Hi, my name's Jade. I'm one of the co-founders of Street that. And I'm Gabriel, you've heard all about us just now.

So, thanks so much for coming to learn about Street Vet. Just to be clear, and you probably see this on the very first slide. So Street is a number of quite a few initiatives that are out there.

Majority of the other initiatives that exist are student-led and With the university, she's got a trustee pauses in the community in Nottingham, all four paws in Edinburgh. We are very keen to learn and work with as many of the other organisations as possible so that we can help to provide the best service that we can. And we're using the term street vetting quite loosely here.

We're referring to providing community-based veterinary services out on the streets and we're gonna use it, we're gonna say street vetting, but really we hope that what we're gonna cover will be relevant to anyone volunteering with any of these other organisations. We also hope that those of you who occasionally see pets presented by homeless pet owners in day practise might also pick up a few nuggets of useful suggestions from this presentation, and we recognise that there will be quite a lot of people who have tuned in, not because they'd like to be out on the streets, but as in volunteering with us, but simply because they are concerned citizens as members of the veterinary profession. And here are some of our volunteers.

Here are some of our street vets and veterinary nurses in Cambridge, Plymouth, Brighton, who else have we got? We've got Bristol on there. You don't recognise any of them.

Sorry. We probably, you probably know someone who's one of our volunteers or volunteering with one of the other organisations, and we keep expanding as Jade is about to tell you. So, as alluded in the initial sort of introduction, what started with the two vets and a backpack has sort of grown exponentially, which is really only thanks to you guys for getting behind it and the veterinary community for supporting it and the public for recognising its needs.

We are in currently 10 locations across the UK. I believe we have 550 registered patients at the moment, and that says 500, so we've gone up since then. And we are about to open in Scotland, which obviously pleases me greatly as that's my, my hometown in Glasgow.

So how, how does sort of street bet work essentially. The best way to look at it is a free home visit on the street. Anything that we can, do in a consulting room, we like to say that we can do, with a street there on the street.

So the important part, the really important. The part, about working with Street bet is that it's all about consistency and gaining the trust of the people that we're working with. So what the most important thing that we find that we try and replicate in every single city that we open is that we are regularly seen.

Different ways that we do that, but most, the way that we find is, I guess, the best way is to work alongside other organisations, other outreach, grassroots organisations. So, the homeless people recognise them, they see them all the time, they trust them, and as an extension of trusting them, we work with them, they start to trust us. So, as again, we talked about, we're Run entirely by vets and nurses, go out volunteering a minimum, we ask for ideally a minimum of 2 hours a month.

And we have the backing of other practises, which basically means that if we see something that needs, for the treatment that we cannot provide on the street, we then have a network of practises that we can work with and refer into for surgeries to be done. So how do we see these animals, a couple of ways, as I sort of said, weekly stations. We also do a mobile outreach.

So, every Sunday, Gabe actually takes to the street and does a proper walking outreach course in certain locations in London, and that can be really important to reach some of the, our clients that maybe aren't able to make it to a weekly station. We do hostel visits, so we make phone calls and find out who, which hostels accept dogs, which are not as many as we'd like, but we'll get on to that a bit later on in another slide. And the last way, which is actually becoming more and more popular, is a public notifications.

So the public are now getting to know who we are and getting to know that we exist and They're, I guess, it's giving them something positive to do, so they maybe walk past someone every single day on the way to work with the dog, and now they feel that there's something positive that they can do to help. So they then can email into our website and let us know where this person is and give us as much information as possible, and with the best will in the world, as we're all volunteers will, will try and, find them. So the next slide is talking a little bit more in detail about the percentages of the medication that we kind of look at and we dispense and no surprise, quite a large percentage of it is, you know, in the parasiticide category.

We do mainly basically in our backpack we've got, what you'd expect, so non-steroidals, antibiotics, topicals, we do do vaccinations, . I would say they're the mainstay, but they can be really critical because it would be the difference between somebody getting a hostel place or not, and that could be so important and actually getting a person off the street because you're vaccinating their dog and allowing them access into a hostel. Again, no big surprise, smaller proportion, of our patients are.

Neutered. So that is multiple reasons, but a lot of it is just due to accessibility and also trust, and we find that as we build up relationships with our clients and they get to trust us, then that conversation can be had, and we have successfully neutered, a percentage of our patients. Again, there's no surprise on the percentage of the animals that we see, but, we do see quite a range, but the majority, that we're seeing our staff terriers.

The important thing to sort of say about our demographic of the people that we're helping, obviously you do have people who are actually sleeping rough on the streets, but we also include those that are of no fixed abode. So, you know, so for surfing and squats and hostels. So as I say, as it says on there, 30% have an address.

Alright, so enough about us. For now, we've got 3 formal objectives. The first one which we're gonna cover is a quick run through through the costs, the costs of having a pet for someone who is experiencing homelessness and possibly more importantly, the solutions which we as vets as veterinary professionals can facilitate.

Jade has already alluded to some of them. The second will be to look at some of the medical challenges we face and really which is faced by this unfortunately growing population. And the third will be to understand the opportunities for providing this community-led, community-based veterinary service to owners who are often quite vulnerable.

