Do This, Don't Do That. Best Friends Conference 2016

Happy and healthy: Keeping animals in tip-top shape in your

environment

Kate Hurley, DVM, MPVMUC Davis Koret Shelter Medicine Program

www.sheltermedicine.comwww.facebook.com/sheltermedicine

Or…a few of my favorite Guidelines

And rescues and foster

homes

www.sheltervet.org

Basis of the GuidelinesIs there one

freedom missing?

How does keeping animals happy and healthy affect our

ability to save their lives?

My very first slide

My very second slide

Theory into practiceThis cat was healthy, beautiful and sweet but tested positive for FIV. Historically our public animal shelter, that had a cat live release rate of only 30% (and an adoption rate of only 11%) as recently as late 2011 would never have offered for adoption a cat positive for FIV. Now that cat live release rates are closer to 90% with adoption rates up to 45% in some months over the past year, we have more time and options for some of these harder to adopt cats. Thanks to all of our programs following the initiatives not only did she find a home but she did it with a length of stay of only 9 days. Arriving on 2/20/15 and being adopted on 3/1/15.

Dominique then and now

Un-vicious cycle• Healthy, happy animals • Reduced costs and

committed, happy staff and volunteers

• Satisfied adopters and community partners

• Increased community support

• Healthier, happier animalsRepeat as necessary

Getting to healthy and happy

• Understanding disease transmission and expression

• Vaccination, sanitation and stress control

• Capacity and length of stay

Key concept: Disease triad

Germ• Virulence• Method of

spread• Co-infections• Dose

Environment• Ventilation• Sanitation• Crowding

Animal• Age• Infections• Normal

defenses• Immunity• Stress

Key concept: dose effect• Dose required for illness

= immune status x virulence

• Reduce dose by reducing source or transmission

• Increase dose tolerated by supporting animal immunity

First favorite guideline

“Good sanitation is an integral part of humane animal housing. Proper cleaning and disinfection practices help reduce the transmission of infectious diseases to both animals and people, and result in a cleaner and healthier environment. A clean shelter also has the added benefits of increasing the comfort level of the animals and presenting a positive image of the shelter to the public. Protocols for proper sanitation are essential for any sheltering program.”

Page 14

Sanitation that works

• Use effective products• Clean where it counts• Minimize stress and

fomite transmission• Perfection not required

nor a reason not to try• First and last, do no

harm

Remember, it’s all about that dose

The right product• Safety• Spectrum• Speed• Efficacy with organic

matter• Ease of application –

stability and system• Cost

Common options

Bleach (sodium hypochlorite)

Trifectant/Virkon (Potassium

peroxymonosulfate)

Quaternary ammoniums

Bruclean(Sodium

dichloroisocyanurate)

ChlorhexidineAlcohol

Accel(Accelerated

hydrogen peroxide)

Soap, elbow grease, drying

Wysiwash (calcium

hypochlorite)

High volume dispensing systems

Quaternary ammoniums

Bruclean(Sodium

dichloroisocyanurate)

Accel(Accelerated

hydrogen peroxide)

Wysiwash (calcium

hypochlorite)

Bleach (sodium hypochlorite)

Stable in solution

Quaternary ammoniums

ChlorhexidineAlcohol

Accel(Accelerated

hydrogen peroxide)

Kills parvo and panleuk

Bleach (sodium hypochlorite)

Trifectant/Virkon (Potassium

peroxymonosulfate)

Bruclean(Sodium

dichloroisocyanurate)

Accel(Accelerated

hydrogen peroxide)

Wysiwash (calcium

hypochlorite)

Good with organic matter

Trifectant/Virkon (Potassium

peroxymonosulfate)

Quaternary ammoniums

Accel(Accelerated

hydrogen peroxide)

Sofas, carpets, yards, back seats, scratching trees….

Fast acting

Trifectant/Virkon (Potassium

peroxymonosulfate)

Accel(Accelerated

hydrogen peroxide)

Helps with everything

Soap, elbow grease, drying

Do no harm• Label containers

– Product, expiration date, initials– Light proof for bleach

• Provide all needed equipment and measuring devices– Tie them down if needed

• Post simple dilution directions• Train and check

– Concentration test strips– Dry erase marker– Glogerm

Incorrect Dilution

In case of toxicity• Remove source• Dilute with

milk/water if ingested• Bathe• Broad spectrum

antibiotics• Pain control!

