Community-Facing Shelter Medicine

The welfare of companion animals is connected to larger systemic and institutional challenges faced by pet owners. Issues such as veterinary care "deserts" (areas with a shortage of accessible veterinary care), poverty, and resource inequity create service gaps for pet owners and pets in underserved areas. Millions of pets live in households of extreme poverty—perhaps more than triple the number of animals receiving services in animal shelters (1, 2).

The benefits of the human-animal bond transcend socioeconomic, racial, and geographical boundaries. Low-cost, accessible veterinary wellness clinics for populations with limited means help promote animal welfare and access to the advantages of pet ownership.

Low-cost clinics also benefit the shelters, as access to affordable veterinary care helps prevent animal surrenders to shelters for medical reasons.

Outreach vaccination programs can suppress outbreaks of infectious diseases among pets in the community and decrease the expression of community-acquired infectious disease in incoming shelter animals.

Benefits of offering spay and neuter outreach programs include the following:

• fewer free-roaming cats and dogs in the community

• fewer animals in need of sheltering services

• lower shelter euthanasia rates

• improved individual animal welfare through the decrease of sex hormone–related diseases and behaviors

• improved quality of life for people in the community as a result of fewer animals with problem behaviors

Various animal shelter initiatives—such as spaying and neutering all shelter animals before placing them in adoptive homes, early-age spay and neuter outreach programs, and mobile spay and neuter programs—help to deliver services to otherwise functionally inaccessible animal communities.

High-quality, high-volume spay and neuter (HQHVSN) services are efficient surgical initiatives that provide accessible, targeted sterilization of large numbers of cats and dogs to decrease overpopulation and subsequent euthanasia. HQHVSN programs meet or exceed veterinary medical standards of care.

Clear communication with clients, appropriate patient selection, and a focus on patient safety increase the quality of patient care and decrease exposure to legal liability.

The following are important components of an effective HQHVSN program:

• protocols for the safe and humane housing and handling of patients

• rigorous infection control procedures

• proper recordkeeping practices

• emergency readiness protocols

• follow-up and emergency care plans

Spay and neuter programs require safe and efficient drug protocol selection, perioperative care, and monitoring to facilitate the spaying and neutering of many animals in a short period. Balanced anesthesia—the administration of a combination of drugs—to safely produce effective analgesia, loss of consciousness, muscle relaxation, and immobility without patient compromise is vital. Each patient should be monitored from the time of premedication and anesthesia administration through the recovery period.

Fluid therapy is not necessary for all elective procedures, especially when the patient is healthy and the procedure is brief.

Many acceptable variations of surgical procedures can be used to spay or neuter cats and dogs. The type of procedure, including length and location of the surgical incision and the ligation and closure techniques, will vary with the veterinarian’s training, experience, and preferences, as well as the individual patient’s needs. Efficiency of movement, gentle tissue handling, hemostasis, and aseptic technique contribute to a repeatably safe, swift surgery and recovery.

Postoperative care, including pain management, helps to ensure the safety and effectiveness of HQHVSN programs.

Free-roaming community animals (unowned, unhoused animals living freely in the community), especially cats that have never become accustomed to living indoors or with people, do not thrive in captivity. A good quality of life for such animals may be attained by trap-neuter-vaccinate-return (TNVR) programs(also known as return-to-field or trap-neuter-release programs). Such programs are often managed or supported by local animal shelters.

Communities that actively manage community-animal populations can rehome friendly and neonatal animals found in colonies to adoptive homes. Over time, management with TNVR programs can appreciably decrease community-animal populations and improve the health of animals that will not do well in captivity.

TNVR programs also alleviate public health and nuisance issues associated with free-roaming animals.

Animal shelters sometimes offer educational programming to the community to promote animal welfare, awareness of career pathways in related fields, empathy and kindness toward animals, and public health and safety. Typical programs include the following:

• puppy socialization classes

• dog training classes

• programs for schoolchildren to teach them safe behavior around dogs

• animal CPR classes for pet owners

• general animal care programming

Some shelters partner with programs to have nonviolent criminal offenders in prisons raise and train puppies and dogs destined to become service dogs (eg, guide dogs) or working dogs (eg, police dogs). These programs promote the use of positive reinforcement for behavior modification and are mutually beneficial for the inmates and the dogs.

Another type of prison partnership allows dogs undergoing heartworm treatment to live with inmates. Such pairings help the dog by restricting its exercise and enriching its interactions with humans during the treatment period.

Animal shelter workers, animal control officers, and first responders may be called to scenes of animals in distress, such as being stranded on thin ice, in treetops, in deep holes, or in swift waters. Although first responders may be highly competent at the technical rescue of humans, they may have little or no guidance or training in conducting animal technical rescues.

Technical rescue workers should be trained in the inherent perils of technical rescue and the proper use of equipment. Organizing and executing a rescue so that it minimizes the risk of harm to the animal in distress and the rescuers requires extensive training and a clear understanding of the role of each member of the rescue team.

Offering technical rescue services not only has obvious benefits for animals but also helps the sheltering organization demonstrate actionable kindness and decreases the risk to bystanders who might try to perform their own rescue without proper training or equipment.

• Association of Shelter Veterinarians’ Veterinary Task Force to Advance Spay-Neuter. The Association of Shelter Veterinarians' 2016 veterinary medical care guidelines for spay-neuter programs. J Am Vet Med Assoc. 2016;249(2):165-188.

• Return-to-field handbook. HumanePro, Humane World for Animals.

• Burke H. Pets in prison: the rescue dogs teaching Californian inmates trust and responsibility. Guardian. April 19, 2020.

• Also see pet owner content regarding the human-animal bond.

1. 20 million pets in the US experience poverty with their families. News release. Humane World for Animals. May 6, 2024. Accessed September 19, 2025.

2. US animal shelter statistics: 2024 animal shelter statistics. ASPCA. No date. Accessed September 19, 2025.