Veterinary professionals enter the field because of our love for animals and a desire to make them well. One of the most challenging aspects of our job is managing strong emotional responses when we are faced with a victim of animal cruelty. Acting as an advocate to see justice done on the victim’s behalf and doing our part in the medical-legal cases are key to managing those emotions.
There is no universal definition of what constitutes animal abuse, cruelty, or neglect. Animal cruelty is not a medical determination but a legal one. Each term has a different definition in each state. Even the definition of an animal varies from state to state. The forensic aspect of an animal cruelty case means that the information and evidence collected will end up in a court of law; veterinary forensic medicine is veterinary medicine practiced in a legal context.
Another legal aspect of cruelty cases applies to the Fourth Amendment of the Constitution. Animals are considered property, and this affects how they are viewed in the eyes of the law. Thus, getting permission to examine the animal, perform a necropsy, or even take photographs must be obtained; otherwise, law enforcement must issue a search warrant. To determine an animal’s health, a veterinarian must be able to perform a physical examination and do diagnostic testing. Once these have taken place, the veterinarian can assess how the medical problem or injury occurred. Veterinarians and veterinary technicians can be summoned as witnesses in court when they have had contact with the animal.
Whether small or large, cases can range from a single animal to hundreds of animals. Large-scale cases examples include hoarding, puppy mills, dogfighting, and cockfighting. There are also “sanctuaries,” “rescues,” and overcrowded shelters that do not provide proper care, creating hazardous environments similar to what is seen in a hoarding or puppy mill situation.
- Hoarding: In hoarding situations, hoarders are often unable to comprehend the harm they have caused to the animals, which adds another layer to the challenge. Cats that come from hoarding situations are often inflicted with upper respiratory tract infections, parasitic infections, ocular disease, and dental disease and have behavioral and socialization problems. Dogs that come from hoarding situations are often in poor physical condition and health. They may have poor hair-coat and nails; be malnourished, dehydrated, and prone to skin infections; have parasitic infections; and have behavioral and socialization problems.
- Puppy mills: Puppy mill mothers are overbred and kept in cramped, unsanitary conditions. They are often not socialized and when placed in a normal environment exhibit behavioral problems, such as inappropriate urination, fear biting, not walking on a leash, or food aggression. These dogs are often bred despite having genetic abnormalities, and this negatively affects the animal’s life because of the chronic illness they cause. The puppies will be afflicted with these problems for the rest of their life; any diseases passed along may not be evident at the time of adoption.
- Dogfighting: Dogs conditioned for fights commonly have scars and wounds in various stages of healing on their head, neck, legs, or thorax. Some dogs may have worn paw pads from conditioning on rough surfaces and very well-muscled physique, and they may exhibit behavioral tendencies, such as gameness with other dogs or fear.1 Pit bulls are often infected with Babesia gibsoni, a parasite associated with red blood cell destruction, which is believed to be transmitted by bites during fighting or from mother to puppy.2 Surprisingly, despite the stress and cruelty these dogs experience, if they are lucky enough to survive, they are remarkably resilient and can become wonderful family dogs. A behavior evaluation by a professional is essential in the rehoming process to make sure they are not a danger to other animals or people. Dogfighting is a felony in all 50 states and is also almost always linked to other crimes, such as illegal weapons, drugs, and gambling.3
- Cockfighting: This blood sport is often a backyard/basement operation wherein roosters are physically altered and forced to fight until one dies. Roosters have their feathers plucked or shaved, wattles trimmed, and spurs removed, and gaffes are placed to act as a weapon to inflict damage on the opposing bird.
Individual cases are brought to the veterinarian with anything from a false history to a known incident. Veterinarians and technicians are trusting and compassionate people by nature and sometimes are not willing to believe that the person who would abuse an animal would also be the one to bring it in for care. Giving people the benefit of the doubt is usually our default response; however, when a law is broken and a patient is harmed, we must consider nonaccidental injury (NAI) or neglect.
