Summary: Shelters, especially larger ones, are made up of different departments that seldom interact with each other. Shelter behavior and veterinary medical teams may have competing priorities due to limitations on their time and resources. However, if shelter behavior and medical teams collaborate, the resulting cooperative care program can be a huge benefit to everyone involved. Working together, behavior and medical teams can create opportunities for more positive experiences for the animals in their care. 

Julio’s first vaccination at Friends For Life Animal Shelter in Houston, Texas, was exhausting for everyone involved.

The 60-pound dog had repeatedly wriggled out of traditional holds and was ultimately wrapped in a blanket and forcefully restrained before the vaccine could be administered. Julio and his handlers were left panting and drained. Sitting on the floor, recuperating from the effort, the wellness and behavior managers were motivated to find a better way. One year later, Julio’s vaccinations were a breeze, after he had undergone a husbandry training regimen designed and implemented by both departments. The improvements in Julio’s behavior toward needles were just the beginning for the shelter; the cooperative nature of medical and behavior operations at FFL had been born.

A division between behavior and medical teams is common in the sheltering world. Staff in both departments typically receive vastly different training. For example, veterinary technicians and assistants are often trained in the “Hold ’em tight, get ’em done” approach because medical departments focus on the efficiency of getting animals through the clinic, while the behavior team emphasizes animal choice and active participation. Medical departments primarily focus on disease treatment and prevention, a more immediate concern; on the other hand, behavior departments focus on the animal’s comfort and emotional health, more of long-term goal. These separate priorities often result in the independent functioning of each department, to the detriment of the animals in their care.

We at FFL, a self-styled progressive shelter, were no exception. Our wellness and behavior departments also operated in a relatively disjointed manner, until what started out as a small interdepartmental project to meet one dog’s preventive healthcare needs grew into a widespread collaborative approach to animal care. We have since collectively developed a comprehensive cooperative care program. We now work together on medical and behavior cases, and we emphasize force-free methods of performing medical examinations and treatments. We even extended our co-action to the services we offer to the public, whose animals are in our care for but a few minutes. 

This article argues the benefits and accessibility of a synergistic relationship between shelter behavior and medical teams, for large and small shelters, municipal and private organizations alike. Such an initiative can seem like a sizeable endeavor for overwhelmed shelter administrators. It certainly did for us at FFL years ago, but now medical-behavior cooperation touches the story of every animal passing through our shelter programs. We often find this to be resource-efficient, which suggests it is possible at more traditional shelters without paid behavior staff.

Cooperative care program

Julio had been adopted from FFL as a 4-month-old puppy with no obvious behavior issues, but was returned six months later for nuisance mouthiness and jumping up. It came to light that his former caregivers had taken him to a facility at which an electronic training collar was used. His caregivers had been coached to apply a shock whenever Julio did not immediately respond to verbal cues. After being returned to the shelter, Julio was in a constant state of arousal, jumping up and grabbing onto his handlers with his dewclaws, tearing clothes, and leaving bloody scratches on their skin, especially whenever he was spoken to or when anyone sat down in a chair in the room with him. He was never aggressive, but he did turn around and mouth wrists when touched in any way. As we quickly discovered during his intake examination, he was especially difficult when restrained: panicking, bucking, scratching, and squirming to get away.

After the seminal moments that followed Julio’s grueling vaccination session, FFL’s behavior and wellness managers developed a plan to train him to press his right hip against the side of a freestanding kennel. This would allow the wellness manager, situated inside the kennel, to administer a subcutaneous injection to his upper thigh. Julio was not restrained at all for this procedure, and the whole experience was a success.

CAPTION: Figure 1. Wellness Manager Erin Stewart, LVT, administers Julio’s first successful vaccination using cooperative care methods.

Buoyed by the outcome of Julio’s husbandry training project, the two team leaders began to seek other ways to apply this approach to medical processes. Inspired by Daryl Hoffman’s presentation at the 2019 IAABC Animal Behavior Conference about carrying out cooperative care on exotics, they contacted the curator of large mammals at the Houston Zoo and arranged for a visit. During that visit, Hoffman described various training exercises used to get animals into position for care routines and demonstrated these with elephants. Most importantly, he described how cooperative care was systematized throughout the zoo, inspiring the behavior and wellness managers to do the same at FFL. 

