Is non-surgical sterilization the best use for $75 million?

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From ANIMAL PEOPLE, October 2008:

(Actual publication date 11-5-08.)

 

 

Is non-surgical sterilization the best use for $75 million?

 

 

CHICAGO--Anxiety tempered enthusiasm as

325 delegates to the Spay USA conference in

Chicago on October 17, 2008 applauded the Found

Animal Foundation pledge to invest $75 million in

the quest to develop a non-surgical method of

sterilizing dogs and cats. Almost everyone had

questions with no quick answers.

First and easiest were questions about

who Found Animal Foundation founder Gary K.

Michelson is, and whether his commitment is

genuine. Michelson has until now been barely

known to animal advocates even in the Los Angeles

area, where he lives and where the Found Animal

Foundation is based.

Found Animal Foundation executive

director Aimee Gilbreath and Alliance for

Contraception in Cats & Dogs executive director

Joyce Briggs and outreach director Karen Green

repeatedly reassured Spay USA delegates that the

$75 million is real money.

Some Spay USA conference attendees

wondered whether they could entice their

veterinarians or friendly scientists in their

communities to start projects that would qualify

them to apply for some of the money. But,

except for a few vets who had already

experimented with non-surgical sterilization

methods, most had little idea where to begin.

Many conference attendees asked if Found

Animal Foundation money might also be available

to help sustain struggling surgical sterilization

programs. Funding for low-cost and free dog and

cat sterilization has diminished with the

resources of donors hit by the collapses of the

stock and mortgage markets. At the same time,

sterilization programs from all over the

U.S.--and around the world-- report increased

demand for their services.

Personnel at both the Pets Are Worth

Saving and Anti-Cruelty Society sterilization

clinics in Chicago mentioned to tour groups from

the Spay USA conference that some of the

increased demand comes from former generous

donors who have fallen on hard times.

Several Spay USA attendees, after

spending heavily on equipment and facilities to

do high-volume, low-cost surgical sterilization,

expressed concern that a move to non-surgical

sterilization might leave them without a revenue

stream to pay off their investment.

Some veterinary surgeons worried that

they might be working to perfect and teach

soon-to-be-obsolete skills.

But as Gilbreath told ANIMAL PEOPLE,

perfecting a non-surgical sterilization method

that qualifies for the Michelson prize will not

be accomplished overnight. Neither does

Michelson expect a non-surgical method to replace

sterilization surgery, Gilbreath explained,

although a non-surgical method that achieved the

same benefits in preventing aggressive behavior

and protecting the health of pets would be

welcome.

The main purpose of developing a

non-surgical sterilization method, Gilbreath

emphasized, is extending the reach of dog and

cat sterilization methods to the people, places,

and animals who are still not served.

Currently, 73% of the U.S. pet dog

population and 86% of the pet cat population are

sterilized, according to marketing research by

the American Association of Pet Product

Manufacturers. Most of the U.S. has not had

street dogs in visible numbers in several

decades. The feral cat population appears to

have dropped by 75% or more within ten years of

the introduction of neuter/return cat control to

the U.S. in 1991-1992.

However, the rapid progress in reducing

animal shelter admissions and killing of homeless

animals achieved during the 1980s and 1990s has

tapered off in the present decade. Drops of a

million shelter deaths per year were accomplished

then, mostly by persuading average pet keepers

to sterilize their animals, and helping them to

do it affordably and conveniently.

Now that the total volume of animals

coming to shelters is less than half of the

number who were killed in shelters 25 years ago,

achieving further reductions requires reaching

the hard cases: the poorest, most remote,

and/or most ignorant of pet keepers, and in the

case of cats, the ferals who are hardest to trap.

The Found Animal Foundation hopes that a

non-surgical sterilization method will ease and

expedite handling the hard cases. In particular,

the Found Animal Foundation hopes to prevent the

estimated 50% of dog litters and 75% of cat

litters that are not planned, about 80% of them

born to mothers who are sterilized later.

The classic dilemma of too many dogs and

cats being born to fill the niches in available

homes has shifted in the U.S. to the point that

almost all dogs entering shelters, and many

cats, once had homes, but for various reasons

lost them. The problem now centers on reducing

dog and cat births to where dogs and cats are no

longer easily available to pet keepers who fail

to keep the animals from roaming, neglect them,

or easily abandon them if they become

inconvenient.

