Recognizing animal abuse and One Health concerns

This bull terrier isn't actually abused, she just looked sad. Sadly, veterinarians deal with actual abuse victims far too often. Photo courtesy Elizabeth Anderson Lopez

 

 

Animal abuse/maltreatment disheartens clinicians and staff alike. This is a subject many would love to pretend doesn't happen. The thought of someone abusing an animal disturbs many of us. However, animal abuse not only happens, but just like with many zoonotic diseases, where animals act as sentinels, identifying animal maltreatment early may help lessen the chance that violence against people arises. A strong correlation exists between individuals who perpetrate acts of violence against animals and an increased propensity to commit acts of violence against humans. Thus, animal abuse poses a potential One Health threat. Early recognition of animal maltreatment and intervention before child abuse, violent criminal behavior (various types), or family violence develops saves lives. As veterinarians, how can we recognize signs of abuse? What is our duty to act? Do we report concerns of animal abuse?

Animal abuse as a sentinel for at-risk violent behavior toward others

Research suggests those who commit animal maltreatment may be at higher risk of abusing others, including children, domestic partners, other family members, or strangers (community violence). Children who suffer from abuse, vs. those who do not, may be more apt to commit animal abuse.^1–7 The psychology behind why those who witness animal abuse, perpetrate it, and those who are abused may be more predisposed to violence against other animals and people is beyond the scope of this article. However, recognizing this link occurs frequently and numerous studies globally demonstrate this connection elucidates the severity of the One Health ramifications of animal abuse.^1–8 As veterinarians, we have an ethical duty to prevent harm to our patients. If by preventing further harm, we protect the people in that patient's life too, we may help prevent further violence.^8,9 Animals may be the sole bearers of abuse, but they also may act as sentinels, and our intervention may improve outcomes for others.⁹

By reporting a case of animal abuse, we may help unmask ongoing cases of human abuse. It is recognized  domestic partners committing abuse may abuse an animal as a way to assert control over another and cause intimidation or submission and fear. Reporting a case of concern may facilitate necessary action for the family, potentially leading to extra non-animal-related assistance.^2,3,8

Approximately eight percent of individuals who are arrested for animal maltreatment have been arrested more than once previously, with up to 70 percent being felonies.^1,10,11 This suggests those who mistreat animals are more apt to commit crimes against society and people. Early recognition and intervention may interrupt this cycle.

It is estimated at some point in a child's life, three to 44 percent of kids will abuse an animal. While some research suggests this is exploration, a part of behavioral development, a child who abuses animals has a two to three times higher likelihood of suffering from abuse themselves.⁵ The majority of animal maltreatment, however, is most commonly perpetrated by adults.⁷

According to the Shelter Animals Count, a program of the American Society for the Prevention of Cruelty to Animals (ASPCA), 2024 U.S. estimates suggest about 10 million animals will die as a result of abuse annually. However, the number of those abused who survive can only be guessed. Globally, they suggest one animal is abused every minute.¹⁰

Animal maltreatment is the catchall phrase that encompasses the FBI's four animal cruelty categories from their National Incident-Based Reporting System (NIBRS)^12,13

1. Simple/gross neglect/cruelty
2. Intentional abuse/torture
3. Organized abuse (organized fighting)
4. Animal sexual abuse

"Remaining current on your state's veterinary practice act will help ensure you stay up to date on any mandatory reporting guidelines. Remember, while we may report concerns, suspicions, frustrations, even cases of hoarding and negligence, our goal isn't to determine if the level of maltreatment fits a specific crime."

 

Don't forget hoarding

Notice this includes suffering resulting from any negligent or intentional action, or from a lack thereof. Though not specifically mentioned in the above categories, hoarding commonly leads to the unintentional abuse of animals, often due to neglect. This may result not just from deliberate harm but also from ignorance and a failure to act or behave in a manner beneficial to the animal.¹³

Hoarding, in the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is classified as an Obsessive-Compulsive and Related Disorder. While animals are not specifically mentioned, they are legally considered property, and thus it is easy to see how animal hoarding fits within the psychiatric conditional definition. Animal hoarding is a true psychiatric condition in which an excessive number of animals are housed and "owned" by a single individual or family.

