Local Vets/IMHS Ringworm Discussion Reference.

David Palmini

I am the veterinarian who was involved. I have been on the Board of Directors since 2008 and provide veterinary services for the shelter including “well checks” and vaccinations, treatment of ill animals, and occasional surgeries. I charge for supplies used at cost, but do not receive any personal financial benefit from treating the animals.

I am posting this response on both Pinecam and 285Bound.

I will try to address the common questions and themes present on both forums.

First: “Why didn’t IMHS reach out for help from the community?”

- IMHS did not solicit foster homes for the cats because ringworm is contagious to people, particularly children, and the spores shed by contaminated animals will infest a home for years.

- During the 2007 outbreak, six of the staff and volunteers developed ringworm lesions themselves. Putting twenty plus exposed or infected cats out into the community would pose a very high probability of human infection.

- We appreciate the concern and how many people in the community want to help, but enlisting private residences could very easily result in neighborhood outbreaks of ringworm.

- Treating the animals in an infested shelter with no isolation facilities would be futile as animals being treated will be re-infected from spores in the environment which is constantly receiving more spores from the infected animals. It becomes a cyclical process.

Recap: Allowing a foster home to house and treat a ringworm cat would result in the home being infested with ringworm spores. It would put human occupants and other pets at risk. It would be particularly dangerous to children in whom it can cause permanent scarring. Because spores are carried on clothes, other neighborhood animals and humans would be at risk. Any home that fostered a ringworm animal could not be considered suitable to foster additional IMHS animals in the future due to contamination.

Second: Regarding the ethics of euthanasia.

- To effectively treat current shelter animals would require closing the facility and suspending adoptions for 12 weeks. IMHS adopts out, on average, 100 to 120 animals every 12 weeks. These are animals that we received from the community as well as animals that are transferred in from larger municipal shelters in Denver that would have been euthanized for space.

- Is it ethical or moral to treat 20 cats, when doing so would result in the loss of another 100 animals that could have been adopted in those twelve weeks the shelter was shut down? This statement may sound calculating, but when faced with several emotionally difficult options, the Board must look at how can we save the most lives?

Third: Transparency and Perception

- Announcements were made on Pinecam, via email to the membership and volunteers, and press releases were submitted to the local media. Articles about the situation are in today’s Canyon Courier and the High Timber Times. IMHS now has a membership on 285Bound as well.

I will do my best given time constraints to reply to additional questions.

Thank You,
David Palmini, DVM

David Palmini

CinnamonGirl wrote: I have a question, did all the cats have ringworm and how infested were they? I think the announcement on Pinecam was unclear, it said several not all?

Out of about twenty five cats, three developed lesions over course of three weeks. All cats were cultured and came up postive.

The challenge with ringworm is the spores that are continuously shed into the surrounding environment. Infected animals drop spores by the thousands, and other animals are, or become carriers, of ringworm. These carriers do not show the classic external signs of ringworm, but still contaminate the surrounding environment with spores.

Given and incubation period of 1 to 4 weeks, we know that by the time the third cat came up positive there had been ringworm spore contamination in the shelter anywhere from 4 to 7 weeks. In this course of time all other cats had to be considered infested/exposed to spores due to the physical set up of the shelter which is basically continuous rooms with limited ventilation.

CinnamonGirl wrote: Did you ask other shelters if they wanted to help out? Did you consider asking for funds, not necessarily space?

Yes we did. But requesting isolated housing of 23 cats is beyond the scope most any other shelter - even the big municipal shelters.
The other question is - to what end goal of relocating the occupants? It would still have necessitated closing down IMHS for 12 weeks which in the end would cost more lives than it would help.

While IMHS always needs funds, money really couldn't help in this situation.

CinnamonGirl wrote: Is IMHS considered a low kill or high kill shelter?

Excellent question that I would like to expand upon. I checked with the shelter manager to make sure I was giving out accurate numbers. It turned out in my first post I understated the adoption numbers. In 2010 IMHS adopted out close to 700 animals and euthanized 35.

