No More Homeless Pets Forum
November 29, 2004

Creating Spay/Neuter Programs that Work

Esther Mechler

Spay/neuter is the key, but how can you really make it happen in your community? Peter Marsh of Solutions to Overpopulation of Pets and Esther Mechler of SPAY/USA will answer your questions about how you can start a spay/neuter program or ramp up your current efforts.

Introduction from Peter Marsh and Esther Mechler:

Thirty years ago, one family dog or cat in five lost his or her life in a shelter every year. Over the years, low-cost spay/neuter programs reduced the death toll to one in twenty. Newly designed programs have cut it still further in some areas, to less than one in a hundred.

The most successful new programs have three things in common: they are effectively targeted, adequately funded and collaboratively operated. We look forward to answering questions about how you can design a program like this for your area.

Questions

Getting government interested in spay/neuter
How can we get ahead of 'Just One Litter?'
What if low cost spay/neuter isn't accessible in your area?
When overpopulation is rampant and strays are considered vermin
Available resources for start-up spay/neuter programs
What is targeted spay/neuter?
Countering resistance to neutering males
How to avoid alienating the veterinary community
Nuts and bolts of publicly funded spay/neuter
Importance of including feral cats in municipal spay/neuter programs

Getting government interested in spay/neuter

How can we get ahead of 'Just One Litter?'

Question from Kay:

I work with two rescue groups, and the majority of people who come wanting help with fixing ferals, strays, and pets have animals who had at least one litter already. I think the spay/neuter message has only been partially successful. Although we are fixing more animals than ever before, we are not getting through to the public about how important it is to prevent that first or second litter. How do we solve this problem to avoid being in the same situation ten years from now?

Response from Esther:

It does sometimes seem truly unbelievable that at the SPAY/USA toll-free hotline, after 11 years, we are still getting so many calls!!! We have fielded so many... tens of thousands already! How can there be any MORE!!! Yet, despite the declining numbers of animals entering shelters over the last decade, we do in fact still have about 5 million surplus animals per year coming into this world, just in the USA. And that is about 5 million too many. So we still need to reach a lot of people...

These folks could be divided into three groups:
- the indigent, who cannot afford to spay or neuter their cats and dogs
- children, who might reach their parents
the veterinarians, who by doing early spay/neuter, could help prevent litters in animals around the age of 6 months

One of the many things I learned from Kathy Savesky of the Bosack and Kruger Foundation is the importance of segmenting your market for your message. And one of the pieces of information we do have about the cat/dog surplus is that a disproportionate number of breeding animals come from poverty areas. These are the main areas we need to target... Early on, I remember someone advising me that a good place to put up flyers is in laundromats. Folks without washers and dryers are likely to have less, if any, discretionary income to spay/neuter their cats and dogs.

SPAY/USA has produced some flyers, the most popular of which are The Kitty Pyramid and the Dog Pyramid, easily reproducible, letter-size posters that show just how fast that one litter translates into another and then another. Over and over we have been told that this poster seems to convince people just how important it is to take action. To view (and print) these flyers just go to www.spayusa.org and click on "How Can I Help?" button. These posters can and should be put up in grocery and convenience stores, pet supply stores, libraries, community centers, social service agencies. At the same web site you can also download "This Baby Can Have Babies of her Own" and "Littermates Can Litter" -- both of which educate folks about how important it is to spay early... a very important part of the puzzle. The fact that folks have too often waited till too late to spay or neuter is a good part of the problem.

Social service agencies and public health departments are excellent places to begin positive dialogues with the people who interface with the public and can help us get the message out. My advice would be to get some input from the people working in the local agencies about how best to do it locally, as conditions vary so in our large country. What may work in Maine, may not in Texas, likewise Alaska and Hawaii.

I remember years ago reading a wonderful brochure put out by the HSUS entitled "Just One Litter." It chronicled the difficult lives of the 5 or 6 kittens born to an unspayed (obviously) mother cat, including, I believe, the births of their own litters some 6 months later. We need to produce more such literature, and also stories in other formats, such as video news releases and public service announcements. Local PSAs can be produced through Audio-Visual departments at universities or local cable stations, tailor-made for the community.

In addition to reaching adults directly, we can reach adults through their children by providing humane education programs in the schools. The Latham Foundation, the ASPCA, the National Association of Humane and Environmental Education, all have excellent resources on how to do this. SPAY/USA, with the help of the ASPCA, has produced a video about the importance of spay/neuter that can be shown to elementary age children. The video is 20 minutes long, comes with a teaching guide, and is called "Throwaways". It is also available in Spanish -- "Rechazados".

Our other audience is the veterinarians... Are we reaching the cats/dogs in time, before they multiply? Obviously not often enough! And unless veterinarians are willing to do spays/neuters before animals can multiply, we will continue to have what Dr. Marvin Mackie calls "woops litters". If cats or dogs who are allowed outdoors are not altered prior to the age of 6 months, there will always be unwanted litters. I suspect that a good number of the unwanted litters come from this set of circumstances, though I do not have hard data for you. In any case, we need to persuade veterinarians to move their minimum age for spays/neuters back by at least a month, from 6 months to 5 months or earlier. You as a rescue group person know how many animals are adopted as kittens and pups, and unless they go to their new home spayed/neutered, there is a chance they will multiply... We do know how to stop this -- through strict Neuter Before Adoption policies, but these require the cooperation of veterinarians willing to spay or neuter at an age much younger than what was traditionally taught in vet schools.

We have come a long way in the last ten years. We need to keep up the momentum, developing new materials and disseminating it in creative new ways, or else, as you say, it will be easy to slip backward and be in a bad situation ten years from now. Thanks for a great question!

Response from Peter:

I think you are exactly right when you say that our spay/neuter message has been only partly successful. The research certainly bears you out. Recent surveys have found that upwards of 85% of all household cat litters are not planned. Fully a third of these accidental litters are "oops" litters that could have been avoided if the pet's caretaker realized how early cats become sexually mature.