Generally, due to a hoarding mentality and related factors, these animals lack basic husbandry, hygiene, and care. As a result, infectious diseases, including parasites, become a key concern, including zoonotic diseases, causing not just the health and well-being of animals to be in jeopardy but also those of the "caregivers" as well. Further, people who suffer from animal hoarding, while often having no ill-will or mal-intent toward animals in general, may be less inclined to relinquish pets when adequate care isn't feasible (financially or due to terminal illnesses). They may not be willing to euthanize and end the suffering of dying patients. They may have a significant emotional attachment to the animals, yet not recognize the animals are not receiving the care they need.^14,15

In cases where you suspect hoarding is playing a role in any negligent animal care, getting animal control (or related entities) involved, as well as law enforcement and public health representatives, is paramount because the health of the individual and anyone else living in the home, as well as the animals, is at great risk. Ultimately, it is a true One Health risk, with environmental concerns in the home, and animal and human health challenges.^14,16–18

As veterinarians, we may need to not only recognize key indicators that suggest one or more of these situations is present (neglect, cruelty, organized maltreatment, sexual abuse, hoarding), but also understand how local and state ordinances/laws define them and what our responsibility to report and intervene may be legally, ethically, and morally.

Do we have a duty to report?

According to the American Veterinary Medical Association (AVMA), "The veterinarian's role is to identify signs of nonaccidental injury and be familiar with applicable cruelty laws in the jurisdiction where the maltreatment is believed to have occurred."¹⁹  Depending on local governances, you may have a legal mandate to report suspected abuse cases. Remaining current on your state's veterinary practice act will help ensure you stay up to date on any mandatory reporting guidelines. Remember, while we may report concerns, suspicions, frustrations, even cases of hoarding and negligence, our goal isn't to determine if the level of maltreatment fits a specific crime. Law enforcement and animal control can investigate and determine whether there are criminal concerns. Our concerns and reporting are to ensure the animal remains safe and prevent further injury. Further, it helps safeguard people, including children, who may be exposed to the same situations.¹³

The AVMA's Veterinarians' framework for identification and response of suspected or known animal maltreatment is a great resource that provides a patient-forward approach to help you and your practice if a case of animal neglect/abuse arises, and assists in managing the situation.

The AVMA defines reasonable suspicion as: "A commonsense conclusion about human behavior, something more than an unarticulated hunch. 'Reasonable suspicion' may exist even when there is some doubt. It requires facts or circumstances that give rise to more than a bare, imaginary, or purely conjectural suspicion."¹³ If you feel you have a reasonable suspicion, according to the AVMA, we have a duty to act even before considering local laws and regulations.

Across the U.S., the reporting requirements of animal maltreatment vary. Sadly, some states have no requirements, while some have no duty to act but provide immunity provisions. Immunity from provisions is a "legal exemption from liability for reporting suspected or known animal maltreatment, so long as it is done in good faith and in accordance with the local statute. Also known as 'permissive reporting.'"¹⁹ Still, some states have voluntary reporting, and others have mandatory requirements. The Animal Legal & Historical Center of MSU has a map, up to date as of 2025, where you can hover over your state and connect to find your State Board of Veterinary Medicine information on the topic and further details.²⁰ Each state not only has differing legal requirements, or a lack thereof, regarding the reporting of animal abuse suspicions by a veterinarian, but also regarding the types of reportable offenses and immunity clauses. The AVMA summary report from October 2021 outlines this information, but make sure to check your state, as updates may have occurred since then.²¹

Recognizing signs of maltreatment

No single type of injury, clinical findings, or presentation provides a veterinarian with a pathognomonic answer key that says, "I was abused." If only our patients could talk in ways we fully understood them.

However, some tell-tale signs may be suspicious for various types of maltreatment. Examples include^9,14,19

1. Neglect: "Poor body condition of patient; owner refusal of treatment, grooming, or care despite a range of options being offered; owner declines euthanasia in cases of unrelievable suffering; lack of concern for patient's welfare; inadequate shelter; excessive number of animals; dangerous or unsanitary environment. There may be an element of self-neglect on the part of the client."¹⁹ Sadly, this level many of us see all too often. The question is, when do we report it? Is there a clear answer? Not usually. When would this type of behavior pose a risk to humans in that owner's social circle, and do we intervene? Or do we treat, educate, recheck, and report only upon failure to return for re-evaluation?
2. Hoarding or breeding mill-type situations (large-scale neglect): We may occasionally run into this type of situation, which may or may not be an intentional act of harm. We may see several animals presenting with poor body condition, matted, unkempt, who may have several infectious diseases and or parasitism; repeat visits due to wounds and injuries from other animals in the home/setting; lack of care, follow-up/follow-through; owner vet hops, going to a new vet every time they seek care.
3. Nonaccidental inflicted injury: While instances tend to occur occasionally to infrequently, with these patients and clients, we may find a history that doesn't match clinical findings and injuries, and we may appreciate numerous wounds in various stages of wound healing, suggesting different injuries and different types of trauma.
4. Dog or cock fighting (organized abuse): These include pattern of bite wounds, linear abrasions and claw marks, clustered on head, neck, and forelimbs; increased prevalence, in particular breed types; owner or another layperson might administer, medical or surgical therapies.¹⁹
5. Sexual abuse: We may encounter injuries to the anal or perineal regions or sex organs. Animals may demonstrate signs of performance, such as thrusting with rectal or vaginal evaluation. One may see evidence of restraint (g., ligature marks, blunt trauma) or evidence of exposure to a hypnotic or sedative.

