The Birds and the Bees…..

downloadAs many shelters have encountered, hoarding situations are often not limited to cats and dogs.  So staff can sometimes be faced with determining housing based on sex to avoid adding to the pet population. Although some exotic species are very social and being housed together can reduce stress, it’s important to be able to sex them to prevent unwanted litters, advise potential adopters, and avoid possible fighting. Sexing different species can be challenging to say the least. Internet searches can be a powerful tool with images and videos to help. But here are some tips all in one place that may be useful:

Rabbits

Rabbits can be tricky. A relaxed male can have obvious testicles. But if nervous, they have an ability to keep them in their abdomen rather than allowing them to descend and be easily identified. If already neutered, it is essential to extrude the genitals to determine sex. There are sometimes only subtle differences between an extruded penis and an extruded vulva. It’s also important to remember proper handling techniques when sexing rabbits since any kind of a struggle can lead to a back injury. 0e55aa8e4a5f6afac5b1cb4ee200e512

Guinea Pigs

Guinea Pigs are somewhat easier. Males will have obvious testicles usually becoming more prominent after 4 weeks of age. If altered, the penis can be extruded to verify sex.

Small Rodents

In some instances males can keep their testicles retracted like rabbits. Otherwise, males can have prominent testicles. Other tips include using the distance between the anus and genitals (where males will have a greater distance), and observing nipples (only in females) to determine sex.

Reptiles and Birds

Laszlo probing drawingThese animals can be the most difficult to sex. Some species have different coloring or physical characteristics that differentiate the sexes (Eclectus parrots have red females and green males). Lizards and snakes can sometimes have sex determined by inserting a probe into the cloaca (the probe will go in further in males). Some species can only be sexed with DNA testing. It’s recommended to involve an exotics veterinarian or specialist to aid in sexing.

With Spring in the air, it may be a good time to brush up on sexing different species because you never know when you may have hundreds of rats on your hands.

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Don’t Be A Martyr

guy sneezingOne of the top priorities of shelter staff is the prevention of illness and spread of disease among the shelter population. Strong emphasis is put on cleaning and disinfection, personal protection equipment, low-stress environments, and safe animal handling. But when considering the shelter population, most staff fail to make the same commitment to keeping themselves healthy as they do for the animals. This is particularly devastating for shelters that are already understaffed and then have to deal with a human outbreak of the cold and flu virus.

According to Gallup, for December 2014 the daily cold and flu reports averaged 4% and 11% of Americans respectively – the highest since 2008 when Gallup first started tracking them. To add insult to injury, the flu vaccine is only 18% effective this year according to the CDC. This year the H3N2 flu virus has been predominant prompting experts to suspect that this year’s flu season could be characterized as severe. H3N2 viruses were predominant during 2011-2012, 2007-2008, and 2003-2004 – the three seasons with the highest mortality rate in the past decade.

So how do we prevent ourselves from getting sick? The simple precautions doctors have been telling us for years still hold true today. swine-flu-mask-for-cat-011813

No touchy: Avoid people who are sick and wash your hands. Shaking hands or touching things used by infected people then touching your eyes or mouth will pretty much guarantee transmission. So sing Happy Birthday to yourself while washing and wash often.

Sleep well, eat well, and get plenty of exercise: Obviously this is the key to good health not just in flu season, but every season.

Vaccinate yourself: Despite it’s low efficacy this year, the flu vaccine can lessen the severity of symptoms. Also, the more people vaccinated the more it leads to herd immunity.

Stay home: If you do get hit with a virus, do yourself and co-workers a favor and stay home. Most people find this the hardest to abide by. They see the short term difficulties of fellow staff members getting all the work done. But in the long run it will be a lot more beneficial to have just one person out sick than the entire staff at some point.

Long story short, don’t be a martyr. The shelter will run without you for a couple of days while you get better.

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A Safe Place

dog crateTraditionally, cats have been at the forefront when it comes to providing a space to hide. It has been well documented that by having a box or carrier to freely hang out in, their stress level can be reduced significantly. In turn, by lowering their stress level we reduce their risk of becoming ill. But it’s not just cats that can benefit from this. Dogs and exotic animals need a place where they ‘can get away from it all’ – at least in their own minds. Imagine yourself in a fish bowl with all kinds of noises and people bustling about. It can be overwhelming to say the least. Even pet owners are being marketed to provide dens that mimic side tables or nightstands, or that match the decor in their home.

Hide spaces don’t need to be expensive. Boxes that arrive with inventory can be stored and available for putting in with small dogs, cats, rabbits or guinea pigs. The nice thing about cardboard boxes is that they are thrown away after use and are conducive to infectious disease control. Toilet paper or paper towel rolls can be used with mice, hamsters or gerbils. Cardboard is also a valuable source of enrichment for small mammals because they love to chew it. Carriers or crates work well with dogs and cats, and can increase living area by providing vertical space. A blanket on top of a carrier can be a comfortable perch for cats and small dogs.

rabbitThe main things to remember are safety (not something that will collapse on the animal), sanitation (if not disposable it needs to be a material that is easily disinfected), size (something they can fit into and naturally stand or turn around in), and positioning (having the opening face people as they walk by doesn’t feel safe to the animal). Most often some great hiding tools can be found in storage around the shelter. But for those who want to make an investment there are commercially available cardboard hide boxes for cats as well.

Knowing What’s Out There: a guide to guidelines and state law

CG-Slider-Animals-TextWe often receive questions from shelters that delve into realms of state law, animal guidelines and best practices. There can be a number of situations that arise creating concern whether a shelter is not only law abiding but also providing the most humane care possible. For instance the question is often asked as to what lay people (non-licensed veterinary technicians, veterinary assistants, volunteers) are allowed to do in terms of vaccines and medical treatment. Another popular query is what, if any, legal requirements there are for transporting animals across state lines. Of course it’s impossible to keep it all straight while managing day to day adventures within the shelter. So the best advice is simply knowing when to ask questions and then finding answers through local and state law, and animal welfare organizations.

New York State

Legal jargon is difficult at best to wade through. Also interpretation can vary from person to person. For example, terminology such as ‘under direct supervision’ vs. ‘under supervision’ could mean the difference between a veterinarian needing to be present in the shelter at the time of administration of an oral dewormer versus a written deworming protocol developed by the shelter veterinarian. Laws pertaining to shelters can fall under different departments (Agriculture and Markets, Public Health, Education) so finding them all in one spot can sometimes be difficult. The link for Laws of New York under New York State Legislature has a search engine which can be helpful. I searched the word veterinarian and this is what came upThe New York State Animal Protection Foundation has a really convenient app that allows you to look up NYS laws from your smartphone. Of course county legislation should not be overlooked in terms of stray hold, seizures etc. Click here to access the Tompkins County codes.

Other States

We strongly suggest investigating your local and state laws to provide the most accurate information. However, a helpful and interesting website on a federal level provided by Michigan State University College of Law is the Animal Legal and Historical Center.  It provides full text cases, statutes and comprehensive explanations.

Guidelines

There’s often the expectation of a law in place to address specifics on themes like housing and transport. When in fact there are only guidelines and best practices. So when not covered by law, it’s recommended these guidelines are followed to provide the most safe and humane care possible. They have been developed by experts in the field and they are incredibly helpful.

Association of Shelter Veterinarians provides Standards of Care Guidelines and Spay Neuter Guidelines. As a shelter, we strongly urge you to read these if you have not already.

The National Federation of Humane Societies  provides best practices for transport and euthanasia.

Ultimately finding the answers will take some work. But hopefully these links will give some idea on where to start.

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CNY Shelter Forum: A Collaborative Experience

frustrated_womanHave you ever felt as though your organization is a small island in the sea of shelter work? Have you ever wished you could find out how others handle situations?

The Central New York Shelter Forum is the brainchild of Dr. Berliner, the Director of Maddie’s Shelter Medicine Program at Cornell University. Hosted by the Shelter Medicine Program , local shelters are invited to meet the first Thursday of every  month at Cornell University. The purpose is to discuss a specific topic (suggested by those who participate) in a friendly, nonjudgmental environment.  Veterinarians and staff from the Shelter Medicine Program initiate the conversation by giving a brief presentation at the beginning. Then the floor is opened up for anyone to ask questions, offer suggestions, or share stories. Feedback from those who have attended so far has shown a tremendous appreciation for simply being able to hear what other shelters are doing.1011871.large

The first meeting took place in September where Dr. Hoshizaki led the discussion on intake protocols for dogs and cats. When to vaccinate, types of vaccines, de-worming, flea/tick control, and  housing are examples of items that were discussed. In our October meeting, Dr. Putnam prompted discussion on spay/neuter programs, surgical age, holding of animals until spay/neuter is performed, and required resources for an efficient spay/neuter program.