So we need to update our spay/neuter message to take into account that the critical issue for many pet caretakers by now has become not WHETHER to have their pets sterilized but WHEN. As part of the new generation of spay/neuter programs we need to move beyond the traditional "Prevent a Litter" spay/neuter message to incorporate a "Prevent a First Litter" component.

Let me tell you a little about how we approached this in New Hampshire. First we worked with local veterinarians to adopt a "B 4 5" sterilization protocol, in which they counseled their clients to have their dogs and cats sterilized no later than five months of age. (This timetable, of course, is not applicable to shelter kittens or puppies younger than that, who should be sterilized before placement.) Adopting an idea used by the Erie County SPCA, we encouraged veterinarians to schedule the surgery for 20 weeks at the time they saw the kitten or puppy to administer pediatric immunizations, so that the timing of the surgery (like the timing of the immunizations) would become a matter of routine protocol in their clinic.

We also need to update our message to explain why the timing of the surgery is so important. We need to explain the WHY of WHEN. In our experience, the most effective way to do that is to go beyond the traditional anti-overpopulation message to emphasize that delaying the surgery will jeopardize the animal's health unnecessarily. For instance, mammary tumors are the most common type of tumors in female dogs and are malignant almost 50% of the time. As spay/neuter activists, we are not doing our job unless we get the message to caretakers that timely sterilization will reduce the risk of developing mammary tumors to almost nil, but that the risk increases dramatically if the dog is allowed to experience heat cycles, even if she does not become pregnant.

The same health-protective spay/neuter message must be gotten to cat caretakers. For cats, mammary tumors are malignant more than 80% of the time and result in high morbidity rates. While timely neutering does not eliminate the risk for a feline of developing this type of tumor, it reduces it by 80%, which should be enough to seal the deal for most caretakers.

As you suggest, the key is to update our spay/neuter message so that we will avoid being in the same situation ten years from now. An effective "Kittens Have Kittens" or "Prevent A First Litter" campaign should help us do that.

Best of luck with your efforts! Let me know if I can be of any assistance.

What if low cost spay/neuter isn't accessible in your area?

Question from Robin:

We find it extremely difficult to persuade veterinarians to offer low cost spay/neuters. There is one low cost mobile clinic that deals with very low-income people and will work with rescue groups, but it can take weeks to get appointments. Vets insist on providing vaccines along with spay/neuters and charge an office visit fee, so along with an FIV/FeLV test and vaccines a cat spay costs up to $350! This is out of reach for many families. What can we do? I think spay/neuter should be subsidized somehow. Any ideas???

Response from Esther:

I can certainly sympathize with the challenges you currently face! At the beginning SPAY/USA had just a handful of participants. Now, over 1,000 low cost spay/neuter clinics and programs are registered in our database. Getting there was just a matter of being very persistent, resourceful and hanging in there. When one way does not work, we'd try another.

First of all, it sure sounds like you need another low-cost mobile clinic in your area! If the one you have is backed up for weeks, the need is obviously there! Is it run by animal control? There is a great model for that in Marion County Florida... Or if there is more need than two mobile vans can meet, maybe you need a super clinic like the one in Asheville, NC -- the Humane Alliance Spay Neuter Clinic. Costs there for female cats are $45, male cats are $30, all adult dogs are $45. This clinic works with some 30 rescue groups and shelters in 20 counties in Western North Carolina. Even low-income people can afford their prices.

Some interesting things that their surveys have revealed were that 88% of their clients had not taken their pets to a vet in the previous year; that 87% of their clients do not even have a veterinarian, that 85% of their clients had not had their pets vaccinated against rabies and that 92% of their clients indicated that cost is a factor in the decision to spay/neuter (or not) their pets. The area vets were not losing business to The Humane Alliance, and they came to realize that.

The Humane Alliance shuttles about 70% of its animals in from adjacent counties, and helped about 18,000 cats and dogs, kittens and pups last year. The euthanasia rate at their local shelter is down by 48% since their clinic opened. Quita Mazzina, clinic director, works with people who are interested in setting up this kind of clinic. The secret is high volume, made possible by The Quick-Spay method, a specialized method perfected by a handful of veterinarians interested in reducing pet overpopulation.

In Connecticut there is, like everywhere it seems, an overabundance of cats. A mobile unit providing low-cost spay/neuter for cats started about 5 years ago, and pretty much covers the state, going to a different city or town each day. Their charge for a cat, male or female, including vaccines, is $57. What this program did as it started up was to contact all the vets in the regions covered and invite them to be on the "vet follow-up list". Understanding that universally a spay or neuter is a one-time event, all these cats would have the opportunity in their post-spay lives to visit a vet on this list. When the letter inviting the vets to be on the follow-up list was sent out, the mobile unit office had 90 -- "yes" replies in three days! The vets have been quite supportive of this program since then.

I have written about private programs. As for subsidized spay/neuter, I will leave that approach to Peter Marsh, who has set up a phenomenally successful statewide program in New Hampshire.

Response from Peter:

You're right on the money when you say that neutering is beyond the reach of many families. Our job as spay/neuter activists is to bring it within their reach, whatever that takes.

It's no coincidence that there are three remaining pools of intact pets: those living in low-income households, those who have ended up in shelters, and free-roaming cats. In every case, either the caretaker needs our help to afford the surgery or the animals have no one to help them get what they need. There are only two sources of assistance: private grants or fundraising and public funding. Allow me a moment to tell you about my experience with each.

Grants and fundraising can help enormously when you start a program or set up a clinic. But they are limited in two ways: (1) they are not likely to be able to provide the amount of funding needed to achieve the volume that greatly reduces shelter deaths, at least five effective surgeries (ones that would not have happened without your help) per 1000 people every year; and (2) they are not likely to be able to provide the funding you need to sustain your program year in and year out, which you will need to do in order to turn things around in your community.