The first step toward establishing a shelter-wide cooperative care program was to create a series of step-by-step husbandry protocols for animals at the shelter, aimed at cooperative training for blood draws, ear checks, and nail trims. The standard training exercises at FFL now include:

• Lean-In: a refined process for getting a dog to target their upper thigh to a handler’s fist for a standing injection to the upper thigh.
• Chin Rest: laying chin on the handler’s lap for subcutaneous injections on shoulder or cervical regions, as well as ear exams and maintenance.
• Bucket Game: Chirag Patel’s protocol (2015) gives animals choice and control over husbandry procedures in that when they look at a treat bucket, the wellness procedure begins, and it continues until the animal looks away from the bucket to take a break. At FFL, this concept is used extensively for nail trims and cephalic blood draws.
• Side Saddle: seated position next to handler, with chin rest in handler’s hand for jugular blood collection.

Figure 2. A progression of FFL dog Lulu’s Lean-In training. For the full protocol, click here.

The behavior team incorporates cooperative care into the daily training and enrichment routines of all dogs living at the shelter, from once a week for maintenance to several times weekly when acquiring new skills. While the time spent training and maintaining cooperative care behaviors is an investment in the animal’s security and well-being now and in the future, we have been able to provide it without pouring hundreds of hours or dollars into every animal. 

Figure 3. Julio’s most recent blood draw using Chirag Patel’s Bucket Game protocol.

The next step is to build a solid system of communication: Training sessions are logged in shelter data management software and biweekly meetings take place to monitor progress and keep team members informed when new goals are set. Wellness staff notify the behavior team when animals are due for vaccinations and blood draws and request training help with non-routine medical procedures in a timely fashion, so that there is adequate time to get appropriate skills in place.

Whatever trained behaviors are employed at the shelter, the ultimate goal is for the animal to get adopted and for caregivers to continue to use these skills to ensure the relative ease of vet visits and routine care. To this end, the behavior team provides off-site cooperative care training sessions for adopted animals when necessary. In fact, the adoption contracts for animals like Julio, who may be particularly difficult to examine and treat, require that the adopter agrees to participate in post-adoption consultations geared toward transitioning their new pet to veterinary care while in their custody.

Developing a comprehensive cooperative care program may seem intimidating, even for humane organizations with paid behavior staff on hand. However, the collaborative nature between behavior and wellness that started with Julio and the cooperative care initiative has expanded to other areas of shelter animal services, suggesting a starting point for organizations that may not be ready to start a new, relatively resource-heavy program.

An interdepartmental approach to shelter cases

With routine training for medical exams and procedures underway, avenues of communication continued to open between the wellness and behavior teams. The increased trust and cooperation brought about a joint approach to shelter cases. The following examples illustrate how collaboration between the behavior and wellness teams with their respective cases results in more efficient resolution.

Chance

Chance joined the FFL program as a young, malnourished puppy. When he first arrived at the shelter, his malnutrition was so severe that he was not able to bear weight on either of his front legs. With the help of our wellness department, he quickly recovered, regaining strength and mobility, and was given a clean bill of health. 

Unfortunately, Chance started showing behavior symptoms soon thereafter: He guarded food and water from his foster, snapping at her every day as she filled his water bowl. He frequently mouthed her hard enough to cause pain without breaking skin, though she was not able to recognize any potential triggers. Attempts to increase his physical exercise were met with refusal to walk any farther than a quarter of a mile. He also started fighting with his foster’s resident dog, latching onto the other dog’s face and not releasing without being pried off.

At about 6 months of age, Chance came to live full-time at the shelter, where he underwent behavior modification and started improving, but he never seemed completely relaxed or comfortable. Behavior staff noticed that he displayed stiffness in his legs after even short walks around the block. He also never spontaneously frolicked when given time off leash, as would be expected of a typical adolescent. Following the humane hierarchy, the behavior team asked the medical team to check for an underlying health issue, even though his health had already been cleared. The veterinary exam revealed a decreased range of motion in his hips, possibly due to hip dysplasia or arthritis. 

