Dealing with ringworm in shelters

There's an authoritative fact sheet about ringworm control in a shelter setting on the UC Davis Veterinary School's Shelter Medicine site. Be aware that it's based in the US, so some of the veterinary preparations mentioned may not be available in the UK. However it does give a very clear explanation of exactly why ringworm is so difficult to deal with in a situation where there is continual pressure to take in more animals who will suffer or die if no space is found to house them.

Ringworm and animal shelters

The Ontario SPCA in Canada has just published the findings of an independent investigation into the handling of ringworm cases at their York region branch last year. It's extremely long and detailed (the link above goes to the summary), but contains lots of very important discussion, not just about how shelters should deal with the issue of ringworm infection, but also about the role SPCAs play in society. 

One thing that comes over very strongly is that the report's co-authors (the former Dean of Ontario Veterinary College and the former Chief Justice of the Ontario Superior Court) essentially looked at everything the SPCA was struggling to do and recoiled saying no-one could possibly cope with it all on the kind of budget they have available.

Ontario SPCA is one of the few SPCAs round the world which have statutory powers and duties to investigate and prosecute animal cruelty entirely independently of the police. It also has virtually sole responsibility for stray animals and apparently an open-ended commitment to take in unwanted animals. Unlike the RSPCA it does get some government funding for its law-enforcement role, but the amount is quite low.

This means its shelters are continually under pressure to house the unwanted and strays and also any animals taken into care as a result of ongoing investigations and prosecutions. Recent legislation imposes conflicting obligations to take all possible measures to prevent spread of disease, while forbidding vaccination of incoming strays because there is no way to get the owner's permission. 

Ringworm is particularly frightening to any shelter because it can infect humans as well as most other mammals, but it is a fungal disease (nothing to do with worms) which normally causes nothing more than self-limiting skin disease (possibly no visible disease at all) in healthy people and animals. 

This means there are really serious moral issues about dealing with cases in a shelter. On the one hand it's essential that the disease is contained (no-one is going to adopt from a shelter if it means all your children end up itching and scratching). On the other hand it's very difficult to justify extreme measures, like mass culling, to control something that the vast majority of people and animals will throw off with  quite minor  treatment.


In OSPCA's case the misery seems to have been compounded by the inherent inaccuracies in scientific tests for ringworm which meant shelter management could never be quite sure whether it was still present or not. The final straw came when staff and volunteers had become so distressed by the probability it would lead to animals being killed that they were refusing to notify management of possible human ringworm infections they were experiencing themselves. This was illegal under Ontario's Health and Safety legislation and the Ministry of Labour then stepped in.  

The independent investigation was set up in response to a campaign against the shelter sparked off by reports that all animals currently in its care were to be euthanased in order to stamp out infection. The failings which it did expose seem likely to fuel further campaigns and I think it's likely these will have the opposite effect from that intended by reducing funding for the shelter while increasing the amount of resources they have to divert into health and safety compliance, and possibly requiring them to set tighter limits on the numbers of animals they can house.


It seems likely that there never was an "epidemic" of ringworm and that the infection was in fact limited to the original group of very matted long-haired cats who had been taken in at the start of the incident. 


Ironically this report comes out as the e-coli salad vegetable incident demonstrates just how difficult it is to pin down the origin and spread of disease, even with all the resources of a government health department.


Incidentally, infections are not a one-way-street: animals can sometimes catch nasty bugs from humans  too.

Internet Resource on Animal Shelter Management

The University of California Davis Koret Shelter Medicine Program site is mainly intended for their own veterinary students, but is a fantastic resource for anyone interested in learning more about proper animal care in rescue conditions.

The site includes downloadable copies of their class lecture notes and links to videos and "webinars" where animal shelter professionals can discuss shared problems and solutions online. UK readers do need to bear in mind that US conditions are sometimes different from ours — some diseases found here don't occur over there and vice versa, for example. However many of the issues (trapping and neutering feral cats; behaviour assessment and temperament tests; assessing prospective animal adopters and so on) are relevant to both sides of the Atlantic.

Some interesting comparisons of the organisational structure of the RSPCA in this country compared to the US in one of the introductory lectures:

Questions from Shelter Medicine Overview Lecture, 04/04/2008
Kate F. Hurley
UC Davis Koret Shelter Medicine Program
Questions generally about shelter standards and regulation:

"I didn't realize that local SPCAs were not affiliated with each other. I'm not sure if that's a good thing or a bad thing--I can see that it would be good to retain some regional individuality, and it probably creates less paperwork/bureaucracy that needs to be worked through. It's probably easier to implement changes, and easier to tailor what the shelter offers to the community. On the other hand, I wonder if it would be easier to get funding, and better for research purposes (easier to access a large amount of "herd health" data) if the shelters were associated."

"Good point about the up and down sides of having all shelters linked. I was recently in England, where the vast majority of shelters are under one of their major charitable umbrella organizations. (Unlike here, all RSPCAs really are part of the same group, for instance.) The power of a large organization gave them broad recognition, seemingly lots of fundraising clout, the opportunity to collect and compare data between numerous shelters, and the ability to implement a set of standards that were generally impressively high in terms of animal housing, health and adoptions. On the down side, chatting with people it sounded like the organizations can be unwieldy to change, there are layers of bureaucracy, and it could be that it’s harder to respond to specific regional issues – likely more of an issue in the U.S. since we are such a large and varied country. Just as we’ve seen many individual veterinary practices absorbed into corporate chains or groups, it does seem possible that we will eventual see something like a large non-profit group operating multiple shelters on a franchise-type model – there are a few groups, such as the Massachusetts SPCA that do operate multiple shelters within a single state. However, I think it’s unlikely that we will ever see the kind of cohesive arrangement that exists in the United Kingdom, just because of the fractured and independent way that shelters sprang up on this side of the ocean. "

Continuing the ringworm theme from yesterday, there's an online presentation on ringworm control in animal shelters with useful pictures of infections (and other conditions which can look similar). It's interesting to see that the cat cages in the shelter they show wouldn't be acceptable in our units except for cats needing to be closely confined for medical reasons, such as fractures or heart problems.

The really striking difference between us and the States is cats — we don't declaw and we do expect they'll normally have more or less free access to the outdoors. Most US animal welfare agencies deprecate declawing, but are absolutely vehemently opposed to letting cats roam freely outside.

Madison's test results are back!

Madison is a very pretty long-haired black cat who was picked up as an injured stray on 14th September after being hit by a car. She had a lot of soreness and bruising which has almost healed, except that she still can't hold her tail completely upright, but she also had dreadful skin trouble, with bald patches which we originally thought were grazes from the accident. After initial first aid at Vet24 and admission to the Vet School hospital it became obvious that the sores were skin disease, rather than injuries. She was infested with fleas, so the most probable underlying source of the problem was flea allergy, but (especially in a long-haired cat) another possibility would have been ringworm.

Ringworm is very bad news indeed for any animal rescue. University of California Davis' Shelter Medicine Program has some detailed information which explains just why we are so paranoid about it. A rescue facility which has had an outbreak will be out of action for a minimum of four months while all animals are treated (twice weekly medicated baths for all cats!).

Anyway, Madison's culture results came back today and she has NOT got ringworm — just very nasty flea allergy, which is responding nicely to treatment. Relief all round.