Releasing Cats to Live Outdoors: Humane, Environmental and One Health Concerns

By Dr. Michael W. Fox & Deanna L Krantz

This review article is in part a response to the publication in Conservation Biology by William S. Lynn and associates “A moral panic over cats” First published: 14 May 2019 https://doi.org/10.1111/cobi.13346 which raises the ethical dilemma of dealing with feral animals, their impact on biodiversity, environmental and public health and concern for such animals’ welfare as sentient beings.

Contemporary society is facing many ethical challenges dealing with wildlife conflicts, the release of non-indigenous and “exotic” species into the natural environment, free-roaming and feral cats and the issue of animals’ rights and well-being.(1) While it has been said that for the truly ethical person all life is sacred and that the merciful man is merciful to his beast, there are no simple moral directives for dealing with livestock predators, “pests”, invasive species and various human-animal conflicts. To resolve ethical dilemmas the interests of all stake-holders/involved parties must be considered as well as the consequences of decided-upon actions. To be involved is to care and to care is a virtue which must be open to moral examination especially when there are vested interests and self-righteous conviction. The desire to care for and rescue others in need, regardless of species and context, like the issue of euthanasia, call for moral reasoning in ethically challenging situations.

Empathy and altruism are virtues which are best modulated not simply by some objective science, subjective belief or moral reasoning at the personal interest level, but by bioethical evaluation. Without such a broader ethical consideration of the consequences of compassionate or other altruistic actions, more harm and suffering may result and which sound bioethical consideration might have prevented.(2). One case in point, involving many dedicated and well-meaning people as well as colleges of veterinary medicine, is the return of cats to the outdoors after being trapped, neutered and released (TNR). (3).

THE CAT PLAGUE

It is estimated that there are 84 million owned cats and 30-80 million unowned across the contiguous United Sates. (4). Cats compete with indigenous wild carnivores, including raptors, for prey and can spread diseases to them and bring home diseases from them as well as from the prey they consume. Kurt J. Matushek, DVM, Editor- in- Chief of the Journal of the American Veterinary Medical Association, in a personal communication states: “Unfortunately, the feral cat problem is one of those intractable issues that doesn’t yet have a good solution. The ecologic impact is enormous (https://news.vice.com/article/feline-massacre-australia-unveils-plan-to-kill-two-million-feral-cats), but the social and economic pressures make eliminating feral cats largely impossible.” As fatalistic as this statement may seem, it is realistic and there are humane and sensible solutions to the now global stray and feral domestic cat problem. It is another tragic anthropogenic calamity and a classic One Health issue which cannot be misdirected by sentiment over sound science and bioethics.

TO KILL OR NOT TO KILL

On Jan 9 2016 the American Veterinary Medical Association (AVMA) House of Delegates approved revisions of its policy on “free-roaming abandoned and feral cats”. (www.avma.org/policy). The revisions include conditional support of TNR provided that cats are properly cared for. (Both private and municipal animal shelters have simply abandoned cats they have neutered and released with no further care in order to claim they are “No Kill” operations). But Alley Cat Allies (who state on their website Jan 2016 that some 500 communities across the U.S. have TNR programs) decried the statement that “the AVMA does not oppose consideration of euthanasia” for community cats, but the statement remains in the final policy even though the American Association of Feline Practitioners and the American Animal Hospital Association submitted amendments to remove the statement. Regrettably, language referring to putting up fences to contain and protect TNR colony cats was deleted in the AVMA’s revised policy statement. Neither euthanasia nor the reality of shelters not having the resources to house many cats or TNR volunteers to provide proper care for “community cats” can be dismissed, along with the significant impact of cats on wildlife: Nor can the role of well managed TNR programs in helping reduce the overall cat population.

TNR Statement from Philip K. Ensley DVM, Dipl. ACZM. Formerly Veterinarian with the San Diego Zoo and Lifetime Member of the San Diego County Veterinary Medical Association, now living in Colorado

“During my last 5 years in San Diego (2005-2010) I participated in TNR clinics sponsored by our local veterinary association in cooperation with the San Diego Humane Society and SPCA. I averaged 4 clinics per year, which took place monthly, averaging over 100 cats per clinic. During that time frame I recall several, perhaps two papers with good data, in the JAVMA indicating the lack of effectiveness of these programs. In San Diego many, many veterinarians participated or loaned out their clinics for the day. Also licensed animal health technicians provided the support in pre op, anesthesia, and post op. I discovered that so many of the feral cats were known locally and fed from back porches of non- owners. I have no data on how these clinics impacted the local feral cat population, but these cats did receive vaccinations, ivermectin, and were treated for minor issues problems. The program created good will for the veterinary association, and I believe led to many of the back porch feeders to even bring in theses cats for appropriate veterinary care down the road. In addition recent graduates had an opportunity to sharpen their surgical skills and meet longstanding practicing veterinarians, as well as retired veterinarians from the community. Also it made the local community people more humane in their attitude toward these cats, as well as other wildlife in the canyons of San Diego. I think I can say it gave the participants a "do good feeling", and led to further support for the local humane societies' animal issues”.

Having trapped, neutered and socialized several feral cats for adoption as well as keeping some ourselves and enjoying their remarkable presence and affection, we feel that every effort should be made to avoid euthanasia because, time and resources permitting, their trust will generally be won over so they can enjoy a quality of life in our homes or sanctuaries with freedom from fear.

Cats (as a “bipolar domesticants”) have not lost the ability to adapt to living in the wild to the degree that we see in many breeds of dog. Their flight-fight-flight neuroendocrine system is activated effectively by the contingencies of the immediate environment and they become effective predators. But many cats lack this capacity and suffer the consequences when lost or released. This system can be subdued in a quiet, secure environment (rarely provided in animal shelters) coupled with appropriate and experienced human interaction. Millions of cats live in two worlds as indoor-outdoor animals (still a cultural norm in the U.K. and many other countries) and often bring home wild animals they have killed or injured such as chipmunks, voles, baby rabbits, chickadees and lizards, require veterinary treatments themselves for injuries and diseases as well as their owners who contract various infections and confront infestations that these cats bring back into their homes and beds.

TNR, RISKS AND BENEFITS

Many municipal, private and publicly funded animal shelters have adopted a no-kill policy for cats brought in by caring people as strays and rescues but are not considered adoptable. This no-kill claim is made possible by so called trap-neuter-release (TNR) (or trap-neuter-vaccinate and release (TNVR)) activities, essentially putting cats back outdoors to fend for themselves. There are too many cats coming in to shelters than can be accommodated for any length of time which is very much needed to enable the recovery and adoptability of many traumatized and “feralized” cats. They are neutered, may or may not be vaccinated minimally and then are released where they were found. Under the banner “Feral Freedom” Best Friends Animal Society in Utah promotes the vaccination, sterilization, ear clipping and return-to-field (RTF), i.e. original location, all cats in shelters considered unadoptable. (5). The Association of Shelter Veterinarians and other professionals in shelter animal care have come to accept TNR unconditionally as per the text book addressing applied animal behavior in the shelter environment. (6).