Chance was put on Cosequin (glucosamine/chondroitin) joint supplements. After only two weeks on the supplement, he was able to tolerate more physical activity, but still showed lameness, so he was given a daily dose of grapiprant, a non-steroidal anti-inflammatory drug meant to alleviate osteoarthritis pain. Radiographs revealed medial coronoid process fragmentation with possible subtrochlear sclerosis, as well as possible left hip joint incongruity, indicating degenerative joint disease which would need to be addressed long-term. Now, Chance benefits from a modified daily physical enrichment regimen. He runs and plays without any encouragement, enjoys regular longer walks, shows reduced mouthiness, and is playing well with other dogs for the first time. 

In the past, the request for a medical reassessment after an animal’s physical health had been cleared, would have been met with reluctance; Chance’s issues would have been written off as purely behavioral, and his gait deemed a normal artifact from his history of nutritional deficiency. The trust that the medical team had for the behavior staff’s observations regarding Chance left them more willing to reassess him, which led to a conclusive diagnosis and treatment plan.

CAPTION: Figure 4. Chance’s progression from a malnourished puppy to a healthy, playful dog. The medical and behavior teams had to work together to develop a successful treatment plan.

Maverick

Maverick was a cat transferred into FFL’s adoption program from a local municipal shelter at 8 years of age. Friendly and easy-going, he was quickly moved to a foster home, where his caregivers noticed that he seemed unusually tidy, even for a cat. They admired his fastidiousness at first, until they realized that he was licking his own fur off. What started off as a healthy coat developed redness and scabbing, then dime-sized bald patches over the course of three months. During this time, he was prescribed first oral then injectable steroids to help with any underlying allergies or inflammation, but nothing seemed to stop his barbering. In fact, his behavior had started to worsen, and he was urinating outside of the litter box and hiding in dark corners. A veterinarian finally prescribed fluoxetine, but also reached out to the behavior department manager. 

After an obvious medical source for his overgrooming could not be determined, the behavior manager first recommended logging any barbering sessions to track a baseline rate of behavior and potential antecedents. It was also clear that there were enrichment deficits in Maverick’s daily routine, so the behavior manager gave the fosters the American Association of Feline Practitioners feeding guidelines (2018), emphasizing multiple small meals a day and the daily use of puzzle feeders. The caregivers were also coached on basic mark and reward training for cats.

Once the enrichment regimen was in place, the rate of Maverick’s barbering decreased from once a day to zero incidents in four months, without ever having started the fluoxetine. By that time, his fosters had decided to adopt him. 

Taking a team approach to shelter cases did not require any additional time or ingenuity. It was merely an increase in mutual trust and respect alone that brought about an efficiency boost, improving the services we offer animals in our care.

Gentle handling

When shelter medical personnel take a stress-free approach to sheltering, they can incorporate elements of cooperative care into their interactions with shelter animals without specialized instruction or the assistance of a formal behavior team. At FFL, our wellness staff have begun applying noninvasive handling techniques as a matter of course, drawn from the philosophy of giving animals choice and agency in their interactions with humans. For example, they have changed how they use treats in basic maintenance exams and how they deliver medications to animals in the program. 

Unless a cat is fearful, fractious, or feral, the medical team can conduct a thorough nose-to-tail exam by strategically positioning a lickable treat tube to lure the cat into various positions for a visual exam with little to no training. For example, most relaxed cats can be lured onto a scale to get a weight. And, when the opening of the treat tube is held over the cat’s head, it’s possible to do a simple oral exam as the cat tilts their head back and opens their mouth.

Figure 5. Despite having medical training rather than behavior training, Laura Thomasson, wellness coordinator, can conduct a nose-to-tail wellness exam on FFL cat Jett without any force or restraint.

When it comes to medical treatments, the wellness team avoids forcing medication down an animal’s throat whenever possible. Instead, the team searches out preferred food items and works to use those as a delivery mechanism for medications. 

