preventive strategies (a holistic approach). When shelters meet these goals, both public relations and adoption rates may be positively impacted. Further, shelter wellness programs must address both the health of individual animals and the health of the population. Shelter medicine has been compared to herd health (Hurley 2004). Indeed, much like a herd‐health approach, population medicine in the shelter utilizes a systematic approach for optimizing animal health in the group. Unlike a herd‐health program for large animals, where production (i.e. meat, milk, eggs, etc.) is the ultimate goal, ensuring the welfare of cats and dogs is the ultimate goal in the animal shelter. In order to implement a comprehensive wellness program for the shelter, establishing goals for and methods of monitoring the population is critical to ensuring animal health and welfare. Medical decisions must be weighed in the context of the population as well as the individual, while also considering animal welfare and the availability of resources. Finally, assessment and follow‐up must be performed on a population as well as an individual level.
Wellness programs will vary depending on the shelter's mission, philosophy, and resources, and may even vary within shelters depending on such factors as intake rate and time of year. However, under no circumstances should a shelter engage in any practice or omission that would result in animals being allowed to suffer unnecessarily or unjustifiably. Inadequate or delayed veterinary care constitutes neglect, which is illegal according to some state laws. When situations arise in which animal welfare cannot be managed, whether due to physical or behavioral disease or environmental conditions such as overcrowding, euthanasia must be considered if no other remedies exist or it is beyond the shelter's ability to relieve animal suffering. Euthanasia, however, should not be used as a substitute for providing animals with proper care. Shelters should implement earnest programs to decrease the euthanasia of adoptable animals and community cats and seek alternatives to admitting an animal if it is beyond the shelter's capacity to provide appropriate care. For example, intake diversion programs may help provide alternative means of providing care for animals that do not need to enter the shelter system, such as food banks, low‐cost veterinary clinics, or neuter‐return programs for community cats. Comprehensive shelter wellness programs that include the delivery of efficient care, thoughtful and timely planning, evaluation, and follow‐up are the foundations of shelter animal healthcare. These programs support the essential goals of animal sheltering: maximizing live release and animal welfare while minimizing euthanasia and suffering. Research is helping to better define protocols for limiting and treating physical and behavioral diseases common to shelter animal populations and to better assess their welfare or quality of life.
2.2.2 Quality of Life
Every attempt must be made to sustain quality of life for shelter animals. Like “happiness,” quality of life remains difficult to define. Both physical and emotional factors contribute to quality of life, well‐being, or welfare. These factors are broad, complex, and very individual. According to McMillan (2000), quality of life “is comprised of an array of affective states, broadly classified as comfort‐discomfort and pleasure states. In general, the greater the pleasant and the lesser the unpleasant effects, the higher the quality of life.”
Criteria are lacking for the objective measurement of the quality of life for cats and dogs; however, subjective assessments utilizing the most information possible can and should be made by medical and behavioral personnel at regular intervals (weekly or daily as indicated). Researchers are giving increased attention to validating quality‐of‐life measurements, which could help ensure humane endpoints for healthcare, define minimum housing standards, and be used for welfare audits in animal shelters as well as other settings where populations of animals are housed (Barnard et al. 2016). The Farm Animal Welfare Council's (FAWC) Five Freedoms represent a benchmark for measuring quality of life or assessing animal welfare (see Table 2.1). Since their introduction by council chair Dr. Roger Brambell in 1965, the Five Freedoms have been applied broadly as key animal welfare principles in numerous animal care settings.
Whereas the Five Freedoms emphasize freedoms from unpleasant experiences (hunger/thirst; discomfort; pain/injury/disease; fear/distress), it is recognized that good quality of life or good welfare is not merely the absence of negative experiences, but also the presence of positive ones. To this end, the FAWC continues to work to better define quality of life for animals across a spectrum of conditions that represent “a good life” to “a life not worth living.” In the case of a life not worth living, defining the minimal acceptable treatment of animals is key. As such, FAWC supports “Banner's principles”, which first and foremost state that “harms of a certain degree and kind ought under no circumstances to be inflicted on an animal.”
Table 2.1 The Five Freedoms.
| 1) Freedom from hunger and thirst by ready access to fresh water and a diet to maintain full health and vigor. |
| 2) Freedom from discomfort by providing an appropriate environment, including shelter and a comfortable resting area. |
| 3) Freedom from pain, injury, or disease by prevention or rapid diagnosis and treatment. |
| 4) Freedom to express normal behavior by providing sufficient space, proper facilities, and company of the animal's own kind. |
| 5) Freedom from fear and distress by ensuring conditions and treatment that avoid mental suffering. |
According to the FAWC (2009), “achievement of a life worth living requires provision for an animal's needs and certain wants, and care by all involved. Wants are those resources that an animal may not need to survive or to avoid developing abnormal behavior, but nevertheless improve its quality of life. They may well stem from learned behaviors, so that once an animal has become accustomed to their provision, then withdrawal may lead to an adverse mental experience. They may also be innate such as space to play, to groom or engage in other normal behaviors.” These tenets purported by the FAWC expand and enhance the principles of the Five Freedoms and can be used to help better define requirements for humane care that promote an acceptable quality of life for animals in a variety of settings, including shelters.
2.2.3 Guidelines for Standards of Care in Animal Shelters
In order to address the absence of professional guidelines for animal care in shelters, the Association of Shelter Veterinarians (ASV) published “Guidelines for Standard of Care in Animal Shelters” in 2010. The first of its kind, this groundbreaking document provides scientific and humane recommendations specifically for shelter animal care. It was written with the Five Freedoms as its basis to ensure all aspects of shelter practices support animal welfare. It identifies ideal, best and unacceptable practices as well as minimum standards of care for shelter animals. The document has been broadly supported by organizations including the National Federation of Humane Societies and the Society of Animal Welfare Administrators (now the Association for Animal Welfare Advancement), the National Animal Control Association, the American Society for the Prevention of Cruelty to Animals (ASPCA), and the Humane Society of the United States as a valuable aid to organizations for ongoing self‐assessment and improvement of animal care regardless of the organization's mission or resources. The guidelines strongly support the importance of wellness programs for animal shelters and are an important source of information for any organization that cares for animals. They are available as a free download from the ASV website at http://www.sheltervet.org. The ASPCA offers a checklist for implementation of the guidelines at http://www.aspcapro.org. Compliance with the guidelines can be expected to improve animal care and welfare, however, it is currently voluntary.
2.2.4 Considerations Regarding Infectious