These various TNR initiatives can be especially cruel when there are no daily feedings of these cats, (or plentiful prey), adequate shelter in bad weather or veterinary care when needed. Once trapped, these cats can be extremely difficult to re-trap for necessary booster rabies vaccinations, treatment for injuries and evident- from- a -distance discomfort from ear mites and Cuterebra blowfly larvae which can even invade cats’ brains. Releasing neutered cats to live outdoors can create a public health risk since they can carry several diseases transmissible to humans*, children and the immunocompromised being especially at risk. (7). TNVR can also create a public nuisance when these cats enter private property.

Wild cat species like bobcats and lynx do not live in “colonies” but in low-density, widely separated hunting territories in numbers proportional to prey-density, usually in a cyclical pattern. The cats’ ranges tend to overlap but contact and conflict, except during the breeding season, are avoided by scent marking and time-place separation. High-density TNR cat colonies/communities are not, therefore, “natural”. They are biological aberrations, a far cry from the wild and of living a natural life as some TNR advocates contend. An ecologically abnormal high density of cats will mean relatively high kill rates of available prey and then starvation unless volunteers come and feed the cats. Not doing so amounts to abandonment, neglect and cruelty in violation of state and federal animal protection laws. To humanely end the lives of such un-adoptable cats where there are no daily volunteers to care for them would not be unethical but difficult when they are otherwise healthy. To give them all a chance because they have a life is as irresponsible as saying euthanize them all. In areas where there is a high prey density, as around human habitation, barns and warehouses, a higher cat population is feasible in such unnatural “ecosystems”, such cats being referred to as “working” cats by TNR advocates. But this should not mean these cats should not be closely monitored and given appropriate care as needed.

SCIENTIFIC EVIDENCE OF TNR BENEFITS

It is evident that the primary beneficiaries of TNR activities are the persons involved, Alley Cat Allies elevating the practice to a cult-like status, and a highly lucrative and politically influential one at that! In her book The Lion in the Living Room, Abigail Tucker cites conservation biologists who regard this organization and what it promotes as “cat hoarding without walls.”

Advocates of TNR make the obvious claim that their established ‘colonies’ of neutered and vaccinated cats in urban and suburban environments where they are released help reduce the overall cat population. But other cats may simply move elsewhere to avoid contact and territorial conflicts with established cat colonies, giving the false impression that there are fewer cats in a given locale. Certainly when hundreds of cats have been neutered and released after a few years there will eventually be fewer kittens and adult cats being brought in to shelters as recently documented in California (8). Until this latter report, which has no documentation on wildlife impact, none of these community-based programs have published any peer reviewed reports showing they have succeeded in effectively controlling feral cat numbers on any significant large scale, but on a small scale in relatively confined colonies as on a college campus, success is evident. (9). Scientific studies of the effects of TNR on targeted cats and the local cat population (10) demonstrate essentially what one would expect following neutering, namely better physical condition and longevity in part determined by the quality of human oversight and supplemental feeding, neutered males being less aggressive and females not having to raise kittens. With fewer screaming cat fights there were fewer public complaints. But none of the reports mention any significant decrease in killing of wildlife where wildlife are present in the TNR cat colony environment: And with a greater longevity such cats clearly could be a problem except in confined or isolated locations and where they are provided adequate food and shelter as needed. The only obvious positive result in terms of the virtual plague of free roaming cats in the U.S. and other countries is that TNR takes cats out of the breeding cycle. But in most situations the cats should be taken out of the environments they invade, harm and suffer, be they breeding or not.

At best, TNR/TRVR cat colonies may indirectly help reduce stray and feral breeding populations of cats when established in significant numbers through competition for the same wildlife food-source. But surely the cost to wildlife and biodiversity (notably competition with indigenous predators such as raptors and various wild carnivores), as well as to the health and well-being of these TNR program cats, far exceeds any alleged benefits in most urban and suburban environments. TNR cats released into open suburban and urban environments do not have adequate protection from being injured and killed by traffic, dogs, coyotes and wide-roaming tom cats and even shot, trapped or poisoned by property owners. Many more caring people put out food for free-roaming cats with no intent to capture/rescue, and in the process help increase cats’ survival and multiplication.

TNR, back-into-the- community release of cats may too often amount to abandoning highly stressed and immunocompromised cats who are put at risk, an act of cruelty and irresponsible from animal welfare, wildlife protection and public health perspectives. Without strict protocols and good management such releases should be prohibited by municipal authorities and State public health authorities just as it is being vehemently opposed by the Audubon and other national bird protection and conservation organizations.

Those TNR programs that provide proper care in adoption-promoting cat sanctuaries, such as indoor-outdoor, complex-environment, group-housing facilities and in closed / “island” colonies on some farms, horse barns, well fenced warehouses and even prisons, may be acceptable from a veterinary bioethics perspective: But with the proviso that all cats are fed on a daily basis and are rejected as colony members if they test positive for feline immunodeficiency virus and feline leukemia, unless the colony is specifically for such afflicted felines.

The cat is the definitive host for Toxoplasma gondii and serves as the reservoir for the parasite that affects all warm- blooded animals world-wide, causing fatalities from overwhelming infestation, especially of the young and of those who are immunocompromised. Millions of infective oocytes of this parasite are passed out in cat feces for 10-14 days after infection and infect farm and other animals that consume contaminated water and vegetables. Cats testing negative for Toxoplasma and then released under TNR programs are likely to quickly become infected after consuming rodents that serve as intermediary hosts for this parasite, the harmful cycle being thus perpetuated. The only way to break the cycle is to keep cats indoors to prevent prey-killing and infection. Shedding of oocytes is rare after the first infection. Toxoplasmosis is more likely to occur in cats with feline leukemia virus and feline immunodeficiency virus. Pregnant women and children are at risk when exposed to cat feces in the litterbox, contaminated soil outdoors and especially improperly handled and undercooked pork and beef.

LOCAL AND PERSONAL CAT ISSUES

After trapping a stray/feral cat on our property we took him to the Animal Humane Society (AHS) in Golden Valley, Minnesota’s largest animal humane society not knowing that they had instituted a “Community Cats Initiative,” supported in part by a grant from PetSmart Charities, that embraces a TNR policy that stipulates that the cat whom we took to them and was not assessed as being adoptable would be returned where he was caught if he was not adopted as a “Working Cat” for rodent control on a person’s property. No instructions were provided about feeding and oversight of such cats. All TNR assigned cats are given only a rabies vaccination and no vaccinations against contagious feline diseases, no test for feline leukemia and feline immunodeficiency disease, (FIV) and are released 24 hours after surgical sterilization. The tip of left ear is cut off for identification purposes as a TNR colony or “Working Cat”. According to the AHS’s annual reports, 4.970 cats had been released between Oct 2014, when the program was initiated, and 2018.