In developing nations the shape of the

issue is considerably different, and the

potential for using non-surgical sterilization

appears to be far greater. In most of the

developing world, fewer than half of all dogs

and cats have ever had homes. Though many are

fed, as " community pets, " most do not have

primary caretakers who can be persuaded to take

them to a clinic--even a free clinic--for

sterilization surgery. Animal control typically

consists of poisoning dogs and cats rather than

impounding them.

Surgical sterilization is already

officially the animal control method of choice in

much of the developing world, though often not

actually done, and is mandated in India,

Turkey, and Costa Rica.

On October 3, 2008 the Veterinary

Department of Serbia became the most recent of

dozens of national public health agencies to

endorse dog and cat sterilization in concept, in

place of impounding and killing homeless animals.

But as Serbian animal advocate Slavica

Mazak Beslic pointed out after the announcement

ceremony, the Serbian recommendation did not

come with any funding and still does not have the

force of law. Beslic told ANIMAL PEOPLE that

what she wants to see is a mandate that redirects

funding from paying garbage collectors to catch

and kill dogs and cats, to paying veterinarians

to sterilize dogs and cats.

This should be coordinated, Beslic said,

with a campaign now underway to eradicate rabies

by distributing oral vaccine baits to wild foxes.

Vaccinating dogs and cats, and sterilizing them

to prevent births of unvaccinated offspring,

would reinforce the fox vaccination effort.

For now, in Serbia as elsewhere,

actually obtaining surgical sterilization service

adequate to replace killing animals has proved

much more difficult than winning endorsements

from governments.

Even when governments put significant

money into surgical sterilization, the funding

tends to fall far short of the need.

The Blue Cross of India demonstrated

surgical sterilization as a method of controlling

the street dog population in Chennai in 1964,

but the Animal Welfare Board of India did not

recommend funding the Animal Birth Control

program to the national government until December

1997. Eleven years later, after a decade of

federal funding partially matched by municipal

governments, the Indian ABC program still

reaches only some major Indian cities, with no

presence in most rural districts.

Other bottlenecks in India include an

acute lack of veterinarians trained to operate on

dogs and cats. A lack of veterinary technicians

often means that Indian veterinarians cannot make

efficient use of their time.

But the most pervasive problem among

Indian ABC programs may be that the vets and vet

techs they have tend to use obsolete surgical

methods. Trained to operate on cattle rather

than small mammals, many make large rather than

minimal surgical incisions; use multiple sutures

to close the unnecessarily large surgical wounds;

fail to maintain strict surgical ascepsis; rely

on antibiotics rather than ascepsis to prevent

post-surgical infection, and hold animals for

three to five days after surgery--sometimes

longer--to ensure that sutures do not open and

wounds do not become infected.

Long post-surgical holding times tend to

overload shelter clinics. The central Tamil city

of Salem in October 2008 tried to solve that

problem by housing about 40 sterilized dogs in

the unused former communicable disease ward of a

city hospital serving a low-income neighborhood

called Ammapet. The hospital mainly provides

obstetric service to the indigent.

" The dogs are kept in the most unhygienic

environment, and the entire area is stinking, "

alleged The Hindu. " Their barking and howling

all through the day and night have not only

disturbed the patients but also the health staff

of the hospital. "

A source described by The Hindu as " a

resident " added that the dogs were not fed

regularly and properly, and were not treated for

post-operative complications, even though this

was why they were kept.

Trained by Bali Street Dog Project

surgeons from Indo-nesia, Animal Help Ahmedabad

founder Rahul Sehgal in 2005 introduced

U.S.-style high volume, same-day-release dog

sterilization to India. The Animal Help team

sterilized 45,000 dogs in 2006, but ran into

unforseen problems.

The first was opposition to same-day

release by much of the Indian humane community,

including People for Animals founder and former

federal minister for animal welfare Maneka

Gandhi. Ms. Gandhi maintained from the beginning

that same-day release could not be safely

practiced in India.

A second problem came when delays in

obtaining payment from the Ahmedabad city

government obliged Sehgal to lay off

veterinarians. Some who had not yet completed

training in the Animal Help methods were hired to

do ABC work in other cities, Sehgal told ANIMAL

PEOPLE, and botched it. Their failures fueled

the humane opposition.

Encountering continuing difficulty in

getting paid in Ahmedabad, Sehgal in 2007 took

his best vets to work in the suburbs of Bangalore

and Hyderabad. While the Ahmedabad ABC program

was interrupted, the unsterilized part of the

dog population bred back up to the carrying

capacity of the habitat, a city dog census

found. Animal Help has continued to work in

Bangalore.

