Animal Welfare Assessment at Four Dog Shelters in Central Uganda: A Cross-Sectional Study using the Shelter Quality ® Protocol

Animal Welfare Assessment at Four Dog Shelters in Central Uganda: A Cross-Sectional Study using the Shelter Quality ® Protocol | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Animal Welfare Assessment at Four Dog Shelters in Central Uganda: A Cross-Sectional Study using the Shelter Quality ® Protocol Lewis Ashabahebwa, Zozianne Hoareau, Paul Ssuna, Dickson Stuart Tayebwa This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9259621/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background : In Central Uganda, animal welfare advocates are increasingly promoting the establishment of animal shelters as a humane alternative to poisoning for controlling free-roaming dog (FRD) populations. However, dogs at these facilities face a number of welfare challenges arising from insufficient resources and substandard management practices. We aimed to assess the welfare of sheltered dogs in Central Uganda by identifying the animal-based welfare issues faced by the dogs, evaluating the housing and management infrastructure, and determining risk factors of animal welfare compromise. We conducted a cross-sectional study in four animal shelters, between July and August 2024. We used structured checklists from the Shelter Quality® protocol (SQP) to collect data on animal-based measures (ABMs), resource-based measures (RBMs) and management-based measures (MBMs). Results : Overall, the shelters housed 141 dogs (average 35.3, range 4-84) across 40 pens (average 10, range 2-17). A total sample of 32 pens were selected from which 81 dogs were assessed. Fifty-seven of the dogs were housed in groups, fourteen in pairs, and ten alone. 35 dogs were females and 46 males, with 32 young, 41 adults and 8 geriatrics. The most prevalent ABMs were; too thin BCS, skin lesions and fear/aggression, reported among 59.3%, 45.7% and 39.1% of the dogs respectively. At pen-level, signs of diarrhea, pain-associated behavior, and stereotypies were commonly seen in 46.9%, 56.3%, and 46.9% of the pens respectively. Multivariable firth’s logistic regression revealed several risk factors of poor welfare outcomes; Skin conditions, especially wounds were significantly associated ‘other’ bedding type (aOR=5.27, p=0.008). Panting was highly associated with poorly ventilated pens (aOR=82.33, p=0.010). Pain-related behaviors in dogs were significantly linked to group housing (aOR=11.92, p=0.006), while a lack of outdoor access was a risk factor for stereotypic behaviors (aOR=20.71, p=<0.001). Conclusion : Our findings indicate that the welfare of the majority of shelter dogs was suboptimal, largely due to inadequate resources, poor housing conditions, and questionable management practices. Improving dog welfare in Ugandan shelters requires regulating intakes and implementing evidence-based management interventions. Collaboration with veterinary providers and intervention from animal protection agencies or government bodies can ensure sustainable, high-welfare operations. Free-roaming dogs canine welfare animal shelters shelter management Central Uganda. Figures Figure 1 Figure 2 Figure 3 INTRODUCTION Animal welfare has gained prominence on the global policy agenda, with a recent focus on the welfare of sheltered animals, particularly dogs ( 1 – 6 ). The World Health Organization estimates that over 200 million dogs roam freely worldwide ( 7 ), with a serious impact on public health through transmission of zoonotic pathogens ( 8 – 10 ), environmental contamination ( 11 ), dog-bite injuries ( 12 , 13 ), and causing road traffic accidents ( 14 ). While the problems caused by free-roaming dogs (FRD) are well documented, the poor health and welfare conditions that plague their lives are less discussed. FRD often suffer from poor diets and starvation ( 15 , 16 ), and high parasite burden due to lack of veterinary services ( 17 , 18 ). In some developing countries like Uganda and India, FRD are nuisances in many communities and are therefore at constant risk of retaliatory mob-violence and mass poisoning with strychnine ( 19 , 20 , 13 ). In such incidents, large numbers of dogs are often indiscriminately targeted, including those not responsible for the initial triggering event ( 19 ). In an attempt to manage the FRD problem while maintaining welfare standards, governments and animal welfare advocates around the world have established animal shelters as rehabilitation centers, where FRD are housed, treated and cared for until adoption or in some cases euthanasia ( 21 ). Although