What IMHS is, or becomes, is totally up to you and the rest of the community. Even within this thread we have seen concerns expressed about IMHS not being able to take in all surrenders whether they are strays or older pets from private homes. Other people expressed concerns about euthanasias being performed at the shelter.

This is paradox that needs to be solved, especially if IMHS expands into a larger facility. Many people would like to see IMHS become an open-intake facility where strays and privately-owned animals can be surrendered at any time. The consequences of an open-intake format is needing to deal with an influx of animals with chronic disease, aggression, and any number of behavioral issues that would make them extremely challenging candidates for re-homing.

CinnamonGirl wrote: Edited to add-- We appreciate you coming on and giving you comments about your decisions on our site.

I sincerely thank you for your interest. IMHS's biggest challenge has always been to get people involved and interested. We currently have several open board position and many volunteer opportunities if you or anyother 285Bounder's are interested.

As this thread shows, humane society work can necessitate being involved in some truly gut-wrenching decisions...but it is also incredibly rewarding.

David Palmini

Lucky wrote: One more question for DR. P . If I brought one of my cats in with ringworm would you suggest putting it down? Or was this a lesser of 2 evils issue?

You would be given the information in the previous two posts as well as a treatment plan for your cat and decontamination advice for your home.

You are correct, this is most definitely a lesser of 2 evils issue in a shelter setting. But the end goal is helping as many animals as possible.

Aspen Creek Vet-Jeff Danielson-DVM

I have the utmost respect for everyone that volunteers, works or otherwise invests in animal shelters. Often these devoted individuals are faced with tough decisions. A tough decision was made at the IMHS last week when 23 cats were euthanized due to a ringworm outbreak.

The question of “how to manage a ringworm outbreak in a shelter?” is too complicated. The space versus finances versus ethics dilemma presented to the IMHS must have been a difficult situation to sort through. Euthanizing an animal with a treatable condition presents an ethical dilemma. Managing a ringworm outbreak in a shelter with limited financial resources and limited space presents a logistical dilemma.

These cats and kittens were euthanized. Based on the responses here and on pinecam, the folks that appear to be opposed to this decision wonder why IMHS didn't present their challenge to the community? Why not solicit feedback from the community before euthanizing every cat in the shelter? I agree with this perspective. I believe isolation arrangements could have been made with adequate outreach.

IMHS is not the first shelter with limited space and resources to be faced with a ringworm outbreak. There are several published treatment plans that shelters have successfully implemented during similar outbreaks. Hopefully this unfortunate situation and the manner in which it was “managed” will help the IMHS and those of us in this community improve the way we provide for homeless animals.

P.S. Feline dermatophytes cannot be transmitted through aerosolization, just direct contact.

Lori Johnson DVM

I must offer another point of view from the veterinary community. When I heard about the mass extermination of 23 cats at the IMHS shelter, my first reaction was disbelief, then horror, then anger. Disbelief that anyone would consider euthanasia as a treatment of choice for a group of cats, of which only 3 (of the 20) had skin lesions that presumably were cultured positive for ringworm. Horror that the other 20 cats were never cultured at all and were assumed to be “in the process of incubating ringworm” and were therefore sent to their death. Anger that a shelter, which has been a part of our community for about 30 years, and is privately funded through grants and public donations from this very same community, would make such a horrendous decision without the benefit of an appeal to the community for help and perhaps even soliciting a second opinion from one of the other veterinarians in the community. All of the veterinarians along the 285 corridor donate to the IMHS on a regular basis either with their time, or money, or by providing pro bono and/or discounted veterinary services, or sponsorship of fund raising activities. Speaking for myself and perhaps for all of us, we would have done anything at all to prevent this tragedy from occurring had we known that it was going to occur. True transparency is letting people know about events before, during and after they occur; not just after.