So, starting off with the costs of having a patent, some of these are obvious, but if you look in the academic literature and what's been published formally, what comes up pretty high near the top is reduced mobility. If you've got a dog, especially an elderly dog, it's gonna be quite tricky to hop onto the back of the bus if you're trying to get somewhere. You can't leave that dog unattended, so making an appointment, whatever that may be for is gonna be quite tricky.

So reduced mobility always features quite highly as one of the genuine costs of having a pet. Obviously provision of daily essentials is itself costly. Although I'm always surprised how how regularly owners I meet do not need any dog food.

They'd much rather have a toy. They can provide for their dog. But we just provide that tiny little bit of top up.

One of the costs that I find absolutely gut-wrenching is the stigma associated with having a dog for someone who is homeless. And if I had a penny for every time I heard someone give an owner a pound or anything and say, this is for him, not for you, that phrase, oh, the number of times I've heard it, it really drives me up the wall. An obvious one, zoonotic disease exposure.

You may think of fleas as being quite a minor inconvenience, but in reality, flea bites have the potential to get infected, especially if you scratch them, if you can't change your clothes, and the whole situation can snowball into quite a severe, zoonotic condition. Bereavement. I'd like to think we help make this less likely, but the simple fact is, whenever an animal does die, unfortunately their owners who are incredibly bonded, as we'll explain in a second, will go through a very acute bereavement process and that is recognised to sometimes activate potentially self-destructive coping mechanisms.

And the really the biggest ones which we will focus on in a little bit more detail is exclusion from hospitals and exclusion from housing. So, yeah, when it comes to housing, I sort of mentioned a wee bit earlier, there's, there are hostels that do accept dogs, but sadly, you know, there, there's not enough. And the other thing that, that happens is if people are fortunate enough to get into a hostel that accepts dogs, there are, there's a period of time in which they can stay, and then they can almost get, I guess, stuck.

In that hostel situation because as we know, it's even more tricky to then get into social housing. Battery at the moment are working on an initiative to try and encourage pets to be allowed into social housing, which is something obviously we're incredibly supportive of and We are hoping that maybe we might be able to work, together on an initiative to try and encourage more hostels to, to take dogs. And the reasons why they're not taking dogs can be, multiple, but I guess the main, one of the main reasons can be that the staff are not, you know, just not trained to work around dogs.

And that is certainly a piece of work that we could, work with Bay to improve or, or look to get training to, to help with this. . The other reasons, can be that, you know, you're taking on the looking after the, the people, and then obviously then the extra burden of that animal and having that to worry about and the welfare of that animal, and feeling that it's then the staff and the hostel's responsibility.

So another piece of work that we're really, really keen to do is is to actually look at the dog policies that hostels that we are working with, who do successfully take dogs have working with them on that policy, and then trying to see if we can get that policy into other hostels and almost make a kind of street that accredited, sort of dog policy where we help them with how they write. Policy, but more importantly, we support them in having the dogs in the hostel. So be it that we help them with a sort of care package when they take in the dog, we do an initial vet check, vaccination, make sure we regularly, you know, visit to keep up food and stocks, and obviously they have a number and an out of hours number should anything happen as an emergency.

So the other thing that, as Gabe sort of said, there's certain things we hear in doing this work that we, we hate to hear and we get told a lot by people becoming voluntarily homeless, and a more less essentially means that they have chosen to give up. And to give up their place in a hostel because they don't want to give up their dog. Now we all know that's not really much of a choice.

So, we see this quite a lot where people are literally on the street because they will not give up, will not give up their dog, and they are sometimes looked upon as voluntarily homeless. And the flip side of that is exclusion from healthcare, healthcare for the owner, not for the dog or cat. It's recognised that, individuals experiencing homelessness who have a dog are more likely to present, for medical care when their pathology is more advanced, often when they haven't got a choice, basically, and when they do present at A&D, if they're on their own, if they haven't got a network of support of people they trust, then they will present with their best friend in tow.

And they will self-discharge. We see this time and time again, unfortunately, individuals who really prioritise the care of their four-legged companion above their own healthcare and self-discharge to get back to them as quickly as possible. But even if someone does complete a period of treatment and is about to be discharged, they're more likely to be discharged back onto the streets because of the lack of pet friendly accommodation which Jade has just been talking about creating very much a vicious cycle.

Finally, it's worth pointing out that medical staff don't have much of the training we have, especially inclusion health clinicians, typically don't recognise the potential for zoonosis. We're starting to provide some information in this arena as much as we can within London and within more natural, national conferences as well, but it's early days yet. So we've talked about the, the cost of owning a dog on the street, but I think we also need to look at why did, why did they do it?

Why do people do it? And I think, you know, we're we're talking to a group of people I'm sure that know exactly the benefits of, of having a pet. You know, the best therapists have got 4 legs, basically.

So essentially there's the companionship element, the fact that, you know, they are warm family, you know. Their best friend, all those things that that we all know. The other things that I didn't really think about and when I first started doing street that was the security aspect.

