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Sheltering Arms

For weeks, cocoa star, a kitten recovering from multiple surgeries, lived on Martha Smith’s desk at the Animal Rescue League of Boston shelter in the South End. “She came to us after she was caught in a fan belt in a car in Charlestown,” says Smith, V97, director of veterinary medical services at the shelter. “She was a stray, a beautiful Siamese about five months old. She had horrible tears to her skin and had required a lot of reconstructive surgery.”

Although Cocoa Star had an implanted microchip from a shelter in the Midwest, information linking her to an adopter could not be found. Smith tried advertising in the newspaper, but no one claimed the cat. “She was from Cedar Falls, Iowa, and someone had cared enough about her to move her to Boston,” Smith says. “But she ended up with us. We put her back together, and it took many months, but she got adopted out, and her story had a happy ending.”

It’s successes like these that get Smith up in the morning and energize her for her work as a shelter veterinarian. As a student at the Cummings School, working in a shelter wasn’t part of her career plan, because until recently, most U.S. veterinary schools did not include shelter medicine among their menu of curricula.

That has changed as the notion of shelter animals as throwaways is no longer accepted. Animal welfare organizations and the public are demanding medical care and permanent homes, not euthanasia, from the shelters that harbor lost, homeless or unwanted animals. And as the practice of euthanizing healthy animals as a way to control population has become increasingly unacceptable, shelters have found themselves struggling with caring for burgeoning numbers of pets, rising costs and the complex medical challenges of managing animals with unknown or incomplete medical histories.

Although there is no national clearinghouse for data on animal shelters, the Humane Society of the United States estimates that shelters care for between 5 and 7 million dogs and cats every year; approximately 3 to 4 million of them are euthanized. Another 2 to 3 million are placed in permanent homes. And while 63 percent of American households have pets, only about 16 percent of those households adopt from shelters, according to the American Pet Products Manufacturing Association.

Keeping these shelter animals healthy (they’re at higher risk for infectious diseases and may pose a threat to public health through rabies and other diseases transmitted from animals to humans), and training veterinarians to care for them and pre pare them for adoption, have become urgent needs.

Enter shelter medicine. The Association of Shelter Veterinarians (www.sheltervet.org), founded in 2003, now has some 600 members and a dozen student chapters— including one at the Cummings School. The association is pursuing board-specialty status for the field. Programs in shelter medicine are offered at a number of U.S. veterinary schools, and the Humane Society of the United States publishes the bimonthly Animal Sheltering magazine.

At the Cummings School, veterinarians in the Center for Animals and Public Policy and the department of clinical sciences are partnering with the Animal Rescue League of Boston and the Massachusetts Society for the Prevention of Cruelty to Animals to design and establish a shelter medicine training program at Tufts. The goal is to offer a certificate in shelter medicine.

Like many of the programs that have successfully launched at the Cummings School, the impetus for the shelter medicine program began with the students. At least half of the students applying for admission write about their interest in animal sheltering. Many have obtained animal-care experience through volunteering or working at an animal shelter.

Three years ago, Annette Rauch, V86, G01, who is interim director of Tufts’ nascent shelter medicine program, supported a group of Cummings students in their desire to launch the Tufts Shelter Medicine Club, now among the most active student groups on campus. The club sponsors educational seminars, takes groups of students on field trips to shelters and holds a yearly drive to provide food, toys, blankets and other supplies to local shelters. And just last spring, the club sponsored a free vaccination clinic for pet owners in the Worcester area.

In their exit interviews before they graduate from the Cummings School, students often express their desire for more surgical training and for more exposure to shelter medicine. The shelter medicine program will address both issues by establishing new courses and surgical and shelter rotation electives.

This fall, in a first step toward full implementation of the program, students had the opportunity to perform additional surgeries on shelter animals in the school’s Luke & Lily Lerner Spay/Neuter Clinic, under the supervision of Susan L. Mitchell, V91, an assistant professor of clinical sciences.

“The spay clinic has the dual mission of serving the local animal shelter community—which means doing up to 30 surgeries a week—and teaching our students,” says Emily McCobb, V00, G03, an anesthesiologist at Tufts’ Veterinary Emergency Treatment & Specialties (VETS) in Walpole, Mass., who served on the working group to develop the shelter medicine program. Contributions from Cummings School overseers V. Duncan and Diana L. Johnson, who’ve adopted many of their pets from shelters, the Kenneth A. Scott Charitable Trust, the Trimix Foundation and the Massachusetts Animal Coalition have helped support the program.

Training more veterinarians in the fi eld will improve the lives of millions of homeless animals in shelters throughout the United States, not only in terms of providing care but in making the public aware of the enormous needs of this animal population. (Even President-elect Barack Obama says the First Dog, a campaign promise to his two young daughters, may arrive at the White House via a shelter.)

“When shelters were started 150 years ago, many people looked at the animals in them as unnecessary, as unwanted throwaway animals, and they were just put to sleep,” Rauch says. “We have evolved to have a more compassionate outlook. Now we believe it’s a worthy enterprise to keep these animals.

Animals are also staying at shelters for longer periods of time, she notes. “They may live there for a week, a month or a year before they find a home. We want a ‘forever’ home for every animal, but to make that happen we want to make sure that our animals are medically and behaviorally healthy—and that’s where shelter medicine comes in.”

Training veterinary students to recognize the special needs of shelter animals, and how to diagnose and treat them, is critically important to addressing long-term solutions for this vulnerable population of animals, Rauch says. Because the typical patients Cummings students see during their in-hospital training have devoted owners and are well cared for, they are not exposed to the range of problems that can afflict animals that have not had regular preventive care, or have been abused or neglected. The new shelter medicine program—including rotations at the busy Boston shelters affiliated with it—will provide experiences students may otherwise not get during their traditional D.V.M. studies.