Turkey mandated surgical sterilization

instead of poisoning street dogs in 2004, but

has never federally funded sterilization

programs. Some city dog sterilization efforts

have allegedly become conduits for routing public

funds to supporters of the politicians in

authority. Others have run afoul of officials

who just want to get rid of the dogs, have no

patience with methods that will take longer than

a term of office to produce results, and resent

the unfunded sterilization mandate.

In May 2008 more than 5,000 dead dogs

were reportedly found in 20-odd mass graves in

the Antalya suburbs of Kepez, Konyaalti, and

Muratpasa. Hundreds of puppies had been buried

alive. Many of the adult dogs had plastic ear

tags confirming that they had been sterilized and

vaccinated by veterinarians using the same

methods as Friends of Fethiye Animals, whose

success in reducing the Fethiye dog population

through sterilization inspired the national

mandate to sterilize dogs instead of killing them.

Prominently exposed and denounced by news

media, the killings shocked much of Turkey, not

least because Antalya, just 200 kilometers from

Fethiye, is among the most affluent cities in

the nation, frequented by European tourists.

Interior minister Besir Atalay convened a hearing

into the dog massacres. No one was criminally

charged.

Meanwhile, with the Antalya case still

in the headlines, similar killings came to light

in Karabuk, about 200 kilometers north of

Ankara, the Turkish capital, and in Kars, 100

kilometers west of the Armenian border.

Surgical sterilization has succeeded in

almost eliminating animal control killing in

Costa Rica, but Costa Rica likewises lacks a

nationally funded sterilization program.

Instead, sterilization surgery is made

accessible nationwide through a variety of

charities, whose work is endorsed but not funded

by the Veterinary Licensing Board of Costa Rica.

The largest of these charities is the

McKee Project, which has expanded to encourage

similar programs throughout Central America and

as far away as Argentina.

" I believe McKee has created a change

that will be lasting, " founder Christine

Crawford told ANIMAL PEOPLE, expressing

particular optimism about progress in Guatemala.

" The only veterinary school in Guatemala is now

training vet students in the McKee surgery

method, " Crawford said. " Unlike in Costa Rica,

where McKee met political opposition from time to

time, Guatemala has thanked McKee for showing

them practical humane solutions without having to

commit big mistakes to get there. "

Starting in 1998 with three veterinarians

trained by Spay USA, funded initially by a

bequest from California activist Mary Ann McKee

and several grants from the North Shore Animal

League, McKee has in turn trained " in the area

of 500 vets, " Crawford says, " in Mexico,

Nicaragua, and Panama, " as well as Costa Rica

and Guatemala. McKee has also trained U.S. and

Canadian veterinarians who visited Costa Rica to

learn techniques suitable for use in remote

locations.

But successful as the McKee Project is,

getting the surgeons to the animals or bringing

animals to the surgeons remains a bottleneck, in

a region where mountains, rivers, and swamps

tend to magnify the effects of bad roads and

distance.

Using an injectible

immunocontraceptive or chemosterilant to

sterilize dogs and cats would require only a

fraction of the equipment and facilities needed

to do conventional sterilization surgery. Mobile

clinics could fly from place to place.

Would-be developers have tried to

perfect an injectible dog and cat sterilization

method for more than 50 years. Though aware of

the need for non-surgical sterilization in remote

and low-income communities, where full-service

vet clinics are few and far between, most of the

researchers have hoped to pay off the development

costs by finding a method suitable for commercial

as well as nonprofit use.

As hormonal contraceptive pioneer

Wolfgang Jochle pointed out to the 2004 ACCD

conference in Breckenridge, Colorado,

commercial considerations have complicated the

development process.

One is that a commercially successful

non-surgical sterilization method might sell best

if it was reversable, unlike conventional

neutering surgery, so that a breeder could use

it to limit breeding, rather than altogether

preventing it. Another is that a non-surgical

sterilization product used in pets must be safe

for many times the usual lifespan of street dogs

and feral cats.

Nonsurgical dog and cat contraceptive

methods have often appeared to be almost ready

for the veterinary marketplace, and several

methods have actually been briefly marketed, but

unforseen complications each time caused the

products to be withdrawn.

