Accessible veterinary care, what does that mean?

Our focus this month is on the JFMS Special Collection about accessible veterinary care which is available for you to read using the link below.

Firstly, Nathalie Dowgray sits down with Dr Linda Jacobson, our special guest editor of the collection. We discuss how the collection came to be, the barriers preventing cats from receiving veterinary care and the work she is doing with the Toronto Humane Society to help both cats and caregivers who are struggling.

Nathalie is then joined by International Cat Care’s Head Of Unowned Cats, Vicky Halls, and they speak with Dr Gemma Ma about her paper on the characteristics of cat semi-owners and their impact in Australia.

For further reading material please visit:
https://journals.sagepub.com/topic/collections-jfm/jfm-1_accessible_veterinary_care/jfm

For ISFM members, full recordings of each episode of the podcast is available for you to listen to at portal.icatcare.org. To become an ISFM member, or find out more about our Cat Friendly schemes, visit icatcare.org


Host:
Nathalie Dowgray, BVSc, MANZCVS, PgDip, MRCVS, PhD, Head of ISFM, International Society of Feline Medicine, International Cat Care, Tisbury, Wiltshire, UK

Speakers:
Linda Jacobson, BVSc, MMedVet(Med), PhD (U Pretoria), Senior Manager of Shelter Medicine Advancement at Toronto Humane Society, President & Treasurer of the Canadian Animal Shelter and Community Medicine Association.

Vicky Halls, RVN Dip Couns, Head Of Unowned Cats for International Cat Care and published author

Gemma Ma, BVSc (USyd), PhD (USyd), Project Manager at Keeping Cats Safe at Home, Community Veterinarian at RSPCA NSW and published JFMS Author.

Creators & Guests

Host

Nathalie Dowgray

What is Chattering With ISFM?

Welcome to Chattering With ISFM, the official monthly podcast of the International Society of Feline Medicine, hosted by Nathalie Dowgray (Head of ISFM). Each month, we chatter about cats and cat-friendly practices with industry experts and contributors to The Journal of Feline Medicine and Surgery. Each episode contains highlights from our longer discussions and interviews, which are accessible to ISFM members at portal.icatcare.org. If you would like access to our full episodes, would like to become an ISFM member, or find out more about our Cat-Friendly schemes, visit icatcare.org.

Nathalie Dowgray: Hello,
welcome to the December 2023

episode of Chattering with ISFM.

I'm Nathalie Dowgray, Head of ISFM,
and host of this month's podcast.

For December, we're going to be focusing
on the JFMS Special Collection, and

that's on accessible veterinary care.

Firstly, I'm speaking with Dr.

Linda Jacobson, and she's our special
guest editor of this collection.

And then in the second interview, I'm
going to be joined by my colleague at

International Cat Care, Vicky Halls.

She's our Head of Unowned Cats.

And we're going to be speaking with Dr.

Gemma Ma on her paper,
Characteristics of Cat Semi Owners.

So welcome everybody.

And I'd like to welcome my special
guest today, Linda Jacobson.

And when we started the special
collection, I think it took us a

while to agree that accessible care
was going to be the best title.

Would you be able to explain what was
meant by the term and what the scope of

the special collection was going to be?

Linda Jacobson: We talked about calling
it affordable care versus accessible

care and ended up choosing accessible
care because what we're really looking

at is perhaps not so much access to
care as barriers to access to care.

Among those barriers, affordability
is really important one,

but there are many others.

We found there were many other barriers
to care that included fear of being

judged, veterinarians not taking
new patients, not knowing where to

go, language barriers, transport,
and then lack of a leash or carrier.

I'd lastly just say that I think
it's a mistake to think that barriers

live in isolation from one another.

They're often interlinked.

In Canada, we have a very
substantial geographic barriers.

We have some communities that are
extremely remote and have no veterinarians

and often no veterinary care.

When they do have access to veterinary
care, that's often clinics that go in

once or twice a year to do vaccinations.

So very limited access to care.

Even in more affluent communities in
Canada, sometimes there are three, four,

five hour drives to certain types of
care, particularly emergency clinics.

Nathalie Dowgray: And I guess we also
have to think about cat factors as well.

There are a lot of cats that they
themselves are the physical barrier

from going to the vet clinic too.

It's something that both ourselves at
ISFM and our colleagues at AAFP recognise

with our Cat Friendly Clinic and Cat
Friendly Practice programs that creating

an environment that doesn't put the
cat and the cat owner off coming back

to the vet can be quite important too.

Linda Jacobson: Yes, absolutely.

And it's a reason that this
collection belongs so nicely inside

the Journal of Feline Medicine and
Surgery simply because cats lack

access to care compared with dogs.