Do no harm• Avoid mopping where

possible• Handheld sprayers or

Anivac applicators where built in systems aren’t possible

• IF mopping, dedicated mop per area, double bucket, and Accel or Trifectant

Rinse

Disinfectant

Priorities• Focus on: • High contact surfaces,

people and body parts• 1st few hours• 1st 24 hours• 1st 3-5 days• Juveniles always• Separating populations

rather than individuals

Putting things in perspective

Putting things in perspective

35 times as much contamination on scrub top versus hand

Controlling clothing• Change of clothing

– Arm coverage for all– Leg coverage for dogs

• Between areas/activities– BEFORE new intakes,

youngsters, surgeries– AFTER handling sick animals,

euthanasia or CLEANING• Risk assessment between

individuals

Hands• Hand sanitizers often superior to

handwashing– 60-80% ethanol or isopropyl

alcohol – 20-30 seconds, all surfaces– Not reliable against panleuk, iffy

against calici• Accel wipes broader spectrum• Hand washing for blood, body

fluids, feces• Gloves when it really matters

Feet• Foot baths don’t work• Don’t worry about it for

routine situations• Dedicated boots or shoe

covers for serious risk– E.g. canine GI,

ringworm• Don’t let cats run around

on the floor during cleaning

My next favorite Guideline“Vaccines are vital lifesaving tools that must be used as part of a preventive shelter healthcare program. Vaccination protocols used for individual pets in homes are not adequate in most population settings. Because risk of disease exposure is often high in shelters, animals must be vaccinated at or prior to intake with core vaccines.”

Page 19

What can’t vaccines do? • Make up for poor

husbandry, stress and overcrowding

• Protect all youngsters under 4 months

• Protect against all strains of URI/kennel cough

What CAN vaccines do? • PREVENT most

panleukopenia, parvo and distemper – In animals over 4 months old

• REDUCE severity of URI/kennel cough

• IMPROVE shelter and community health and public relations

Maximizing shelter vaccines

• Vaccinate immediately– If not sooner!

• Vaccinate everybody– With a few exceptions

• Repeat frequently in youngsters– No > than every 2 weeks

• Continue vaccination to 5 months of age

• Vaccinate against important diseases only

Basic cat vaccines• SubQ modified live FVRCP

– Kittens Q 2 weeks from 4 – 20 weeks

– Adults once at or before intake

– Double check that it’s live• +/- IN FVRC once at intake

for kittens > 2 weeks• +/- repeat SubQ vaccine

once 2-4 weeks later in healthy adults

Basic dog vaccines• Modified live SC DHPP (DA2PP)• Puppies every 2 weeks from 4-20

weeks• Adults once at or before intake

– +/- revaccination after 2-4 weeks

• IN Bordetella bronchiseptica (kennel cough) once at intake– + adenovirus, +/-

parainfluenza– Oral second choice– Subcutaneous third choice

The problem with puppies and kittens

Adapted from Greene’s infectious diseases of the dog and cat

Maximizing shelter vaccines• Transport in a clean carrier

and clean vehicle• Place on a clean surface• Handle with clean hands

and clean clothes• Place in a clean cage• Leave in peace for at least

24 hours• Protect puppies and kittens

Maximizing shelter vaccines

• Buy from a reputable source• Store correctly• Handle carefully by trained

staff• Document with initials of

person administering• Periodically observe

especially if vaccine resistance suspected

Do no harm• Post adverse recognition

and response protocol– Signs, action steps, phone

numbers, drug doses, map, etc.

• Encourage reporting of mistakes

• FVRCP spills on skin – Wipe with safe disinfectant

• IN Bordetella given SC– Local SC fluids, systemic

antibiotics, monitoring

Want to learn more?

http://virtualconsultant.sheltermedicine.com, shelter animal health

My next favorite Guideline“Successful enrichment programs prevent the development and display of abnormal behavior and provide for the psychological wellbeing of the animals. Enrichment should be given the same significance as other components of animal care, such as nutrition and veterinary care, and should not be considered optional (ILAR 1996).”

Page 34

Dose effect

Dose effect

If you can’t control one stressor, mitigating other stressors and adding coping tools will help

WHEN does stress matter?