In New Hampshire, we had operated a private neutering assistance program for more than a decade before we got public funding. We were able to keep the shelter death toll from getting worse but weren't able to drive it down, as we'd hoped. Once we got state funding ten years ago, we were able to do five times as many surgeries. As you might expect, the impact was dramatic. The first year, more than three thousand fewer cats and dogs died in our shelters! And the death toll kept dropping for the next six years.

You're right... spay/neuter should be subsidized somehow. Pet overpopulation is not our problem alone. It's everybody's problem, at least it should be. Everyone should help end it. In recent years, dozens of local groups have been able to secure funding for low-income neutering assistance programs or to help feral cat caregivers. Most of them, like us -- and probably like you -- came to realize that they could not end this tragedy alone... no matter how hard they tried. I'd encourage you to follow the same path. It made all the difference for us.

If I can help, be sure to let me know.

When overpopulation is rampant and strays are considered vermin

Question from Stephanie:

I'm writing from Manila, Philippines and our organization offers free or low-cost spay/neuter to pets. How can we convince the vets to help our spay/neuter efforts? I know we live in a third-world country and money is a big issue, but what about the animals?

We used to have the support of the biggest vet clinic chain in our city, they gave FREE spays to two (2) cats every week, but for the past months, they have been refusing to do the procedure. I know that this is a monetary issue, but how can we convince them to offer the procedure again?

Our organization definitely would benefit from the free surgeries as the cats we are helping are strays, and we couldn't afford the regular spay rate (US$68/cat). We don't have a solid TNR (Trap, Neuter, Return) program here either, so the cats are really overpopulated to the point that people see them as vermin instead of pets.

Response from Peter:

I was delighted to hear about your program. I'm sure that you've already overcome many more difficult barriers than we face here in America. For this reason, I don't believe that I have the experience to be of much assistance to you.

All is not lost, however. Esther has worked with groups throughout the world and is very familiar with international animal welfare organizations that provide assistance to groups like yours. Allow me to defer to her.

Response from Esther:

Your dilemma is universal; wherever any animal is overpopulated its species is seen as vermin. That is why we started SPAY/USA -- simply to reduce numbers. It is fascinating how attitudes toward animals improve as their numbers go down. The best examples of that are the bald eagles and the whales! While we can assume our cat and dog numbers will never get so low that they will be considered rare, we can do a lot to reduce the numbers.

Because you are writing from the Philippines, I will use a model program that I learned about last autumn when I had the privilege of attending the Asia for Animals conference in Hong Kong -- a conference someone from your group should attend. You will make many new contacts who are traveling down the same path. Among the many amazing attendees were Sherry Grant and Dr. Komang Sutiati from Bali. In 1998 in Indonesia, they started a program called the Bali Street Dog Project. This is a TNR program for dogs -- yours may focus on cats.

While the two free cat spays a week previously offered to you by the city's biggest vet chain may have been nice for the two cats, this kind of volume is virtually meaningless in attacking the kind of volume you face. You may as well start over with a new model.

The Bali program has two branches, the Full Clinic and the Street Program. The field program concentrates on village animals that are brought to a large van for neutering/vaccinations during scheduled visits. The medical team includes 3 doctors and 2 catchers accompanied by volunteer doctors, nurses and laymen. The street program concentrates on stray dogs (you can substitute cats) and beach dogs. These are brought to a smaller van or tended on the beach or parking lot.

Their clinics are on an emergency call or targeted basis. The education component is on a one-on-one basis with the tourists and locals. This program includes two doctors and two catchers plus volunteers. The goals of both the Field Clinic and the Street Program are:
- improve the health of Bali's street and village dogs (cats)
- reduce the population of street and village dogs humanely
- improve the level of vet medicine in Bali
- raise the level of public and professional animal welfare awareness.

The web site for the Bali Street Dog Project is www.yamp.com/balidogs.

Also, The Hong Kong SPCA has a wonderful Cat Colony Caregiver Programme (CCCP) as well -- a great model. In the first year of the program, ten caregivers brought in a total of 207 cats to be altered. As of 2003, cats were being trapped at the rate of 100 a month and over 2200 have been treated. Caretakers must be registered. The SPCA accepts the cats 24 hours a day, 7 days a week, keeping them post operation for a couple of days for observation. Those cats that are friendly and kittens are fostered and adopted. Caregivers in outlying areas often bring "their" cats to the SPCA's mobile clinic as well. This model may work well for you since you are in a huge urban area.

What about funding? The Bali program is funded by several sources including International Foundation for Animal Welfare, World Society for Protection of Animals, Humane Society International, and the Bali Street Dog Fund Australia. Once you begin to network with successful program leaders from your region you will find amazing resources, both human and otherwise to help you solve this problem. As the one door (the two cats a week) closed, you will find a much bigger and better door may have opened for you.

Available resources for start-up spay/neuter programs

Question from Katie:

We're located in a rural vacuum where animal welfare, let alone spay/neuter assistance, is of little or no concern to the powers-that-be. After planning for over two years to establish a spay/neuter program for our many thousands of low-income pet owners, we have been jump-started by our organizing an animal alliance of eleven humane organizations and animal controls in an eight-county area last July and the recent donation of a 23' RV trailer we are currently modifying into a mobile unit (the only way to serve such a huge rural area). We currently have $3,100 from recent fundraising activities. What resources are available for a START-UP Mobile Spay/Neuter Program without a track record? We will serve very low-income rural clients at an estimated average cost of $30 per operation excluding co-pays.

Response from Peter:

Congratulations on putting together your alliance. Over the years, I've found that the groups who've accomplished the most have been those who were able to work well together with others. That certainly has been the case in New Hampshire. Even though the members the Pet Overpopulation Committee that oversees our state program may not see eye to eye on everything, we all agree that it is unacceptable to put a healthy dog or cat to death and have been able to work together from this common ground.

