Animal hoarding: Its roots and recognition

IN OUR PROFESSION, we regularly discuss the veterinarian's role in recognizing and reporting suspicions of deliberate animal abuse.1-3 It is a positive step for the profession, for animals, and for society that veterinary medicine has embraced responsibility for preventing cruelty to animals. But we also need to attend to a more subtle and less well understood form of severe cruelty: the chronic, large-scale neglect that occurs with animal hoarding.

Animal hoarding is a pathological human behavior that involves a compulsive need to obtain and control animals, coupled with a failure to recognize their suffering. And like other forms of animal cruelty, hoarding can sometimes be a sentinel for serious neglect of people, particularly dependent children, the elderly, or people living with disabilities (see boxed text "Links with human neglect"). Thus, from both an animal welfare and a public health perspective, animal hoarding merits our attention.

Links with human neglect

The accumulation and neglect of large numbers of animals by caregivers or owners was first described by Dooley Worth and Alan M. Beck in 1981. Their report detailed 31 cases of multiple-animal ownership in New York City.4 Subsequently, reports from animal welfare agencies have documented that hoarding cases are not uncommon and occur nationwide. The animal victims are often subjected to severe lack of sanitation, disease, crowding, confinement, and starvation, and they often die—all of which go unrecognized by the hoarder. Frequently, the shared human and animal living spaces are so filthy and full of trash they are deemed uninhabitable.

The term animal hoarding was coined in 1999 by the Hoarding of Animals Research Consortium (HARC)—a group of mental health, social service, veterinary, and animal welfare experts—because the then widely used term for this problem embraced by animal shelters—animal collecting—was more consistent with a benign hobby than with the reality experienced by the animal victims of this behavior.5 In contrast, hoarding, an accepted term applied in the medical literature to the pathological accumulation of inanimate objects, is frequently suggestive of squalor, impaired functioning, and a wide spectrum of psychological comorbidities (see boxed text "The psychology of animal hoarding").6,7

Several surveys suggest that at least 3,000 cases of animal hoarding occur annually in the United States, involving at least a quarter-million animals.5,8 Many other cases likely remain undetected because of the secretive nature of animal hoarders. The average number of animals involved per case has a skewed distribution. A median of 39 and 47 animals has been reported in two case series,5,8 but some cases involve hundreds of animals.

The psychology of animal hoarding

Every veterinarian is likely to encounter hoarding in practice. However, clues to its presence can be subtle and easily misinterpreted because, unlike with deliberate abuse, overt intent to harm is absent, and some hoarders may masquerade under the guise of legitimate shelters, sanctuaries, hospices, or rescue groups. A further complication is that the public persona of an animal hoarder may be sympathetic and persuasive.

Features of animal hoarders

Common features of hoarders include poor insight, lack of resistance to the compulsion to hoard, and poor treatment motivation.7 HARC has defined an animal hoarder as someone who5

• Accumulates a large number of animals

• Fails to provide even minimal standards of husbandry and veterinary care

• Fails to act on the deteriorating conditions of the animals or environment, even if the animals are starving, diseased, or dying

• Fails to act on the negative impact of the hoarding on his or her own health and well-being and that of other household members.

This failure to act is accompanied by varying—and typically large—degrees of denial regarding the extent of the deterioration.

Since Worth and Beck's report in 1981, a second case series formally detailed the severe impairment in household functioning observed in cases of animal hoarding,8 and another speculated on possible psychological underpinnings.9 Two reports in a law journal have described case features as well as the legal difficulties encountered during intervention.10,11 One of these reports discusses a single case in some detail: that of a woman who traveled across the United States with 115 dogs confined to a bus and who resisted or eluded all attempts at intervention until she was finally arrested in Oregon in 1993.10 Her trial ultimately involved eight court-appointed lawyers, six judges, and three prosecutors. Although her case may have been unusual in the protracted trial proceedings, other features were quite typical. Features of some representative cases are listed in Table 1. A comprehensive national database of hoarding case reports can be found at www.pet-abuse.com.

Table 1 Examples of Recent Animal Hoarding Cases

Animal hoarders are typically single, older, socioeconomically disadvantaged females who live alone.5 However, this behavior can cross all socioeconomic and demographic boundaries. Ample reports of animal hoarding exist involving men, married couples, families, people with white-collar jobs, and even healthcare professionals such as physicians and nurses. Sadly, and perhaps most paradoxically, documented cases of veterinarians who are animal hoarders exist as well.

The list of animal species hoarded is long and varied. Cats, and to a somewhat lesser extent dogs, are the most commonly hoarded species, likely due in part to convenience. But hoarding of farm and wild animals has also been reported, including horses, birds, reptiles, rodents, and both native and foreign wildlife species. The underground trade in exotic and endangered species, facilitated by the Internet, has made it surprisingly easy for private individuals to acquire poisonous vipers, primates, tigers, wolves, and other animals that pose inherent dangers to the hoarder as well as the community.