The Cummings School is ideally situated to offer a concentration in shelter medicine, says McCobb of Tufts VETS. “We are lucky that New England is such a nexus of animal welfare. We have leaders in our state at the MSPCA, the Animal Rescue League of Boston, as well as the Massachusetts Animal Coalition—and there are many other small rescue organizations and animal welfare organizations here. As a region, we are considered progressive and animal-welfare-oriented. So the resources for our students are great,” she says.

“If you’re welfare motivated, if you care about not just the individual animals but also the problems we have with animal welfare in our society, shelter medicine is a nice niche,” says McCobb, who’s also a director of the Massachusetts Animal Coalition. “You can really feel like you’re making a difference. You become the advocate for all the animals that are in the shelter and those that will be in the shelter in the future.”

Two of those advocates graduated from the Cummings School more than a decade ago, before shelter medicine had found its way.

“The shelter environment used to be difficult to work in,” says Gary L. Weitzman, V89, chair of the District of Columbia Board of Veterinary Medicine and executive director of the Washington Animal Rescue League. “But that’s not where the specialty is now. Shelters are not dark dingy places anymore. Really good shelters have associated hospitals and are doing cutting-edge medicine. And I love it. I really hope that this specialty becomes more prevalent and more of an opportunity for new graduates. It offers everything you ever wanted to do as a vet.”

Weitzman began his career in private practice before joining the Air Force and working in public health. He also managed a breast cancer research program for the U.S. Army. Eventually, back in civilian life, he opened a practice in San Francisco. After selling it, he moved to Washington, D.C., to help direct a congressional cancer research program. To keep his hand in veterinary medicine, he volunteered at the Washington Animal Rescue League. “They said, ‘By the way, we need a medical director. Are you interested?’ And I said, one million percent, yes.”

He’s never looked back. Although Weitzman welcomes the opportunity to practice hands-on medicine, he says the really great moments come when the animals fi nd homes. “When you are in the lobby and you see a dog or a cat that you worked on going home to a new family—our front desk will make an announcement, like ‘Zydeco is going home!’—that’s the best thing.”

Like Weitzman, Martha Smith came to shelter medicine by a circuitous route. After earning an undergraduate degree in international relations, she ended up in Boston. “I was working temp jobs, and when you work temp in Boston, you end up in the healthcare fi eld,” she says. “I got a job as the second-shift radiology librarian at Massachusetts General Hospital. My job was to make sure that everybody got the X-rays they were supposed to have—they were still on fi lm at the time—and that they were fi led away properly so they could be found when people needed them. But I was getting in trouble because I was spending more time looking at the X-rays than I was making sure they were going where they were supposed to go. It made me think that I have this strong interest in medicine and answering the unanswered questions. So I decided to go back to school.”

Within weeks of enrolling at Tufts, she had found her passion. “There was never a dull moment,” she says. “Every experience opened my curiosity. During my zoo rotation, I wanted to be a zoo vet. During my dairy rotation, I realized I loved dairy cows, so I was going to be a dairy vet. It was such a rich experience.”

Smith had what she describes as a “brief stint” in private practice, but the fit wasn’t right. “I started volunteering at the MSPCA shelter and really enjoyed it. The shelter manager at the time said, ‘You’re a shelter veterinarian.’ And I laughed. ‘As if there really were such a thing,’ I said. I wasn’t even really aware that shelters employed veterinarians.”

But the MSPCA obtained funding for a staff veterinarian, and offered Smith the position. “After about three months I realized I didn’t have to look around anymore for what I wanted to do. I was a full-time shelter veterinarian.”

Inevitably, an important component of shelter medicine is animal cruelty investigation. “Shelter veterinarians are playing a growing role in the forensic investigation of animal cruelty,” says Smith, who works closely with law enforcement in Boston.

Adds Weitzman: “The only downside of taking care of homeless animals is the inherent emotional issues that come with seeing that abuse and neglect and cruelty—but doing something about that is really rewarding. You get to intervene for the animal.”

Shelter medicine is advancing on all fronts, Smith says—the medical, the surgical and the behavioral—in response to pressure from society to rescue and rehabilitate, rather than dispose of unwanted animals. A lot of what shelter medicine focuses on is assessing animals’ needs and figuring out how to make them adoptable.

“You have to find out where the deficits are, and if it’s something that’s broken that we have the resources to fix to make the animal sound before it goes out. Or is this some thing that will continue to cause the animal suffering, and it’s time to make that fair decision on behalf of the animal and euthanize it,” Smith says. “But our emphasis is on rehabilitation. The no-kill movement is a beautiful thing—to try to save as many of these animals as we can. It has become societal, and it has created the need for shelter veterinarians to keep science in it. When science leaves animal welfare, and it becomes simply a matter of passion, that’s when good intentions go wrong.”

Ten years ago Smith moved from the MSPCA to the Animal Rescue League of Boston, which was opening a new shelter. “This organization is very reactive in terms of getting animals off thin ice and off of cliffs and out of trees and all that stuff,” she says. “I enjoy the immediacy, and of course I am responsible for seeing that all these animals are healthy and cared for and get into homes.”

Smith grew up in a Navy family, and says she never really felt settled. “Maybe it was my itinerant childhood and that fact that I had no place to call home that led me to feel that ensuring that these animals will have a home that lasts matters most to me.”

She has adopted a cat and two dogs from the shelter. “People always ask me, ‘How do you not come home with a thousand animals?’ I promise you that with almost every single animal that I examine, [I think] ‘I’m going to take you home.’ And I do take a piece of them home with me. But you learn to find the balance where you don’t literally take them all home. You learn to love and let go.”


This story, written by Catherine O’Neill Grace, originally appeared in the Winter 2008 Tufts Veterinary Medicine magazine.