I'm afraid, though, that I have very limited experience with helping people get what they need to get a mobile clinic up and running. Esther does, however. In fact, she has helped many of those who are now operating mobile units get started. You may also want to look in the Forum archives for Celeste Crimi's account of how they started the Oregon Neutermobile. It's from the December 15-19, 2003 Forum. Celeste and Esther have the experience and qualifications to answer your question much better than I ever could, so please allow me to defer to them.

Response from Esther:

Congratulations! You are definitely on the right track in my book! A mobile clinic is so helpful in a rural area such as yours where people in need and their companion cats and dogs are spread out over a wide space. While suburban and the better-off urban animal protection groups can afford new mobile spay clinics, more and more small groups like yours are turning to retrofitting RV's, vans and trailers. This is a great way to provide needed services at a low price.

I first turn to my friend Joyce Hillard, founder of Spay/Neuter Arkansas, for her advice on finding what you need. To quote her article in our book, Guidebook to Mobile Spay/Neuter Clinics (which will be downloadable from our new web site www.spayusa.org by mid-December... we hope):

"In the absence of vast or even adequate amounts of money, one way to help equip a low cost clinic is by scrounging. The best method of effective scrounging starts with creative begging. To beg properly, you must first obtain introductions and develop friendships with purchasing agents for the state health department and hospitals. Scrub nurses are of immense help too. These people must either love animals or you, and understand what wonders you are trying to accomplish. Now you must begin to curry favor followed by groveling and very polite nagging..."

Joyce goes on to explain that as a non-profit organization, and often just as a citizen, you are qualified to be a recipient of equipment that is regularly being replaced in hospitals and clinics. Such equipment may include portable autoclaves, centrifuges, microscopes, instrument trays, IV stands, the occasional operating table or light, sponges and bandages, gloves, surgical drapes, disposable needles and syringes and so on.

And as Joyce points out, "Stuff that you cannot use may be given to other organizations, used for bartering for stuff you want, or disposed of properly and safely..."

Leslie Appel, D.V.M., the dedicated founder of Shelter Outreach Services operating in the rural Finger Lakes region of western New York State, made us aware of a fabulous regional program in her area called Intervol (web site: www.intervol.org). One part of this effort is called Recovery of Unused Medical Supplies, or RUMS. Just in one small part of the country, tons of unused, but workable, equipment and supplies are collected from area hospitals and distributed to local, national and international organizations including health care facilities, clinics, medical education programs, schools, and the regional humane societies to distribute the supplies and equipment. This program saves the donating facility the expense of disposal and reduces the environmental impact of landfill use -- and isn't it useful to us! Don't we need this in other areas as well! Who is listening here? We hope there are other such programs out there, and if not that someone will start them...

While Dr. Appel does not operate a mobile van, she does operate a mobile MASH style program where the necessary supplies are transported in a van to the surgery sites. They cover several counties, altering dogs and cats from families of low-income, shelter dogs and cats, strays, feral and barn cats and dogs. These in-kind donations from Intervol help keep expenses low.

A third person who comes to mind in this area of resourcefulness is Dr. Jeff Young of Planned Pethood Plus in Denver, Colorado. He has developed portable surgery tables, instrument trays from everyday materials, and so on. These he packs into a van, and brings affordable spay/neuter services to extremely remote areas to target 70 to 80% of the free-roaming animals per "blitz." Dr. Young is always ready to help others equip their own spay vans at minimum cost.

Having listed a few ways now to maximize your dollars, I will say that the fact that you have an alliance of eleven humane organizations (most of whom probably do have a track record) and a web site to answer questions donors and foundations will have, you are in a good position to ask for help from foundations. PETCO Foundation, PETsMART Charities and the D, J & T Foundation have all been very helpful to local groups that have a good business plan in place. Do visit with other leaders of groups in your area to see who was able to help them, to get advice and recommendations from them and to network your group so it will be up and running sooner. Good luck to you and don't forget to call SPAY/USA to have your program listed on our database!

Comment from Alex:

We are a small group of 4-5 volunteers in the Reading, PA area. For the past year we have been helping Trap, Neuter, Return (TNR) feral cats by traveling about 60-75 miles each way to low-cost spay/neuter clinics. We have managed to sterilize about 200 cats in just over a year. Although it is not a huge number, it's better than nothing until we can raise enough to buy our own spay packs and get a clinic going ourselves.

I wanted to tell other groups who feel they have no good options that www.catswithnoname.net has a nationwide listing of rescues and spay/neuter groups that are willing to help.

What is targeted spay/neuter?

Question from Lori and Janet:

What are your opinions on providing low-cost (or even no-cost) spay/neuter services for folks who truly do not need financial assistance? We hear stories of people pulling up to the vet office in a $50,000 car and handing over a low-cost spay/neuter certificate. In the end, the most important result is that the pet gets spayed, but I'd love to hear your opinions on this issue.

Also, what are the best ways to find out if someone truly does "qualify" for spay/neuter assistance? Are there certain questions you can ask on the application? Our spay/neuter voucher program is operated by volunteers, so we want to make sure the people we help are truly in financial need. When I see that some of our clients' pets are current on shots or that other pets in the family have already been fixed, I begin to wonder if these people would've gotten the surgery done anyway. How can we get the best bang for our buck so that we're helping folks who wouldn't otherwise have gotten their pets fixed?

Response from Esther:

As I started SPAY/USA 14 years ago, my thought was Rich Cat, Poor Cat -- they can all have kittens! So who cares?
But as the years have gone by I have become more aware of three things:
- If the low-cost service is provided to all, rich and poor alike, the local vets are far more likely to oppose the clinic or program and
- Since our funding is limited, we need to use it where it is most needed and
- Most of the shelter intakes seem to be coming from the low-income areas.

So, over the years with experience, and a lot of nagging from Peter Marsh, I have come to admit that indeed we probably do need to target low-income. Wealthy folks with those BMW's who do not spay or neuter must be dealt with in some creative ways that are probably not part of this forum.

