Saturday, February 15, 2014

"No-Kill" - A Movement of Shortcuts, Excuses, and Suffering

Some in Delaware have tried to say that the many examples of cruelty that we saw at Safe Haven were merely the result of bad management at Safe Haven. While I agree that Safe Haven was poorly managed from the very start, whether it be their unrealistic proposal given the actual donations they were actually receiving, or their attempt to do "No-Kill" dog control for the same price as the previous vendor which we KNEW WOULD FAIL, these same issues are occurring in the communities that "No-Kill" claims they have been successful in.  

A recent Petition For Declaratory Judgment And Injunctive Relief filed by Ellen Jefferson DVM against the Texas State Board of Veterinary Medical Examiners makes it clear that the animal suffering that happened here at Safe Haven is also happening in other so called "No-Kill" communities, and that people fostering for these "No-Kill" shelters and rescues are placed in an a horrible situation of having to watch an animal suffer as a result, as we read about in the CAPA investigation with Canine Nation, and the story about the Safe Haven foster Maggie.  This is the reality of the movement that our Governor and legislature have chosen to foolishly listen too when they passed CAPA in our state.  

Dr. Ellen Jefferson - Executive Director for Austin Pets Alive and San Antonio Pets Alive

While "No-Kill" advocates in Delaware have touted the success of these communities, I've heard for some time that Austin and San Antonio fosters were frustrated with the utter chaos that occurs due to the fact that they are sending so many animals out into foster care.  Clearly the logistics of the scramble to get animals out the doors to anywhere, and the costs would be daunting to care for that many animals offsite and provide the proper care that is promised to fosters.  

But there are apparently shortcuts that have enabled those communities to do that, even though it's clear from the case highlighted in this Petition that the German Shepherd mix named Starlight did suffer as a result of the shortcuts.  But the petition and the Exhibit C complaint also show that this isn't an isolated case, and that the very procedures that left this dog without veterinary care are in fact standard operating procedures.  
23. A week after Meade accepted the dog for foster care, the dog gave birth to five healthy puppies, all of which were later adopted, including one by Meade. In mid- November 2012, however, Meade noticed that the dog was apparently ill or injured. Over a three-day period, she exchanged e-mails and texts with SAPA!'s hotline volunteers who, in turn, contacted Dr. Jefferson for advice. As TBVME knows, the number of SAPA! and APA! foster caregivers and the wide area over which their homes are scattered make it impossible for Dr. Jefferson to provide on-site care to each animal SAPA! owns and places in foster care. For example, on November 12, 2012, the day the disputed dog initially exhibited difficulties, SAPA! had 737 animals in foster care in 307 homes. pg 10 Excerpt from Petition for Injunctive Relief by Dr. Ellen Jefferson of Austin Pets Alive and San Antonio Pets Alive