A vet tech involved with this program told us “These are wild, feral cats”, implying that being unadoptable by her behavioral assessment they belong in the wild. Behavioral assessments of in-coming cats in shelters may be extremely limited, cats who hiss from understandable fear being designated unadoptable, yet with time and understanding, feral cats can often be fully rehabilitated. (See photos below). Many cats are by nature, shy animals. They are rarely given the benefit of hide-boxes in their holding cages. They would likely fail adoptability tests by shying away and even hissing defensively when approached by a human. Yet inherently shy cats often adapt well and enjoy a quality of life as in-home human companions, many coming to enjoy being petted and groomed. Other cats failing the adoptability evaluation would be the more aggressive cats. Most of these are tom cats who may become more tractable and adoptable a few weeks after castration. We have taken in and rehomed two of these “Community Cats” who were released on our property by the AHS.

The AHS’s TNR program was adopted on the basis of the University of California at Davis veterinary college’s advocacy of Trap-Neuter-Return as an alternative to euthanasia. Under the Million Cat Challenge, a joint project of the UC Davis Koret Shelter Medicine Program and the University of Florida Maddie’s Shelter Medicine Program, TNR is being promoted nation-wide. Their website states that they are “supported by our participating animal shelters and their spay/neuter partners, as well as many national and regional organizations” They are also “ grateful for the contributions of our sponsors, especially Maddie’s Fund, whose generosity made this campaign possible.”

Regardless of personal belief in some right to life or public relations ploy to promote a compassionate “no kill” image, TNR programs are too often examples of misguided altruism causing much suffering to homeless cats who are released in various neighborhoods without any routine monitoring and care. Shakopee MN veterinarian Ron Gaskin DVM, tells us he has had to amputate a stray cat’s frozen tail and do other surgical treatments of cats suffering from severe frostbite. Yet one Minnesota and nation-wide advocate of TNR asserted to us that “TNR-selected cats are put into their natural habitat” (as predators). But this “natural habitat” is not natural for this domesticated species even if they are predators. They have no place in the natural ecology of the North America or Europe. But as a “naturalized” introduced species (and super- predator and devoted, empathic parent) many argue that the cat has a place in the anomalous and dysfunctional ecosystems of human creation---our cities, slums, third world villages, family farms and stables, docks and warehouses.

RODENT CONTROL & FELINE DISEASE CONTROL

The cat’s public health role in rodent control is questionable since adult rats are difficult to kill and close association with diseased rodents may actually facilitate the spread of zoonotic diseases into the human community. (11).

All TNR programs should consider selectively vasectomizing prime mature tom cats to help maintain the social and territorial integrity of the neutered colony--- provided they do not themselves emigrate from the selected area which fencing or natural barriers in many instances would help prevent. Not testing TNR cats for feline immunodeficiency virus (FIV) could introduce this contagious viral disease into existing colonies and to the broader population of owned, free-roaming indoor-outdoor cats, the latter cats also being contributors if they are already infected. According to one report (12) the incidence of FIV has increased by some 48% between 2009-2013.The combination of being captured, caged, surgically neutered and given rabies vaccinations could suppress the immune systems of TNR cats and those in an asymptomatic/carrier state with FIV or feline leukemia virus (FLV) or both could then shed the viruses and spread the infections to other cats.

As veterinarians Walter E. Cook and David A. Jessup write in their letter on this issue, “… although some cats may do reasonably well in some protected outdoor situations, it is our experience that feral cats suffer more and die sooner than owned and protected cats.” We agree with them that local animal control organizations must put humane options first and give greater emphasis on “stemming the flow of kittens into free-ranging populations through mandatory, enforced spaying and neutering of pet cats and stronger message about responsible pet ownership is a good goal.” (13).

Cat lovers across the U.S. support TNR programs in their communities ideologically and financially, many feeling a sense of purpose in going out in all weathers to feed “colonies” of these poor cats. But with few exceptions, the ecological and animal welfare impacts of unfed, un-monitored “colonies” of released cats from animal shelter/humane society operations call for either the euthanasia of un-adopted cats or the setting up of suitable facilities to contain them totally and at the same time provide for their basic needs and behavioral requirements to help insure their health and well-being.

IMPACT ON WILDLIFE

Free roaming cats are a significant presence in rural and state wildlife management areas. (14). Three ‘habitat zones’ within the state of Minnesota designated forest (FO), transition (TR), and farmland (FA) scent station route visitation rates (% of routes with detection), in order of increasing magnitude, were 10% (wolves), 14% (domestic dogs and bobcats), 22% (coyotes), 29% (red foxes), 31% (domestic cats), and 33% (raccoons and skunks). Regionally, route visitations for domestic cat – FO 15%, TR 48%, FA 54%. FA (farm land) includes both farms and rural communities, many with free-roaming indoor-outdoor cats that could serve as breeding loci for a diaspora of cats into wildlife areas wherein their breeding has yet to be documented while their reduction in numbers by larger predators, especially coyotes, is most probable. The adverse impact of domestic cats spreading diseases to bobcats, lynx and other carnivores may be considerable.

A systematic review and quantitatively estimated mortality caused by free-ranging domestic cats in the United States concludes that they kill 1.3–4.0 billion birds and 6.3–22.3 billion mammals annually. Un-owned cats, as opposed to owned pets, cause the majority of this mortality. The authors conclude their findings “suggest that free-ranging cats cause substantially greater wildlife mortality than previously thought and are likely the single greatest source of anthropogenic mortality for US birds and mammals. Scientifically sound conservation and policy intervention is needed to reduce this impact.” (4). These authors note that : “Projects to manage free-ranging cats, such as Trap-Neuter-Return (TNR) colonies, are potentially harmful to wildlife populations, but are implemented across the United States without widespread public knowledge, consideration of scientific evidence or the environmental review processes typically required for actions with harmful environmental consequences.---- Claims that TNR colonies are effective in reducing cat populations, and, therefore, wildlife mortality, are not supported by peer-reviewed scientific studies.” (For documentation see references # 15 & 16).