Regardless of what category a patient fits in, if you see something that doesn't sit right, you question the history the owner is giving you, the history keeps changing, if owners refuse care despite making allowances for cost constraints, make no effort to obtain funds, refuse humane euthanasia, make comments outwardly, which I have heard on more than one occasion with suspect cases that make you suspicious, stick with your gut. I have heard statements like "I will just shoot him at home," or "He's just a dog, I don't care if he heals, my wife made me bring the dog." Interestingly, if you suggest you will need to contact animal control for a welfare check or hint at some type of law enforcement intervention, even "just" informing the Humane Society, stories may change, and care will then be accepted, sometimes only solidifying our suspicions.

Recognizing an animal being abused, neglected, or mistreated can be challenging, but a few clues, especially when found in combination, may include:^9,19

• Low body weights/body conditions without concurrent disease to suggest a cause
• Rib fractures with no known trauma
• Scars, traumas, multiple wounds, especially in breeds that may suggest an animal is being used as a bait dog
• Multiple fractures with no reported trauma
• Ingrown collars
• Overt neglect, including overgrown nails (into paw pads), severe matting, ectoparasite infestations, poor hydration, and clinical signs of chronic, untreated illness

Additionally, client factors or triggers may also hint at something fishy:^9,19

• History changes frequently throughout a visit
• Different family members have different stories
• Owner(s) fail(s) to show emotional attachment in a way that seems appropriate (hard to judge since no one has the same emotional response to an animal)
• Family members seem submissive or fearful of the main client
• A client is argumentative when addressed about the condition or even just routine questions
• An unknown person is blamed for the injuries/actions
• Concerns for training, discipline manifest, such as the owner raises their hand and the pet cowers or pulls too roughly on a choke collar
• Listen to the kids (especially younger than 10 years old) as they are usually more direct and forthcoming, and may provide additional insight or say something that hints they may be abused, as well
• Someone expresses that the home environment isn't safe
• Delay in medical care without explanation (most will say it is financial, or they were "treating at home," or they didn't know that they were sick, and those may be all true, non-abuse cases), but when they fail even to provide an explanation or become argumentative when asked

A situation where we meet against a fine line, asking ourselves whether it is neglect or not (perhaps the owner's ignorance of medical care needs), is challenging both emotionally and intellectually. Intuitively, it is hard for someone with medical knowledge to know what the layperson should recognize as concerning. Further, cases that seem like neglect or ignorance, yet the owner makes every attempt to treat the pet, perhaps deserve the benefit of the doubt.

Reporting cases of concern

When you have a case of concern:^19,21

1. Ensure your medical records are as detailed as possible. This includes documenting any client communications. Even side comments an owner may make about other family members/friends, care they self-rendered, and willingness or not to permit treatment should all be properly documented.
2. Take pictures to document injuries and the overall condition of the pet. I often take before (clipping and cleaning) and after photos, as well, and attach them to the chart. Documenting what the pet looks like before and after shows overall appearance, severity, coat condition, and body condition, and helps document the severity and location of wounds. It can also help support if there are various wounds in different stages of healing.
3. Document any behavioral characteristics of the pet. Does the pet cower if the owner raises their arm? Does the pet seem better away from the owner or with them?
4. Know your hospital's procedure/policy for handling suspect cases, and if unsure, contact management.
5. If you have a case you suspect, and you are in a mandatory reporting state, follow the laws/ordinances in your jurisdiction for reporting.

Remember, it is not our job to prove wrongdoing. So, you have to decide if the animal could be at risk for further harm, if there are people at risk, if the history, PE findings, and injuries support your concerns, and if so, have a duty to report.

