages separated 3-4 feet if handling is appropriate

1- Space

Canine upper respiratory disease can spread up to 20 feet from normal breathing

2- Barriers Barrier can be a simple as a piece of rope across a kennel to prevent people from touching animals they shouldn’t

This works well for diseases that are not airborne but are spread by direct contact and can be combined with an empty run or cage between sick and healthy

2- Barriers Or the Barrier can be more solid like a piece of Plexiglas, a sheet of plastic or even a shower curtain

2- Barriers It may not look beautiful, but it works!

3- Procedures

Changing gloves between animals, hand washing, wearing coveralls or scrubs and use of foot baths can “isolate” sick animals

3- Procedures While hand sanitizers don’t kill all the “germs”, the mechanical act of washing hands decreases the viral or bacterial numbers making transfer less likely.

3- Procedures

Approach local hospitals or surgical centers for donations of gloves and gowns they would otherwise throw away

3- Procedures

Set up a foot spray stationwith a 1:30 bleach solution in it, and have everyone spray their feet after being in “sick area”.

Preventative Medicine

Owner surrendered animals from small private homes (NOT Hoarders) can usually be safely placed in the main population immediately once screened for parasites.

Shelter transferred animals should be isolated from the preexisting population for 7 days. May be able to adopt out before that time if healthy.

Canine Influenza isolation protocols are for 14 days after the last possible exposure. 20% of infected dogs show no symptoms but can shed virus for 2 weeks.


Know what each disinfectant actually kills or controls. Don’t use product just because is “smells good” or “hides odors” use it because it kills the germs you need to kill.

1:30 bleach solution •Cheap •Kills Parvovirus, Distemper, Panleukopenia, Bordatella, Canine Flu….. •Need to use separate detergent


Realistically, not everyone will give you the food you request, but by blending the food well and using at least 50-75% of your specified food, you can minimize diet change issues. Use the same procedure to minimize dye in cat food.

Shelter Transfers/ Transportation- Best Practices Sending Facility or Organizations Receiving Facility or Organizations

Sending Facility/ Organizations- Best Practices  Know what your “endemic” diseases are and be honest with your receiving groups and facilities. Within your facility AND within your community!  Carefully screen animals prior to transportation for contagious disease. Even if a receiving group ok’s a contagious dog, you just put the whole transport at risk by loading that animal into the vehicle.

Sending Facility/ Organizations- Best Practices  Preventative care should occur at least a week prior to transport…. Minimizing stress until vaccines have a chance to become active.  Inspect transport vehicles, and know your volunteer transporters, and have strict rules for handling of animals and disinfecting of equipment……. i.e. dog riding loose in vehicle…..how do you disinfect a car seat???

Sending Facility/ Organizations- Best Practices  Minimize mixing of animals from different groups during transport…. Isolate just as in shelter using SPACE, BARRIERS, AND PROCEDURES if mixed loads must occur.

Receiving Facilities/ OrganizationsBest Practices  Follow appropriate intake procedures discussed.  Advise sending shelter of diseases, symptoms observed after the animals arrive at their destination.  Quarantine new animals from pre-existing animals due to higher disease risk after stress of transport.

Receiving Facilities/ OrganizationsBest Practices  Remember that even if the dog or cat was “healthy” when it left the sending rescue, it could have started showing symptoms during transit, or immediately after transport….  Remember that animal may have been in the incubation period of a disease prior to transport.

Receiving Facilities/ OrganizationsBest Practices  Remember……Incubation period of Distemper 3-6 days.  Incubation period of Parvo 3-14 days (usually 4-7)  20% of Canine Influenza cases are asymptomatic but contagious.  Did dog get exposed during transport?

 Quarantine STARTS when animal is under your control… there is too much outside your control in transit

Infection

Clinical

Subclinical

Transmission of Infection Direct

e

l

k

Indirect

k

Indirect

Housing and Traffic flow

Housing and Traffic flow Methods of directing the flow of traffic (human and animal) to limit cross contamination between sick animals and health animals. Also to minimize contact between new animals and pre-existing animals.

The Shelter Veterinarian Roles: • Standing Orders • Disease Control Policies • Training of Staff • Disease Outbreak investigations

Responding to a sick animal within your facility or organization First ISOLATE! Then:  Treat the individual  Identify exposed/ at risk animals  Look at where animal came from  Review policies and procedures if becomes an outbreak

Responding to a sick animal within your facility or organization What is the illness

Responding to a sick animal within your facility or organization What is the illness? How is it spread?

Responding to a sick animal within your facility or organization Covered by Standing Orders?

Responding to a sick animal within your facility or organization Highly Contagious? Serious illnessinconvenient illness??

Responding to a sick animal within your facility or organization While canine influenza falls into the disease of inconvenience for most animals….. Some get very ill and need hospitalization. No dogs have immunity to h3n2 flu, so 100% of your dogs may become infected with 80% showing symptoms. H3n8 flu is still circulating as well, and the vast majority of dogs have no immunity to it. Can you financially afford a flu outbreak?

Responding to a sick animal within your facility or organization Zoonotic disease?

Responding to a sick animal within your facility or organization Zoonotic disease?

Responding to a sick animal within your facility or organization Are other animals at risk? Were some of these animals already adopted? Do we notify the adopters?

QUESTIONS? SPECIFIC TOPICS