We're hoping that the cat
friendly practices will

start to help close that gap.

The other factor is that cats
are so good at hiding illness.

So if they aren't receiving regular
preventive care and people are only

taking their cat to the vet when
they're sick, that would mean that

many cats would not be seen until
the illness is quite far advanced.

It's very interesting in our survey,
something like 10 to 12 percent of

respondents said that the barrier to
accessing care was fear of being judged.

So the concern is that if people wait
too long, either because they haven't

realised the cat is sick, or because they
felt that they couldn't afford the care,

but then they get to a point where it's
urgent, that they may still not access

care because of a fear of being judged.

Nathalie Dowgray: During COVID,
there was more demand on services.

I'm really interested to know what sort
of impact that has had on the work that

you guys do at the Toronto Humane Society.

Linda Jacobson: So in terms of the
impact of the pandemic and what we've

been seeing after the pandemic, there
are really three big factors at play.

One is the veterinary capacity shortage.

There's also shrinking of disposable
income because of escalating housing

costs, food costs, inflation, and then
growing inequality in many countries.

And then veterinary costs have
far outstripped inflation from the

perspective of the Toronto Humane Society.

We've seen a real crisis in the city
post pandemic with pet caregivers

really struggling to find a lot of
different needs for their pets, not just

veterinary care, but veterinary care
being a really important one of them.

As an organisation, we have really
been shifting to a much more proactive

approach to pet human families, not just
accepting that relinquishment is the

solution to caregivers who are struggling.

So we start off with our Pet Parent
Support Network, where we try

and understand what the problem
is and whether we can help to

keep that pet in its loving home.

We do some counselling.

We have training services that
can sometimes help people.

We can offer food carriers and
other kinds of support as well

as preventive veterinary care.

And then we also have an urgent care
foster program where if people are in

temporary trouble, we can foster their
pet for six months and sometimes up to a

year while they get back on their feet.

We have a really sad cat story that
happened recently where we were sent a

photograph by an older man of him and
his cat, and he said he was about to be

evicted and that he wanted us to help
his cat by finding a foster home for her

because he was worried that she wasn't
going to be able to withstand the cold.

And there we were thinking, what is
this poor man going to do in the cold?

So one of the things we've done is we've
hired a veterinary social worker and

she actually has very good connections
with agencies in the city, and hopefully

we'll be able to reach out to them
and see if we can actually help this

person as well as just helping his cat.

Nathalie Dowgray: Brilliant.

That's really interesting and, and really
interesting to hear this, the proactive

approach that, that you guys are taking.

I just picked up on a term
that you mentioned there around

a veterinary social worker.

Would you be able to just briefly tell me
what that sort of skill set looks like?

Linda Jacobson: We work at the
interface of people and animals, and

we're pretty good at the animal side.

And there's a lot we don't know
about the human side because that

wasn't what we were trained to do.

So veterinary social workers at
the organisational level, they

can help staff with stress,
compassion and fatigue and burnout.

And those types of issues, and they can
also help both staff and clients with

grief counselling in shelter environments.

That's really important because
people become very attached

to the animals in our care.

And then they also act as an
interface between us and people who

are in trouble and the agencies in
the city who support those people.

For many people in those kinds
of circumstance, what keeps

them alive and what gives them
something to live for is their pet.

And that's where we can step in through
our veterinary social worker and

really help to maintain those bonds.

Nathalie Dowgray: Brilliant.

I think that is really
important, isn't it?

One of the biggest barriers for people
that are homelessness in terms of seeking

out shelters is often they don't want to
lose their pet if they actually go into

it a more suitable accommodation for them.

So it is such an important piece of work.

So thank you so much for all of your work.

Linda Jacobson: You're very welcome.

Thank you.

Nathalie Dowgray: And now Vicky Halls and
Gemma Ma are going to join me and we're

going to be talking about cat semi owners.

So firstly, Gemma, what I found really
interesting in your paper is this

sort of concept of semi ownership.

Why did you think they were an
important group to understand?

What's different about semi owners?

Gemma Ma: This is behaviour
that we've observed in our

shelters for a really long time.

We know that people have
relationships with stray cats, but

they don't consider they own them.

We have, in our community, lots of
people are really worried about wildlife.

They really are worried about the
impact that cats have on wildlife.

This is interesting because semi owners
are a population that we found in this

study that have really different beliefs
about cats, they're less concerned

about the impacts they have on wildlife,
they're more likely to believe that

cats should be allowed to roam and
that they shouldn't be contained.

So they're a bit different to the
rest of the cat owning community

and the rest of the Australian
community, but they're also a group

who obviously really care about cats.