CONCLUSIONS

Euthanasia (when cat sanctuaries are not yet available or are full and foster-home care-givers too few) is surely more humane and ethical in most situations than returning cats to the outdoors to fend for themselves. TNR should not be used primarily as a political/public relations ploy by animal shelters to claim that they are “No Kill.” For millennia cats have served societies around the world as pest and disease controllers especially in and around human settlements, food and seed-storage and other kinds of warehouse and dock-side centers of industry and commerce. They have also served as human companions, even saving care-givers’ lives (from fire especially), and giving emotional benefits to millions. We surely owe more to domestic cats than neutering and releasing them outdoors to fend for themselves. Continuing to justify using TNR cats to ostensibly control rodents especially in low-income urban and suburban communities should be questioned (treating the symptoms of dystopia rather than addressing the root causes) and put on the right track from a One Health perspective. (17). This includes consideration of the health and well-being of cats, protection and conservation of wildlife and of the public’s health. Releasing cats to live outdoors under TNR programs should be limited to establishing, closely monitoring and caring for un-adopted cats from the community in well-fenced sanctuaries, warehouses, horse stables and small farms. In low income urban areas with high free-roaming cat populations, as in many third world countries, TNR will at least mean fewer litters of kittens being born and fewer dying from diseases and starvation. As has been recently shown testing TNR cats for FIV and removing those who test positive had a dramatic effect in preventing spread of this disease in the remaining population. (18). Releasing TNR cats without prior testing for such retroviral infections could put other cats at risk in the community.

It is a widely held belief that feral cats are wild and belong in the wild. Such a belief is akin to accepting feral pigs in Hawaii and Florida and dog packs and goat herds on the Galapagos islands. The domestic cat has no place in the indigenous carnivore ecology of North America since it is a descendant of the Middle Eastern desert cat Felis sylvestris lybica. To accept domestic cats as part of the wildlife community of North America and do nothing to control their numbers is to put an accelerant on the anthropogenic causes of the demise of song bird, small mammals, wild cats (bobcat, lynx and puma) from highly contagious viral diseases domestic cats can harbor, as well as other wildlife species, habitats and biodiversity--- and further undermine public health security.

Cats are only one of many species ( from earth worms, carp, house sparrows, house finches, common pigeons, starlings and pheasants to house mice, brown and black rats, pigs and horses) that are non-native to North America but have successfully colonized and become “naturalized”. The total eradication of the domestic cat-gone- feral and of other long-established non-indigenous species is neither feasible nor scientifically sound because of potential adverse ecosystem and biodiversity consequences in some locations. (19).

Containment of TNR colonies to prevent incursions by non-neutered and possibly diseased cats may be the best possible protocol, as confirmed in a detailed stochastic demographic simulation approach to evaluate removal, permanent sterilization, and two postulated methods of temporary contraception for free-roaming cat population management. (20). The authors of this report state:

“Our models include demographic connectivity to neighboring untreated cat populations through natural dispersal in a metapopulation context across urban and rural landscapes, and also feature abandonment of owned animals. Within population type, a given implementation rate of the TR strategy results in the most rapid rate of population decline and (when populations are isolated) the highest probability of population elimination, followed in order of decreasing efficacy by equivalent rates of implementation of TNR and temporary contraception. Even low levels of demographic connectivity significantly reduce the effectiveness of any management intervention, and continued abandonment is similarly problematic”. (italics ours).

While animal shelters have taken on this feral and free-roaming cat overpopulation issue and with dedicated staff sought to rectify this serious problem for decades, it will continue unabated without better public education and strict ordinances concerning the licensing, vaccination and prohibition of off-property roaming of all owned cats. A random survey of cat owners in Australia identified the major barriers to people keeping cats indoors, most notably the belief that it is cruel to deprive cats of their natural physical and emotional needs to be outdoors which was more prevalent than the belief of other owners that their indoor, confined cats were happy and safe. (21).

Several professional organizations involved in wildlife protection and conservation, notably the Wildlife Society, (22) have voiced opposition to TNR activities and while the veterinary profession in the U.S. has shown more equivocation, but at least one review concerning veterinary ethics and professional responsibilities sees euthanasia as a more humane alternative to TNR, asserting: “If a fraction of the millions of dollars being expended to neuter, re-abandon, and feed cats was directed toward enhancing education and supporting more effective animal control ordinances and their enforcement, we would be much farther down the road toward effectively reducing the problem of free-roaming cats than we are today.” (23). Yet to avoid alienating cat owning clients and cat loving supporters, veterinarians in practice and animal protection organizations may give conditional or unqualified support of TNR and never mention euthanasia as a humane alternative.

A University of Bristol, UK survey of young cats being killed or injured by road traffic drew the obvious conclusion that cats would be safer if never allowed to roam free and hunt along the roadsides but asserted that "there are a number of health and welfare concerns associated with exclusively indoor cats." (24). Veterinarians with the Royal Society for the Prevention of Cruelty to Animals express a similar opinion that "keeping cats indoors can provoke frustration, unwanted behavioural challenges and lead to unavoidable sources of stress and compromised health, particularly if the home has multiple cats." (25). It is also believed that allowing indoor cats outdoor access improves their health by reducing the incidence of obesity and cystitis but the best prevention of these common health problems more likely lies in providing biologically appropriate diets.(26).

Such generalized statements and beliefs provide support for the advocates of TNR and to cat owners who let their cats roam free. Yet the “unwanted behavioural challenges” are surely very different for cats who have never been allowed outdoors compared with those who were indoor-outdoor cats and then were never allowed outdoors again. A third and fourth category may come from owners of cats in the latter and former categories who allow their cats out at- will or on a regular basis into an escape-proof enclosure or yard, or who take them for a walk on a leash and harness.

The best "prevention" of indoor confinement-frustration/outdoor deprivation as we see it is to keep more than one cat, neuter all, provide good nutrition, an enriched environment and never allow cats from kitten-hood to become indoor-outdoor cats. This is still a cultural norm in the U.K. and many other parts of the world including the U.S. (where many municipalities prohibit cats being allowed to roam off the owners' property) which needs to be more comprehensively addressed by the veterinary profession. Considering the “life style” and interests of the cat owner rather than the best interests of the animal patient first and foremost undermines animal welfare and protection laws, the duty to care and veterinary bioethics.

POSTSCRIPTS

IN PRAISE OF THE “NATURAL”/ABORIGINAL CAT

The black-striped, barred and spotted tabby or alley cat is the prototypical original domestic cat coming in shades of grey, brown, gold and silver which provide them with excellent camouflage as crepuscular hunters of small prey.

Many of these graceful, agile, resourceful and empathic felines can be found in free-roaming populations as the predominant phenotype or landrace, possibly descendants from early settlers’ cats. They may be in some ways more behaviorally demanding than many less highly vigilant and active purebreds but overall are probably healthier if not more intelligent and interesting. We wish that more people would adopt such cats and kittens rather than purchase pure breeds, many varieties of which are highly in-bred and can be emotionally and financially demanding with various diseases of hereditary origin. This situation is far worse in pure breed dogs who have been domesticated for thousands of years prior to the cats domesticating themselves. We can all surely save the cat from a similar fate. (27).