Stress matters from the first moment an animal

is in your care

Enrichment and stress control basics

Separate predator and prey

Provide environmental control

Reduce noiseMinimize moves for

catsSeparate eating and

toilet areas

Hiding placesSoft beds Variety of toysAdequate litter boxesLights out at nightQuiet and active

interactionAdequate housing

Separate dogs and cats• Sight, sound and smell• Visual protection for

intake areas, carriers, housing

• Elevated shelves in common areas

• Self-closing doors• Alternate good housing

for small dogs and pups

Creative solution

Puppies say, Yay for

portals!!!

Environmental control• Visible vs not• Up vs down• Cool vs warm

www.sheltermedicine.com, “curtain”

• Soft vs hard• Social vs alone• In vs out…

Beds• At least 3 inches thick• High sided especially for

fearful animals• Stay with the animal

unless heavily soiled• Make sure there is also a

cool, firm area in the cage/kennel large enough for the animal to stretch out to full body length

Hiding places

www.sheltermedicine.com, “elevated bed”

• High shelf/elevated bed instead of box if floor space is limited

• Box/bag/bed instead of shelf if height is limited but floor space is adequate

• Partial front cover and/or towel over elevated bed if both floor space and height are limited

• Dogs need hiding places too

Same cage, different furniture

Minimize moves for cats• Directly causes activation

of feline herpesvirus (URI)– Cage to cage– Cage to carrier– Single to group

• If you must move cats, retain bed, use familiar carrier

• Smaller group size in colony housing to limit disruption

Separate food and toilet• Important for

housebreaking, public presentation, feline food intake

• Double compartment housing

• Place food, water, bed all on one side

• Adequate sized litter box for cats

Feel free to spot clean the

clean side

Toys and treats are good!• Enhance adoption as

well as providing enrichment

• Rotate toys regularly• Place towards front of

enclosure• Offer interactive and

solo options

Balanced socialization• 72 hours for vaccines and

health check• More for less is more• Evaluate beforehand:

– Animal?– Cage/kennel?– Signs?

• Control for animal (carrier ideal for cats)

• Ensure some designated quiet time as well as active busy time

Monitoring always

Cat housing basics• Double compartment

– Side to side in holding areas, up to down in adoptions ideal

• Adequate height to stretch n’ scratch

• At least 9 square feet of floor space for singly housed cats

• At least 18 square feet of floor space per cat for group housing

sheltermedicine@ucdavis.edu for portal ordering information

Dog housing basics• Double compartment

– In and out ideal where weather permits

– Partial visual barrier between compartments

• Adequate size for dog, bed, toys, cool and warm surfaces

• Generally no > 2 dogs per run

• Separated at feeding time

Good housing

Is easy to clean and disinfect

effectively

Has room for beds, toys and

behavioral expression

Gives animals environmental

choices

Facilitates friendly

interactions

Provides a quiet, relaxing atmosphere

Keeps food and drink clean and

away from waste

Frees up staff time for animal

care

Affects animals almost 24 hours a day while in a shelter’s care

Want to learn more?

http://virtualconsultant.sheltermedicine.com, shelter animal behavior and enrichment

Feeling a little overwhelmed?

The mother of all Guidelines“Every sheltering organization has a maximum capacity for care, and the population in their care must not exceed that level. Factors that determine capacity for care include: the number of appropriate housing units; staffing for programs or services; staff training; average length of stay; and the total number of reclaims, adoptions, transfers, release, or other outcomes.”

Capacity for Care (C4C)• Meeting the 5 freedoms

of animal welfare for all animals in a shelter, rescue or foster homes

• Good housing is the foundation

• Independent of intake and outcomes

• But tends to make both better!

67

How much capacity do you need?

Holding capacity: how many animals you can care for at once

Flow capacity: how many animals you can care for over time

One more favorite• “Length of stay has a dramatic effect on the

experience and needs of animals in shelter care. The type of care and enrichment provided to sheltered animals must be appropriate to the length of stay. Average or median length of stay is also a key factor contributing to the number of animals present in the shelter each day, which in turn affects the ability to provide adequate care.”