Table 2 Types of Animal Hoarders and Their Defining Characteristics*

A particularly insidious form of animal hoarder is the institutional or quasi-institutional hoarder. These individuals masquerade (often quite effectively) under the guise of legitimate shelters, sanctuaries, hospices, rescue groups, or foster care providers. Often the deception is sophisticated and deliberate and may serve both as a conduit for donations as well as a way for these individuals to obtain an air of legitimacy, which furthers their ability to obtain animals. Some hoarders may even have official nonprofit status or may pursue such a designation if they feel threatened.

Three types of animal hoarders

If anything characterizes animal hoarding, it is the heterogeneity of the syndrome. As with the hoarding of inanimate objects, which is described as the final common pathway of a variety of psychological disorders,12 HARC thinks there is considerable variation in the precipitating factors that result in animal hoarding. This finding is critical to intervention, as personal experience has taught us that a one-size-fits-all solution does not exist.

Figure 1. The relative time frame for deterioration of husbandry conditions for different types of animal hoarders.

At a workshop in April 2004, an expert panel, which included mental health, social service, and law enforcement personnel experienced with animal hoarding cases, proposed that based on differences in how hoarders related to people and animals, they might be grouped into three types: the overwhelmed caregiver, the rescuer, and the exploiter (Table 2).13 The three types can possibly be distinguished in terms of the pace at which care lapses (Figure 1). The intensity of intervention needed to successfully improve conditions likely varies depending on the type of hoarder as well (Table 3). For example, if a veterinarian-client-patient relationship based on trust and concern can be developed with overwhelmed caregivers, veterinarians may be able to help them improve their level of care, reduce the number of animals they have to a manageable number, and accept help from other appropriate resources. In contrast, such an approach is not likely to be of use with the exploiter type, who will likely require more aggressive forms of intervention driven by law enforcement personnel.

Barriers to resolution

Animal hoarding is a complex phenomenon that does not lend itself to easy solutions. Barriers to resolving and preventing hoarding exist at numerous levels (e.g. legal, regulatory, medical, and societal). Lack of awareness of hoarding is the first and most global barrier, and veterinary professionals can help raise this awareness. The veterinary profession can help address three other closely linked barriers:

• A lack of legally mandated husbandry standards for animals kept in private or nonprofit institutional or quasi-institutional settings such as shelters, rescue operations, foster care, sanctuaries, and hospice.

• A failure to assess the psychological suffering animals experience from long-term crowding and lack of socialization accompanied by an inability or unwillingness to convey this suffering to authorities.

• A failure to recognize the cumulative effects of long-standing substandard conditions.

Table 3 Intensity of Intervention Required for Different Types of Animal Hoarders*

Lack of regulation

Animal care in shelters, sanctuaries, rescue operations, foster care settings, and hospices—whether private or nonprofit—is largely unregulated. The Federal Animal Welfare Act, which applies to dealers or laboratory animal facilities, does not apply to these operations. National animal welfare groups such as the ASPCA or the Humane Society of the United States (HSUS) are not umbrella groups for local shelters and have no authority to regulate their activities or set standards of care. Other than the Colorado Pet Animal Care and Facilities Act (Colorado Statute 35-80-101), I am not aware of any in-depth standards at the state level that apply to the broad range of facilities and individuals who may provide care for unwanted animals, particularly long-term. Some states may have generic kennel regulations, but these are typically limited in scope, represent a minimum standard of care, and do not address issues of long-term confinement.

One consequence of failing to legally mandate husbandry standards for these types of institutional or quasi-institutional settings is that assessments of proper care become obvious targets to dispute. When called on to evaluate husbandry in these settings, veterinarians must make use of available objective standards to bolster their professional judgment. Guidelines for companion-animal care in shelters and animal rescue operations recently issued by the American Veterinary Medical Association (AVMA) are available.14 The Tufts Animal Care and Condition (TACC) scales can also be a useful tool when triaging large numbers of animals and succinctly summarizing their conditions.3,15,16 Veterinarians should not underestimate the value of their own professional opinions as animal care experts, drawing on these other resources when appropriate.

Unrecognized psychological suffering

Confirming the extent of poor husbandry is an important step in establishing that animal neglect has occurred. However, veterinarians, other animal care professionals, and most pet owners intuitively recognize that meeting the letter of the law regarding husbandry may not preclude poor welfare. Particularly in a hoarding situation, there may be substantial suffering from long-term crowding, intensive confinement, lack of exercise, and lack of socialization. Demonstrating this poor quality of life may be particularly critical in cases in which the basics of food and water are minimally present and the medical conditions are not dire, or when problems may be less severe for some animals than others (e.g. newly acquired vs. those in long-term care). Ironically, saving animals from euthanasia is likely the most common defense proffered for even the most egregious lapses in care (e.g. those resulting in large-scale starvation and death as a result of being '"saved"). Such a defense should be rejected out of hand.

Veterinarians are in a position to educate authorities about animals' psychological suffering because of our expertise and training. A large body of scientific literature is available regarding the importance of addressing the behavioral needs of animals in zoo, laboratory, and farm settings to ensure psychological well-being; much of this information is accessible in a recently edited volume on assessing quality of life and mental well-being in animals.17 Ultimately, veterinarians need to be confident in their professional judgment and should avoid the temptation to make excuses for substandard care or be swayed by a hoarder's claims of good intentions.

How can veterinarians help stop animal hoarding?

Failure to recognize harm or neglect of multiple animals

Finally, I believe a substantive difference exists between the neglect of an individual animal and the suffering that may occur when multiple animals are kept together for extended periods in conditions of crowding, squalor, poor medical care, and lack of socialization. Suffering is magnified in large groups of neglected animals because these animals may be stressed by aggression from other animals, may have to fight for food or protect litters, may be exposed to contagious disease, and may endure the proximity of predator species.

When multiple individual indicators of well-being (body condition, coat, sanitation, health, behavior) simultaneously deteriorate to varying degrees over a period in many animals, such deterioration is often not recognized (or is impossible to establish under current cruelty laws) as part of an overall pattern of chronic neglect and suffering, which is far more severe than deterioration of any individual factor. When the focus is on evaluating each animal only individually, without the context of environment and duration of neglect, important considerations may be lost.

We need to find more effective ways to establish the extent and duration of neglect necessary for conditions to finally deteriorate into a hoarding situation. Veterinary input is critically needed to help courts understand the big picture, in which the whole may be much worse than the sum of its parts (see boxed text "How can veterinarians help stop animal hoarding?").

What to do if you encounter an animal hoarder

Every veterinarian in companion-animal practice is likely to encounter animal hoarders at some point. You will need to judge each situation individually, carefully considering the degree to which you wish to become involved.

Veterinarians have an ethical duty to report suspected animal abuse, and in 14 states there are statutes protecting them from civil and criminal liability for reports made in good faith. But reporting animal abuse is not always as simple in practice as it sounds in theory. Although every state has statutes that criminalize animal abuse, the enforcement of these laws is by no means uniform and often exists at the local, rather than the state, level. For example, in many communities, investigative authority may rest in a local humane society or Society for the Prevention of Cruelty to Animals (SPCA) with police powers or a municipal animal control office, which is often based within the police department. Some communities may have no separate entity for enforcing these laws, which are then left to the appropriate arm of the local police, sheriff, or municipal animal control. So before you encounter a case, identify and become acquainted with the appropriate authorities in your area. Given the sensitive nature of these cases and legitimate concerns about confidentiality, developing a working relationship with the executive director, board president, administrator, or chief investigative officer will help you better understand how a case will be approached, what options are available for intervention, and what role, if any, you as the reporting veterinarian might be expected to play as the case unfolds.

Veterinarians may be reluctant to report hoarding for a variety of reasons, including concerns about breaking confidentiality, unwillingness to become involved in a protracted legal proceeding, fear of retaliation, or a belief that an adversarial process is not likely to serve either the client or the animals well. This reluctance is another reason for consulting with the appropriate investigative agency before a case arises and for becoming involved in, or initiating, a community-wide interdisciplinary task force that has the mandate and ability to address suspected cases of animal hoarding and abuse. By understanding each other's concerns, we can creatively resolve abuse problems in a manner everyone is comfortable with. The benefits of an interdisciplinary approach to addressing animal hoarding are described in an informative report, available online at no charge at www.tufts.edu/vet/cfa/hoarding.13

Some veterinarians may choose to become more directly involved in hoarding cases, helping with animal rescue and evacuation, collecting evidence, and providing expert testimony. These areas of involvement increasingly require specialized expertise, and veterinarians are strongly advised to become familiar with principles of animal evacuation and rescue, evidence collection, and courtroom testimony. An excellent reference for these issues is the recent shelter medicine textbook edited by Drs. Lila Miller and Stephen Zawistowski of the ASPCA in New York.16 For additional information about animal hoarding, consult the HARC Web site, www.tufts.edu/vet/cfa/hoarding.

Gary J. Patronek, VMD, PhD

Center for Animals and Public Policy

Cummings School of Veterinary Medicine

Tufts University

North Grafton, MA 01536

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