The effect of withdrawing products from

the commercial market in developed nations has

often been to send the message to the developing

world that the products are categorically unsafe

and unsuitable. Continuing to investigate

refinements of these products in developing world

laboratories could be done for a fraction of the

cost of doing further research in the U.S. and

Europe, but except for the development of

zinc-based chemosterilants similar to Neutersol

in India, Brazil, and Thailand, little has

been pursued.

Meanwhile, advances in surgical

sterilization technique have enabled the most

skilled dog and cat sterilization specialists to

castrate male animals in as little as four

minutes, and spay females in as little as six

minutes. At that rate of speed, the difference

in veterinary time expended between surgery and

injection is slight, and surgery has advantages

in altering the behavior and improving the

longevity of animals that injectible methods so

far have not conveyed.

One of the long-sought advantages

anticipated from injectible sterilants was that

animals could be sterilized at any age. Since

1993, however, when early-age surgical

sterilization was endorsed by most leading

veterinary organizations and humane societies,

early-age sterilization surgery has become the

norm rather than the exception at U.S. clinics,

and is beginning to catch on worldwide--but not

without resistance.

ANIMAL PEOPLE recently visited the Bali

Street Dog Foundation and Bali Animal Welfare

Association clinics in Indonesia.

Founded in 1998 by Balinese vet Listriani

Wistawan and U.S. expatriate Sherry Grant, a

longtime Bali resident, the Bali Street Dog

Foundation originally operated under the umbrella

of the Yudisthira Swarga Foundation, named in

honor of a Hindu king who refused to enter heaven

without a street dog who had been loyal to him.

The foundation has taught high-volume,

same-day-release dog and cat sterilization

throughout southern Asia, including in Sri Lanka

and Banda Aceh after the Indian Ocean tsunami.

BAWA, founded by American expatriate

Janice Girardi, a 30-year resident of Bali,

handles the eastern side of the most populated

part of Bali. Working in temples and community

halls, the BAWA mobile clinic sterilizes about

40 dogs per day. Members of the BAWA

demonstrated safe dog-netting during the 2008

Asia for Animals conference.

Most of the BAWA veterinarians were

trained by the Bali Street Dog Foundation--but

BAWA does not do early-age sterilization surgery,

even though Girardi acknowledges that the biggest

obstacle they face in trying to reduce the local

dog population is that most of the dogs manage to

have a litter before they can be caught and

sterilized.

Veterinarians who practice early-age

sterilization have almost unanimously emphasized

to ANIMAL PEOPLE for more than 15 years that

young animals are easier to operate on because

their reproductive organs are not yet injured,

diseased, or misplaced, and that they recover

from surgery more rapidly, with less risk of

infection. Yet the BAWA veterinarians,

including visiting veterinary advisors from

Australia, insisted to ANIMAL PEOPLE that

early-age sterilization remained beyond their

ability.

Back in the U.S., early-age

sterilization practitioners who were told about

the BAWA perspective just shrugged. Similar

arguments used to be heard in the U.S., too.

Another long-anticipated advantage of

using an injectible sterilant was avoiding

complications of surgery, thereby enabling

clinics to hold animals for shorter post-surgical

observation and recovery intervals. The

introduction of gas anesthesia, however, has

almost eliminated complications of anesthesia

after sterilization surgery. Even where gas

anesthesia is not used, the advent of early-age

sterilization has given surgeons daily practice

at operating with minimal incisions, requiring

much less suturing and presenting far less risk

of becoming infected.

Early high-volume sterilization

clinics reported surgical complication rates of

up to 4%. Same-day release of altered male

animals was rare; same-day release of female

animals was unheard of.

Today, same-day release of all animals

is not only the norm but almost mandatory at many

major U.S. clinics, with high surcharges for

leaving an animal at a clinic overnight.

Post-surgical complications have become so rare

at clinics that practice small-incision surgery

with strict asepsis that the Foundation Against

Companion-animal Euthanasia, in Indianapolis,

did 14,000 surgeries before losing an animal-- an

older cat who had respiratory trouble under

anesthesia--and has now maintained a comparable

record through more than 100,000 surgeries since

mid-1998.

Emulating the FACE approach, with a

former FACE vet as chief sterilization surgeon,

the Chicago Anti-Cruelty Society did more than

13,000 sterilization surgeries in 2007 with only

four post-surgical complications. The

Anti-Cruelty Society has sterilized more than

75,000 animals under their adapted version of the

FACE protocol since 1999. The Anti-Cruelty

Society fee of $50 for holding an animal

overnight is as high or higher than the cost of

surgery, in part because keeping animals at the

clinic inhibits efficiency in doing the overnight

cleaning and maintenance that enables it to work

at high speed again the next day.