So I I remember speaking to one of our clients and he said, you know, I look after him during the day, and he looks after me at night. And that sort of really sort of struck a chord with me. Interaction, you know, The number of our clients that can literally be sitting on the street and people walk past and don't speak to them, you know, for 8, 10, the whole day, you know, hours, nobody speaks.

But having a dog, it can be, as you know yourself, if you go out walking the dog, people are much more likely to talk to you. And so the, the dog can act as a conduit to conversation. .

The other one that we talk about a lot and we hear people say a lot is, is that sense of redemption. So we have clients who, they got their dog, and that dog was then the kind of catalyst to sort of turning their life around, either stopping drinking or, you know, stopping taking drugs. These dogs give them a purpose, give them a reason to get up in the morning, you know, I've Got to go and walk the dog down the street.

I've got to make sure the dog eats. I've got to make sure the dog has water. And then gives them a routine.

And that in itself is a sense of responsibility that can really help to turn a lot of people around. And the last one, you know, we'll talk about this in another slide, but sometimes the dogs themselves are their only link to a previous part in their life, which was a lot happier. We don't have many graphs in this presentation, but this one I, I do like, I do like to use.

It's obviously very difficult to quantify how attached someone is to their pet, but if you were able to ask a great big long questionnaire and out of that come up with a score, an attachment score, which is what's quantified there on the right. What has been found in a couple of different studies, that have specifically looked at this is that individuals who have been chronically homeless, have higher attachment scores on average than members of the general public who are securely housed. And this really is, it really does emphasise the the power of this companion bond that we do come across quite regularly.

So, another question that we get asked a lot, and again, I don't know that I thought about this enough before I started to do this, but, you know, where, where do they get their dogs, where do the dogs come from? So the over and above the vast majority of the clients we see have had their dogs before they were made homeless. So in some of those sort of parts that say there in the column, so one of them used to be the owner deceased son's dog.

Another had bought the dog when things in their life were going well. And obviously then, you know, as life happens, sliding doors and they end up in a, in a different situation. Some of our clients certainly have rescued the dog, so, one in particular fished the dog out of a plastic bag in a canal.

And then we have the famous Bailey who is up there that you can probably see just to the middle there, whose owner Andy, paid £12 for him, from people on the street. So I think the overriding thing, take home message is that these dogs were usually in the client's lives before they were made homeless. So in another thing just to sort of talk about, and again we get asked about it a lot, you know, what the health, what's the health status like of these of these pets, are we finding more problems?

Are we seeing specific problems? There was a study, done in Cambridge by David Williams and Sarah Hogg, where they looked at, homeless. Dogs belong to the homeless clients versus those that were housed and yeah, interestingly, but again, we could, you know, echo the results found that the health status of these dogs were comparable, to those that are in houses.

We, it was also found they're less likely to suffer from separation anxiety, mainly because they are constantly with their human. But certainly the over sort of riding underlying thing to, to point out is that, you know, they are really, really well cared for. So, how can vets help and alleviate some of these costs?

Well, one thing we have ended up doing quite regularly is writing pet references, and these are very, very simple, simply certifying the date of the last heopparasiticide treatment of the last vaccination administered, as Joe's as Jade's mentioned, this is often a prerequisite to getting into a hostel. Advocacy and empowerment very simply going along with an owner to a meeting, be that a housing meeting, a social services meeting, even a police station if they need to report a crime against themselves or anything like that, or if they've lost their dog and need to get CCTV footage, simply having someone there, someone in a position of authority able to support them makes a massive difference. Provision of kennels, there are a number of different situations in which we've found it very useful to, to just make candles available for short periods of time, be that for the owner to seek medical care themselves or for a range of other reasons.

But the, what I would do want to emphasise is we always have to have a contract in place and we would encourage anyone else considering doing this to have a contract in place, and we're in fact very rarely able to foster because of the risks to the fosterer. Monitoring of potential zoonosis, that one's pretty straightforward. As I said, fleas can be a nuisance, they can be far worse than that, but also the amount of phytoses, sarcos, and so on.

Support and bereavement, we've had some of our volunteers specifically trained to do this, to support, owners as they go through bereavement, but certainly we're not alone in this, and for example, the Blue Cross provide us with cards we can hand out to individuals who may want to call in and talk to someone they don't know, which is sometimes even, even easier. And we are occasionally part of safeguarding referrals. So for example, if someone needs to get out of an abusive situation quickly, we sometimes get called in to provide emergency kennels just to make that happen as quickly as possible.

And that, that certainly is a very rewarding part of of our contribution. So that sums up the, the, the costs as we see them, the costs that are recognised, and some of the potential solutions we can facilitate. Then the next section, we'd like to focus a little bit more on the rather unique medical situation we face.

So, as you'd imagine, street vetting does pose unique challenges. There's a photo of me on the next slide, running urinalysis by Liverpool Street Station, trying not to let members of the public see what I'm doing and I'm playing around with urine. But hey, we got the results, obviously finished it off with sediment when we got back home, but yeah, I do have a centrifuge at home.

