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.

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.

3. The Basics- Intake
 Cats
◦ Fvrcp
◦ Frontline
◦ Strongid
◦ Chip
◦ Rabies
◦ Felv/fiv test
 Dogs
◦ DHLPP
◦ Bordetella
◦ Strongid
◦ Chip
◦ Rabies
◦ Hw Test (6 months
and older only)
◦ Ivermectin

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

16. Raising Money for Cici

17. Cici’s foster helps raise funds

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

21. Case Study-Rusty
 Anti-inflammatories
 Xrays
 Cost= $100

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

24. Case Study- Lily
 Couldn’t put her
feet down
 Cost $200

25. Case Study- Honey Biscuit

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
:)

27. Honey Biscuit in Her New Home
Cost: $350

28. Case Study- Elsie Ethrington
 Shelter vet said she
must be euthanized
immediately
 6 fractures in pelvis
 8 weeks later
 Cost: $200

29. Case Study- Biggie
 Bandaged for 2
months
 Amputation
 Cost $400

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

32. Chico in foster home
recovering

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

36. Infections
 Skin Infections
◦ Mange
◦ Ringworm
 Viral Infections
◦ Parvo
 Parasite Infections
◦ Heartworms
◦ GI Worms
◦ Fleas/ticks

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

40. Case Study- Trudy

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

48. Chronic diseases that require
lifelong management
 Feline Leukemia
 FIV
 IBD/Allergies
 Arthritis
 Kidney
failure/Diabetes
 Hypo/hyper thyroid

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

56. Athena!