Infectious Disease Management in Animal Shelters. Группа авторов

as appropriate. The medical record should also document assessment and follow‐up, including an assessment of the animal's adoptability or other outcomes. Copies of the patient's medical record should be made available to adopters so appropriate ongoing care can be provided.

In addition to the obvious need for medical record‐keeping for individual animals, populations also benefit from thoughtful record keeping and data collection. For example, several goals of the shelter wellness program might include decreasing the incidence and prevalence of infectious diseases in the shelter and following adoption, decreasing the incidence of problem behaviors in the shelter, decreasing the rate of return of animals to the shelter for problem behaviors, increasing the adoption rate, decreasing the euthanasia rate due to disease, and so forth. By identifying and tracking measurable factors (often called performance targets in large animal medicine), it is possible to measure progress toward these goals. In shelter medicine, such factors may be more appropriately termed “welfare targets.” Once baseline data (such as disease rates) are established, it may be possible to measure the impact of protocol changes on population health by evaluating individual welfare targets. A system for regular reporting will make it easier to identify both positive and negative trends in animal health.

      Finally, record‐keeping can be used to facilitate tracking of national and regional trends in animal sheltering. In the United States, Shelter Animals Count (https://shelteranimalscount.org) is an independent, not‐for‐profit organization that maintains a national database that promotes standardized data collection and sharing. Launched in 2015, this national initiative with “broad collaboration from the animal welfare community” seeks to enroll all U.S. shelters in order to generate evidence to elucidate the best sheltering practices for promoting and saving companion animals' lives and preventing homelessness.

2.4 Policy and Protocol Development

      Shelters should have written policies and protocols in place that detail how medical and behavioral problems will be handled (Hurley 2004). Policies and protocols should be based on research and facts as well as the individual organization's mission, philosophy, and the availability of resources (including facilities, staff, and veterinary care). Policies and protocols are best established by a committee that is responsible for shelter health issues, including the shelter director or manager, medical and behavior staff, and other key individuals. The goals of the committee should be to establish definitions or descriptions of the disease or problem behavior in question, a description of the methods that will be used to diagnose or recognize the condition and a general policy regarding the disposition of animals affected by the condition. In addition, protocols should include details on who should be notified, housing guidelines, sanitation procedures, treatment, and documentation in each case. These written protocols should serve as guidelines for systematic triage and care of animals in the shelter.

      In addition to establishing policies and protocols for commonly encountered diseases and problem behaviors of shelter animals, protocols should also be developed to ensure prompt recognition and treatment of pain and emotional distress in animals. Protocols should include provisions for conditions that cause both acute and chronic pain and/or distress. Many shelters receive animals that are victims of cruelty, neglect, and/or trauma; protocols should include provisions for recognition and triage, with the provision of adequate pain control and nursing care as a priority, or emergency euthanasia if necessary when animal suffering cannot be eased, including those in their stray holding period. For shelters that do not have a veterinarian on staff, protocols should contain information for obtaining emergency veterinary care and assistance with cruelty cases.

2.5 Wellness: Physical Health

The basic physical health of cats and dogs should be systematically addressed in the wellness program protocols. Protocols should include provisions for vaccination, parasite control, spay‐neuter, identification, proper nutrition and physical exercise, grooming, periodontal/oral disease prevention, and individual‐specific care (see Table 2.2). Protocols should be reviewed and updated periodically as needed.

      2.5.1 Vaccination

      The high likelihood of exposure to disease and stress and the potentially life‐threatening consequences of illness in shelters make vaccination against certain diseases essential. There is no doubt that proper shelter vaccination protocols substantially reduce disease in the shelter and improve animal health. It is important for staff to be educated about the role and limitations of vaccines as part of wellness program training. Though they represent an essential component of a comprehensive wellness program for an animal shelter, vaccines are not “magic bullets” that can prevent disease altogether. Instead, vaccines are health products that trigger immune responses in animals and prepare them to fight future infections from disease‐causing agents; they do not treat disease or provide instant immunity. In many instances, they provide only partial protection, lessening the severity of future diseases but not preventing them. For example, canine and feline upper respiratory disease (URI) cannot be prevented by vaccination, whereas canine distemper (CDV) and canine and feline parvovirus (CPV and FPV, respectively) can be effectively prevented when vaccines are used correctly. But even so, there may be sporadic cases of CPV, FPV, and CDV in shelters, especially in young puppies and kittens due to waning maternal antibodies and the window of susceptibility to these diseases. It must also be remembered that even the best vaccines take some time to provide protection, and vaccine failure may occur when animals enter the shelter already incubating disease. Finally, it is important to recognize that vaccine failure will occur in some individuals, regardless of the protocol used, and that vaccines are not available for all diseases seen in shelters.

      Guidelines developed specifically for the vaccination of cats and dogs in animal shelters have been well described by the American Association of Feline Practitioners (AAFP) (Stone et al. 2020) and the American Animal Hospital Association (AAHA) (Ford et al. 2017). Certain “core vaccines” are recommended to be administered on intake whenever possible to all cats and dogs that enter shelters. Core vaccine recommendations for shelter animals vary from the guidelines for vaccination of privately owned pets. Shelter core vaccines target diseases that represent significant morbidity and mortality, are widely distributed in shelters, and for which vaccination has been demonstrated to provide relatively good protection against disease. Core vaccines for shelter cats include parenteral feline parvovirus (FPV or panleukopenia), FHV‐1 (feline herpesvirus type 1 or feline rhinotracheitis virus), and feline calicivirus (FCV). Core vaccines for shelter dogs include parenteral vaccines against canine parvovirus (CPV), canine distemper virus (CDV), and canine adenovirus (CAV‐2, hepatitis), as well as intranasal vaccines against Bordetella bronchiseptica (Bb) and canine parainfluenza virus (CPiV). Some vaccines are not generally recommended for use in animal shelters either because of undemonstrated efficacy in the shelter setting, low risk of disease transmission within shelters, and/or delayed onset of immunity following vaccination, rendering them impractical and of limited use in a shelter setting. In addition, when the use of unnecessary vaccines is avoided, costs and potential vaccination reactions are reduced. However, veterinarians should use their professional judgment when administering vaccines; general shelter vaccination guidelines may need to be adjusted for individual shelters due to the changing prevalence of a disease in the region, increased efficacy or safety of a vaccine, development of a new vaccine, etc.

Rabies vaccination is recommended in both cats and dogs prior to adoption when a licensed veterinarian is available to administer the vaccine (or by shelter staff in accordance with state laws). New owners should be advised that rabies vaccination for dogs is mandatory in most jurisdictions, and proof of vaccination may be required for dog licensing. Rabies vaccination is also warranted when animals are housed long term in shelter facilities. Animals being held for rabies bite quarantines should be vaccinated against rabies by a licensed veterinarian in accordance with state law and the guidelines provided by the current Compendium of Animal Rabies Prevention and Control. Though the Compendium is not law, it forms the basis for many state laws regarding the management of rabies and