For example, the medical team needed to administer Baytril to a rat, D’Artagnan, for a ruptured abscess. The rat was comfortable around humans but not tolerant of being restrained in the way necessary to traditionally medicate him. Since D’Artagnan loved meat baby food, the wellness team made a medication “parfait” by layering the Baytril with baby food in a syringe in a manner akin to Ingrid Johnson’s Kitty Parfait method (2013). When the wellness staff member administering the parfait approaches the rat’s cage, D’Artagnan moves to the front of the kennel toward the syringe. While the medication in the syringe may not be palatable to him, he unfailingly ingests it, knowing that the meat follows. With the parfait approach in place, there has been no trouble medicating D’Artagnan. 

Figure 6. D’Artagnan positioning himself at the front of his cage to take his medicine.

The partnership between the behavior and medical departments has been the catalyst for these relatively small changes in the routine procedures of the medical department. Though these changes are simple and relatively easy to implement, they have greatly reduced the level of stress experienced by our animals at the hands of shelter personnel.

Collaboration in the field

The ripple effect of the collaborative relationship between the two departments does not end with the animals in shelter custody, but also extends to members of the public. In March 2020, when the COVID-19 pandemic began in earnest in the United States, FFL started offering free curbside veterinary clinics on a biweekly basis to the community. During these clinics, FFL provides exams and tests, routine vaccinations, heartworm and flea preventative, and food at no cost. During an average clinic, FFL administers approximately 200 vaccinations and conducts nearly 80 heartworm and 20 FeLV/FIV combo tests on approximately 100 dogs and cats total. Some of these animals have never received veterinary care or been appropriately socialized, and about half of them demonstrate fear-related behaviors toward novel people and environments. 

Veterinary visits can be intimidating for animals under the best of circumstances, and the pandemic makes matters worse; social distancing forces animals to receive medical care while their owners remain in the car. Our clinic lead, an IAABC ADT, knew this reality made it even more important to find ways to minimize the animals’ stress during their visit.

During the early stages of the clinic, the FFL clinic lead consulted with the veterinarian and veterinary technicians to establish the most ideal, least stressful handling restraint techniques. These recommendations were combined with our behavior best practices of utilizing positive reinforcement and establishing individual animal preferences, including treat choice, whether they like affection, handler preference, specific equipment, and different handling or restraint techniques.

The animals are treated in a large, open warehouse space donated to FFL for the clinics. When designing the clinic setup, the clinic lead and veterinarian considered where and how to arrange the treatment areas, allowing efficient medical treatment while minimizing potential stressors for the animals by: 

• Limiting the distance that the animals must travel from their caregiver’s vehicle
• Maintaining a low handler to patient ratio (one handler:one animal)
• Providing adequate space so that patients do not feel threatened
• Erecting visual barriers to separate animals from different households
• Ensuring the lowest possible noise levels within the area
• Using minimal handling and restraint

Animal handlers and veterinary technicians work hand in hand to adhere to least intrusive, minimally aversive (LIMA) principles and ensure that each animal is handled on a case-by-case basis and in a way that least stresses the animals. Sometimes it’s as simple as gently holding the animal and giving out treats – hot dog pieces, cut-up chicken, squeeze cheese, or peanut butter – during an exam, blood draw, or nail trim. Other times, the new environment, combined with complete strangers and the invasiveness of a veterinary exam, is more difficult for the dog, and the handler/technician teams discuss how best to handle each animal based on the behaviors exhibited.  

With these more challenging cases, the FFL clinic lead and veterinarian review the animal’s behavior together and establish the best course of action to safely provide the care that the animal requires. At times, we may decide to follow an alternative path to provide the least stressful experience overall, including taking the animal closer to the car with the owner, bringing the owner into the treatment space, dispensing pre-visit medication and rescheduling the animal, or having the animal visit the shelter.

Figure 7. A handler delivers squeeze cheese to a dog to minimize their stress during their visit to the FFL free drive-thru clinic.

By collaborating proactively and in the moment, the behavior and medical teams create the most pleasant veterinary visits possible for the animals. One clinic client even emailed to say that “the care and respect shown to the animals and everyone was well beyond anything I’ve ever experienced in the pet field or medical field. I’ve been to numerous doctors over my lifetime and wish a lot of them were as caring as your employees.” This collaboration truly does benefit both the animals and the people involved.