NAI occurs when a person intentionally harms an animal. Many types of injuries are caused by NAI. Blunt-force trauma can cause contusions, abrasions, lacerations, or fractures. Sharp-force trauma presents as stab wounds or incised wounds from a knife or blade (FIGURE 1). Features involving fractures that raise the index of suspicion for nonaccidental injury are multiple fractures, transverse fractures, fractures in more than one region of the body at once, fractures in various stages of healing, and delayed presentation.4 A 2016 study in the Journal of Forensic Sciences looked at NAIs and motor vehicle accidents (MVAs) and showed that NAIs were more likely to be fractures of the skull, teeth, vertebrae, and ribs; scleral hemorrhage; damage to claws; and older fractures. Bilateral rib fractures with no cranial-caudal pattern were more likely to be caused by NAI than by MVA.5
One of the most challenging aspects of a physical examination on an injured patient is distinguishing accidental injury from NAI. Repetitive injuries should always raise a red flag. Unfortunately, there is no certain indicator of abuse. However, the best way to start the analysis is to consider the force needed to cause the injury, location of the injury, and whether it matches the history and time frame. Other NAIs include gunshot wounds, sexual abuse, asphyxia, drowning, thermal injury, and poisoning. Gunshot wounds provide solid evidence to aid in the prosecution of the case. Projectile trajectory, wound examination, and proper collection of evidence (including recovering the projectile, radiographs, and wound photographs) are all important aspects in handling these cases. Sexual abuse is a difficult differential for any veterinarian to put on their list. However, it should be considered if physical examination shows trauma to the urogenital/rectal orifices or parts of the body where the animal is held for restraint. Although rare, it can occur, and it may not leave much physical evidence.6 Asphyxiation can result from suffocation, strangulation, hanging, drowning, or injury caused by high-heat items (hot water, cigarettes). We all know neighbors are often being accused of poisoning when an animal presents with an illness of unknown origin. However, poisoning or ingestion of a toxin can occur if someone is trying to retaliate against a person, eliminate neighborhood “pests” (ie, stray cats or barking dogs), or out of amusement or curiosity.1
Neglect is the most common type of animal cruelty seen in the veterinary hospital. The question we must ask is whether the neglect warrants a criminal charge. Some forms of neglect may be corrected by client education, and some are clearly criminal, with any scenario in between. It is difficult for a prosecutor to prove intent, so evidence must be collected to document the animal’s condition. Neglected animals can present emaciated (as a result of long-term inadequate nutrition), excessively matted hair coat, an embedded collar, skin disease, or untreated wounds or diseases. An example of an extreme form of neglect is a severely matted dog whose fur is one large mat. The animal’s skin can also become ulcerated due to urine scald, compounded by the lack of oxygen to the skin by the matted fur. The tightness of the wet fur can cause strangulation of the limb, sometimes requiring amputation.
Red flags should be raised when the history doesn’t match the physical examination findings. If the patient fell from arm’s height, could the injury have occurred? If you believe that it could not, ask open-ended questions. Suspicion should be raised if the history varies, the client fumbles through a story, the client’s behavior is odd or aggressive, the client shows a true lack of concern about the animal, or the client repeatedly responds “I don’t know” when asked what happened. An excellent resource exists for veterinary professionals, titled “Practical Guidance for the Effective Response by Veterinarians to Suspected Animal Cruelty, Abuse and Neglect,” is available online through the American Veterinary Medical Association.7
THE IMPORTANCE OF REPORTING
No matter the type of abuse, the veterinarian should be prepared to contact the authorities to report the findings. In some states, veterinarians and/or technicians are mandated to report suspected abuse, cruelty, or neglect, just as physicians and nurses are mandated to report child abuse. Immunity laws are in place in some states for good faith reporting, which protects the reporter from liability. Suspicion for abuse is all a veterinarian or veterinary technician needs to have when filing a report. Even though veterinarians are concerned about the potential for harm to the business or the veterinarian’s reputation caused by negative media attention, social media, protesters, or decline in clientele, it is more common that the public will support the prosecution of a perpetrator of animal abuse. Consistent mandatory reporting and immunity laws in all 50 states would be helpful to remove the fear that prevents many veterinarians from reporting. Unfortunately, many states lack resources to follow up on cases once the report is filed. The American Animal Hospital Association advocates for hospitals to create a protocol for the identification and reporting of animal abuse and cruelty.8
It should be a responsibility of every veterinarian and technician to consider the importance of reporting and follow through. There is a documented link between animal cruelty and interpersonal violence, and it can be the tip of the iceberg when an abused animal ends up on your exam table. The National Link Coalition (nationallinkcoalition.org) provides numerous resources on the topic of animal abuse and its correlation with child abuse, elder abuse, domestic violence, and other violence. We have all heard that serial killers start by abusing animals in childhood, and although that is an extreme form of violence, a recent study in the International Journal of Juvenile Offender Therapy and Comparative Criminology found that the only statistically significant predictor of adult interpersonal violence was recurrent childhood animal cruelty, above race, education, and residence.9 So, when you report the abuse, you could be saving other lives—animal and human.
A CASE TO REMEMBER
In a case I was involved with, the owners, who were the perpetrators, brought into the emergency service an extremely emaciated and nearly deceased Dalmatian dog, weighing just 14.5 kg. She was unconscious, hypothermic (temperature <91°F), hypotensive (systolic noninvasive blood pressure <30 mmHg), in severe hypovolemic shock, and dying of starvation (FIGURE 2). The owner brought her in but showed absolutely no regard or concern for the state of the animal. In fact, the owner tried to assure us she was “fine yesterday.” She died almost immediately upon arrival. The case went to court, and the client was found guilty. Soon after that we learned there were 2 other dogs in the house, also not in much better condition than their housemate; 6 children were removed from the home. The 2 living dogs were scavenging in the yard; their gastrointestinal tracts were full of sticks, grass, rocks, and dirt, which was captured on radiographs and provided forensic evidence of starvation. This case also illustrates the animal, both living and deceased, as evidence. At the scene, the animal control officer obtained photographs of chewed-up trees and dirt holes, empty food bags and dishes, and empty water bowls. The photographic evidence was very powerful in this case. Had the veterinarian not reported, the situation would have continued.
This tip-of-the-iceberg situation has remained at the forefront of my mind in each case that comes through the door. Most of all, it showed me how important it is to have excellent documentation, evidence collection, photographs, and diagnostics, as well as the fortitude and persistence to stand up for a patient that could not speak for itself. I know the animal did not die in vain; it has become my passion to be a voice for victims of cruelty using the tools of the forensic sciences. As a technician, I have learned that my voice is important, and so is yours.