Page 18

http://maddiesinstitute.typepad.com/chewonthis/2015/06/decreasing-shelter-length-of-stay.html

Length of stay and healthThe strongest prognostic factor for coughing (regardless of vaccine group) was the number of days spent at the shelter, with each additional day increasing the risk of coughing by 3%

Edinboro, Ward, et al. (2004). "A placebo-controlled trial of two intranasal vaccines to prevent tracheobronchitis (kennel cough) in dogs entering a humane shelter." Prev Vet Med 62(2): 89-99.

Length of stay and health

• Holt, D. E., M. R. Mover, et al. (2010). "Serologic prevalence of antibodies against canine influenza virus (H3N8) in dogs in a metropolitan animal shelter." J Am Vet Med Assoc 237(1): 71-3.

Number of days in the shelterwas the only factor significantly associated with positive serologic test results. For every 3 days in the shelter, the odds of a positive serologic test result increased significantly by 2.2.

Length of stay and health

Dinnage, Scarlett, et al. (2009). "Descriptive epidemiology of feline upper respiratory tract disease in an animal shelter." J Feline Med Surg.

Although time spent in the shelter was anticipated to influence URTD risk, the magnitude of its effect was surprising. The cumulative probability of developing URTD escalated quickly with increasing time spent in the shelter, progressing from approximately 5% after the first 2 days…to over80% after 2 weeks in the shelter.

Housing, health and LOS• Adequately sized,

double compartment housing for newly admitted cats reduces risk of URI

• Reducing URI reduces LOS

The biggest surprise with C4C was going from isolation being full all the time…

To Isolation looking like this – ALL THE TIME

Kim Monteith, BC SPCA, Vancouver, BC

Housing, stress and LOS• Adequately sized,

double compartment or group housing reduces stress and encourages friendly, active behavior

• Adopters respond to friendly, active behavior

• Reduced stress and friendly, active behavior reduce LOS

“Everyone is less stressed…euthanasia is

down 40%...we can now take in more surrenders

and strays”

Housing, staff time and LOS• Adequately sized,

double compartment housing takes less time to clean and helps reduce disease spread

• Staff that spend less time cleaning and more time interacting with adopters will reduce LOS

“Adoptions are up, sickness is down, staff

have more time.”

Number of animals housed and LOS

• More individuals waiting does not change the rate of outcome• For a given rate of outcomes, length of time waiting is determined by

the number of individuals waiting• Self sustaining at any level• Fewer, better quality housing units means fewer individuals waiting

Decreasing the # in line at any one time is the most powerful way to decrease the length of

time in the line

“Euthanasia down by 15%...length of stay decreased by an amazing 63%”

What’s your magic number? • Determine your optimal

average LOS: – Pre-adoption 3-7 days– Adoption 7-14 days

• Obtain for last 2 years:– Monthly intake – Monthly on-site adoptions– Adults vs juveniles

• Multiply daily average for the month by target LOS

• Create a monthly plan

More details

http://www.animalsheltering.org/resources/magazine/, May/June issue

Yet more details

http://www.millioncatchallenge.org/resources/capacity-for-care/adoption-driven-capacity

FAQOther than better housing,

what are some of the things you can do to shorten length

of stay?

Keep them moving! Limited or no intake quarantine

• Careful exam and daily monitoring instead• Maximum 3 days to verify health and vaccine protection• Don’t wait for booster vaccines

Minimize stray hold to live outcome for unidentified cats and litters of puppies• Especially litters of kittens, return to field candidates

Place adoption candidates straight into adoption• Owner surrendered or unidentified strays (even if not available)• Or, allow adopters and rescue partners to view and place holds

on strays

Keep them moving!Consider spay/neuter/adopt for kittens at robust

6 weeks/1.5 pounds• Kitten socialization different than puppies

Optimize frequency and timing of key services• E.g. surgery and foster return prior to weekend

adoptionPlan for proactive rather than reactive promotion

• Individual (“slow track”) and seasonalPerform daily rounds to stay on track

Seriously?Sent: Wednesday, April 08, 2015 7:16 AMTo: Kate HurleySubject: Fwd: SpokAnimal

Being fortunate enough to be an ASPCA target community taught us so much and allowed us to think outside the box to save lives. I'm proud to say we are at a 98.9% live release rate today! We bring in about 300 animals a month from all over and are kicking ass at finding them homes. Our average length of stay for all animals is 2.7 days.

Thank you!