By Kyrsten Jade Janke
Humane Canada is a particularly special conference for animal shelter and community medicine professionals. While the breadth of animal welfare topics explored by the conference is broad, the issues faced by animal welfare professionals are shared. This event brings together a individuals with varied backgrounds to share their experiences in the field. Last month, CASCMA was honoured to curate an Accessible Care track for the conference, with the goal of identifying and providing tools to overcome obstacles to veterinary care in the country.
As all services work to improve their accessibility, the CASCMA Access to Care track speakers shared experiences and research so that impactful evidence-based policies and strategies can be used to overcome social, economic and structural barriers. Dr. Linda Jacobson introduced her newly published papers quantifying the access to care problem in Canada and the barriers reported by pet owners. Chris Robinson, Ann-Marie Patkus, and Dr. Hanna Booth formed a panel to discuss how they worked to increase Spay/Neuter access to their respective organizations. Dr. Sara Ritzie spoke about the tangible affects compassion can have on improving access to care, and Dr. Gina Bowen and Dr. Valli Fraser-Celin relayed their experiences using hormonal implants as a form of temporary spay/neuter in remote communities.
Access to Veterinary Care in Canada: A New Knowledge Base
Dr. Linda Jacobson, President of CASCMA and Director of Science and Advancement at Toronto Humane Society, has made substantial inroads to quantifying the accessible care gap and the barriers creating it. Through two publications in 2024, “Trends in companion animal access to veterinary care in Canada, 2007 to 2020” and “Barriers and Lack of Access to Veterinary Care in Canada, 2022” , we now have national Canadian-centric data to describe inaccessible care. Prior to these two studies, policies and strategies to improve access to care had to use American data as a reference. The first, describes the breadth of the problem by trying to elucidate the number of animals without a veterinary relationship. The second surveyed pet owners asking them to report on whether they had experienced a barrier to care and what barriers were experienced. This study revealed differences between the barriers to care faced by Americans and Canadians. Unsurprisingly, cost was a barrier, but was notably a barrier for individuals regardless of income level. Furthermore, while cost was reported as the overwhelming reason for access to care issues in the US, in Canada an inability to get an appointment was reported as a significant barrier alongside cost.
While the inaccessibility of veterinary care is appreciated on a daily basis by those working in animal sheltering and community medicine, understanding the breadth of the problem and the Canadian-specific nuances provides stronger evidence for program development, government funding and the development of measurable national goals. The issues quantified in this presentation were echoed throughout the other access to care presentations.
How can we Increase Spay/Neuter Access in Today’s Landscape?
Techniques to ensure spay and neuter services are accessible depends on the community you’re providing the service to. To understand the many aspects involved, a panel of varied community medicine professionals was rallied onto a panel to discuss: Chris Robinson, Executive Director of Canadian Animal Assistance Team (CAAT), Ann-Marie Patkus, Chief Financial Officer at East Village Animal Hospitals, and Dr.Hanna Booth, a veterinarian from Toronto Animal Services (TAS). Each of these speakers represented an organization that provides low-cost accessible spay/neuter to different populations, with CAAT providing spay/neuter to remote indigenous communities, East Village Animal Hospitals providing low-cost high-volume services to low-income pet owners in Toronto, and TAS providing mobile services to Toronto communities. Despite these differences, all three shared many similar lessons.
Ann-Marie and Chris both spoke about the importance of providing services where the community communicated a need. In the case of CAAT, community trust was built and animal welfare most improved when they approached a community about what it’s animal welfare needs were and provided those services where they were able. In doing this, they addressed the communities lived experiences with their pets, as well as fostering trust. As Chris explained, “Humane education turned into knowledge sharing that went both ways”.