But beside the point, doing all that on the streets is quite tricky. Having just emphasised how bonded the owners we work with are to their, to their pets, that in itself poses a challenge. For example, if we need to separate them for an operation like that, our owners do face quite a heightened level of anxiety when they're away from their pet.

We do need to safeguard the owners. We've got to recognise that they are potentially vulnerable, and we'll cover this in a bit more detail later on. But even the items we give them and the medications we're able to prescribe have to recognise the their vulnerability, the position of other people being able to see what they've got and so on.

It's a difficult practise environment. I've covered that, but also about the medical and social priorities are different. If you'd imagine a visible wart on a dog's head, something which is probably no clinical significance, but as people walk past that owner and dog every day.

Regularly you have members of the public stopping, pointing at the dog, saying your dog has cancer, and I can come along and say definitively, maybe even take an FNA if needed, that I'm not concerned about it, but the rest of society won't, and the societal view of that is going to be very different. And obviously some of the medical cases and some of the risk factors we come across are pretty unique. The biggest one there is the dogs we see have an incredibly varied diet.

That's everything from McDonald's to baby food. In fact, one of the fattest dogs I ever worked with belongs to an to an anorexic gentleman who used to sit outside McDonald's every day. You can guess what his dog ate all day long.

Most of the dogs we see are older dogs. We, I, I know, I know a photo of a puppy was used to advertise this webinar. That was just to draw you in.

We see very few puppies and in fact, the graph on the right, is a quantification of the age group of the dogs we see compared to those currently in Savsnet, and we see more dogs over 8 years old, we see more of the older dogs. So we're really looking at diseases of the older staffy. The histories we get are often fragmented.

They've often had an injection somewhere from a vet practise in London and then they went down to Brighton and being seen by someone else, and so goodness knows, leading somewhat chaotic lives does mean that the histories we get may not be the nicest, neatest straight line, and we often have to do quite a lot of digging to work out what's been done previously. When say a dog has an injury or whatever, some of the home remedies we've seen have been rather ingenious, keeping paws dry, plastic bags don't stay on. McDonald's cups sometimes do, not for very long admittedly.

We're always aware of the potential for non-acidental injury and AI, although I can confidently say we've never really suspected it. We always keep it in the back of our minds, but it's never popped up as something for us to really be worried about in an individual case. Our treatment priorities can also be different from what you'd expect in day practise.

So if you imagine a tiny little hostel room that's just about big enough for a single bed to squeeze in, now add a biggish staffy with diarrhoea in that room, and suddenly you've got quite a big problem. Fleas, I keep mentioning fleas, but that's another great example and very simply, incontinence or PUPD in a hostel room that can cause the owner to get evicted. So we're not talking about fixing the dog, we're talking about keeping the owner housed.

I remember the first time I, I prescribed chicken and rice to someone on the streets. I really wasn't thinking. And the owner turned at me and said he'd love to eat that himself.

But simply prescribing chicken and rice is not going to work. We're not going to be able to get that. We need to provide ID usually.

Crate resting is tricky. We can sometimes provide a buggy for owners to push dogs around, say if they've got bad stifles or they've just had orthopaedic surgery, but if the owner has to walk 5 miles from where they sleep to where they eat, they're going to have to do that twice a day every day. So simply saying the dog needs to rest for the next 4 to 6 weeks is not going to work.

No fridge, so we can't prescribe insulin, for example. So diabetes is an extremely tricky condition to treat when you haven't got access to keeping insulin cold. Equally, many of the dogs we see get weekly checks and naturally we need to be quite careful not to overdo it, not to over diagnose and go over top over the over overboard, but at the same time that does mean we can pick conditions up far earlier than the the situation you'd expect even when dogs are being checked by their owners at home.

At the same time, the flip side is also true that we sometimes will only see a dog once and may need to treat it quite aggressively. For example, if the owners are passing through a city we're established in, and we are unlikely to see them again for a period of time. And the final point on this slide is we avoid using topical treatments that recognises the fact that many of the owners we work with are in constant physical contact with their patent.

We had a a very specific conversation with a pharmaceutical company that provides a color-based product and we decided that in this situation it's not a good idea. To have the owner in constant contact with the dog and therefore in constant contact with the dog's collar. So the other things we have to think about is constantly be aware of the owners, and their situation.

So. We definitely have to consider, as one of the things was talking about, obviously, the access to, like, being able to give insulin or things that need to be kept in a fridge, but we also have to consider, using things like, you know, for treating epilepsy or, you know, any kind of addictive medication that can actually make the the owner a target, and it's not actually safe for us to prescribe for them to be carrying around with them. Privacy is, yeah, just so important.

So we have very strict kind of social media policies. All of our social media is run through one channel, so we have one Facebook account, Twitter, Instagram, and it's kind of all overseen by one sort of small group of people. Ultimately, because we want to protect these owners.

So before we take any photos at all, we get their permission. We don't put out any photos of the owners or any that have, you know, recognisable tattoos or anything like that, because you've got to consider their lives and what might have been going on, you know, we have had people in the past who are in a witness protection programme, for instance, or we have owners who have children that don't know they're homeless or who or who have parents who don't know that they're homeless. So You know, it's a really, really strong consideration that everything we do, we have to consider that they're vulnerable, and we have to safeguard them.