INDOOR & INDOOR-OUTDOOR CAT CONSIDERATIONS

Keep cats permanently indoors has welfare considerations, especially the provision of a cat-safe and cat - stimulating environment, ideally including the companionship of other cats; by being provided biologically appropriate diets rather than those with high carbohydrate and vegetable protein content from GM ingredients; and from owners/caregivers knowing the basics of feline behavior and appropriate care and handling. Without the knowledge of proper, responsible care, including early spay/neuter, people will abandon young male cats when they start spray-marking in and around the home, and female cats who become agitated when in estrus and want to go out, are allowed out and become pregnant. This adds to the seasonal influx of litters of kittens into shelters. All members of the species Felis domestica should be regarded and treated as domestic, confined to home and immediate property, microchipped, vaccinated and neutered, and ideally kept with at least one other compatible member of their own species.

Allowing indoor cats to go outdoors at any time, unsupervised and roaming out of their owner's property---and often not spay/neutered and therefore producing ever more kittens--- and killing wildlife in the process,--- should be prohibited in every community. Free-roaming cats around people’s homes are the most common cause of indoor cats becoming extremely disturbed, house-soiling, developing stress-related health problems such as cystitis, and attacking each other, so-called redirected aggression. Others may show displacement behaviors such as excessive-self grooming and self-mutilation. Chronic and sub-clinical health conditions such as high blood pressure and arthritis ( mainly from improper nutrition), as well as hyperthyroidism may be aggravated by such stress of territorial invasion by indoor-outdoor, free- roaming, lost and feral-living cats including those who have been released by local humane society/animal rescue organizations under the TNR-no-kill banner.

TNRrealitycheck.com - Trap-Neuter-Release is not a humane or effective solution for feral cats

Includes United States Department of the Interior /FISH AND WILDLIFE SERVICE letter in support of NJ ban of TNR, with the statement that US Fish and Wildlife Service considers "all domestic and feral cats (a non-native and invasive predator)"

Legal standing re the relevancy of the Endangered Species Act

FWS "Supports efforts of volunteers or organizations that trap and neuter free-ranging cats, but require that animals be adopted and kept indoors or be released into managed areas that are appropriately fenced or otherwise enclosed to prevent animals from roaming outside of a contained space."

http://abcbirds.org/wp-content/uploads/2015/06/2009.11.20-FWS-letter-in-support-of-NJ-ban-of-TNR.pdf

Also includes: SAMPLE PETITION: We, the undersigned, are opposed to Ordinances that permit Feral Cat Colony Management, also known as Trap-Neuter-Release or Trap-Neuter-Return or TNR or Community Cat Management.

Releasing cats in the UK

One of us ( Fox) sent the following letter to the British Veterinary Record ( published April 15, 2017, p 386.) because I was concerned that veterinarians were divided over the issue of keeping cats indoors and even suggested that cats enjoy better health when allowed to roam outdoors.

IN OR OUT? IS THERE A DILEMMA FOR CAT WELFARE?

It is encouraging to see the question being raised by Yeats and Yates (2017) concerning the welfare of cats being kept indoors or allowed to roam free, against the background of road kill data provided in the “Bristol Cats” study by Wilson et al (2017). They face the culturally accepted norm of cats being allowed to leave their owners’ properties, a common situation with the dog population until the road Traffic Act of 1988 and the Control of Dogs order of 1992.

The University of Bristol, UK survey of young cats being killed or injured by road traffic drew the obvious conclusion that cats would be safer if never allowed to roam free and hunt along roadsides especially by fast vehicular traffic but the authors assert that "there are a number of health and welfare concerns associated with exclusively indoor cats." (Wilson et al op cit ). Veterinarians with the Royal Society for the Prevention of Cruelty to Animals express a similar opinion that "keeping cats indoors can provoke frustration, unwanted behavioural challenges and lead to unavoidable sources of stress and compromised health, particularly if the home has multiple cats." (Yeats & Yates op cit) Such generalized statements provide support for the advocates of trap-neuter-release of purportedly unadoptable cats and to cat owners who let their cats roam free. Yet the “unwanted behavioural challenges” are surely very different for cats who have never been allowed outdoors compared with those who were indoor-outdoor cats and then were never allowed outdoors again. A third and fourth category may come from owners of cats in the latter and former categories who allow their cats out at- will or on a regular basis into an escape-proof enclosure or yard, or who take them for a walk on a leash and harness.

Experienced and responsible cat owners will attest that the best prevention of such “behavioural challenges” of indoor confinement-frustration/outdoor deprivation is to keep more than one cat, neuter all, provide an enriched environment and never allow cats from kitten-hood to become indoor-outdoor cats. But this continues to be a cultural norm in the U.K. and many other parts of the world including the U.S. where many municipalities prohibit cats being allowed to roam off the owners' property and must be microchipped and /or have collars with ID tags.

Regardless of offending and losing some cat-owning clients and supporters respectively, veterinarians in private practice and animal welfare organizations surely need to be more engaged in changing the status quo of accepting free roaming cats in communities rural and urban for cats’ sakes and for documented reasons of wildlife protection and public health. Considering the “life style” and interests of the cat owner rather than the best interests of the animal first and foremost undermines animal welfare and protection laws, the duty of care and veterinary bioethics.

YEATS J & YATES, D. (2017) Staying in or going out? The dilemma for cat welfare. Veterinary Record180, 193-194

WILSON, J.L., GRUFFYDD-JONES,T.J. & MURRAY, J.K. (2017) Risk factors for road traffic accidents in cats up to age 12 months that were registered between 2010 and 2013 with the UK pet cat cohort (‘Bristol Cats’). Veterinary Record 180:195

Michael W. Fox BVetMed, PhD, DSc, MRCVS

Golden Valley, Minnesota USA

We sent a personal communication to the above authors stating:

We appreciate your co-authored study published in the Vet Rec this past February.

We live in Minnesota where cat trap-neuter-release programs are popular as they are across much of the U.S. but are being questioned by many veterinarians, wildlife biologists and others.

We note in your paper that you assert "there are a number of health and welfare concerns associated with exclusively indoor cats" and we would appreciate your enumeration of these.

The list may be different for cats who have never been allowed outdoors compared with those who were indoor-outdoor cats and then were never allowed outdoors again. A third and fourth set may come from owners of cats in the latter and former categories who allow their cats out at- will or on a regular basis into an escape-proof enclosure or yard, or who take them for a walk on a leash and harness.

The best "prevention" of indoor confinement-frustration/outdoor deprivation as we see it is to keep more than one cat, neuter all and never allow cats from kitten-hood to become indoor-outdoor cats. This is still a cultural norm in the U.K. and many other parts of the world including the U.S. ( where many municipalities prohibit cats being allowed to roam off the owners' property) which needs to be addressed by the veterinary profession.