These cats did not need to be euthanized. Ringworm is a very treatable condition in both animals and people. It is not a lethal disease. The fungal spores are ubiquitous in the environment. They are in the soil, where many times people can contract ringworm from gardening and children can get it from playing in the dirt. The spores can also be carried on the haircoats of dogs and cats and not cause any lesions or symptoms on the pets but can be spread to other pets and people. In fact, people with ringworm lesions that they contracted from other sources can pass the infection on to their own pets! Ringworm is most common in puppies and kittens and in stressed animals, such as those housed in a shelter or kennel with poor husbandry and or overcrowded conditions. Adult animals are less likely to get the disease even if they have been exposed to another pet that is infected with the fungus. Animals that have already had exposure to ringworm seem to develop some immunity to it, and even if they develop the infection again, the lesion will be smaller and resolve more quickly. This also appears to be the case in many people. Many animals and people that are exposed to the spores never even develop lesions. In my almost 30 years of practicing veterinary medicine, I have successfully treated many cases of ringworm in both dogs and cats. There are many new drug protocols available now that do not require daily medication be administered to cats. Nor is it necessary to constantly dip or shampoo these pets.

What I find ironic is that the cat that developed the first lesion was from outside of the community from another shelter in Denver, presumably sent to the IMHS to avoid euthanasia at that shelter. Then it was euthanized here anyway. Perhaps someone in our community would have been willing to give that first cat a home and treat it had they known of its situation (death vs. adoption and treatment). There are many pet owners in our community who are able to assume the “risks” of housing and treating a dog or cat for ringworm. I have rarely ever had a pet owner who took care of a ringworm infested animal have all their other pets also develop serious lesions. It will happen from time to time, but it is not common. I have never heard of “neighborhood outbreaks of the disease” that resulted from someone treating their ringworm infected pet. Perhaps some epidemiologists could comment on that for us.
There is a standard protocol in veterinary medicine known as the brush technique to culture seemingly normal cats for ringworm. A brand new toothbrush is used on each cat and is brushed through the hair coat of the cat and the bristles are allowed to inoculate the culture media several times. Cultures take about 3-5 days to be read, at which time a determination can be made if a cat is actively carrying the disease. The 20 cats that were asymptomatic for lesions should have been cultured and if they were negative on the first go around, they could have been placed in a home situation as a “possibly infected cat”, but perhaps they were never going to get the infection anyway. Again, if the community had been notified of the problem at the shelter, I believe people would have stepped forward to help. When it becomes a death vs. foster temporarily situation, people will come forward to help. The three cats that had lesions could have gone to foster homes that were experienced in taking any necessary precautions to avoid exposing the cats to “all the neighborhood children.”

Historically, IMHS has always had cases of ringworm appear in the animals that were housed at the shelter. Many of these were carried in by the kittens and puppies that came to the shelter. All animal shelters are always battling ringworm. It is always going to come back, especially in shelter environments such as what currently exists at the IMHS shelter (older, less desirable materials for flooring, cages, etc; lack of proper dedicated isolation rooms, movement between the people that come to look at the pets in the different areas) Unfortunately, our small community does not have the resources to build a facility that has just opened to replace the old Table Mountain Shelter. And that may always be the case up here. How will IMHS handle the next outbreak??
I also have concerns about the timing of this latest outbreak of ringworm at the shelter and the recent change at the shelter of using pellets that are mass produced to be burned in pellet stoves as a form of litter in the litter boxes. This was done about 3 weeks before the outbreak. Did anyone at IMHS research whether pellet stove pellets could be a source of fungal spores?? Since they are produced from dead pine trees (some of which are beetle killed and all of us in CO know how the beetles and fungus work together to kill the trees), are they treated with a fungistat? Is it good to expose cats to chemically treated pellet stove pellets??
And why is it the cats that are always persecuted? What if this had been 23 dogs? Would they have all been euthanized like the cats were? Why were litters of kittens euthanized by IMHS in 2009 because they had ringworm??

