When the bond breaks: Relinquishment, hoarding and abuse: Part 1 (Proceedings)

The Association of Human Animal Bond Veterinarians defines the human animal bond as the relationship between people, animals, and their environment. Veterinarians should focus on providing education, resources and support to clients, the public and other professionals in order to create, enhance and sustain an ethical and mutually satisfying relationship between animals and people. When a positive bond has formed, not only do pets make us feel good, but now there is scientific evidence that they are good for our physical health as well. There has been widespread publicity about the emotional value of pets, particularly for troubled children, the elderly, and people recovering from major clinical illnesses like heart disease and depression. Much attention has been given to current medical research that reveals other positive aspects of pet ownership: i.e. reduction of stress, loneliness, blood pressure and the number of visits to the doctor's office. Pets are increasingly considered to be members of our families. It is reported that one of the main reasons people refused to leave New Orleans to escape the hurricane Katrina disaster was because the evacuation centers and shelters would not take their pets, and one of the reasons they returned to the area early was out of concern for pets they had to leave behind. The American Pet Products Manufacturing Association (APPMA) estimates that 63% of U.S. households own a pet, which equates to 69.1 million homes. They also estimate the amount of money spent on pet food, toys, accessories and veterinary care in the United States in 2006 was 38.5 billion dollars! This certainly paints a pretty picture of the human animal bond and the life of pampered dogs and cats in the United States.

However, what happens to these family members if the bond never forms or fails? The consequences are usually tragic for the animals, resulting in abandonment, relinquishment, or abuse. This is the part of the picture that still goes largely unnoticed by both the veterinary profession and the public. Animals who are victims of an unformed or broken bond often wind up as a problem for local humane societies and animal control shelters to deal with. No one knows the exact numbers, but the fact is that millions of animals are euthanized in animal shelters every year. Shelter euthanasia numbers may not be an accurate way to measure the scope of the pet population problem because many of these animals are surrendered specifically for euthanasia due to old age or medical problems in lieu of going to a private practice (Kass et al 2001), but the numbers are still unacceptably high. It has been said that the number one cause of death of dogs and cats in the US is euthanasia in an animal shelter, yet the veterinary profession has been slower to respond to this crisis of homeless animals than to diseases that kill far fewer animals. Many shelters are striving to reduce the number of healthy, adoptable animals who are euthanized every year through aggressive adoption and spay neuter programs, but one of the highest risk factors for death for dogs and cats in this country remains ending up in an animal control shelter.

One of the goals of The National Council on Pet Population Study and Policy (NCPPSP), a coalition of animal welfare and animal control organizations, breed groups, industry and veterinary professionals formed in 1993, is to conduct studies to determine the "number, origin and disposition of pets (dogs and cats) in the US and to recommend programs to reduce the number of homeless pets in the US." Members of the coalition include the American Humane Association (AHA), American Society for the Prevention of Cruelty to Animals (ASPCA), American Veterinary Medical Association (AVMA), the Humane Society of the US (HSUS), Cat Fanciers Association (CFA), American Animal Hospital Association (AAHA), American Association of Feline Practitioners (AAFP), Society of Animal Welfare Administrators (SAWA), National Animal Control Association (NACA) , Massachusetts Society for the Prevention of Cruelty to Animals (MSPCA), Association for Veterinary Epidemiology and Preventive Medicine (AVEPM) and American Pet Products Association (APPMA). The Council reached the conclusion that "many human-companion animal relationships fail because people have inaccurate and inappropriate expectations of their pet's medical and behavioral needs, and their role and responsibility in providing for these needs." In addition, they determined that the top ten reasons for dogs being relinquished to shelters included 1) Moving, 2) Landlord issues, 3) Cost of pet maintenance, 4) No time for pet, 5) Inadequate facilities, 6) Too many pets in home, 7) Pet illness, 8) Personal problems, 9) Biting, and 10) No homes for littermates. The top ten reasons for cats being relinquished to a shelter included 1) Too many in the house, 2) Allergies, 3) Moving, 4) Cost of pet maintenance, 5) Landlord issues, 6) No homes for littermates, 7) House soiling, 8) Personal problems, 9) Inadequate facilities, 10) Doesn't get along with other pets.

People will often tolerate many types of problems and hardships to keep their pets when a strong bond has formed. Veterinarians should be familiar with the issues that increase the risk of relinquishment of pets to shelters and be prepared to intervene on behalf of their patients and other animals to restore the bond when the appropriate opportunity presents itself. They can be instrumental in keeping animals in their homes by offering affordable behavior counseling and neutering services. In this period of economic decline, they can offer innovative ways for clients to pay for medical care to avoid relinquishment for expensive but treatable medical problems. Animals who have been neutered or been to a veterinarian for medical care have a lower risk of relinquishment than intact animals who have never received veterinary care. They should also work with shelter programs and encourage clients to adopt animals from a reputable shelter, breeder or rescue group rather than purchasing animals from a pet store. Reputable breeders and shelters will attempt to match a pet with the new owner's life style and expectations so that it is more likely that a positive, lifelong bond can be formed. Veterinarians can also support pet friendly legislation that allows pets in housing, and oppose breed specific insurance and breed bans that prohibit ownership of certain breeds. The reader is directed to the NCPPSP website at www.petpopulation.org for more information on this topic.