sheltering is the most common method of controlling FRD in some developed nations, it is less utilized by developing countries due to its costly nature ( 22 ). Until recently, the Uganda Society for the Protection and Care of Animals (USPCA) operated the only animal shelter in the Uganda ( 23 ). Through a growing interest in animal welfare in the country, sheltering initiatives have increased in recent years ( 24 ). However, their exact numbers remain unknown since many are not formally registered. Under resource-poor settings, shelters often depend solely on financial support from donors and well-wishers to run daily activities ( 25 ). Unfortunately, donations are an unreliable source of funding, prone to fluctuations from seasonal changes in donor income or unexpected events like the COVID-19 pandemic ( 26 , 25 ). As such, when financial shortfalls arise, they can lead to inability to provide basic health and nutritional needs to the dogs, compromising their welfare ( 26 ). In addition, while the target is to rehome the dogs, shelters in developing countries often end up overcrowded due to low adoption rates ( 25 , 27 ), imposing further strain on already limited resources. Ensuring optimal welfare in animal shelters requires a context-specific understanding of the underlying challenges affecting these establishments and the resultant welfare issues among the dogs ( 25 , 27 ). This information is crucial for informing evidence-based interventions, guiding resource allocation, and strengthening management practices aimed at improving animal wellbeing and adoption outcomes ( 28 , 29 ). Unfortunately, in developing countries particularly on the African continent, there is a paucity of published data on the operational realities of animal shelters. To address this gap, we conducted a welfare assessment using the Shelter Quality® Protocol (SQP) in four dog shelter facilities across Central Uganda. We aimed to identify the animal-based welfare issues faced by the dogs, evaluate the housing and management infrastructure, and determine risk factors of poor welfare states. Our findings offer crucial insight into the nature and extent of animal welfare challenges faced by sheltered dogs in Uganda. This information provides a foundation for developing data-driven strategies to ensure that shelters function as welfare-oriented and sustainable alternatives for managing free-roaming dog populations in the region and similar socioeconomic settings. MATERIALS AND METHODS Study area We conducted this study in Central Uganda. The animal shelters were located across four districts, namely; Kampala (0.3250 o N, 32.5857 o E), Mityana (0.4016 o N, 32.0440 o E), Luweero (0.8271 o N, 32.6277 o E) and Wakiso (0.0630 o N, 32.4467 o E) as shown in Fig. 1 . The central region is the most densely populated area in Uganda due to its major urban centers including Uganda’s capital city, Kampala. This rapidly growing urban environment offers conducive hiding places and feeding grounds for FRD such as abandoned buildings in slum areas and garbage piles. In addition, poor dog ownership practices like allowing dogs to roam freely and breed uncontrollably ( 30 ), support the existence of a substantial population of free-roaming dogs in the region. Study design and animal shelter selection procedure We conducted a cross-sectional study between July and August 2024. For inclusion in this study, a shelter was defined as any government, non-government, or privately owned facility that housed stray, lost, abandoned, or surrendered animals and facilitated their rehoming or adoption ( 21 ). No minimum number of dogs was set as an inclusion criterion, as the total number of shelters in the study area was unknown, and applying such a threshold could have excluded facilities with small populations. Shelters were identified using a purposive sampling approach. Relevant local animal welfare organizations, including the Vetconekt Initiative, and District Veterinary Offices (DVOs) across the region were consulted to identify facilities meeting the predefined inclusion criteria. This comprehensive search yielded seven shelters, all of which were contacted by telephone to assess eligibility. Six met the criteria, and four ultimately consented to participate. Dog sample size determination Following the SQP guidelines ( 31 ), the sample of dogs to assess per shelter was determined by the total population of housed dogs using the minimum sample required for reliable data as outlined in Table 1 . The SQP recommended exclusion of sick or hospitalized dogs, those younger than 6 months (puppies), and new arrivals (i.e., those sheltered for less than 2 months) from the shelter population during sample size determination. Puppies may not reliably exhibit welfare issues representative of the general shelter population since they are still-developing physiological and behavioral systems. Similarly, newly admitted dogs may not have spent sufficient time under shelter conditions to manifest welfare-related changes, while sick dogs could bias the findings toward poorer welfare outcomes due to their compromised health status. However, we were unable to conclusively identify and exclude dogs that were less than 2 months old at the shelter because some shelters did not isolate new arrivals while others did so for only about a week. Table 1 Sample size recommended by the Shelter Quality Protocol ® for individual assessment. Total number of housed dogs Number of animals to assess up to 29 All dogs 30–59 30 60–89 40 90–139 50 140 over 60 Data collection We conducted a three-step welfare assessment using structured checklists adopted from the SQP (see Additional file 1 ), following the sequence of shelter-level, pen-level and individual-level evaluations. These levels corresponded to management-based measures (MBMs), resource-based measures (RBMs), and animal-based measures (ABMs), respectively. Each welfare measure is an indicator for one of the twelve animal welfare criteria across the four principles for assessing animal welfare, as illustrated in Table 4 . Unless specified, detailed descriptions for how each measure was assessed and scored are available in the additional file 2 (see Additional file 2 ). The assessment team was comprised of three veterinary professionals, who received prior training on how to use the SQP through a preliminary assessment at one of the shelters. We also used this opportunity to identify any limitations of the protocol under our settings, which we outline in the proceeding passages. Further, we utilized this preliminary assessment to establish inter-assessor agreement over certain subjective measurements like behavioral observations in order to maintain consistency during the data collection process. However, no formal statistical analyses were performed because this was a training and harmonization exercise for assessors with a limited number of observations. Table 4 Shelter Quality Protocol ® welfare principles, criteria and their corresponding measures. Principle Welfare criteria Welfare measure (type) Sub-measures Level of assessment Good feeding Absence of prolonged hunger Body condition score (ABM) Feeding (MBM) Feeding regime Type of diet Special diet Individual Shelter Absence of prolonged thirst Water supply (RBM) Type of drinkers Availability of water Cleanliness of water Safety of drinkers Pen Good housing Comfort around resting Bedding (RBM) Safety of pen (RBM) Cleanliness of animals (ABM) Type of bedding At least one bed/dog Safety of bedding Bedding cleanliness Sharp edges Pen Pen Individual Thermal comfort Thermoregulation (ABM) Shelter from adverse weather conditions (RBM) Signs of thermal discomfort Shelter from excessive sun, wind, rain. Air circulation. Pen Pen Ease of movement Space allowance (RBM) Pen Good health Absence of injuries Skin condition (ABM) Lameness (ABM) Presence of wounds; swellings; hair loss Individual Individual Absence of disease Evidence of pain (ABM) Signs of diarrhea (ABM) Coughing (ABM) Pen Pen Pen Absence of pain induced by management procedures Surgeries and pain control (MBM) Presence of operating procedures for post-surgical monitoring Presence of hospital pens Presence of protocol of analgesia Shelter Appropriate behavior Expression of social behaviors Social housing (MBM) Single housing pens Pair housing pens Group housing pens (≤ 5 and > 5) Shelter Expression of other behaviors Abnormal behavior (ABM) Barking (ABM) Exercise (MBM) Repetitive and compulsive behaviors Exercise in outdoor areas Walking at leash Pen Pen Shelter Good human-animal relationship Reaction to human (ABM) Training and rehabilitation (MBM) Presence of training personnel for activities with dogs, and specialized personnel in behavioral rehabilitation Individual Shelter Positive emotional state Emotional state (ABM) Qualitative Behavioral Assessment Pen We began by filling out the management questionnaire through an interview with the shelter manager (see Additional file 1, Table 2 ). We obtained information on the following management-based measures; social housing, exercise, training and rehabilitation, surgeries and pain control, and feeding (Table 4 ). Because shelters either lacked or had inconsistent records on mortalities, intakes