Are there such prohibitive initiatives being considered in the U.K. or is it too politically sensitive for veterinary-client relations and the RSPCA's supporting membership?!

In our limited experience with rescued feral cats kept indoors, some will never show motivation to ever go outdoors or frustration being confined after being neutered. Most of the cats we have trapped and re-habilitated/socialized were young adult tom cats.

Best regards Deanna L. Krantz and Michael W. Fox

One of the authors of the Bristol study sent the following reply asserting the health benefits to cats of roaming outdoors:

----- Original Message ----- From: Jess Wilson jess.wilson@bristol.ac.uk To: FOX/KRANTZ/ IPAN ipan@erols.com Sent: Wed, 12 Apr 2017 11:01:48 -0400 (EDT) Subject: Re: Re Risk factors for road traffic accidents in cats

Dear Deanna Krantz and Michael Fox,

Thank you very much for your email and for your interest in our study. Please accept my apologies for the delayed reply.

As mentioned in the paper, cats without outdoor access have been reported to have increased behavioural issues in a study carried out at the Animal Behaviour Clinic at the Barcelona School of Veterinary Medicine (Amat and others 2009). A previous study using data from the same 'Bristol Cats study' cohort found that cats with no outdoor access, or restricted outdoor access, were at an increased risk of obesity (Rowe and others 2015). This has also been found in other studies, as referenced in the 2015 study. Increased signs of lower urinary tract disease have also been associated with exclusively indoor cats (Willeberg 1984). The mention of these issues was intended to suggest that an owner's decision about how to keep their cat should not be based on a single variable alone, such as risk of an RTA, rather than to suggest that outdoor access was preferable. We do appreciate and understand that cultural norms differ between the UK and the US, where predators pose a greater risk to cats than in the UK.

Your distinction of various categories regarding cats' outdoor access (i.e. those that have never been allowed outdoors compared to those that have previously been allowed outdoors, and also those that are allowed into an enclosed area or on a lead) is a very good one. The Bristol Cats study has collected data relating to the extent of outdoor access, and also on the indoor/outdoor status of cats at various time-points, and we do intend to investigate the influence of this on health and behaviour within our cohort.

We are not aware of any prohibitive initiatives being considered in the UK at this time.

Kind regards,

Jess

OUR IMMEDIATE RESPONSE :

Dear Jess, In response to your citations supporting the health benefits of cats getting outdoors, I would argue that the big scotoma/lacuna of the veterinary profession is in companion animal nutrition, feline in particular, many actually selling biologically inappropriate diets to their clients. The essentially convenience-junk dry kibble cat foods widely advertised and purchased by uniformed and trusting cat owners have a high cereal and non-animal protein content, are obesogenic and many cats with cystitis and urinary calculi improve when transitioned on to a biologically appropriate diet. In other words they do not need to go outdoors to enjoy better health, they need to be properly nourished physically as well as psychologically/behaviourally indoors.

Best regards, Michael W. Fox & Deanna L.Krantz.

*Diseases transmissible from cats to humans include: Capnocytophaga, Chlamydiosis, Leptospirosis, MRSA resistant Staphylococcus aureus, Tuberculosis, Pasteurellosis, Plague, Salmonellosis, Yersiniosis, Tularemia, Cat flea typhus, Sporotrichosis, Cat scratch fever, Ringworm ( Dermatophytosis), Malassezia dermatitis, Chaga’s disease (American trypanosomiasis),Giardiosis, Dipylidiasis, Echinococcosis, Larva migrans, visceral, Larva migrans cutaneous, Strongyloides, Acariasis (mange), Rabies.( Ref: The Merck Veterinary Manual, 2010)

ALL PUBLIC HEALTH OFFICIALS SHOULD NOTE:

Cat feces can contain pathogens transmissible to humans and other species, wild and domesticated, be they around farms, in rural, suburban, urban or slum communities. In the latter there may be a trade-off where a lack of sanitation and high rodent numbers are a threat to public health slightly offset by cats’ predation on infective wildlife.

See ‘Outdoor fecal deposition by free-roaming cats and attitudes of cat owners and nonowners toward stray pets, wildlife, and water pollution’ by Haydee A. Dabritz, et al Journal of the American Veterinary Medical Association July 1, 2006, Vol. 229, No. 1, Pages 74-81 https://doi.org/10.2460/javma.229.1.74

This study notes: The cat population in Cayucos, Los Osos, and Morro Bay, Calif was estimated at 7,284 owned and 2,046 feral cats, and 38% of surveyed households owned a mean of 1.9 cats/household. Forty-four percent of cats defecated outside >75% of the time. Annual fecal deposition (wet weight) by owned cats in the 3 communities was estimated to be 77.6 tonnes (76.4 tons). Cat owners were more likely to oppose cat licensing and impounding stray cats and support trap-neuter-return for stray cats and less likely to be concerned about water pollution, than were non-cat owners.

Conclusions and Clinical Relevance—Feral cats represented a sizeable proportion (22%) of the free roaming cats in this area and could be contributing 30.0 tonnes (29.5 tons) of feces to the environment per year. However, feral cats are not the principal source of fecal loading because owned cats defecating outdoors contribute an estimated 77.6 tonnes (76.4 tons) or 72% of the annual outdoor fecal deposition.

There are several not uncommon diseases that can be passed on to humans from cats’ feces, detailed by Cornell University College of Veterinary Medicine:

https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/zoonotic-disease-what-can-i-catch-my-cat

“ Salmonella poisoning, also called salmonellosis, is caused by a group of bacteria called Salmonella, and can lead to diarrhea, fever, and stomach pain. It is possible to contract the disease from infected cats, which can carry Salmonella bacteria and pass them in their stool. Although salmonellosis usually resolves on its own, some individuals require medical attention to address severe diarrhea or the effects of the infection on organs other than the digestive tract.

Salmonella is more commonly found in cats that feed on raw meat or wild birds and animals, so owners can reduce the risk of salmonellosis in themselves and their cats by keeping cats indoors (italics mine) and feeding them cooked or commercially processed food. Wearing gloves when cleaning litterboxes or gardening (in case outdoor cats have defecated in the soil) and washing hands thoroughly after these activities is also recommended.

Certain feline intestinal parasites, including roundworms (Toxocara) and hookworms (Ancylostoma), can also cause disease in people. Children are particularly at risk due to their higher likelihood of contact with soil that has been contaminated by cat feces. Although most people infected with feline intestinal parasites do not show signs of illness, some people may get sick. Visceral larva migrans, a potentially serious disease that can affect various organs, results from consumption of Toxocara eggs (for instance, when soiled fingers are placed in the mouth). Toxocara larvae may then migrate to abdominal organs, including the liver, or to the central nervous system. Symptoms of visceral larva migrans may include fever, fatigue, coughing, wheezing, and abdominal pain. Ocular larva migrans is the term used for a condition in which Toxocara larvae migrate to the eye, causing visual disturbances, abnormal eye movements, or eye pain and discomfort.