Other things that to think about is, you know, put a label on something, it might all get scrubbed off. So what we try and do the best that we can and get sort of alluded to this is we try and get as much as we can ourselves at an outreach. So if it's for instance a directin tablet, we can give it there and then, and we know that they've had it.

In terms of drugs like Metaam, you know, we'll have a pen and we'll draw on so that if it does, get wiped off the label, they can be very clear as to how much they should be giving. Street vet, as you can imagine, we're not the the only organisation and in an emergency situation, sometimes they may turn up at a practise to get some emergency care. And so you've always got to bear in mind that this one dog might have been ill, the owner presented as an emergency and had one off shot of pain relief at another practise.

So you've got to keep your wits about you and, and ask relevant questions and try and get as much history as you can, . And the other thing again, that did not cross my mind at all when I started to do this, but we were advised by other outreach workers because they, when they go out, they do not give out things like belts and to people who are experiencing homelessness because they can be used as for other reasons, like, unfortunately, as tourniquets. So we also have to now take into consideration when we're handing out things like collars and hand sanitizers to make sure they're alcohol free.

So that takes us on to the last objective, which is to understand the opportunities and considerations for providing community-based services to prevent potentially vulnerable owners. This is really reflecting on the opportunities we have as vets. So, if you think of an individual who has for a period of time being let down time and time again by by organisations that have promised anything from housing to simply a tent or a sleeping bag.

A lack of trust builds very, very quickly, and that fundamentally impairs access to other services over time. And the very simple fact is many outreach and social work professionals do not value pet ownership. So when we come along, we've got a natural conversation starter.

We've got a natural way in to start building that trust. If you think back to that box plot I showed you ages ago, One of the questions that are used in, in, in coming up with an attachment score to a to a dog or a cat is asking people to rate whether the statement that I like people who like my dog is true. So when we come along and we're animal lovers, we're vets, we're veterinary nurses, we're good with animals.

We were there to help them automatically we've got a weigh in. And that gives us a way of building engagement not just with ourselves, but with other service providers as well, which is increasingly being recognised, increasingly we are being asked to take part in safeguarding referrals in emergency responses to owners who need acute care, but also to start providing allied healthcare professional training, which we're increasingly sort of building our capacity to do. Ultimately, we have a very marginalised human population, but also a marginalised veterinary population.

As Jade said, most of the treatments we've prescribed are preventative ectoparasiticides and so on. We have had a number of success stories. So in building this trust, we estimate we've had around 20 dogs who've been allowed to neuter in 2018.

It doesn't sound like a lot when you put it in the context of the far bigger organisations, really 20 out of 500. We're quite pleased with that. In addition, as well as that trusts, many owners will struggle to access veterinary care because of the challenge of having to sit in a crowded waiting room.

To many people, that's absolutely a no no. They're not going to be able to do it. That doesn't just include agoraphobic people, we do have, owners have identified themselves as being agoraphobic, but also with PTSD and associated mental conditions, many individuals will not want to be sitting in a crowded waiting room.

We do provide a safety net in emergencies for these patients. Jade will tell you about some of those cases very, very soon. And the big one I think is dignity and euthanasia.

Ultimately, we're dealing with diseases of the older staffy. Some of them will eventually be put to sleep, and we've had owners say, I shudder to think what I would have had to do if you weren't here to put my dog to sleep to help ease this pain. So, on to a few cases, just I've got a kind of varied kind of example, but, this I guess comes back to the importance of the, the weekly check.

So, we had a, a case where a mammary lump was identified and we have quite clear ways in which we can mark and measure, lumps because obviously from one week to the next, we might not have the same, street vets and street nurses doing the outreach. So it has to be very clear on the note. And they're all uploaded onto a computer system called Provet that we can compare.

And it was found, and again, this is due to the owner's commitment coming every week that this lump was, was indeed growing. So we, were incredibly fortunate to have the support of Goddards, who gave us 10 free cases a month, 10. 3 cases a month for the whole of 2018, which was just remarkable.

So this particular dog went into one of their hospitals and had the disease stage removed and submitted for histopath, and it was confirmed as an adenocarcinoma at the time she was in season, so she wasn't spayed. Then again, just an example of About what what exactly what Gabe was saying about, you know, diarrhoea in a small environment is an issue. We were actually living in a toilet cubicle, and their dog got HGE.

So as a result of that, that's obviously something that needs to be treated and dealt with, quite urgently. So again, we had the good fortune of being able to send her into Goddards for hospitalisation and care. There was a period of time where there was hope that We're going to get a hostel room.

So we postponed on this space for a bit, but and eventually decided to go ahead to stay. And she had that done and recovered well. And the good outcome to this is that she is now in an accommodation with her owner.