I was told by two different board members that the decision to euthanize was either financial (the shelter would have been closed for 2-3 months while the cats were treated there, but yet they could not be treated successfully there anyway). Or it was a liability issue (we can’t have these cats out in our community being treated because it is a public health issue and everyone out there in the community is going to get ringworm and sue us). Or it was ethical (look at all the other animals we are going to be able to save and adopt out if we can get rid of these cats and decontaminate the shelter and reopen quicker).

Consider this scenario - once it was determined that the shelter had once again housed a pet that had ringworm and was going to need to be disinfected anyway whether the cats stayed at the facility or not becomes unimportant. The cats should all have been cultured, an appeal sent out to the community for help. People that volunteered to house these cats could have signed a waiver that they understood there was a risk involved in exposing themselves to a cat that had been exposed to a cat that had ringworm lesions, etc, etc. Granted this would have taken a bit of time and effort, but we would have saved 23 innocent lives. Isn’t that what the Humane Societies are all about?? Taking in the strays and the homeless and the huge number of abandoned and relinquished pets and doing everything possible to place them in loving permanent homes?? Some of those 23 cats that were euthanized were most likely specifically relinquished to IMHS because they are known as a “no kill or low kill shelter”, which means that their cat had a greater chance of being placed into a home. How would these people feel now if they knew what happened to their cat??

CreatureKeeper

A collective voice is much louder than a single one. A growing number of people are gathering to create this voice; just send an email to to be added to the email list. I'll be working with the group to help everyone (hopefully) understand how to work with and/or apply for the board and how to use their membership votes at the annual meeting in May (if necessary). I believe Dr. Palmini wrote the date, time and location of the next board meeting in his post on this thread.

Discussions surrounding the euthanasia policy revision of 2008 were held during closed sessions of the board meeting with the exception of the meeting where I presented my thoughts and revisions that were deemed to be unsatisfactory by the board. My revisions included allowing foster homes to make educated decisions for themselves, requiring educated fosters to agree to a waiver releasing IMHS and it's directors of liability related to fostering animals with ringworm and allowing these homes to officially adopt the animal and take full responsibility for it's treatment, etc. I also argued that I felt they were not representing the wishes of their membership and supporters.

There is a reason noone here knows about any of this; you weren't supposed to know. I allowed myself to be manipulated into silence "for the good of the organization" once and it is my sole regret from my time at IMHS. It will not happen again.

Let's work together to make IMHS what everyone thought it was and wants it to be. I have to believe that the current board and staff really do want what is best for the organization and are hopefully willing to work with their supporters to achieve that end.

CreatureKeeper

I think it's important to note that a donation is very similar to an investment. We donate to organizations that best represent our beliefs and expectations. We do expect a return. There is nothing wrong in donating to those organizations that represent our personal values and not donating to those who don't. The world is filled with people with differing opinions and philosophies and we all have to choose who and what we want to support. It's also simple economics; rescues "sell" themselves based on their mission and the public supports them by buying (donating towards) their efforts. We speak with our money; products that don't sell well are no longer produced. The same applies to the non-profit world. Organizations that don't represent their membership/supporters well either flounder or are forced to change. I believe the posters who have referred to "withdrawing their support" are using this logic in regards to the situation at IMHS.

CreatureKeeper

I made a realization in the days since this announcement was posted; one which requires a little background so bear with me. I am the former shelter manager for IMHS and worked for the organization from March 2007 through March 2010. When I started at IMHS, the shelter was nearly out of money and between volunteers, staff and board members, had only a handful of people who were regularly involved. The organization had a tarnished reputation in the community and a rather bleak outlook. I was fortunate to be a part of the wonderful transition caused by the work and input of hundreds of people who came together for something they believed in. I knew that the character of the shelter was key to rebuilding a successful organization and made every decision over the next three years with this in mind. I hope that readers of this post will understand that I’ve decided to share some of my experiences in hopes of giving you a chance to make a difference in the direction of the shelter should you want IMHS to operate differently in the future.

You’ll need to determine for yourselves what it is you expect from IMHS. In the past, it was a “no-kill” shelter until the rescue community as a whole shifted to the more appropriate terms of “limited intake/low-kill” and “open intake”. Both have their places in the world. I joined IMHS with the understanding that I was part of a low-kill organization that used euthanasia only as a last resort unless an animal was suffering.