Response from Peter:

Thanks for this question. It brings back all the angry calls I've taken over the years from vets who have just contributed a discounted surgery to someone who pulled up to their clinic in a car that the vet couldn't afford. Or the vet who was asked to honor six discount certificates for a breeder's litter of Golden Retriever puppies. And you can't blame the vets. We raise our own funds for our private program and it's often a contest to see who's angrier about being taken advantage of, the vets or us.

The answer to your question highlights the theme of the Forum this week: the new generation of neutering assistance programs incorporates the lessons we've learned from a generation of spay/neuter advocacy. Among the most important of those lessons is that the original open access or untargeted programs, which were open to everyone regardless of income, are no longer effective for three reasons.

First, they aren't effective. Much of the time they provide subsidies to people who would have had their pets sterilized anyway, which doesn't help reduce the shelter death toll. It only helps fatten their bank accounts. When pet sterilization rates were much lower, open access programs were necessary to popularize neutering. With the current high sterilization rates, though, more than 75 cents of every dollar spent on untargeted subsidies is wasted. You might as well tear up your money and throw it on the sidewalk.

Second, because untargeted programs offer discounts to everyone -- whether they can afford to have their pet sterilized or not -- you can't offer a big enough subsidy to reach the folks who need the most help. Offering a $40 voucher to all comers is enormously expensive, but is of no value to an impoverished caretaker who still can't afford to pay the other $60 (or more) that it will cost for the surgery and ancillary costs, like pre-surgical immunizations and exam fees.

Finally, not only are untargeted programs expensive and ineffective, they understandably alienate veterinarians, who deserve to be our primary partners in this struggle. In my experience, veterinarians across the country will be more than willing to pitch in with us if subsidies are provided only to those who truly need them.

To answer your second question, the best way to "qualify" people for your program (and get the most bang for your buck) is to use Medicaid as your eligibility criterion. There are four reasons for this. First, it's less intrusive (human services administrators have already done the intruding!) Second, it's cheap to administer. Just asking people to provide a copy of their Medicaid card with their application costs everyone very little.

You should be able to administer the program for about $8 per surgery, even less if the program is administered by volunteers, which is very realistic. Third, it accurately differentiates between people who really need help and those who don't (that is, it has high validity). Finally it avoids having to ask participating vets to do the intruding or even to do a lot of paperwork. The goal must be for them to spend as much of their time as possible on surgery, the best use of their very valuable skills.

All of which is not to say that you are not right to suggest that our job is to neuter every animal we can, whether they live in low-income households or not. It is, but it's a matter of prioritizing our resources. Right now we need to make sterilizing the three remaining pools of intact animals (those living in low-income households, those who end up in shelters, and free-roaming cats) our highest priority. Once you've effectively met the needs of these animals, you may want to move on to help pets living in increasingly wealthy households, perhaps ultimately even reaching the pets kept by the $50,000 car owner. If you get to that point, however, you may want to keep two things in mind: (1) don't attempt to get public funding to help pets living in middle- and upper-income households because ending pet overpopulation is not as high a priority for most people as it is for us; and (2) for the same reason, don't ask vets to discount their prices for these clients. That way, you'll spare yourself the "Mercedes" calls from angry vets.

Countering resistance to neutering males

Question from Mary:

I'm working to develop an outreach voucher program in the rural, Hispanic communities near Las Cruces. SNAP (Spay/Neuter Awareness Program) here in Las Cruces has focused on the local town area up to this year. I am getting rural Hispanic folks to participate on a small level, but seems like they are only willing to spay the females. I'm trying to figure out what the resistance is with neutering the males. Any ideas/experience working in similar situation?

Response from Esther:

The reluctance of human males to have male dogs neutered has been an issue for a long time... For years scientists have been working on a product that would sterilize males non-surgically. This past year the first of such products, targeting male dogs, has come on the market; it is called Neutersol. While field trials have gone on for years in China, Mexico and Costa Rica, the FDA-approved product is now being used successfully in Texas and New Mexico here in the U.S.

I spoke with Dr. James Weeden, who works with the SNAP program in New Mexico and asked him about response to this new method of delivery. He found that many people who were reluctant about surgical neutering were lined up for clinics held in the Southwest -- in fact, the word he used was that the organizers were overwhelmed with the turnout. People stood in line for hours with their large male dogs, including pit bulls. In the end this particular clinic did 216 males in one day with two vets, going at a pace of about 10 to 12 dogs per hour. Dr. Weeden felt it was a good indication of the ability of the product to increase speed of delivery and to bring in people who had been reluctant.

The only problems with the procedure can be with mis-injections, i.e. in the scrotum but not the testicles. When the extremely fine, 28-gauge needle is used properly, there should be no pain or discomfort in more than a couple of animals out of several hundred.

If this product is accepted by the "humane community", it is hoped that other companies will proceed with the development of similar products, some of which could be used to sterilize feral cats in a way easier than we are using now. Just bringing down the numbers by another 50% would make this worthwhile and bring us very close to solving the problem.

Meanwhile, the underlying problem is still that of education. We need to recruit esteemed civic leaders and sports figures who will convince both adults and children of the importance of this... Products are good tools, but having an informed and compassionate public will be the ultimate victory for all of us. More on that from Mr. Marsh!

Response from Peter:

I'm afraid that resistance to neutering male companion animals (especially dogs) is widespread. National surveys consistently show that a significantly higher percentage of female dogs are sterilized than males. While I am not aware of any studies that shed much light on why this is the case (if any Forum members are, perhaps they can supplement my answer), I suspect there are several reasons: (1) Living with a female dog in heat in the household can provide an enormous and urgent incentive to have her sterilized; (2) The chaos that arrives with a litter of kittens or puppies can provide a similar incentive; (3) Males dogs, especially large breeds, often are looked to for household security and caretakers may be concerned that a sterilized dog may not be as effective a "watchdog"; and (4) The idea of castration may give some male caretakers the willies.

