INNOVATIVE APPROACHES TO SAVING THE LITTLE ONES

Becky DeBolt, DVMHSUS-UC Davis Koret Shelter Medicine Fellow 2014

Young-Williams Animal CenterDirector of Shelter Medicine

Knoxville, TN

Presenter

Presentation Notes

We have a lot of puppies and kittens that enter our facility but do not leave alive. I wanted to find ways to get this highly adoptable population out the door quickly and safely!! ASK: How many vets are in the room? backgroud: I was in priv practive for 5 yrs and got into sheltering by chance. I absolutely love it! And have been there for 5 years. I knew nothing of sheltering or shelter med when I started

Goals for today…

Find ways to save puppies and kittens!!

Dispel myths Some history from my

shelter Vaccinations in young

animals

ASV Guidelines How to estimate age Barriers for moving

them through quickly Overcoming our

barriers (changing procedures)

Results so far…

Why Focus on Puppies and Kittens?

Lost opportunity!

Highly adoptable

Smaller subset of population

Predictable seasons

MYTH BUSTERS!

Can you really send them out “that” young?

If you keep kittens and puppies until they’re older, their immune systems will be more robust when they get to the adoption floor

Myth: Fact:

If you keep kittens and puppies until they’re older, their immune systems will be more robust when they get to the adoption floor.

So more time in the shelter means more exposure to disease.

…consider foster. Longer LOS = higher

chance of death. adoptability when

young.

Myth: Fact:

But they need a booster!....

Waiting to move them up until they have had their “booster” will keep them healthier.

Myth: Fact:

Waiting to move them up until they have had their “booster” will keep them healthier.

Common misconception

Details on “boosters” coming up!

Every time animals wait in a shelter, their LOS increases.

Longer LOS = higher chance of death.

Myth: Fact:

But the public will make them sick!

The public will spread disease on the adoption floor by touching them.

The public will spread disease on the adoption floor by touching them.

Risk of disease is higher in the shelter than out.

Staff is bigger source of disease than the public!

What about their “buddies”?

Must stay in shelter with littermates until 8 weeks old.

Myth: Fact:

Must stay in shelter with littermates until 8 weeks old.

Great in ideal world! But…Shelters are not

ideal worlds Miss other socializations Make recommendations

for socialization with conspecifics by adopters

If acquire disease, may mean euthanasia

Look at big picture

Myth: Fact:

They’re too little or young for surgery, aren’t they?

Surgery & anesthesia are not safe when animals are 6 weeks old.

Myth: Fact:

Surgery & anesthesia are not safe when animals are 6 weeks old.

Different/manageable needs. But there are: “…safe

anaesthetic and surgical protocols …that produce lower morbidity and similar mortality rates in early-age neuters compared with traditional-age neuters”. (J Feline Med Surg. 2011 Joyce, Yates.)

Numerous studies looked at surgery at 6 weeks. whentospay.org/get-the-facts

Must weigh risk vs reward for your organization & community.

Myth: Fact:

A Little History…2007

Shelter Health Evaluation by UC Davis Koret Shelter Medicine Program in 2007

Kittens held in a nursery until they gained weight

Puppies held until their two week “booster” vaccination

TO BOOSTER? OR TO RE-VACCINATE?

To Booster? or To Re-vaccinate?

Booster definition: administration of killed product vaccine (rabies, K9 influenza, some bordetella, lepto, some Lyme)

First vaccination immune system recognizes the virus/pathogen priming response in immune system

second vaccine 2-4 weeks later primed immune system response that “boosts” off the initial response

Incomplete protection until “boosted” response is complete!!

1 vaccine ≠ immunity

To Booster? or To Re-vaccinate?

Re-vaccination:

Modified-live Vaccine (MLV) –FVRCP, DA2PP, Bord intranasal

1-step immune response

Some protection within hours of distemper vaccine!!!

So, why revaccinate with MLV?

YOUNG animals (less than 20wks) maternal antibodies neutralize the vaccination and prevent immunization

Re-vaccinate to try to catch a point when the vaccine reaches the immune system and initiates immunization

Age at which maternal antibodies wane is unpredictable

Animals > 20 wks : Re-vaccinate as safety net Poor vaccine handling, improper administration, poor

response Under ideal circumstances, no revaccination needed

Window of Susceptibility

Window when they are completely vulnerable to disease

You vaccinate maternal antibodies neutralize it

But the maternal antibodies are waning so if…

expose to natural disease not enough antibodies to protect kitten/puppy it gets sick

This is why you must re-vaccinate young animals!!!