The majority of new staff and board members during the October 2007 ringworm outbreak agreed and we put our plea for help out to the community. We were given an answer in the form of a location to house our cats while we cleaned out the shelter. They spent a total of 12 weeks in this location while we medicated them and continued with daily cleaning, etc. At that time, we were pretty early in the organizational “rebuild” and had 2 staff members and 1 board member available to take care of the daily cleaning, medicating and office functions. It was unrealistic to try to also operate the shelter at the same time so the decision was made to close the shelter until we could move back all the animals. I feel that there are adequate resources that, should the decision have been made differently in this case, the shelter could remain open while the animals were cared for offsite.

Yes, the move was stressful for the cats. So are car rides to receive important veterinary care. I was one of the staff members charged with daily care and I held, kissed and pet the cats every day. I put them in carriers and placed them outside so they could get sunshine and fresh air while I cleaned (as did my coworker). They may have received less socialization than in a shelter setting, but they all came through alive and were placed in adoptive homes. The one kitty that has never completely adjusted was part of a feral litter which are tough to socialize under normal circumstances. I truly believe that one semi-socialized kitty out of the 30+ that we treated is a pretty good ratio. BTW – I adopted one of the guys who spent the 3 months being treated with the others and he is arguably one of the most social cats I’ve known.

Fast forward 1 ½ years, a handful of board members come and gone (board members establish the policies of the organization) and we come to May 2009 and an unhappy homecoming from what was a great vacation. I returned to learn that it had been decided to euthanize a litter of kittens due to ringworm. Most upsetting to me was that they had a foster home (where they had been prior to diagnosis) who was willing to house and treat, at their own expense, all of the kittens until they were fungus-free. This began my losing fight against euthanizing for non-fatal and more mildly symptomatic diseases.

Shortly after this situation, the euthanasia policy was revised to allow euthanasia to be considered for any circumstance reducing adoptability. During this same time, the foster home affected by the euthanasia of their foster kittens was trying to determine how they were going to deal with the situation. They also had the best interests of the organization at heart and were kind enough to deal with me vs. “going public” with what had happened. I spent the next several weeks working with the board on more revisions to the euthanasia policy and believed they would hold up their end of the bargain to investigate other options before deciding to euthanize an animal if it wasn’t suffering.

During my experiences working with the community I found that this is an amazing group of individuals who step-up when duty calls. I’m very happy to be a part of this community. So, why didn’t my husband and I offer our heated garage, caging, money to buy supplies? Why didn’t any of you? Because we weren’t afforded the opportunity to help. I have no doubt that between staff, board members, volunteers, foster homes, Pinecammers and 285Bounders, we could have helped IMHS accomplish another extraordinary feat.

As it stands, IMHS is on one end of the “low-kill shelter” spectrum….really one step away from an “open intake” shelter in which animals are euthanized for space. The other end of the spectrum is an animal sanctuary which, I’m sure everyone agrees, is not appropriate for IMHS (at it’s current location, for sure!) either. So, what is it that YOU, the supporting community, the community this shelter is supposed to serve, wants??? If you want IMHS to operate further away from their current location in that spectrum, you’re going to have to get involved and do something about it. The board and staff do not own the organization. The organization is membership driven which means paid members get to decide who they elect to represent their philosophies on shelter management and euthanasia. Being involved does require a commitment so you all need to decide how important this is to you.

In case you’re interested, I believe board meetings are held the 3rd Thursday of each month, 6:30pm at the Elk Creek Fire Department building on Richmond Hill. The general membership meeting is held in May and the current board is required to not only notify current members, but also post a public notice. Each member is allowed to vote; memberships may be purchased online, at the shelter and even at the door of the membership meeting. If you’re considering a donation to help offset any costs the shelter incurred with this ringworm infestation, make an investment by signing up for a membership….then participate!