Both FACE, headquartered in a former

heavy equipment garage, and the Anti-Cruelty

Society, whose clinic was built in 1933,

demonstrate that technique rather than fancy

surroundings make the difference. What they do

could be done anywhere, with comparable emphasis

on cleanliness and economy of motion.

Yet another advantage of injectible

sterilization is that it could presumably be done

efficiently in remote locations. But remote

location surgery has also come a long way since

the first Spay USA conference back in 1993

featured veterinarians Jeff Young and Peggy

Larson explaining how they respectively converted

an old school bus and an old van into mobile

clinics.

Young, of Planned Pethood Plus in

Denver, visited Native American reservations

throughout the Rocky Mountains region,

eventually deciding that using a vehicle to haul

supplies to stock temporary clinics set up in

community halls or tents was more efficient than

trying to operate inside the vehicle.

Larson, in northern Vermont, found

that having volunteers deliver animals to her

fixed-site clinic made far better use of her time

than trying to go to where the animals were.

Soon after the first Spay USA clinic,

Philadelphia-area vet tech Liz Jones converted a

mobile home into a mobile sterilization clinic.

Jones learned that mobile homes are not built to

take the stresses that a high-volume

sterilization clinic must. Currently planning to

start a dog and cat sterilization program in

Tanzania, Jones is weighing the options among

mobile and fixed-site approaches.

Sean Hawkins, who in 1993 was just

beginning the Houston-based Spay-Neuter

Assistance Program under auspices of the Fund for

Animals, invested nearly 10 times as much on his

first mobile clinic as Young, Larson, and Jones

had. Hawkins' then-controversial decision to put

the clinic into a large heavy-duty truck turned

out to be the right choice among the available

options.

These days a mobile sterilization clinic

can be ordered ready to go from at least half a

dozen makers of veterinary and animal control

vehicles. Discussion of mobile sterilization at

the 2008 Spay USA conference consisted of a few

brief resumes of issues to consider in deciding

what kind of vehicle to order, chiefly from

Gregory Castle of the Best Friends Animal

Society's " No More Homeless Pets in Utah "

cmpaign, as prelude to much talk by Castle and

others about how to do the promotion and

community organization that is necessary to make

a mobile sterilization campaign succeed.

Personifying the transition from a focus

on technical issues to recognition of the

importance of community organizing might be

Oklahoma Spay Network coordinator Ruth

Steinberger, of Bristow, Oklahoma, who spoke

three times at Spay USA 2008. Steinberger,

neither a vet nor a vet tech, has only been

involved in animal work for a little more than a

decade. Her background is organizing for social

justice.

Known first on Native American reservations

for investigative exposés of miscarriages of

justice, published in Native Times and Lakota

Journal, Steinberger remains active on behalf of

human rights--but animal work now takes most of

her time.

Steinberger helps to facilitate more than

22,000 low-cost or free sterilization surgeries

per year for dogs and cats in the less affluent

parts of her own state, and assists similar

programs in other western states. In

appreciation of her work Steinberger received the

2006 Henry Bergh Award from the American SPCA.

What Steinberger does, and teaches, is

the groundwork needed to make any public health

campaign succeed, whether the subjects are

animal or human. If the groundwork is done,

Steinberger demonstrates, medical or veterinary

time can be used most effectively. If the

groundwork is not done adequately, a campaign

will not succeed, regardless of what medical or

veterinary techniques are used.

Steinberger worries that in times and

places where funding is scarce, dog and cat

sterilization programs will cut back on

organizing and outreach, to focus on providing

services while overlooking the necessity of

getting people to bring animals to use them. The

best way to make the most efficient possible use

of veterinarians and technicians, Steinberger

emphasized, is to make sure that the people and

animals are lined up waiting when the vets and

vet techs arrive.

Steinberger displayed slides of long

lines of Native American reservation residents

with their animals. Many had traveled for hours

before dawn to reach her clinics, and would

travel long into the night to get home.

--Merritt Clifton

 

 

 

--

Merritt Clifton

Editor, ANIMAL PEOPLE

P.O. Box 960

Clinton, WA 98236

 

Telephone: 360-579-2505

Fax: 360-579-2575

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