In an instance where you think there is some ignorance and lack of timely action, but the pet received the care it needed to the degree the owner could afford, schedule a recheck for a few days later and advise them that if they don't make it, you may check on them or have someone do so. While you don't need to inform them of this, in cases of mild neglect, it may simply reinforce to them the seriousness of the act and emphasize that the recheck is crucial. However, if they fail to keep that appointment, you may report it so that, at the very least, a welfare check can be performed on that pet, and, if needed, criminal action can ensue.¹⁹

The AVMA framework recommends the following steps.¹⁹

1. Determine if reporting is mandatory in your state. If so, is immunity provided from civil liability?
2. Document, document, document. This includes photos, conversations/discussions, and SOAP notes. Preserve any evidence, such as a removed embedded shock collar, and label it with the time, date, patient's information, and your initials.
3. Determine who to report any suspected cases to. The National Link Coalition has a database that provides information for vets who need to report such concerns. Verbal reports are often made, and the details emphasize that the injury is non-accidental and suspicious in nature. All verbal reports should then be followed by a written one.

Regardless of whether you are reporting in a mandatory or voluntary state, the AVMA's framework recommends for any suspect case, a request for a subpoena of the veterinary records be made to ensure confidentiality is protected to the best of their ability and to protect the practice. Though this may vary, it still varies with the state/jurisdiction.

The AVMA's framework includes a useful reporting template that you can use and adapt for your practice. Using this and a hospital-established SOP may help guide you in cases as described above.

Animal abuse: a One Health concern

Because of the recognized link between animal violence and violence against people, when we see negligence or abuse rear its ugly head, we are duty-bound to act. Perhaps it is a hoarding situation, and the family members are providing the animal's care and intervening; maybe we just want to treat, follow up, and, if no recheck occurs, then report. Perhaps we are dealing with presumed ignorance. Someone who didn't know that waiting for several days after bite wounds could lead to severe illness, again, maybe that is a prime opportunity for client education. If a recheck occurs, great. If not, then we may consider reporting.

However, if you have signs of abuse, a history of one owner doesn't match that of another (especially a child's version), you have records from seven other vets within a year suggestive of numerous traumas and injuries, you take radiographs and find numerous fractures in various stages of healing, then reporting ethically and morally is a no-brainer. It isn't always black and white, but remember if your spidey sense is tingling, you get a bad feeling, and you have medical evidence to back up your concerns, it isn't our job to prove criminal activity. Our job is to involve authorities and find people who can check on the animal, the environment, and the people in the pet's life to ensure the pet is safe and receiving the care it needs.

While animals act as sentinels for infectious diseases and even abuse or maltreatment, veterinarians, by reporting concerns, may in turn act as sentinels for human family members at risk. Thus, recognizing animal abuse and reporting it promptly is a duty we cannot shirk or take lightly.

Ensuring we are aware of what to look for in cases of maltreatment, know when and whether we must report concerns, understand the possible broader implications when issues are identified, provide continuing education, and include training in veterinary education institutions for veterinarians and paraprofessionals is paramount. By improving awareness, recognizing options, and managing emotional situations for all involved, the goal is to bring broader awareness to the profession. Things to consider include:⁹

1. We ultimately want to build awareness of concerns of animal abuse, which go above and beyond the mere health of the animal, but also may lead to concerns about other animals and people in the social network.
2. We want to assist those involved in cases of maltreatment with ethical concerns, duties, and financial constraints, while following legislation in our regions.
3. Ideally, we hope to be protected from indemnity; however, this isn't a provision in all states. Still, it shouldn't be the reason one fails to report maltreatment with possible One Health ramifications.
4. If you and your staff haven't had training on identifying animal abuse or do not have established standard operating procedures (SOPs) for handling cases of concern, I recommend that they be developed to minimize stress and emotional turmoil that can ensue when handling cases like this.

As veterinarians, we took an oath to do no harm. By speaking out against animal injustices, we may be doing our part to help prevent future One Health consequences. Further, by recognizing cases of maltreatment and reporting them appropriately, we may reduce the risk of adverse health outcomes for other animals and human family members, even strangers, and thus, our sentinel role helps to protect others.

 

Erica Tramuta-Drobnis, VMD, CPH, is the CEO and founder of ELTD One Health Consulting, LLC. Dr. Tramuta-Drobnis works as a public health professional, emergency veterinarian, freelance writer, consultant, and researcher. She is passionate about One Health issues and believes that addressing pet health, food safety, agricultural health, and other related concerns can help highlight the interconnection of human, animal, and environmental health. Veterinarians are primed to be at the forefront of One Health initiatives, and she is passionate about issues from antimicrobial resistance to infectious disease control, vaccination health, and wildlife conservation. She is a strong advocate of evidence-based veterinary medicine and the president-elect of the Evidence Based Veterinary Medical Association (EBVMA). She hopes to promote the use of evidence-based practices through her writing and clinical work, preserving the human-animal bond and improving health outcomes within a One Health context.

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