The Problem…

When does protection start from modified-live vaccines???

…full protection in 3-5 days…

ANY QUESTIONS???

2009 - Rules of Adoption

Kitten Rules:2lb to go to adoption floor Just <2lbs: deworm for 5 days, perform surgery,

then move up at 2lb They sat in vet clinic for this timeOften got sick

Foster if too young Not many foster homes

Euthanize if too small and no foster Led to crowding

2009 - Rules of Adoption

Puppy Rules:3 holding rooms – all-in-all-out5 day hold for dewormingHad to be 8 weeks old for adoption Foster if too youngFew foster homes

Euthanize if too young and no foster Led to crowding

2009: Stats At That Time

Intake Euth % euth Adopted% Adopted

3352 2887 86% 400 12%

Juvenile Cats in 2009

Intake Euth % euth Adopted% Adopted

2323 1360 59% 805 35%

Juvenile Dogs in 2009

THAT WAS THE MOTIVATION FOR CHANGE…

ASV Guidelines

ASV Guidelines for Standards of Care in Animal Shelters

“(When) Operating beyond capacity for care …services required for moving animals through the system are delayed. These delays prolong average lengths of stay for animals, leading to increased daily population.”

Longer LOS means more stress and illness

Working toward the guidelines

Decreasing Length of Stay (LOS) is imperative to saving the lives of kittens and puppies

Must get them out more quickly to keep them safe

Working toward the guidelines

Length of Stay until adoption of owner surrenderedpuppies and kittens in 2013

LOS of Kittens(days)

LOS ofPuppies(days)

May 2013 29 5

June 2013 8 10July 2013 21 11Aug 2013 24 9

Sept 2013 31 6Average

LOS 19.8 days 9.0 days

Working toward the guidelines

Between April and Sept 2013 (6 months) we had 211 owner surrendered kittens that got adopted

Last slide told us their LOS was 20 days animal care day = each day that you care for an

individual animal

211 kittens x 20 d LOS each = 4220 animal care days (over 6 mos)

Working toward the guidelines

If we could decrease LOS for owner surrendered kittens that get adopted to 10 days

211kittens x 10 d LOS each = 2110 animal care days (over 6 mos)

1 care day costs $5-10 so you save $10,550 Shorter stay, less exposure to disease.

http://sheltermedicine.com/shelter-health-portal/information-sheets/length-of-stay

ESTIMATING AGE

Estimating Age

Who estimates the age of the animals? Often based on teeth for dogs and weight for cats Teeth and weights aren’t exact

Siblings…..

Photo Courtesy: Dr. Newbury

Estimating Age by Weight

Kittens generally gain 1 lb/ month But where did the kitten come from? Was mom well nourished? If it’s been in foster care, does age-by-weight seem

accurate?

Photo Courtesy: Dr. Newbury

Estimating Age by Teeth

Development varies by breed Small breed dogs are prone to teeth that don’t erupt

Development varies within a litter Our litter of pups at 7 weeks had no erupted

premolars

44 days old!

Photo Courtesy: Dr Newbury

Age Estimation:Know Your Developmental Milestones

10-14 days Eyes & ears open Wobbly walk Constantly gaining

weight (kittens double weight in 14 days)

Photo Courtesy: Dr. Newburyhttp://aspcapro.or/tip-of-the-week-act-your-age-part-i

Developmental Milestones

3-4 weeks 3 weeks: Eliminate on

their own Eyes are blue Hearing/vision

improve Incisors erupt, then

canines

I hear you!

Developmental Milestones

4 weeks: Thermoregulation

improves Eye color changing Improved

coordinationPremolars may start

to erupt (4-12wks)SocializationVaccination

Photo Courtesy: Dr. Newbury

Developmental Milestones

5 weeks: Pouncing, hunting Wrestling More teeth

Photo Courtesy: Dr. Newbury

Barriers for Puppies & Kittens

What is keeping them from getting adopted sooner?

Barriers – Legal Restrictions

Stray hold time Varies by state 3 days in TN Special laws for kittens/puppies? Litters?