Important thing to kind of mention as part of Street bet that we, commit to supporting any of our clients that do transition off the street for up to a year. OK, on to another one, you will see a kind of trend, I guess. We do see quite a bit of lumps and bumps with the dogs on the street, so either ones that have not been neutered, and so therefore mammary lumps or as we are dealing with a large population of staffies, we do see quite a lot of mast cell tumours.

So yeah, this, this particular dog has had quite a bit done with us. So two mast cell tumours, if in a on the street and removed. Urinary tract infection treated and, most recently, X-rays, due to like a chronic lameness, which then became more acute.

We have just had, a TPLO done pro bono at North Downs. And yes, we're, we're monitoring that, that other limb with a suspect that that might also go the same way. And yeah, most importantly, also featured on For the Love of Dogs programme and got to hang out with Paul O'Grady.

So yeah, next one, is, I guess a, a good, a good example, of a dog that hadn't had a vet check in, in quite some time when they came to, to see us, and the owner was concerned about the dog's skin. And on examination, we discovered that the testicles were not similar. We were able to go into street vet mode and perform quite a lot on street side.

So yeah, we've got hematocrit readers, glucometers, refractometers. And dipsticks in the backpack, and so we were able to do quite a lot of that on the street. Gabe also has a blood analyzer in his house, alongside a microscope and some other other bits and pieces.

So he ran the blood in his flat. And yeah, then the dog was taken in and castrated and the pathology came back to the lax cell tumour and 3 months later, all the problems with the skin that she had been worried about had been resolved. This one, she's our kind of probably our famous one.

If you do end up, following us at all on any of our social media, you may well have met Belle. So we'd seen her, she was quite a, a bonded client, so her and her owner very regularly, and then, . Like a freak accident.

Basically, she was run over by a train. What then ensued was just showing, in my mind, the amazing collaboration that has all come about, with street bets. So the owner had our various number, which he called, that.

Was ours for that area was the RSPCA. They arranged for officers to go down to get her from the track. She was then went back to the RSPCA and was stabilised.

Once she was stabilised, we were in a position that they assessed who, are an ambulance service, then transported her to Goddards for ongoing care, and they, offered us, I think in that particular instance, did that pro bono, which was amazing. Yeah, then into Goddard's practise where she had a leg amputation, I nucleation and was in a hospital for, a number, a number of weeks. During that time, the team who were really well sort of bonded with the owner were amazing at.

Keeping him really up to speed as to what was going on and, and just keeping him reassured that she was in, in the best hands. And then she decided very recently to develop a mast cell tumour. So, yeah, she's not having very good luck at the moment, but, yeah, we, we're on it, and she is getting the care that she needs.

And last but no means least, this is, yeah, 75 kg staffy with heart condition. So this one's quite a new case for us, but yeah, the owner. Presented as they were concerned about her because she seemed a bit lethargic, on exam, yeah, she had like a heart rate over 300, so the team, quickly got into action and arranged for a cardiology workup which was, done pro bono at East Anglia, which was amazing, and she was diagnosed with narrowsoventricular tachycardia.

And has since started on Amodrone, and Frozamide and, yeah, Pim Bendan which we are very grateful to both Lainger and Dera for helping us to, provide that for her. So those are the 3 that covers the 3 main objectives we hope to get through today. Hopefully you've found lots of it useful if you do, in fact, street vets out on the streets, so be that through street vet itself or any of the other organisations.

And at the same time, I hope those of you who just wanted to learn a little bit more about the general societal aspects of what we deal with, have found our presentation informative. And with that, all we've got left is to let rain say thank you to you on the very last slide. And I, yes, you never know with videos.

They don't always work, but this one did. Gabe and Jay, that was absolutely fascinating. Folks, I told you you were in for a treat tonight.

I know that I have been in, in amazement and awe at what you guys have learned and and how you have to cope with this. And yeah, I really take my hat off to to the amazing work that you are doing and with your group of volunteers, it's tremendous. Thank you.

Thank you. We do have a couple of questions coming through. I think some of them you've touched on briefly, but maybe you want to expand on them.

Belinda asked, Before you started talking about it, but she asked, what are the, are the, the animals like when they are separated from their owners? Do they exhibit separation anxiety? Have they got, you know, because of being constant companions, and how do you deal with that?

Yeah, absolutely they do. So if we can, we will obviously try and keep the owner, you know, so a lot of the time the owner will come to the practise with the animal if they're going in for a procedure. It mainly comes down to, if we do have to think about foster, then we would always prefer a foster in a home environment.

Rather than kennels, because these dogs really don't do what we found very well in a kennels environment. So Foster is always preferential and obviously the shorter vet stay as possible that we can get away with. So, for instance, if we're looking at getting space done, we would look at trying, if we possibly can to get a laparoscopic spa done.

Again, looking at the return to being able to be out in the street and being able to be reunited with their owner as soon as possible. The flip side to that though is that the vast majority of the dogs we work with are so incredibly friendly with people. They don't tend to be very good with other dogs, but they have to be good with people.

That's, I mean that's what they do day in and day out. So they do actually get along really well with the veterinary staff and practises, but also if they end up being Fostered, they tend to settle into a new relationship reasonably quickly. I always tell owners when we return dogs to them that the dog won't recognise them for the 1st 30 seconds or so, and I've seen this a couple of times.