Cutaneous larva migrans, an itchy skin disease, is caused by contact with soil contaminated with Ancylostoma larvae. These larvae may penetrate and migrate under the skin, with resultant inflammation, itching and pain, and raised, red linear lesions in the skin that follow the larva’s migration. Proper hygiene, including washing hands before meals, cleaning soil from vegetables, and reducing exposure to cat feces can prevent infection”.

It is uncertain whether species of Giardia that infect cats are contagious to humans or vice versa, although recent studies suggest the possibility of cat to human transmission. Careful hygiene will eliminate the risk of accidental ingestion of cysts.

Toxoplasma ( From https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/toxoplasmosis-cats ) Toxoplasmosis can be transmitted to humans, although most otherwise healthy people infected with this organism show few if any signs of disease. The exceptions to this are immunocompromised individuals and pregnant women, both of whom should be very careful to avoid exposure to infective Toxoplasma oocysts (see our article on Zoonotic Diseases).---

---The Centers for Disease Control and Prevention (CDC) has recently identified toxoplasmosis as one of five neglected parasitic infections of people due to its high prevalence. More than 60 million people in the U.S. are thought to be infected.

Reducing the incidence of toxoplasmosis in cats requires measures to reduce both exposure to infective oocysts and shedding of oocysts into the environment. Cats should preferably be fed commercially prepared, cooked foods (appropriate heating inactivates any T. gondii cysts that may be present) and should not be allowed to eat uncooked meat or intermediate hosts, such as rodents. They should also be denied access to facilities housing food-producing livestock and food storage areas.

Because cats only shed the organism for a short time, the chance of human exposure via cats they live with is relatively small. Owning a cat does not mean you will be infected with Toxoplasma. Since it takes a minimum of 24 hours for T. gondii oocysts in cat feces to sporulate and become infective, frequent removal of feces from the litter box, while wearing gloves and washing hands afterward, minimizes the possibility of infection.--- Indoor cats that do not hunt prey or consume raw meat are unlikely to be infected with T. gondii. In the U.S., people are much more likely to become infected by eating raw meat and unwashed fruits and vegetables than by handling cat feces. The possibility of infection after gardening in soil that has been contaminated with cat feces also exists, and this possibility can be mitigated by wearing gloves and by washing hands after gardening.

Pregnant women and immunodeficient individuals are the two populations most at risk of developing health problems after T. gondii exposure. In utero infection is of the greatest concern in humans. Between one-third and one-half of infants born to mothers who acquired Toxoplasma during pregnancy are infected. The vast majority of women infected during pregnancy have no symptoms themselves, and the majority of infected infants will show no symptoms of toxoplasmosis at birth. Many of these children, however, are likely to develop signs of infection later in life, including loss of vision and hearing, mental retardation, and, in severe cases, death.

In people who are either undergoing immunosuppressive therapy or have an immunosuppressive disease such as acquired immunodeficiency syndrome (AIDS), toxoplasmosis may cause enlargement of the lymph nodes, eye and central nervous system disturbances, respiratory disease, and heart disease. In these patients, especially those with AIDS, relapses of the disease are common, and the mortality rate is high”.

The authors can be reached at animaldocfox@gmail.com Website www.drfoxonehealth.com

REFERENCES

  1. Sterba, J. Nature Wars: The Incredible Story of How Wildlife Comebacks Turned Backyards into Battle Grounds. New York, Broadway Books, 2012
  2. Hardin, G. The Limits of Altruism: An Ecologists View of Survival. Bloomington Indiana, University Press, 1977
  3. See Million Cat Challenge: Return-to-field. Available at www.millioncatchallenge.org/resources/return-to-field
  4. Loss, S.R, Will, T. & Marra, P.P., The impact of free-ranging domestic cats on wildlife of the United States. Nature Communications 4:136, 2013. See also Marra,P.P. & Santella, C., Cat Wars: The Deadly Consequences of a Cuddly Killer. Princeton NJ., Princeton University Press, 2016.
  5. www.bestfriends.org/Save-Lives-With-Feral-Freedom/
  6. Weiss, E et al (eds) Animal Behavior for Shelter Veterinarians Ames, Iowa, Wiley Blackwell, 2015
  7. Gerhold, R.W. & Jessup, D.A. Zoonotic diseases associated with free-roaming cats. Zoonoses Public Health 60: 189-195, 2013
  8. Edinboro C.H. et al. Association between a shelter-neuter-return program and cat health at a large municipal shelter. JAVMA 248: 298-308, 2016
  9. Foley, P. et al, Analysis of impacts of trap-neuter programs on populations of feral cats. JAVMA 227: 1775-1781, 2005
  10. Key Scientific Studies on Trap-Neuter-Return http://www.alleycat.org/document.doc?id=385
  11. Glass GE, Gardner-Santana LC, Holt RD, Chen J, Shields TM, Roy M, et al. (2009) Trophic Garnishes: Cat–Rat Interactions in an Urban Environment. PLoS ONE 4(6): e5794. doi:10.1371/journal.pone.0005794).
  12. www.stateofpethealth.com
  13. Cook, W.E. & Jessup, D.A., Common ground for feral cats. JAVMA 247: 141-142, 2015
  14. Erb, J. Carnivore Scent Station Survey Summary, 2014. Minnesota Department of Natural Resources, Forest Wildlife Research Group
  15. Longcore, T., Rich, C. & Sullivan, L. M. Critical assessment of claims regarding management of feral cats by trap-neuter-return. Conserv. Biol. 23, 887–894, 2009
  16. Lepczyk, C. A. et al. What conservation biologists can do to counter trap-neuter-return: response to Longcore et al.. Conserv. Biol. 24, 627–629, 2010
  17. Fox, M.W. Healing Animals & the Vision of One Health, Amazon.com 2011
  18. Garigliany, M. et al. Risk factors and effectiveness of selective removal on retroviral infections’ prevalence in Belgian stray cats. Vet Rec Jan 9th 45, 2016
  19. Pearce, F. The New Wild: Why Invasive Species Will Be Nature’s Salvation. Boston, Beacon Press, 2015
  20. Miller, P.S., et al. Simulating Free-Roaming Cat Population Management Options in Open Demographic Environments. PLoS ONE 9(11): 2014. e113553. doi:10.1371/journal.pone.0113553. pmid:2542696
  21. McLeod, L.J. et al. Keeping the cat in: drivers and barriers to cat containment. Preventive Veterinary Medicine 122:339-344, 2015
  22. The Wildlife Society. Policy 25: feral and free-ranging cats. Available at: www.wildlife.org. Accessed March 1, 2017.
  23. Barrows, P.L., Professional, ethical, and legal dilemmas of trap-neuter-release. Animal Welfare Forum: Management of Abandoned and Feral Cats. JAVMA 225: 1365-1369, 2004
  24. Wilson, J.L., Gruffydd-Jones, T.J. & Murray, J.K., Risk factors for road traffic accidents in cats up to age 12 months that were registered between 2010 and 2013 with the UK pet cat cohort (‘Bristol Cats’). Veterinary Record 180:195, 2017
  25. Yeats, J & Yates, D., Staying in or going out? The dilemma for cat welfare. Veterinary Record 180: 193-194, 2017
  26. Fox, M.W., Hodgkins, E. & Smart M.E. Not Fit for a Dog: The Truth About Manufactured Cat and Dog Foods. Fresno CA, Quill Driver Books, 2009.
  27. http://vetbook.org/wiki/cat/index.php/Genetic_diseases_of_cats See also Tuan, Yi-Fu. Dominance and Affection: The Making of Pets. New Haven CT Yale University Press 1994

