Infectious Disease Management in Animal Shelters. Группа авторов

widely implemented in US shelters over the last decade, provides an example of this phenomenon. (Spehar and Wolf 2019). These programs involve sterilizing, vaccinating and returning cats to the location of origin, and are differentiated from traditional Trap/Neuter/Return (TNR) programs in that they target cats admitted to the shelter as part of normal animal control services, versus specifically captured with the intent to have the cat sterilized. Analysis of one of the first large‐scale RTF programs demonstrated not only a reduction in euthanasia of over 75%, but also a 99% decrease in the number of cats euthanized for URI. With an additional outlet for healthy cats other than adoption, shelter managers are far less likely to face a choice between crowding or euthanasia – and the impact on feline health can be dramatic.

1.3 Capacity for Care: Blending Shelter Medicine and Management

      The foregoing examples demonstrate the synergy that occurs when shelter health and shelter management practices work in support of each other. The most effective infectious disease control program will address the overall functioning of the shelter as a system, balancing animal intake with the organization's ability to provide appropriate care and find suitable outcomes. The success of this approach has been demonstrated in a shelter management model known as “Capacity for Care,” which has been linked to decreased disease and euthanasia and increased live release rates (Karsten et al. 2017). Though piloted with an emphasis on cats, this model applies equally to dogs and involves optimizing the number of animals housed at any one time; actively managing the LOS of animals in the shelter; providing housing for each animal that meets or exceeds the ASV Guidelines for Standards of Care in Animal Shelters and using methods such as scheduled admission and removing barriers to adoption to maintain the population within the organization's humane capacity without resorting to increased euthanasia (CFHS 2016).

      Whether used under the formal umbrella of the Capacity for Care management model or otherwise, these practices, when combined, represent an integrated approach that powerfully supports animal health and limits environmental disease transmission. Under these conditions, it is realistic to expect the spread of serious infectious disease to be a relatively rare event. The shelter practitioner can then turn their attention to the chapters within this text that focus on methods to treat animals that enter the shelter already infected, or to improve the health of animals in the community.

      Conversely, when housing is poor, LOS prolonged, or animal care is otherwise compromised because shelter capacity is exceeded, even the best vaccination, segregation and sanitation practices will be insufficient. In the face of repeated outbreaks or high levels of endemic disease, the reader is encouraged to revisit this chapter and access other resources – including the numerous guidelines, texts, and consulting services now available – to bring the shelter population into greater balance with the organization's ability to provide care.

      1.3.1 Right‐Sizing the Population

      The ASV Guidelines for Standards of Care caution that “Every sheltering organization has a maximum capacity for care, and the population in their care must not exceed that level” (Newbury et al. 2010). The “right‐size” for the shelter population at any one time can be defined as that which maximizes the number of animals served while not exceeding the organization's capacity to provide humane care. Limits on capacity include the number of adequately sized housing units, staffing level, and availability of specialized medical and behavioral care where needed.

Some of these numbers are relatively straightforward to determine. For example, in order to generate an estimated maximum population that can be accommodated, housing units can simply be counted, while total staff time available for daily animal care can be divided by the amount of time required for care on a per animal basis. The National Animal Care and Control Association (NACA) and Humane Society of the United States suggests a minimum of 15 minutes per animal per day for cleaning and feeding as a general guideline (NACA 2009). However, as expectations for care increase and shelter admissions shift toward animals requiring more medical and behavioral care, the time required per animal is better calculated based on direct observation and documentation of average care needs.

      Even when housing numbers and staff time are ample, it may still be advantageous to maintain the population below the maximum that can be physically accommodated (Swanson 2015). Rather, the ideal size of the population is driven by the average daily expected throughput (intake or outcome) of animals multiplied by the target LOS to the best possible outcome. The “average daily throughput” should generally be based on monthly intake and outcome estimates based on past performance and, ideally, should be calculated separately by species and age of animals (juvenile versus adult).

      Though calculations should ultimately be made separately for holding areas and other common pathways such as animals awaiting transfer to partner agencies, the ideal number of animals available for adoption provides a straightforward illustration and can be a good place to start. This number has sometimes been described as “Adoption Driven Capacity.” For instance, if a shelter expects to perform 60 adult cat adoptions in one month, based on historical trends and aims to keep the LOS for cats at no more than 15 days, the calculation for the ideal number of cats awaiting adoption is as follows:

      Sixty cats adopted per month/30 days in a month = ~two cats adopted on average each day. Two cats adopted each day × 15 days target LOS per cat to adoption = 30 cats on average that should be available for adoption at any given time.

      Doubling the number of cats available from 30 to 60 would mean that cats stay twice as long on average unless the increased population somehow bring in twice the number of adopters. Conversely, reducing the number of cats awaiting adoption from 30 to 20 (for instance via a one‐time adoption promotion event) would lower the average LOS from 15 days to 10 (20 cats available for adoption/two adoptions on average per day). The benefits this population decrease could have, in terms of staff time and resource allocation, as well as the direct health effects of reduced population density and shorter LOS, will be apparent to the reader.

      This example is provided only as a brief illustration. Detailed instructions on “right‐sizing” shelter populations are beyond the scope of this chapter but can be found elsewhere, often under the heading “Capacity for Care” (CFHS 2018; Karsten et al. 2017). Suffice to say that performing these calculations and developing strategies to right‐size the shelter population and maintain it at that level are a vital component of a successful shelter health and infectious disease control program.

      1.3.2 Length of Stay (LOS)

      Reducing the LOS in shelters is an end in itself, provided that it does not come at the expense of successful life‐saving outcomes. From a welfare perspective, even the best shelter housing does not replicate the experience of being in a home. Meeting an animal's behavioral needs becomes more challenging the longer they remain in confinement. Studies have also documented an increased risk of shelter‐acquired disease as LOS increases (Dinnage et al. 2009; Edinboro et al. 2004). Behavioral deterioration and illness in turn can lead to yet longer stays, triggering a negative cycle that can be difficult to reverse. To avoid this, pro‐active plans and consistent checkpoints should be in place, and LOS should be reported and evaluated on a regular basis as a vital indicator of shelter animal and system health.

      1.3.2.1 Pathway Planning and Daily Rounds

In addition to right‐sizing the population as described above, methods to reduce the LOS include active “pathway planning” toward the best possible outcome for each animal from the moment of admission (or even more ideally, before the animal is admitted), and performing daily population rounds to keep each animal on track. The daily rounds team should include staff members able to assess and resolve clerical‐/client‐service issues (such as administrative paperwork and client‐contact concerns) as well as animal care, medical and behavioral issues. The daily assessment should include an evaluation of the following:

       Paperwork/computer record (including any signage on the animal's housing unit)

       Animal location within the facility and with