Let's take a moment to see how you may be able to address each of these issues. Neutersol, a non-surgical sterilizant, which Esther discusses in greater detail, may alleviate the concerns some caretakers have with the idea of castration. If possible, then, your program may want to offer this as an option to those who would not have male dogs surgically sterilized. To my mind, though, it should only serve as a back up. Surgical sterilization deserves to remain the sterilization method of choice because by reducing male hormones that may cause a dog to wander from home or become aggressive, it makes him a better household companion. Allow me a moment to explore this idea more fully.

To end companion animal homelessness, it isn't enough for us to prevent litters of kittens and puppies from being born in such great numbers that caretakers can't take care of them and end up bringing them to shelters. That was the focus of the first generation of spay/neuter programs, whose simple message was "Pet Overpopulation is the Problem: Spay/Neuter is the Solution." That approach was so effective that kittens and puppies now only make up about 15% of all the animals who enter our shelters.

Now, because of the changing profile of the animals admitted to shelters, our fight now is not just against Pet Overpopulation (excess litters of kittens and puppies), it's against Shelter Overpopulation. We need to address all of the reasons why dogs and cats become homeless, of which pet overpopulation is just one. This doesn't mean that surgical sterilization doesn't deserve to remain the primary weapon in our arsenal. It does, because it provides substantial behavioral benefits that make it less likely for a cat or dog to be relinquished to a shelter.

Indeed, studies by Dr. Gary Patronek and his colleagues have shown that fully a third of all the dogs and cats who are relinquished end up in a shelter because of behavioral problems that arise from being sexually intact. And while more than 80% of all cats living in households have been sterilized, less than 10% of all feral cats are sterile. To a great extent, then, the sterilization of household cats may serve as a type of "immunization" that keeps them at home, instead of migrating to feral colonies as unsterilized household cats often do.

As a practical matter, then, I think that the resistance we encounter with caretakers not choosing to surgically sterilize male dogs points to another area in which we need to update and improve our spay/neuter education programs. We need to do a more effective job emphasizing the health benefits and positive behavioral impact that come with surgical sterilization, for both males and females. This will require going beyond our traditional anti-overpopulation message, because the male animal's household does not bear the brunt of a new litter.

In closing, allow me to suggest something that may provide many caretakers with stronger and more immediate motivation to have their male dogs sterilized than a community education initiative. The public health costs inflicted on the community by unsterilized male dogs are enormous, especially for the larger breeds. Unsterilized dogs make up only about 40% of the household dog population but account for more than 80% of all dog bites and an even higher percentage of serious maulings. If New Mexico laws allow it, you may want to work with public health agencies to get a dog license ordinance passed in Las Cruces which levies a significant surcharge to license unsterilized dogs and than work with public health officials to get it enforced.

Best of luck to you and the others at SNAP!

Comment from Crystal:

I have a comment on overcoming resistance to neutering males... Sometimes people who won't listen to the "population control" benefits of neutering will listen to the "makes things more pleasant for the pet guardian" angle. For instance, I knew a woman who didn't want to get her male cat neutered because "He wouldn't be the one having kittens." What did finally induce her to neuter her cat was being told that neutering would stop his roaming and fighting and save much money on vet bills. Another neutering issue for cats (and intact male dogs) is "stinky pee" - tomcat and intact dog urine smells really, REALLY rank. Neutering makes for a much more bearable odor. Finally, neutering and spaying make for more affectionate pets with much calmer, more lovable dispositions, and thicker, sleeker fur coats! Showing people what's in it for THEM makes them more cooperative.

A big Thank You to Esther and Peter for donating their time and expertise in the forum this week!

How to avoid alienating the veterinary community

Question from Crystal:

How do we make sure that low-cost or free spay/neuter programs do not alienate veterinarians? In order to reduce pet overpopulation, the cooperation of vets is essential, but in the past there have been strained relationships between vets and providers of free or low-cost neutering. Some vets believe it undercuts their business, and so on. How do we balance respect for vets' businesses and need to make a living with the necessity of spaying and neutering by any means necessary?

Response from Esther:

Yes, years ago, there was an ongoing battle which Peter Marsh calls The Vet Wars. This war pitted "animal welfare advocates" against the vets, a lose-lose situation for everyone, most particularly of course, the animals. We are starting to communicate and collaborate better as we learn that vets cannot be expected to solve the problem alone and vets learn that most of us are targeting our requests for their help to cover only those most in need. We do not expect them to sterilize the pets of the wealthy at low or no cost, we hope they will join us to sterilize the strays/ferals/pets of the indigent at reduced rates whenever possible.

My hope is that more states will follow the lead of New Hampshire, where a publicly funded spay program was set up specifically for those in need -- those on some form of public assistance. These programs bridge the difference between what the poor can afford to pay and what would be an acceptable bottom line for veterinarians...

These programs will have to be set up very carefully with no loopholes or possibility of misuse of funds. I encourage people interested in setting up this type of program to confer with Peter Marsh regarding specifics. A great deal of work needs to be done within each state to set up a meticulously crafted set of rules and regulations and an infrastructure that includes veterinarians, rescue and shelter personnel and other groups that work with or are interested in animals. The goal is really to set up a first-rate referral program in each state, which will provide a safety net for folks with pets but no discretionary funds to cover sterilization costs for those pets. Thus we can have hope for the day when shelters will no longer be overflowing with unwanted cats and dogs, kittens and pups.

Response from Peter:

Yes, the cooperation of vets is essential to the success of a spay/neuter program; I know it has been for ours. Actually I think it goes even further than that. I've come to believe that the speed with which we end companion animal homelessness in America will depend in great measure on how effectively we engage vets in every aspect of the struggle. Allow me a moment to explain what I mean. Then I'll get right to your question.

We've come to recognize, through the bitter experience of the past generation, that we cannot adopt our way out of pet overpopulation, no matter how hard we try. Prevention is the only cure. And veterinarians are uniquely situated to deliver all the preventive services we need to keep companion animals from becoming homeless in the first place. They can counsel their clients about the benefits of surgical sterilization for their companion animals and the right time to have the surgery done. They can help their clients effectively respond to any pet behavioral issues that may arise more effectively than anyone else, their credibility is so great. And they can help their clients understand why all responsible caretakers provide permanent identification for all companion animals who live with them. When we fully engage the veterinary community in our work, I am convinced they will shift our progress to fast forward. I have no doubt that the veterinary community has the tools and talent to eradicate overpopulation just as they have eradicated all other epidemic threats to small animals, like canine leptospirosis and parvovirus.