As soon as they realise, as soon as they recognise the smell, they just go absolutely berserk and just turn into puppies again. That's, that's gotta be so rewarding. So the fostering you're talking about, that's if the owner has to go into, into hospital or something to have something done for themselves.

Yeah, it kind of it it it is, yeah, so if they're the owners are going to hospital or, sometimes they're going into a rehab programme, and they obviously will not go, unless they're their animals looked after, so that can sometimes be a situation in which we're asked to help, or, you know, we had a dog that had a fracture, and obviously needed to be properly crate rested. It was a puppy. Our young dogs so we foster situation to get that rate and rested for a period of time and equally dogs post TPLO we've we've got a few and we need to look at, you know, the best postoperative management for them as well.

We've had several cases as well also in which the owner's housing situation changes. So for example, they are out on the streets and then end up in a hostel that is not It's pet friendly, but they know they're going to be there for a couple of weeks, so we can take care of the dog for a couple of weeks while they transition from there into social housing, into independent housing. So there are many different situations in which just having somewhere safe you can leave the dog or cat does make a massive difference.

Incredible. Gabriel, you just touched on this a minute. About the dogs being very friendly and that Gina wants to know, do you find that you need to approach the dogs differently or handle them differently because they, you know, they may be shy or, I mean, they mentioned aggressive and that sort of thing.

Quite the contrary. First of all, we're in an environment they are used to being in, it's their home environment. I use that term quite loosely.

So we do find it's actually quite easy to do a lot of what you consider to be tricky procedures out on the street. I mean, and the last whoever. If you can think of the last time you nail clipped a Jack Russell terrier, suffice it to say the last one I did, I didn't even need its owner to hold it.

I just picked its paw up and started clipping away and she was perfectly calm and just let me do it all. So, obviously, we do see some dogs. That, you know, you need to be wary of, you need to use a muzzle, and we need to safeguard the public as well.

If I'm emptying anal glands, I've had a member of the public literally jump on the dog whose anal glands I was emptying in the middle of Oxford Circus, because her dog has this done at home all the time and she knows exactly what the main vet man is doing. Oh The sigh says it all. Sue asked, you know, what about providing something like a history book for these owners so that you know, if they go from vet to vet there is some sort of continuity.

So what we do, at the moment is they all get given, at the time an out of hours card and on the back of that card we'll write the treatment that we've done for that day. The, the difficulty comes is a lot of the time. You can't really rely on that being kept and not getting lost, or, you know, discarded in some way.

So after an outreach, we will always, you know, within 24 hours our notes get written up on pro vets. So I, I completely appreciate what she's, what she suggested the tricky bit is just knowing that it's not gonna get lost, but we have also recently, well, it's In the in the midst of happening, we've got a street vet tags that are going to go on all of our patients and just say Street bet registered and then on the back it has our out of hours phone number because we've also find that though we hand them a card with the out of hours number on, sometimes they lose it. And so at least if it's on the dog's tag, then, you know, if there's ever any problems, they've always got access to our.

Is number. The beauty of the Provet cloud system we use is that wherever we are, even if the dog is seen in Brighton and someone sends us an email saying, can you please send us the history through? I can usually get that pretty quickly and we can get that history sent very, very, very, very quickly, irrespective of where the dog's being seen.

So that, that has been really helpful as well. Incredible. Guys, I'm gonna open up a whole can of worms here and I'm hoping you've got a short answer for it.

There are loads of questions coming through of is there a street vet in my area? How can I get involved? Do you allow people who are non-vets to be involved in this?

And the questions go on and on and on. Tell us how we get involved with you guys. What, what do we do?

What do people do? What do corporations do to sponsor you, give you financial assistance. So in, in terms of the locations where we are, I can list them for you.

We're in London, Bristol, Brighton, Birmingham, Plymouth, Southampton, Cambridge, Cheltenham, Cornwall, Peterborough, I think I haven't missed anyone, and London, and we are opening next week in Glasgow. So if you are interested and you want to go here, please don't be put off by the fact that we're not in your area. Because, we are very interested to hear from people who believe that there's a need in their area, and then we can, we can look from there.

So if you're interested in volunteering, please do email in the [email protected].

And we can certainly give you some sort of questions to sort of look at in your area to see what's relevant, and then we can, we can go from there because we have a lot in the pipeline, but the, the next actual one confirmed is Glasgow. And in terms of how else you can help, fundraising is, is very welcomed, and we've had some amazing people do some very incredible fundraising for us, within their practise or just independently. In terms of at the moment, we only do accept qualified vets and nurses, that's for insurance purposes and to help us actually with outreach, but that's not to say that there aren't other ways that people can.

I mean it's mainly going to be a fundraising point, but as we get better and there's probably gonna be some admin roles that that start to open up as well. I guess we haven't really covered what it takes to launch street vets or an equivalent practise in a new city and that's everything from registering a new veterinary practise premises which will then have its own veterinary medicines directorate inspection. To having a team lead in places and the committee behind them, who is able to take phone calls from emergencies during the day before the out of hours provider is active, and so on and so forth.