Some places don’t require stray hold on juveniles or litters.

Legal Age for Adoption Check laws – local and state

None can be sold in Knox Co <8wk. Exemption for shelters at very bottom

Will your organization work around the laws?

Barriers – Age Restrictions

Minimum Age for adoption Check your laws Re-assess technique for estimating age Health insurance plans for adopted animals

Underwriters require animal to be 8 wks old But…they aren’t going to challenge you Vet submitting claim should report the same age

Do you have self-imposed restrictions?

Barriers – Size Restriction

Size Restriction for Adoption Who made the rules and why?

Surgical weight restriction Are your vets ok with pediatric surgery?

Are there other people who say it’s not safe?

Take a couple extra stepstoward safety Donated rice in donated adult socks Donated baby socks Feed young ones in a.m. before S/N Feed immediately afterward

Donated baby socks = Warmer feet

If you’re worried about size at surgery…

“It would be highly unlikely that mortality or morbidity due to complications from surgery would match the rate of morbidity and mortality seen in the kitten nursery at the time of the visit.”

- Dr Newbury, UC Davis Koret Shelter Health Assessment, 2007

Ways around the barriers

What can you do to: Change internal restrictions 1st

Weight Age Hold times

Implement or improve foster program Review/ challenge the Laws

Overcoming Our BarriersRemoving Internal Restrictions

Change internal requirements Weight – lowered required kitten weight to 1.5 lbsWeight does not have an absolute correlation with ageWe were concerned about the small kittens doing poorly on

the adoption floor so we have started a Kitten Wellness Program (details next)

Age – made sure vet is estimating age in young animals and we round up if borderline There is really no way to know for sure, so we are

“guesstimating” in favor of saving lives

Kitten Wellness Program

Train volunteers

They come in once daily to weigh, feed, monitor kittens Quiet time of day when they won’t be in the way of

adopters, but after cleaning

Check list so we can watch the weights Notify supervisor if weight has gone down

Vet to check sheets on rounds in a.m.

Work in progress…

Kitten Wellness Program

Overcoming Our BarriersRemoving Internal Restrictions (cont…)

Change Internal Requirements Hold times – Decreasing hold time for puppies to 3 days as

required by law Implementing Open-Selection for Kittens Healthy kittens

good body condition no discharge no diarrhea no hairloss

> 1.5lbs Start deworming protocol Designated area of adoption floor will house kittens Special color cage card, “Adopt me today! I can go home on___”

Overcoming Our BarriersLegal Restrictions

Next battle… Eliminate stray hold for puppies & kittens

At least no stray hold for litters

Calculated our RTO of juveniles RTO of juveniles 2010-2013 at YWAC

Puppies: 3% Kittens: 0.85% Why not shorten LOS when so few go back home? Save shelter resources

Have Our Changes Helped?

JuvenileCats

Jan-Apr2013

Jan-Apr 2014

Intake 214 162

Euth 67 33

Euth % 31% 20%

Adoption 101 105

Adoption %

47% 65%

JuvenileDogs

Jan-Apr2013

Jan-Apr 2014

Intake 521 321

Euth 90 70

Euth % 17% 22%

Adoption 359 227

Adoption %

69% 70%

Summary

Let go of the myths Do NOT hold them to re-vaccinate!! Remember: longer LOS = increase risk of death Estimate age to save lives Identify barriers that prevent swift, safe passage of

kittens and puppies through your shelter Find some ways around those – work with

management

When you’re about to give up…try one more time!

No luck in past discussions about open selection or fast-tracking

In early May I tried 1 more time The result:

stop holding puppies more than their 3 day stray hold work on fast tracking owner surrender pups talked about changes to puppy adoption space Implement open selection for kittens ASAP talked about doing portals on cat adoption floor (that’s

another presentation…)

Recommendation: Keep Trying!

Know the ASV Guidelines for Standards of Care in shelters

Go to conferences, webinars!! Use the resources:

Shelter Medicine for Veterinarians and Staff (Miller and Zawistowski)

www.sheltermedicine.com (not just medicine!) www.animalsheltering.org www.aspcapro.org

MANY THANKS TO:

DR NEWBURY THE KSMP FELLOWS!

HSUS – FABULOUS FELLOWSHIPYOUNG-WILLIAMS ANIMAL CENTER

Questions??