Now to answer your question... In my experience, spay/neuter programs need to do only two things to secure the support of the mainstream veterinary community: (1) target subsidized neutering assistance programs so that only the people who genuinely need help are eligible to receive it; and (2) pay vets fairly for the services you ask them to provide. Allow me a brief comment about each.

Targeting is critical to secure the support of the veterinary community. I don't know of any way to operate a low-cost or free spay/neuter program without alienating vets if subsidies are offered to everyone, whether they need them or not. Indeed, traditional untargeted or open access programs played a significant role in the debilitating Vet Wars that Esther mentioned in her answer. The good news is that targeted programs not only offer us a chance to work collaboratively with vets, they are much more effective, dollar for dollar, in reducing shelter admissions and deaths than untargeted programs, which is, of course, the bottom line.

As you say, it's also essential to respect vets' business interests and their need to make a living by paying them fairly for the services you ask them to provide. While it may be reasonable to ask them to help support a targeted program by discounting their fees by 10-20%, it is not fair to ask them to offer a much greater discount. This will likely mean that you have to secure a source of funding to replace the traditional approach in which vets are expected to provide the subsidies themselves by discounting their fees so much that they take a loss. Well-targeted programs, though, are cost effective enough and provide such substantial benefits to the community that they are a good investment of public funds.

It all works together: public funding allows you to pay vets fairly, which encourages their broad support. And the support of the veterinary community not only makes the program more successful, it makes it easier to secure public funding in the first place and to keep it.

Best of luck in your work! Let me know if I can be of assistance.

Nuts and bolts of publicly funded spay/neuter

Question from Diane:

Our SPCA has started a low-cost spay/neuter clinic that we run out of our shelter. At this point we have a wonderful vet who comes in and does spays and neuters for about $20.00 an animal. She is very fast, but she alone cannot do enough to make the impact we are determined to make. There are many veterinary practices in our area, but none willing to work cheap. I know we have to do more than fund raise and write grants. I would like some nuts and bolts information about how Peter Marsh got his state funding. Also, in regards to how picky we should be when enlisting new vets... how important is it that they are on board with operating on feral cats and juvenile patients (starting at 2 months/2 pounds)? Some vets are reluctant to perform spay/neuter for feral and/or young patients. Is it just the fear of the unfamiliar?

Response from Esther:

Peter will fill you in on how he got his state funding.

Diane, I agree with you that too many vets are reluctant to perform spay/neuter on feral and/or young patients. But it usually takes a vet (or several of them) to convince other vets to open their minds. Would your excellent vet be willing to host an evening with movies* and free popcorn (or other incentives), showing the videos to as many area vets as are willing to come? I am referring to a couple of great videos on pediatric and feral spay/neuter techniques, each designed to persuade vets to consider doing these "new" procedures:

- AHA's "The Case for early Neutering" (complete with a fabulous booklet) contact AHA S/N Video, 63 Inverness Drive East, Englewood, CO 80112
- Auburn University College of Veterinary Medicine's "Working with Feral Cats in Practice". Send a check for $10 to Auburn U. Foundation, C/o Dr. Brenda Griffin, Scott-Ritchey Research Center, College of Veterinary Medicine, Auburn University, Auburn, AL 36849.

Ideally, you could find another vet or two who lives fairly near you who would join your vet as these videos are shown, helping to answer questions and providing moral support for her, and brainstorming on how to promote further use of these techniques in your region.

Probably your own vet will be put to best use by saving her for the early and feral spays, since she knows how to do them fast and well. Until, and unless, the other vets learn these newer practices, you are right to be "picky". After all, NO cat or dog, kitten or pup should ever, ever, leave a shelter unaltered!!! At this time only your current vet is in a position to ensure that. Let us hope at least a few of the other vets will overcome their fears. Feel free to contact us with more information about where you are -- often we can refer you to others you may not know who may live nearby, and can help you expand your program.

The ferals do need attention, and unless there are very few of them in your area, it will probably take several vets to do the numbers needed to alter 70 to 80% of them -- the percent needed to make a real difference. The basic rule in doing ferals seems to be "do not touch the cat while he or she is awake." There are humane traps and squeeze cages to ensure that the injection to render them unconscious can be given through the cage with no need to hold or even touch them. These and many other points are covered in the "Working with Feral Cats in Practice" video. Alley Cat Allies also has materials for vets as well as feral colony caretakers.

Response from Peter:

A legendary community organizer, Saul Alinsky, once said, "Power in America gravitates to two poles: people with money and people with people." As usual, when we began working to get a publicly funded neutering assistance program in New Hampshire, we didn't have much money. In fact, that's one of the reasons we weren't able to get where we needed to go without help. But we knew that most people hated the idea that healthy cats and dogs were being put to death every day in our shelters. We knew they would support us if we came up with a realistic plan to end the killing. We knew we had people. To succeed, we had to do what all grassroots organizers do: identify our supporters, mobilize them, and organize them so they could pitch in at the right time.

The nuts and bolts of our campaign began, as most do, with "doing our homework", an intensive process in which we collected all the information we could about shelter overpopulation in New Hampshire and the approaches advocates had taken in other parts of the country to solve it. While this may seem at first to be a detour, the data you collect usually turns out to be of enormous value in the legislative process, both to convince legislators that your proposal is well thought out and to put together a program that, in the end, will succeed in doing what you hoped it would do. Since then, Aimee St. Arnaud, Best Friends' Community Programs Director, has put together an invaluable tool to guide you through this process. It's called "A Community Needs Assessment". It is available on Best Friends' website (http://www.bestfriends.org/nomorehomelesspets/pdf/assessment.pdf). I'm sure it would be of great assistance to you.