So actually launching in a new city is not trivial, that's not just from a financial point of view, but very much from a practical, infrastructure. It needs to be in place to offer a sustainable service on the ground. But we're not the only organisation and certainly apart from the veterinary sphere, there will be local grassroots organisations out helping people, irrespective of whether or not they've got dogs, and we're able to do a lot for a small proportion of individuals experiencing homeless, homelessness, but by all means, go out and volunteer with everybody else as well.

That's excellent advice, excellent advice. So I've just lost the message. There was, I think her name was Louise from Yorkshire.

You, you have a big challenge ahead of you and I'm sure if you email in, street vets will give you loads and loads of guidance and Gabriel will be able to expand a bit more on what is actually needed to open up in your area. We have a couple of questions coming through related to microchipping of these dogs and registering them. Do you register them according to their microchip?

Are they registered on a central database? And if the dog gets lost, how does it get returned to an owner that doesn't have an address? Are they, do these people have mobile phones to be contacted on, or?

Yeah, so the microchipping, so every, every animal is obviously checked to see if they have a microchip, and as we sort of alluded to before, a lot of these dogs were with their owners before they were homeless. A lot of them are already microchipped. If they are not microchipped, then obviously we will just microchip them there and then on the street, we have a really great relationship with animal care, who kindly, give us the chips, for all of our cities.

And one of the things that they do for us, which is brilliant, is they offer us a lifetime, a free lifetime change of address for these owners, because as you can imagine, that, that can change quite a lot throughout their, throughout their, life. Time. So in terms of where do we register these, these microchips, you'd be some of these owners, you know, are in hostels, so they'll register it to a hostel, but also majority have a friend or a member of family that they are happy to have the the microchip registered to.

In terms of mobile phones, yeah, a lot of them do have a mobile phone, and so they will usually be able to give us a mobile number, that we can attach to that, microchip, application. Just on that, just to say owners that don't have mobile phones and let's say we feel quite strongly that we want to be able to get in touch with this particular owner because we're worried about the dog or we've got blood results for them or they're going in to have a procedure done, then, you know, we do have on our Amazon wish lists a sort of burner phones or cheap phones that we will, buy and then give out to our owners so that we know that for that period of time they're definitely contactable. That's absolutely incredible.

Folks, I just want to point out if you are getting a little bit of weird sound coming through, it's because Gabe and Jade are sitting in the same room, so you can sometimes pick up the one's voice on both microphones. I do apologise for that, but it's just unfortunately how the situation has developed. Gabe and Jade, we have loads of comments coming through about what an excellent presentation.

What a great idea. I, I, I think your info atrevet's email address is going to be loaded up with people wanting to help you. We've even got a a a comment here that's come in and it says excellent presentation.

I wish you were in California where we have a very bad problem with homelessness. So yeah, can be arranged, I'm sure. I was gonna say you could fly over there, but no, let's not do that, shall we?

Yeah. Belinda wants to know, do you have any situations where people are not eligible? Yes.

I would say it's, it's kind of been, I've probably, I've noticed it more in, in the areas where we're starting to open where there isn't a Blue Cross equivalent or a PDSA, where there's people who are obviously vulnerable but are not actually, I guess, homeless, so in, in all situations, we will always ask when we register an animal we ask a question, are they registered anywhere else? Blue Cross PDSA if they are, then we help facilitate them getting to that practise. So we've got really good relationships with the Blue Cross and the PDS.

So that we can sort of all work together. So in London, for instance, the Blue Cross gave us vouchers that we can hand out to allow one year access to Blue Cross and equally we're working with the PDSA to help sort of facilitate access to to to their services as well. But .

Yeah, it's, it's a tricky one. I'm discovering it more as I say in areas where there's no Blue Cross and there's no PDSA where people are clearly in need, but they're not necessarily homeless, and we have to be very, sort of mindful of, eligibility and and the best way that we can assess it, to be honest, is, is through the people that we work with. So we're working closely with outreach providers, and by actually being out in the street.

You learn very quickly, you know, who the people who are in need of our help are, and they all kind of, to be honest, protect the service. So people who are receiving help from the service, want to protect the service and make sure it's not being, exploited, and I guess they'll be the first to sort of say, you know what, we don't know if that person is actually homeless, but, yeah, majority of the time it's just a case of redirecting them to the PDS or the Blue Cross. Excellent, excellent.

Folks, we've got a lot of questions coming in about how to get involved and everything else. I refer you back to what Jade said earlier, [email protected].

Good luck to the person that's gonna be manning that one. I think it's you. However, there are lots and lots of enthusiastic people that get involved.

So I, I, I hope that you guys get the help and everything else and the support and you continue to grow and develop from strength to strength. Thank you very much. It's my privilege to be able to thank both of you for giving up your time to come and talk on the webinar about a very, very worthwhile cause.

To everybody that has attended, thank you so much for your time tonight to dawn my controller in the background for making everything happen seamlessly. It's been an absolute honour and a privilege. So goodnight to everybody.