Many dedicated veterinarians have contributed their expertise to help alleviate the cat plague and associated animal suffering, wildlife harm and public health risk, as evidenced by these citations published in the Journal of the American Veterinary Medical Association.

  1. Estimation of effectiveness of three methods of feral cat population control by use of a simulation model Robert J. McCarthy, Stephen H. Levine, J. Michael Reed Journal of the American Veterinary Medical Association Aug 2013, Vol. 243, No. 4, Pages 502-511

  2. Response of feral cats to vaccination at the time of neutering Sarah M. Fischer, Cassie M. Quest, Edward J. Dubovi, Rolan D. Davis, Sylvia J. Tucker, John A. Friary, P. Cynda Crawford, Teri A. Ricke, Julie K. Levy Journal of the American Veterinary Medical Association Jan 2007, Vol. 230, No. 1, Pages 52-58

  3. Analysis of the impact of trap-neuter-return programs on populations of feral cats Patrick Foley, Janet E. Foley, Julie K. Levy, Terry Paik Journal of the American Veterinary Medical Association Dec 2005, Vol. 227, No. 11, Pages 1775-1781

  4. Time and financial costs of programs for live trapping feral cats Felicia B. Nutter, Michael K. Stoskopf, Jay F. Levine Journal of the American Veterinary Medical Association Nov 2004, Vol. 225, No. 9, Pages 1403-1405

  5. Use of the anesthetic combination of tiletamine, zolazepam, ketamine, and xylazine for neuteringferal cats Lindsay S. Williams, Julie K. Levy, Sheilah A. Robertson, Alexis M. Cistola, Lisa A. Centonze Journal of the American Veterinary Medical Association May 2002, Vol. 220, No. 10, Pages 1491-1495

  6. More feedback on taurine deficiencies in cats, dogs . . . . Additional input on feral cat debate Journal of the American Veterinary Medical Association Dec 2003, Vol. 223, No. 12, Pages 1729-1730

  7. Humane strategies for controlling feral cat populations Julie K. Levy, P. Cynda Crawford Journal of the American Veterinary Medical Association Nov 2004, Vol. 225, No. 9, Pages 1354-1360

  8. The welfare of feral cats and wildlife David A. Jessup Journal of the American Veterinary Medical Association Nov 2004, Vol. 225, No. 9, Pages 1377-1383

  9. Seroprevalences of antibodies against Bartonella henselae and Toxoplasma gondii and fecal shedding of Cryptosporidium spp, Giardia spp, and Toxocara catiin feral and pet domestic cats Felicia B. Nutter, J. P. Dubey, Jay F. Levine, Edward B. Breitschwerdt, Richard B. Ford, Michael K. Stoskopf Journal of the American Veterinary Medical Association Nov 2004, Vol. 225, No. 9, Pages 1394-1398

  10. Analyzing approaches to feral cat management—one size does not fit all Michael K. Stoskopf, Felicia B. Nutter Journal of the American Veterinary Medical Association Nov 2004, Vol. 225, No. 9, Pages 1361-1964

  11. Thoughts on Animal Welfare Act compliance . . . . More on feral cat welfare Journal of the American Veterinary Medical Association Jun 2004, Vol. 224, No. 11, Pages 1749-1754

  12. Evaluation of the effect of a long-term trap-neuter-return and adoption program on a free-roamingcat population Julie K. Levy, David W. Gale, Leslie A. Gale Journal of the American Veterinary Medical Association Jan 2003, Vol. 222, No. 1, Pages 42-46

  13. Outdoor fecal deposition by free-roaming cats and attitudes of cat owners and nonowners toward stray pets, wildlife, and water pollution Haydee A. Dabritz, E. Robert Atwill, Ian A. Gardner, Melissa A. Miller, Patricia A. Conrad Journal of the American Veterinary Medical Association Jul 2006, Vol. 229, No. 1, Pages 74-81

  14. Some common ground on feral cats may be emerging . . . . Speaking out against painful, unnecessary surgeries Journal of the American Veterinary Medical Association Dec 2004, Vol. 225, No. 11, Pages 1662-1663

  15. Population characteristics and neuter status of cats living in households in the United States Karyen Chu, Wendy M. Anderson, Micha Y. Rieser Journal of the American Veterinary Medical Association Apr 2009, Vol. 234, No. 8, Pages 1023-1030

  16. Thoughts on shelter medicine . . . . More on animal rights struggle . . . . Feral cat welfare debate continues . . . . Animals and World War II POWs Journal of the American Veterinary Medical Association Jul 2004, Vol. 225, No. 2, Pages 198-200

  17. Calls for vaccine challenge studies .... Believes feral cat welfare has dark side .... More on early-age gonadectomy .... Debate on grade-III mast cell tumors continues Journal of the American Veterinary Medical Association Apr 2004, Vol. 224, No. 7, Pages 1069-1071

  18. Evaluation of cat and owner characteristics and their relationships to outdoor access of ownedcats Elizabeth A. Clancy, Antony S. Moore, Elizabeth R. Bertone Journal of the American Veterinary Medical Association Jun 2003, Vol. 222, No. 11, Pages 1541-1545

  19. Avian influenza debate continues. Blueprint for action receives praise. Final letters for now onferal cats. Progress being made in live animal classroom conditions. Journal of the American Veterinary Medical Association Dec 2002, Vol. 221, No. 11, Pages 1546-1549

  20. Characteristics of free-roaming cats and their caretakers Lisa A. Centonze, Julie K. Levy Journal of the American Veterinary Medical Association Jun 2002, Vol. 220, No. 11, Pages 1627-1633