Then we began the identification and mobilization process. Details about the legislative campaigns are also available on Best Friends' website in a Best Friends Magazine article titled "The Campaign for a Publicly Funded Spay/Neuter Program", so I won't repeat them here. The best description of the essential nuts and bolts of an effective grassroots lobbying campaign is contained in a 1999 book by Bob Smucker, The Nonprofit Lobbying Guide. It's published by Independent Sector and is available in the Publications section of their website (www.independentsector.org). This book also includes the clearest explanation I've seen of the best way for grassroots groups to undertake legislative initiatives without jeopardizing their non-profit status, so it's a twofer.

One of the best things about a legislative campaign like this is that all the work you do helps you down the path you need to follow anyway to make a world in which there are no more homeless companion animals. To borrow a strategy from children's advocates, it takes a village to end homelessness. To succeed, we need only to follow the path they have taken to get the kids out of the mines and mills and orphanages. Best of luck as you travel down that path.

Importance of including feral cats in municipal spay/neuter programs

Question from Julie:

My community has a significant feral and free-roaming cat population. We will soon have a municipally funded spay/neuter assistance program. However, it will not include feral cats, so I'm concerned that we will not see a significant decrease in shelter intake. Can you give examples of municipally funded programs that do cover Trap, Neuter, Return (TNR) for ferals? The main objection mentioned by our municipal officials involved how to prove the cats are not from other communities that are not contributing financially to this program.

Response from Esther:

Peter will cover some of these programs with which he has had contact. I urge you to contact Alley Cat Allies for ideas on how to reach public officials. They have produced a special 9-minute video specifically to address these officials.

In Bridgeport, the officials I approached regarding the problem of feral and stray cats were not City Council members or the mayor, or even animal control, but public health. They were very receptive, and I would have been surprised to see them use an excuse like "you need to prove that the cats are not from other communities..." They deal with problems from a holistic viewpoint, and always focus on solutions. Have you spoken with the Public Health Department yet? They may be very willing to work with you.

Even if the cats are from some other place, they are in your community now, and your community's challenge! If your politicians would prefer to develop a regional cat program, that would be terrific! But, honestly, it sounds more like they just do not want to deal with what is.

I urge you to develop a private program for now, just to ensure things do not get worse. Even if you spay/neuter a few hundred cats, it will help. Once you can demonstrate success, and perhaps the political landscape changes for the better, you will be able to secure public funding. Meanwhile, many feral cat programs have come up with amazing ways to raise funds until public funding can be obtained. Please have a look at a couple of our old SPAY/USA Network News articles catalogued on our www.spayusa.org web site. These articles are:
- Finding Funding for Fixing Feral Felines -- Winter Issue, 1999 and
- Putting the FUN back in Fundraising -- Winter 2002

We do have extra hard copies here at our office if people want them; just contact us for them.

Alley Cat Allies has a Feral Friends Network, which is a national network of dedicated people doing the kind of work you are. There are more and more of these city or regional cat networks developing across the country, and as they cooperate, there will be increasing strength to improve public policy regarding cats. That is our true goal. I have a wonderful quote from Jane Goodall, one of my real heroes, on my wall; she says, "Only if we understand can we care. Only if we care will we help. Only if we help shall they be saved."

Response from Peter:

I'm happy to hear that you'll soon have a publicly funded neutering assistance program in your community. Many of the reasons why that program will prove to be a wise investment of taxpayers' money apply equally well to a program that helps sterilize and vaccinate free-roaming and feral cats. In fact, the public health risk from unmanaged feral colonies is much greater than that resulting from unsterilized household cats and dogs.

Over the last several years, an increasing number of progressive municipalities have provided funding to sterilize and vaccinate free-roaming cats. I'm sure that Esther will tell you about how she secured funding from the Bridgeport (CT) Health Department for the Bridgeport Cat Program. Feral cat protection groups from Toledo and Columbus (OH) to Haverhill (MA) to Berkeley (CA) and Brevard County (FL) have secured funding for their programs, too. Becky Robinson, the Executive Director of Alley Cat Allies (www.alleycat.org) can give you a much more complete list of all the feral cat advocates who have secured government funding for their programs. Another excellent resource is a paper Aimee St. Arnaud, Best Friends' Community Program Manager put together titled "Public Funding for Spay/Neuter". It's available on Best Friends' website (http://www.bestfriends.org/nomorehomelesspets/pdf/FundingSN.pdf).

Don't be reluctant to organize an aggressive campaign to secure public funding for your program. Always keep in mind that the "trap and kill" programs around the country are all paid for with our tax dollars. It's entirely appropriate for us to make sure that our money is spent more wisely... and more humanely.

Creating Spay/Neuter Programs that Work

Introduction from Peter Marsh and Esther Mechler:

Questions

Getting government interested in spay/neuter

Question from Francine:

Response from Esther:

Response from Peter:

How can we get ahead of 'Just One Litter?'

Question from Kay:

Response from Esther:

Response from Peter:

What if low cost spay/neuter isn't accessible in your area?

Question from Robin:

Response from Esther:

Response from Peter:

When overpopulation is rampant and strays are considered vermin

Question from Stephanie:

Response from Peter:

Response from Esther:

Available resources for start-up spay/neuter programs

Question from Katie:

Response from Peter:

Response from Esther:

Comment from Alex:

What is targeted spay/neuter?

Question from Lori and Janet:

Response from Esther:

Response from Peter:

Countering resistance to neutering males

Question from Mary:

Response from Esther:

Response from Peter:

Comment from Crystal:

How to avoid alienating the veterinary community

Question from Crystal:

Response from Esther:

Response from Peter:

Nuts and bolts of publicly funded spay/neuter

Question from Diane:

Response from Esther:

Response from Peter:

Importance of including feral cats in municipal spay/neuter programs

Question from Julie:

Response from Esther:

Response from Peter: