Hello shelter med fans! My name is Colleen, and I am a fourth-year student at Cornell’s College of Veterinary 
Medicine. I have been involved in the animal sheltering community since the day I turned 14 and was officially old enough to start volunteering at my local shelter. As a vet student, I have been involved with the student chapter of the Association of Shelter Veterinarians, participated in low-cost wellness clinics in local communities, and taken my love of outreach and spay/neuter on the road with Rural Area Vet Services trips to American Indian reservations in Arizona and the Dakotas. Although I will be pursuing an internship in private practice next year, I intend to remain involved in the shelter medicine world, both as a resource for shelters in my community, and as a liaison between private practice and the shelter. As a student on the Shelter Medicine rotation, I have been asked to reflect on my experiences in the world of the shelter veterinarian, and what shelter medicine is.
Shelter medicine is…
…working with people.
How many people work or volunteer in a shelter because they just looooove dealing with humans and all of their delightful quirks? Most folks end up in the animal sheltering world because they care deeply about animals, and they wish to help make a difference and affect some sort of positive change. One of the first things we are taught in vet school is that veterinary medicine is as much about people as it is about animals, and the same is true for animal sheltering. Shelters cannot be funded, built, staffed, or maintained by animals; there is an essential human component that must be fulfilled. While there may not be a client directly attached to every animal as there is in private practice, shelter staff and volunteers may become attached, and are often the ones responsible for running tests and administering treatments. It is the shelter veterinarian’s responsibility to educate and inform, so that the best care can be given.
A shelter veterinarian’s work does not stop at the doors of their own shelter, either. Shelter vets may also consult with veterinarians, staff, and volunteers from other local shelters, as well as shelters from around the country. During one of our rounds sessions this week, we discussed a consultation that the shelter veterinary team was involved with at a nearby shelter. This shelter houses over 200 cats, and has been struggling with feline illness of unknown cause. During our rounds discussion of this case, we talked about what steps we could recommend to this shelter, including training for staff and volunteers to recognize early signs of illness, testing of all cats for certain infectious diseases, and separate housing for sick and healthy cats. Many of these principles have been discussed in a more abstract form during the shelter medicine elective classes I have taken, but to see them applied to a real-life situation truly drove home their necessity and importance.
Shelter Medicine is…
…thinking on a population level.
Just as in private practice, a shelter veterinarian is required on a daily basis to assess the physical health and well-being of individual animals in the shelter. This week alone, the medical staff saw weight loss, vomiting, diarrhea, a heart murmur, and mange (in different animals). Each of these animals was examined individually, and a diagnostic and treatment plan was developed by the vet staff. In dealing with individual patients, shelter medicine is similar to private practice. However, shelter veterinarians must also think about the entire population of animals in their shelter, and how illness in one animal can affect the rest of the animals in the shelter.
One of the most common diseases encountered in shelters is feline upper respiratory infection, or URI. URI cannot be spread to people, but it is highly contagious among cats, and an outbreak can sweep through a shelter in a matter of days. During an epidemiology class in my second year, modeling a URI outbreak served to highlight the importance of sanitation protocols, treatment regimens, and judicious and meticulous data collection in tracking the number of new cases as well as resolving existing cases. While on an externship to a large shelter out west, I experienced first-hand the daily measures taken to prevent a URI outbreak. Cats with potential signs of URI were noted by staff and volunteers, and checked by members of the veterinary team. Confirmed URI cases were moved to a separate ward for treatment, and previously occupied enclosures were thoroughly cleaned and disinfected according to established protocols. When administering treatments to cats in the URI ward, I had to wear a separate set of scrubs that I would change out of before handling any other animals. All of this may seem overly pre-cautious in preventing the spread of infectious disease of essentially a kitty cold, but the cost of treating an entire shelter full of sick cats, both monetarily and in terms of individual cats’ welfare (not to mention the PR challenge of having a shelter full of sick cats), far outweighs the cost of these preventative measures.
Shelter Medicine is…
…making the hard decisions.
A shelter veterinarian must keep not only an individual animal’s health and welfare in mind, but also the health and 
welfare of the entire population of animals in the shelter in mind. This often requires the shelter vet to make difficult decisions regarding individual animals. Take for instance, the friendly elderly cat with diabetes. She has a lovely personality, and is otherwise healthy, but diabetes is not a condition that can be cured. In order to manage diabetes, she will require insulin injections multiple times per day as well as regular blood work and diligent observation to ensure her diabetes remains well-controlled. Despite even the best care however, she is still at risk for a diabetic crisis, where the body’s sugar levels spiral out of control, causing a cascade of physiological events that can end in a coma, or even death if not treated immediately and aggressively (i.e. an expensive emergency room visit). Does the shelter have the time and money to put into the initial treatment for this cat? Does the shelter have enough trained personnel to administer insulin injections, draw blood regularly, and monitor for signs of a diabetic crisis? Is it reasonable to expect an owner in the community to take on the cost and responsibility of caring for this animal? And even if the answer to these questions is yes, is it fair to the other animals in the shelter’s population to spend resources on one animal that could perhaps be used to the benefit of several other animals? These are difficult questions, but they are very real questions faced by shelter veterinarians every day, and they have no right or easy answers.
Shelter Medicine is…
…hard work, tough decisions, and working with diverse and sometimes difficult personalities (both human and animal).
But at the end of the day (or month, or year, or decade), you can look back at the work you have done, and feel a genuine sense of accomplishment. Through spay/neuter initiatives, wellness clinics, and outreach and education programs, shelter veterinarians have real power to affect positive change in their communities and further abroad. With the recent development of shelter-specific internships and residencies, shelter medicine is becoming a recognized and respected specialty in veterinary medicine. Data collected from shelters has been used to refine disease outbreak protocols, show trends in population management, and develop standards of care for shelters. It’s not always snuggling puppies and kittens, but it is always challenging, rewarding, and fulfilling. (And some days it IS snuggling puppies and kittens!)