470745_10150786259925903_1732259428_oOur next CNY Shelter Forum will take place on November 6th at 5:30pm. Casey Lomonaco, the Behavior Programs Manager from the SPCA of Tompkins County, will start a discussion on Top Behavior Problems found in the shelter. Any shelter within a reasonable distance from Cornell University is welcome to join us. If you would like details on when and where it all happens please email sheltermedicine@cornell.edu

HSVMA RAVS: Life changing

Monstro waiting to be neutered in WA RAVS clinic

Monstro waiting to be neutered in WA RAVS clinic

I’ve been participating in a wonderful and compassionate organization known as RAVS since 2010. RAVS, an acronym for Rural Area Veterinary Services, is part of the Humane Society Veterinary Medical Association and brings veterinary services to rural communities. Community members not only face financial impediments to veterinary care, but geographic location often makes it impossible to visit the veterinarian. I could rattle on endlessly about RAVS – the setup, the breakdown, the locations, the people. But it would be much easier for everyone to visit their website at http://www.ruralareavet.org/ and http://blog.humanesociety.org/wayne/2014/09/hsvma-mobile-veterinary-clinics.html.

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The Maggie Mobile pulls ‘The Rig’ in WA sunset

What I would like to share is the impact it’s had on my life. I’ve been a veterinary technician for 20 years. When I was in college, the average number of years a tech worked in the veterinary field was 5 years. For a variety of reasons that number really hasn’t changed. Up until 2010, I had worked primarily in emergency and critical care. I was feeling burned out, underappreciated, and looking for a career change. Then I did a RAVS trip. Never before had I witnessed what a dramatic effect a team of veterinary professionals and students can have on a community and their pets. Through this sense of accomplishment, I was able to recommit to my profession. And there are hundreds, if not thousands, of stories just like mine.

Omak Longhouse

Omak Longhouse

I was reminded of the impact RAVS has on the animals it serves just this past August. We were doing a field clinic in Washington State on the Quinault Indian Reservation. Hunter, a 5 or 6 year old Boston Terrier, came in to be spayed. She was 8 weeks postpartum and it was suspected she was still hemorrhaging from her uterus. She was weak, anemic, yet still a great mom. In surgery, the bleeding was confirmed and her uterus was very friable. Dr. Paul Breckenridge, an experienced RAVS staff veterinarian, performed the spay without complications and stopped the bleeding. On recovery though, Hunter appeared restless and panting. She seemed to be exhibiting signs of hypocalcemia. It was unusual considering she had had the puppies 8 weeks prior, and being a MASH style clinic we did not have the means to test her calcium level. But that’s just one more thing RAVS teaches you – troubleshooting. Without knowing what her calcium level was, we definitely did not want to give her injectable calcium due to potential cardiac side effects (as in the heart stopping). But then Windi Wojdak, the director of RAVS, suggested we try some oral supplementation. So we pulled out the TUMS and gave her a slurry. Within the hour, Hunter was resting comfortably in her cage. Hunter’s visit to the RAVS clinic saved her life.

Hunter with her student anesthetist, Leah

Hunter with her student anesthetist, Leah

Not only did RAVS change my life on a conscious level, but it did so in a very literal sense as well. Through RAVS I met my current boss, Dr. Elizabeth Berliner, Director of Maddie’s Shelter Medicine Program at Cornell University and RAVS junkie. Because of her, I was afforded the opportunity to step outside of emergency and critical care and try out shelter medicine. Yay Shelter Med!

Assessing Anesthetic Needs for the Clinic

drugThose shelters that offer spay/neuter services may find themselves mulling over the ideal anesthetic protocol. What we’ve encountered is that there are a lot of variables to consider when developing a protocol tailored to your shelter’s needs. The constant variables remain the same among all clinics – adequate anesthesia, adequate analgesia, minimal stress and wide margin of safety. But what we often find through trial and error are variables that are associated with staffing, services offered,  and resources available.

Number of surgeries

Most High Quality High Volume Spay Neuter (HQHVSN) clinics perform 30-50 surgeries per day. This not only dictates a minimum staff requirement, but may demand an IM cocktail over IV induction.

Staffing

As mentioned with HQHVSN, proper staffing is essential for keeping surgeons where they belong – in surgery. However staffing can also have a profound effect on what drugs are used and how they’re administered. Does the person running induction have an assistant to help with induction and to move the patient into surgery? If not, an IM protocol may be warranted for prep and intubation. What is the comfort level and skill of the induction staff? Can they intubate on their own? Can they perform IV induction? Is there someone designated to recover patients? If the same people are doing induction and recovery, patients will need to recover quickly.