Conclusion

Humane organizations have the best interests of companion animals at heart and do their best to remain animal-centered in the face of a pervasive overpopulation problem. Overwhelmed shelter departments often focus on their individual priorities, resulting in a silo mentality and a fractured, inefficient organizational culture. Most of all, the separate operation of behavior and medical teams does not enhance the overall well-being of the animals in their care.

Since that first moment that our wellness and behavior managers made a conscious effort to bring our teams together, we have seen the following advancements in our shelter programs: 

• A comprehensive cooperative care program allows resident animals to participate voluntarily in blood draws, vaccinations, nail trims, and other routine procedures. Because the animals feel in control of what is happening to them, medical visits are safer and less stressful for them and their handlers.
• Cross-training is the norm, with the behavior team receiving training on how to handle needles, give injections, and draw blood, and the medical team receiving training on reading body language and low-stress handling. 
• Joint approaches result in more efficient resolution of shelter behavior and medical cases.
• Medical exams, preventative procedures, and treatments are carried out in a less invasive fashion, prioritizing the emotional health of the animal.
• Our post-adoption counseling includes an emphasis on training to reduce stress during routine husbandry practices.
• Our curbside clinic reaches far beyond the shelter, offering services to the public with a LIMA approach in mind, impacting community animals despite only getting a few minutes with each one.

A synergistic approach to animal sheltering is within reach for humane organizations at a wide range of available resource levels. Making strides toward animal-centered ideals in shelter behavior and medicine is not an all-or-nothing concept. A humane organization without paid behavior staff may decide to adopt one or two changes to make medical procedures less intrusive, for example. At FFL, with each new collaborative effort, this integrated approach became easier and easier to apply to other areas of shelter operation. At times, it may seem to our own team that we have come so far and invested so much, but then we remember – it all started with just one dog.

References

American Association of Feline Practitioners. (2018). How to Feed a Cat: Addressing Behavioral Needs. 

Hoffman, D. (2018). Increased Animal Welfare at the Houston Zoo through Training. Presentation: IAABC Animal Behavior Conference, Houston, TX, United States.

Johnson, I. (2013) Medicating Tricks and Tips. Fundamentally Feline, July 22, 2013. Retrieved January 08, 2021.

Patel, C. (2015) The Bucket Game Introduction Part 1. Retrieved January 08, 2021.

Acknowledgements

Thank you to:

• Laura Thomasson, Suzanne Turner, and Alese Zeman for providing invaluable input throughout the writing process.
• Beth Brown, PC Chang, and Olivia Sison for sharing their photos and videos with us.
• Dulce Garcia, Shuyan Huo, Erin Stewart, Joanna Wachowiak-Finlaison, and Sherry Waddell for appearing in those photos and videos.

Melissa Taylor is the Behavior and Training Manager at Friends For Life Animal Shelter in Houston, Texas. Melissa has logged more than twenty years in shelter animal behavior, starting with an internship at the ASPCA’s Animal Behavior Center in New York City. She developed a lasting love for cooperative care from training livestock and wildlife as the Coordinator of the Behavior and Training Department at the Houston SPCA, and applies the same principles to the dogs, cats, exotics, and humans she works with now at Friends For Life. Over the course of her career, she has focused on the development of shelter humane education programs, particularly those for volunteers, with the intention of mentoring new companion animal trainers and behavior consultants with practices steeped in evidence and based on building trust, security, and partnership. Melissa has started several shelter behavior volunteer programs and consults with other humane organizations on starting such initiatives of their own.

Lori Seelhoff, DVM, graduated from Texas A&M University in 1992 and Texas A&M Veterinary College in 1996. She has worked in small animal practices ever since, first in Central Florida for 18 years and now in her hometown of Houston, Texas. Her professional interests include feline medicine, emergency medicine, soft tissue surgery, and volunteering in animal welfare/rescue. Outside of her clinic, she is actively involved in Friends For Life Animal Shelter as both a board member and their medical director. 

Jennifer Pallanich, CPDT-KA, is an animal care specialist and behavior volunteer at Friends For Life Animal Shelter in Houston, Texas. Most of her career has been spent as a trade journalist covering the oil & gas industry. She has since shifted her career to focus on animal behavior and sheltering and uses her writing skills and animal behavior knowledge to share ways to improve the lives of shelter and companion animals and their people.