They love cats, they really prioritise
cat well being and welfare, which is

really interesting because it creates this
polarization in Australia, between the

people who are semi owners or the people
who really support the semi owners and

love the cats and the ecologists and the
wildlife conservationists, but the good

news is that when it all boils down, the
objectives on all the sides are the same,

that we all believe that there are no cats
left living these difficult lives on the

streets with no one looking after them.

We have to find a way to get these two
groups of people who disagree to work

together towards the same objective of
actually just getting all these cats

into homes and looked after properly.

Nathalie Dowgray: Vicky, I
don't know if you had some

questions around that as well.

I'll hand over to you if you want.

Vicky Halls: You were very specific
in your paper, which I really liked

about categorising cats differently.

And I know that in different parts
of the world, we use these same

words, but we don't use them to
describe the same type of cat.

Gemma Ma: Definitions are so important.

I think what is less important is
the actual words that are used are

less important than how they're
defined and making sure that they're

defined really clearly and in a
way that's relevant to management.

The important point to consider
is that all the cats in Australia

are essentially the same.

They are the same species.

We don't have great genetic data, but
what we do have suggests that these

are one continuous population, all
the cats in Australia, the difference

is in their relationship with people.

So some cats have no relationship
with people whatsoever.

They're living as wild creatures in the
bush, living off their own instincts,

no support from people whatsoever.

We call those feral cats.

And then we have ones who have an indirect
relationship with people or people who

don't consider themselves the owner.

So we refer to them as unowned cats.

Often they're called stray cats.

I think that can be a useful term as
well, because it's very commonly used

in the community and lots of people
understand that as a reference to an

unowned cat, but I think the problem with
using stray as a term, is that it can

also describe the cat's behaviour rather
than its actual relationship with people.

And then a stray cat, a cat that's
roaming in the street, for example,

could be a feral cat, it could be an
unowned cat, it could be an owned cat.

And you don't know, but it's
straying, it's roaming in the streets.

I think it's very important that the
current threat, the draft updated threat

abatement plan, has divided cats into
a binary of feral cats and pet cats,

which I think is very problematic.

That third category in between is missing.

The unowned population in between the
feral cats and the owned cat is the

key to managing cats in Australia.

The narrative generally is
if you're feeding stray cats,

you're making the problem worse.

Just don't feed them, which is
really unhelpful advice because if

you've got a hungry cat in front
of you, it's really hard to just

let them starve on your doorstep.

So trying to stop this compassionate
behaviour without providing an alternative

for that animal is really problematic.

And it's going to make it harder
to work with the semi owners.

And it's also going to create this huge
barrier for the semi owners to take on

official responsibility for the care
of the cats that they're looking after.

Because if they have to become
an owner in, inverted commas,

that can be impossible for them.

Often people who are semi owners are
semi owners because they can't take on

ownership officially of the cat, whether
they're in accommodation that doesn't

allow pet ownership, whether they don't
have the financial resources to commit to

all the obligations of having a pet cat.

A whole bunch of different reasons,
but I think we want to remove as

many barriers as we can to getting
these cats looked after properly.

Vicky Halls: I think that's
a really interesting point.

It's then difficult to engage with
those people at all, if they then feel

that they're doing something illegal.

Gemma Ma: In our experience, there's
a whole bunch of different categories,

different types of semi owners.

There are the people who just
have one cat who turns up on their

doorstep and they look after it.

There's the people who have
50 at their house, but they

consider them to be unowned cats,
but they look after them all.

There are the people who travel out of
area and all over the place, feeding

different colonies in different locations.

And they do that, they spend huge
amounts of their own time and

money looking after these cats
who are not their responsibility.

I say they're all united.

They're not just empathetic, but
they're acting compassionately on

their empathy for these creatures
that are seen in front of them.

And they're actually a huge resource.

They really care and they can really
help with cat management intervention.

We're actually working, we've
got 11 of these desexing programs

that we're running right now.

We're heading into our
second year at the moment.

So, collecting lots of data and
we'll be writing this up eventually.

Watch this space.

Vicky Halls: That is very exciting.

Nathalie Dowgray: Thank you for listening.

The Accessible Care Special Issue
is available on the JFMS website.

We hope you'll find it
a useful collection.

If you're an ISFM member, don't forget
you can access the full version of

the podcast and all the other ISFM
member benefits including congress

recordings, monthly webinars and clinical
clubs, the discussion forum, and much

much more at portal.icatcare.org.

We'll be back again next month with
our regular monthly chattering.

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ISFM on your preferred podcast platform.

Have a happy new year everyone.