Exhibit C is the hearing notice and complaint against Dr. Jefferson which begins on page 41 of the Petition file.  Below is an excerpt from that complaint.
Respondent holds a license to practice veterinary medicine issued by TBVME. As a
licensed veterinarian in the State of Texas, Respondent is required to comply with the Act and the Board Rules. On November 23, 2012, the Board received a complaint from Mrs. Sheryl Meade of Converse, Texas ("Mrs. Meade") concerning Respondent's care from October 8, 2012, through November 15,2012, of a three-year old female German Shepherd mix named "Starlight."
On October 8, 2012, Mrs. Meade agreed to foster Starlight for the animal rescue organization in San Antonio, Texas named San Antonio Pets Alive. On October 15, 2012, Starlight gave birth to a litter of five puppies. Respondent is the founder, president, executive director, and lead veterinarian of San Antonio Pets Alive in San Antonio, Texas.
On November 12, 2012, Mrs. Meade noticed that Starlight was lethargic, appeared to have blood coming from her urethra, refused to eat, was trembling, and appeared to be in pain. Mrs. Meade first sent an email to the email address that San Antonio Pets Alive gave her as a foster to request veterinary care, When Mrs. Meade received only an automated form email in response, she contacted the emergency number for San Antonio Pets Alive by text message that evening or same day, explaining Starlight's symptoms, requesting medication, and inquiring as to whether it was safe to let Starlight's puppies continue nursing. The emergency volunteer forwarded all of Mrs. Meade's messages to Respondent, who agreed with the volunteer by text on November 12, 2012 that the symptoms sounded like a urinary tract infection, and prescribed 200 mg of the antibiotic Amoxicillin twice a day for ten days. Respondent had not examined Starlight or met Mrs. Meade prior to issuing a diagnosis for Starlight and prescribing and dispensing medication. The only means of interaction between Respondent and the owner of Starlight between October 8, 2012, and November 15, 2012, was indirect via telephone or other electronic device.
The San Antonio Pets Alive volunteer covering the emergency number responded to Mrs. Meade via text that Mrs. Meade could come pick up medication for Starlight at the volunteer's house that night. The volunteer informed Mrs. Meade that the volunteer would not be available to see her in person, but would leave the medication for Starlight in a bucket on the porch of her house. Mrs. Meade retrieved the drugs for Starlight from the bucket on the volunteer's porch. The label for the bottle of Amoxicillin stated that it had been dispensed by Respondent even though Respondent had not performed an examination of Starlight to be able to make the determination that the Amoxicillin was necessary and required for the veterinary medical treatment of Starlight. However, the prescription label was also missing both Starlight's name and her species, which is required by Board Rule.
On November 14, 2012, Mrs. Meade did not see any noticeable improvement in Starlight's condition despite administering four doses of the medication over the course of 48 hours as directed by Respondent. Mrs. Meade then contacted the emergency telephone number again via text message to let San Antonio Pets Alive know that Starlight was not improving, and was still lethargic, in pain, and dripping blood from her urethra. Mrs. Meade sent a total of three text messages, and inquired how long it should take for the antibiotics to begin resolving the symptoms.
The San Antonio Pets Alive volunteer texted Respondent, "Mama dog w/uri is slighty btr but still lethargic. She has taken 4 amoxis so far[.] Foster is asking if we can gv her something for pain." Respondent responded by text message to the emergency volunteer, prescribing two tablets of Tramadol twice a day for three days. Then the emergency volunteer forwarded a message from Mrs. Meade, stating, "[S]he is still dripping blood. Not real heavily but when I put her on my lap I get blood smears on my pants." Respondent texted the emergency volunteer, "Is she in heat?" The volunteer responded that the dog had just had puppies. Respondent then texted the emergency volunteer, "Ohl That's normal. Unless there is a foul odor. Doesn't need antibiotics." In that response, Respondent is admitting that the Amoxicillin that she prescribed was not necessary or required for Starlight's veterinary medical treatment.
The emergency volunteer and Respondent continued to discuss by text message the fact that Starlight was still bleeding. The emergency volunteer pointed out that Starlight had not just given birth since the puppies were four weeks old. Respondent was undeterred in her belief that the bleeding was not a cause for serious concern, texting in response, "Prob in heat again then." The emergency volunteer reiterated, "She's been lethargic and eating less just this wk-still ok?" Respondent responded, ''We can just continue the antibiotics since already started. Yes. If foul odor to blood occurs the[n] reassess," and reiterated the prescription for Tramadol. Respondent did not record the Tramadol prescription in her patient records for Starlight. Respondent did not examine Starlight before making a differential diagnosis of her condition, determining that continued treatment with the same antibiotic was appropriate, or prescribing Tramadol, an addictive drug that is frequently abused by humans.
The San Antonio Pets Alive volunteer manning the emergency number responded via text that she had "txted doctor." The volunteer later texted that "The doctor thinks it may not be a uti and she may just be in heat. But she says we shld finish the antibiotics and can add some pain meds for a couple days and see how she does. Let us know rt away if a foul odor is coming from blood or if she gets worse." The volunteer informed Mrs. Meade by text that 'CY olunteer in Selma will dispense pain meds for you." Mrs. Meade responded immediately, objecting, "Ok. But she seems lethargic. Is that a heat symptom?" The volunteer texted Respondent, "Foster is ?ing if the lethargy cld be a sign of heat since it is new," to which Respondent responded via text, "Possibly." The volunteer then responded to Mrs. Meade, "She said it can be." Again, no one from San Antonio Pets Alive suggested that Mrs. Meade have Starlight examined by a licensed veterinarian and Respondent did not examine Starlight before further diagnosing Starlight's medical ailments.
On November 15,2012, the next day, Mrs. Meade again texted the San Antonio Pets Alive emergency number to let them know that Starlight still had no energy. In her three texts at 3:39 pm, Mrs. Meade described Starlight as a "limp little rag doll" and as "[l]istless." In response, the volunteer manning the emergency line that day asked only if Starlight was eating or drinking. No one from San Antonio Pets Alive suggested that Mrs. Meade have Starlight examined by Respondent or any other licensed veterinarian.
At 4:27 p.m., the emergency volunteer texted Respondent: "That dog w/the maybe uti/in heat is still extremely lethargic. Foster said she was full of energy till this week and now is a rag doll. She is eating/drinking but foster is really worried. Sound like it might be anything else?" In response, Respondent texted the volunteer, "Definitely could be low calcium." Respondent then recommended that Starlight be given calcium supplements. Respondent did not examine Starlight before recommending calcium supplements as a treatment for her reported lethargy or before diagnosing Starlight as having low calcium.
At 4:43 p.m., Mrs. Meade asked if there was anything she could feed Starlight to improve her condition. At 5:25 p.m., the volunteer manning the emergency line responded that "Dr. J said mama shld get all the wet and dry puppy food she wants. And you can add calcium tabs if you want." Mrs. Meade immediately inquired "How much calcium?," but the emergency volunteer did not respond. The emergency volunteer asked Respondent by text, "How much calcium? In tab form," but Respondent did not respond.
At 7:37 p.m., Mrs. Meade again texted the emergency telephone number for San Antonio Pets Alive, saying, "Something wrong. Her eyes are startin to bug I tried to sit her up but she flop over. She needs a vet," and immediately thereafter, "I think she is dead." An hour later, the emergency volunteer responded, "Sheryl, I am so sorry to hear about Starlight. Thank you so much for all you did for her."
Despite Mrs. Meade's repeated, consistent, and insistent attempts over three days to get Starlight the veterinary medical treatment she needed, Respondent never provided it. Respondent never performed an examination of Starlight to determine what medical ailment Starlight was suffering from. However, that did not deter Respondent from blindly prescribing Amoxicillin, Tramadol, and calcium supplements for Starlight's veterinary medical problems. Moreover, Respondent did not change her treatment plan even when Mrs. Meade's regular text messages describing Starlight's symptoms over three days showed that Starlight was deteriorating rather than improving with the treatment Respondent had prescribed. Nevertheless, in her response to the Board, Respondent explained that it is her opinion that the treatment that Starlight received through this process with San Antonio Pets Alive was preferable to being euthanized as Respondent believes Starlight would have been if Starlight was left in the shelter.
The patient records for Starlight that Respondent submitted with her response to the Board contained two non-contemporaneous amendments dated November 28, 2012, and December 20, 2012, providing details of symptoms, diagnosis, and treatment. Both of these amendments were made after Respondent received a letter from the Board on or about November 27,2012, informing her that the Board had received a complaint and opened an investigation regarding her treatment of Starlight. There was no indication in the patient record for Starlight that these late entries were amendments, or were intended to supplement, change, or correct the record. 
Additionally in her response to the Board, Respondent identified financial constraints as the reason that San Antonio Pets Alive does not take its animals to licensed veterinarians except in extreme emergencies, and explained that the animals that are housed in foster homes receive most of their veterinary care from volunteers and veterinary technicians who "possess some knowledge in veterinary medicine" to evaluate and treat as many cases as possible. San Antonio Pets Alive medical liaison volunteers also "receive and sign out for a kit that contains a small amount of basic medications like Amocillin and Tramadol when they are trained" so that the volunteers will have that medication when necessary. As Respondent stated in her letter to the Board: "These volunteers answer email from fosters around the clock, use their own phones for emergency calls, and text or call me with every case on which they are contacted," all without Respondent or any other veterinarian ever examining the animal patient. In this way, Respondent explained, San Antonio Pets Alive avoids the costs associated with hiring sufficient licensed veterinarians to examine each animal and thereby establish the veterinarian-client-patient relationship (''VCPR'') necessary for a Texas-licensed veterinarian to legally practice veterinary medicine. Respondent noted that "our resources are quite limited in contrast to the large number of animals" that San Antonio Pets Alive takes in. Respondent explained the lack of examinations by a veterinarian for the animals in San Antonio Pets Alive is specifically intended to eliminate the costs of veterinary care from licensed veterinarians: "We treat over 5,500 animals per year and, because of our limited resources, this 'triage' communication system that exists between me and our volunteers is also necessary and critical." - Complaint beginning pg 41 - Excerpt from Petition for Injunctive Relief by Dr. Ellen Jefferson of Austin Pets Alive and San Antonio Pets Alive