Neuter vs Spay

What’s good for the girls may not be needed for the boys. Spays take longer and are more invasive requiring longer anesthesia and stronger analgesia.

Anesthetic Drugsphoto(7)

Sometimes accessibility to drugs will determine the anesthetic protocol chosen. Accessibility can include cost and proper licensing to order scheduled drugs. Drugs like dexmedetomidine are quite pricey and may be cost prohibitive if the majority of patients are large dogs. However, the volume of dexmedetomidine used can be greatly reduced when used in a combination protocol. This in turn can reduce cost. Although morphine is cheap and a terrific analgesic,  it’s not always an option for many clinics because it’s a schedule II drug and requires special ordering and documentation.

Keeping in mind that every animal is an individual and will respond differently to any anesthetic protocol, there’s a lot to consider when deciding on an anesthetic protocol to fit your program. The following resources can assist in getting started:

http://sheltervet.org/wp-content/uploads/2012/08/VTFASN_JAVMA_Guidelines.pdf

http://www.vasg.org/

http://veterinarynews.dvm360.com/dvm/data/articlestandard//dvm/332004/110470/article.pdf

http://www.aapma.com/resources/TTDex_injectable_chart-2012%5B1%5D%20%281%29.pdf

Asking other clinics about their experience with the protocols they use is extremely helpful. Here at Maddie’s Shelter Medicine Program, Cornell University, we are happy to discuss some of the protocols we have used and the effect they have had on our surgery day (sheltermedicine@cornell.edu).

Variety is the Spice of Life

RatJust when you think you’ve got the routine down, a very small patient shows up on your surgery list. Next thing you know you find yourself researching anesthetic protocols for rats. Most shelters require dogs and cats to be spayed or neutered prior to adoption. Should we have the same recommendation for rats? Well, when you consider how prolific rats are, it could be argued that overpopulation is a concern. Rats can go into heat as early as 5 weeks, they have a heat cycle every 4-6 days, their gestation period is 22-23 days, their average litter size can vary from 2-20 kittens, and they have a postpartum estrus cycle 24 hours later …..well you do the math. Before you know it, an uneducated owner could go from two rats to rat hoarder.rat2

Studies have also shown that spaying rats can reduce the risk of developing mammary tumors and pituitary tumors. Pituitary tumors are hormonally induced, so by removing the source of estrogen, their development can be decreased. In turn, mammary tumors are avoided as they are usually a result of the pituitary tumor. This may provide a longer life span and higher quality of life. Although studies haven’t been conclusive for male rats, neutering could still be performed if there was a chance of co-housing with females.

Surgically, the procedures are very similar to kittens. So surgeons experienced in high-quality, high volume, spay and neuter (HQHVSN) and pediatric spay/neuter may feel a natural segue into rat surgery. However, rats can have a higher anesthetic risk creating the need to keep surgery time as short as possible. Drug doses are very different from dogs and cats so calculations need to be exact. Also, rats are chewers. So avoiding tissue glue or anything overtly irritating along the incision is essential to prevent self- trauma and dehiscence. But one of the biggest considerations is providing safe and low stress handling of rats before, during and after the procedure.  Therefore, the comfort level of the veterinarian, technicians and staff are of the utmost importance.rat surgery

References are essential and two very good ones to have on hand are:

Ferrets, Rabbits, and Rodents: Clinical Medicine and Surgery, 3e Paperback

by Katherine Quesenberry DVM MPH Diplomate ABVP (Author), James W. Carpenter MS DVM Dipl ACZM (Author)

Exotic Animal Formulary, 4e

by James W. Carpenter (Author)

Acquainting yourself with local exotic veterinarians and rat rescue groups can also be a valuable resource. Along with advice, they may be able to assist with adoption, or provide help if rat intake is not an option. If there is a veterinary teaching hospital in your area they most likely have an exotics department. The Association of Exotic Mammal Veterinarians website allows you to search by state to find a member veterinarian at http://www.aemv.org/vetlist.cfm. Also http://mainelyratrescue.org/rattieblog2/?page_id=54, and http://www.ratchickratrescue.com/links.html#rescues have helpful rescue links and allow you to search for rescue groups by state.

Rats are social and intelligent companions who, unlike other rodents, don’t have a strong desire to latch onto your fingers when handling. This, along with their hardiness, make them ideal pets for children and adults and are definitely worth the added research.svd