All three panelists shared their struggles with government legislation. Hanna spoke of TAS’s struggle to lobby the government for their mobile clinic license to allow them to operate a mobile SNIP program. Chris spoke about the CAATs team origin as an international organization as they weren’t able to operate within Canada. Even now, she reports, each province has different compliance requirements. Ann-Marie echoed these sentiments, as legislative barriers have impeded their clinics ability to provide low cost care as well. As all vet clinics must be owned by a vet, they aren’t eligible to be a non-for-profit. Being an NFP/Registered Charity would open fundraising and grant opportunities to subsidize their clients services. While all three reported that things have improved dramatically in recent years, there are still many regulatory steps that would ease the work organizations are doing to improve accessible care.
Facilitating Access to Veterinary Care – Expanding Spectrum of Care
Dr. Sara Ritzie, a community medicine resident with the the Ontario Veterinary College, gave an interactive presentation on the role of compassion in increasing public trust and the improved animal welfare that results. She spoke tenderly about a case involving an owner and his dog, Rocky. She first described a situation in which an owner calls about an injury their dog has sustained, that by all descriptions sounds terribly infected. In asking the audience how they would feel toward the owner and the dog many of the audience members wondered at why he hadn’t sought care earlier.
However, Sara went on to explain the barriers the man was facing: he was from a remote community that was more than a handful of hours from the nearest clinic, he had had negative experiences with veterinarians in the past, there were cost concerns associated not just with treatment, but the gas to get to care, and a lack of knowledge (as the owner thought that by licking the dog was keeping the wound clean and allowing it to heal). With compassion, Sara was able to navigate the situation in a way that preserved the human-animal bond and got the dog the care he needed.
In the end, she had us entertain what might have happened had man been approached with judgement instead. If the relationship between the vet/organization and the client was damaged, the client may not trust the advice provided and delayed veterinary care for future pets. Approaching the situation with compassion for the barriers to care the owner was experiencing, Sara was able to preserve the human-animal bond and strengthen the trust between owner and veterinarian.
Hormonal Implants: Increasing Access to Veterinary Care in Remote Communities
Hormonal implants as an alternative to surgical sterilization have existed since 2007, but was not available in Canada. In 2018, Dr. Gina Bowen was able to secure a batch using an Emergency Drug Release for a remote community in Northern Manitoba. In this presentation, Dr. Gina Bowen and Dr. Valli Fraser-Celin presented their experiences with these implants. Dr. Bowen is the Director of Services for the Winnipeg Humane Society, and Dr. Valli Fraser-Celin is the Project Manager for the community pet care project at Ontario Veterinary College.
It should be appreciated that spaying/neutering dogs in remote communities comes with additional barriers compared to urban centers, including: temperature (as many of the pets are free roaming), remoteness (cost of access), and personnel availability. Gina explained that temporary injectable sterilization has many benefits in these environments as they can be given without risk at low temperatures (compared to the concerns of releasing post-surgical dogs into the outdoors), the weight of equipment is considerably less, and the number and degree of training required by personnel is lower.
Many of these communities had never experienced a vet, and surgical sterilization was received with anxiety and trepidation. Owners were concerned with leaving their pet at the clinic, the unfamiliar risks of anaesthesia, and the idea of removing something from the animal that was natural. Often the community was used to litters and didn’t necessarily view population growth as problematic. However, the behaviour benefits of sterilization in males (decreasing wandering, dog fights, etc.) was particularly appreciated and Gina reported that owners often saw the behavioural benefits of the injections, and later chose permanent sterilization.
Summary
Despite the myriad of situations, communities, and types of care being offered in these presentations, a few common themes became evident. While accessibility has long been a topic in shelter and community medicine, accessibility has been an area of wider awareness since COVID. With that comes resources to gather nation-wide data on barriers and accessibility to veterinary care that can inform the topics highlighted in each presentation: compassionate care, legislation and regulatory advances that facilitate accessibility, and a community-led response by shelter and community medicine professionals.
For all those who were able to attend, it was lovely to meet so many of you. For those who were not, we hope this summary gives you a taste of the resources available in this wonderful community.