Animal hoarding is a subject that raises a lot of concerns and questions for veterinarians and other health care and law enforcement professionals. Most veterinarians will eventually encounter an animal hoarder yet they have received little, if any training on the recognition or management of this problem. On the surface, people who take in multiple animals may seem to epitomize the human animal bond at its best, but animal hoarding is a multifaceted problem that usually causes extreme animal suffering. The Hoarding of Animals Research Consortium (HARC) was formed in 1997 to take a multidisciplinary approach to study the problem. The various agencies making up the consortium changed the name of the problem from animal collecting to hoarding. A case definition of an animal hoarder from the Illinois statute is someone who 1) accumulated a large number of animals that overwhelmed their ability to provide minimal standards of nutrition, shelter, sanitation, and veterinary care; 2) denied the deteriorating conditions of the animals and environment; and 3) denied the negative impact of the collection on health and well-being of themselves or other household members. Some experts believe that many hoarders suffer from an obsessive-compulsive or other type of psychological disorder. Hoarding is not a situation where good intentions have gone awry; dead and severely ill animals were found in 80% of the cases studied. The animals appear to be essential to the identity of many hoarders. Some of the research that has been uncovered by the consortium suggests that hoarders come from unstable family backgrounds where the pet may have been the only stabilizing factor in their lives. Animal suffering is very real, regardless of the intent or state of mind of the hoarder.

Hoarders are not just the stereotypical well meaning "cat lady". It is true that nearly three quarters of them are women who live alone, but they are represented in every socioeconomic level and many professions, including shelter rescue workers, physicians, veterinarians and technicians. Some do have minors living with them. Almost half are over 60 years of age and cats are slightly more hoarded than dogs, although it can be other species as well, including farm animals. They can be very clever and use several veterinarians to escape detection.

Hoarders are frequently well known in the community. People may even drop animals off at the home of the hoarder, unaware of the conditions of the home environment. They are most often discovered as a result of complaints from neighbors about filthy, abysmal sanitation, strong odors and a stench coming from the house or excessive noise from barking. In severe cases the ammonia levels from urine accumulation may approach toxic levels, leading to a condemnation of the property and removal of both the animals and hoarder from the premises. There may be anywhere from a few dozen to hundreds of live animals with conditions ranging from normal to near death. In extreme cases, dead animals and evidence of cannibalism may be found. Many of the animals' health problems are due to starvation and/or chronic infectious disease, such as respiratory infections and skin problems, including ear mites, mange, fleas, ringworm, ingrown nails etc. The caregivers themselves may be suffering from neglect and other medical and, as mentioned earlier, psychiatric problems.

Veterinarians who suspect their clients may be hoarders should resist the temptation to handle these cases by simply offering discounted and pro bono services because that only serves to enable their behavior and prolong animal suffering; instead they should file a report to get assistance for both the human and animal victims of this problem. Some warning signs of hoarding include

1 Perfuming or bathing the pet to conceal odors

2 Using a surrogate pet to get medications for other unseen animals

3 Ahowing an unwillingness to say how many pets are owned

4 Claiming to have just found an animal in deplorable condition,

5 Having a constantly changing parade of pets

6 Office visits for problems related to poor preventive health, filth, overcrowding and stress (fleas, ear mites, intestinal parasites, upper respiratory infections) rather than chronic diseases

7 Rarely bringing in the same animal again

8 Traveling great distances for care at odd hours

9 Demonstrating an interest in acquiring even more animals

10 Seeking heroic and futile care for animals just acquired

11 Inability to tell how many animals they have

12 Attempting to get refills of medication without bringing animals in

13 Description of source of the animal that doesn't match the animal's condition

Veterinarians should not try to handle hoarding cases alone, as treatment or simple removal of the animals from true hoarders never solves the problem. They will always obtain more animals unless there is constant follow up monitoring and counseling. A community inter-agency approach involving the departments of health and social services, psychiatrists, law enforcement, animal shelters and veterinarians is necessary to find a resolution to the problem of animal hoarding. It should be noted that these cases often require a massive outlay of resources to handle appropriately, which may partly account for the reluctance of law enforcement and shelters to handle them. Animal shelters are on the front lines with these cases and are frequently caught unprepared to handle the large number of animals that may be rescued and brought to their facility in urgent need of veterinary care. It is particularly frustrating for shelters because, although the animals are often unadoptable, they must be treated and held for prolonged periods of time until the case has been resolved. This often results in huge unrecoverable costs for their care and displaces the adoptable animals in the shelter. If the court grants permission for euthanasia for medical or behavioral reasons, the resultant negative publicity from the media can be quite challenging to handle. The hoarder is often portrayed in a sympathetic light unless the conditions are completely intolerable or dead animals can be found on the premises. Prosecution of these cases for animal cruelty, removal of the animals, mandatory counseling and follow up monitoring to prevent recidivism are just a few suggested strategies for handling these cases. An unfortunate development over the years has been that many animal shelters have been identified as havens for animal hoarders, who take in animals and never adopt them out. For a complete description of animal hoarding, refer to the hoarding consortium website at http://www.tufts.edu/vet/cfa/hoarding/.

As the demographics of the American population change, different cultural attitudes about the human animal bond will be encountered by veterinarians in their practices. Part of the veterinarian's oath is to use their skills for the benefit of society through the relief of animal suffering and the promotion of public health; and to practice conscientiously and in keeping with the principles of veterinary medical ethics. Educating clients and the public about responsible pet ownership; providing affordable spay neuter, veterinary care and behavior counseling; and taking a leadership role protecting animals is surely as much a part of the profession's responsibility as practicing quality medicine profitably. Hopefully more research and education will be devoted to the human animal bond in the future to help enrich and save the lives of more animals by developing a better understanding of hoarding and devising better strategies for keeping animals in their homes and reducing relinquishment.

References furnished upon request.