Sadly, this foster did everything that she could do for the dog that was owned by San Antonio Pets Alive.  She contacted them every step of the way.  She tried to make the organization realize that the dogs condition was worsening.  And finally she had to watch poor Starlight die after suffering for several days.

To add insult to injury, the petition merely makes excuses for their shortcuts and justifies this cruelty to Starlight by pointing to the fact that they saved other animals.  But clearly we don't know how many animals have already suffered similarly, or will in the future face the same suffering, with hundreds of animals that don't have access to medical care.

If an individual failed to treat their suffering animal, they would be prosecuted under animal cruelty laws.  So it seems SAPA and Dr. Jefferson have been treated far more leniently that the average citizen would, since the hearing is only to establish whether there were violations of the Texas Veterinary Licencing Act.
6. Failure to seek veterinary care. Conviction for failure to provide necessary care upheld where owner declined to seek medical care for dog (or, alternatively, turning dog over to SPCA at no cost) where dog suffered from heartworms with obvious symptoms. Elam v. State, No. 01-89-00048-CR (Tex. App.- Houston 1990) (unreported).  - Texas Animal Protection Laws 
But this case does bring up a point of contention between "No-Kill" activists and the rest of us. How will communities be able to prosecute cruelty in the future when we sit back and watch our "No-Kill" shelters and rescues subject animals to the very same cruelty?  The "No-Kill" movement is in effect weakening the very laws that have protected animals from suffering without proper care.

My sympathies to the foster who tried so hard to make the dogs owner (San Antonio Pets Alive) understand that the dog was critically ill and needed veterinary care.  Nobody that volunteers to help animals should be placed in this difficult situation by a shelter or rescue.