and adoptions, these were unreliable and thus not reported in this study. In line with recommendations from ( 1 ), we supplemented the management checklist with additional relevant questions reported under the ‘notes’ section at the end of the assessment. The additional measures included; the sources of funding, presence of vaccination and parasite control schedules, surgical sterilization information and presence of a veterinarian at the shelter. Following the shelter-level assessment, a dog sample size to assess was determined (Table 1 ), along with a corresponding sample of pens for pen-level assessments by dividing the dog sample size by 3 (since 3 is the recommended maximum number of dogs to assess from each pen, or 4 for pens housing 5 or more dogs). Pens were selected from different modules of the shelter to offer a representative sample of the various housing facilitates, animal groups and ages, for instance; single-housed, group housed, adult, young, geriatric and so on. During the pen-level assessment, the assessor stood outside of the selected pen, still, passive, making no loud noise and not interacting with the animals unless required by the protocol. When interacting with the animal, the assessor kept a neutral, relaxed posture, if the animal was showing excessive fear or distress the assessor interrupted the assessment. We collected data on the following RBMs; space allowance, sharp edges, bedding, water supply and shelter from adverse weather conditions (see Additional file 1, Table 3 ). Some ABMs were evaluated at the pen-level; During the development of the SQP, the latter measures had a very low prevalence at individual level and a consensus was reached to assess them at pen-level since they were too relevant to exclude entirely from the protocol ( 31 ). The measures in question are; thermoregulation, abnormal behavior, signs of diarrhea, coughing, evidence of pain. We did not collect data on the emotional state as indicated in the SQP because assessors were unable to accurately distinguish the different emotional states, for instance, anxious from hesitant or fearful or nervous. At the end of each pen-level assessment, we randomly selected dogs from each pen to observe for the individual-level assessment. We observed dogs individually and recorded data on the following ABMs; reaction toward human (fear or aggression test), body condition score (BCS), cleanliness of the animals, skin condition, and lameness (see Additional file 1, Table 3) Age class was estimated with the help of the shelter manager and categorized as young (6months-2years), adult (3–6 years), and geriatric (over 7 years). Close physical interaction with the dogs from inside the pens was prohibited by some shelters as a safety precaution and to prevent excessive arousal or agitation among the dogs. Therefore, we were unable to accurately assess ectoparasite presence by observation alone, hence thus this measure from the assessment. Statistical Analysis We analyzed the data using STATA version 15.0. Descriptive statistics were employed to explore variations in welfare standards across shelters through MBMs and RBMs, and the most relevant welfare issues were summarized using ABMs. To assess associations between welfare issues and potential risk factors, we used Firth’s penalized logistic regression, with ABMs as the dependent variables and RBMs and MBMs as independent variables. Firth’s method was selected due to issues observed with standard maximum likelihood logistic regression, including convergence failures, extremely high odds ratios, and wide confidence intervals. To account for clustering within shelters and ensure more reliable estimates, we included “shelter” as a fixed effect in all regression models. Bivariate analysis was first used to select candidate variables for the multivariable models, with those having p ≤ 0.25 considered for inclusion. Multivariable analysis was conducted using manual backward elimination, allowing decisions to be guided by both theoretical relevance and statistical significance, with p ≤ 0.05 considered statistically significant. Each ABM was modeled with multiple RBMs and/or MBMs. To limit overestimation of odds ratios, we assessed confounding at each elimination step, considering a variable a potential confounder if its inclusion changed the main exposure’s odds ratio by more than 20%. (Position of Table 4 ) RESULTS General information. The total population of dogs across all the shelters was 141 (mean: 45.3, range: 4–84), housed in 40 pens (mean: 10, range: 2–17). On average, all the assessments were carried out between 13:00 EAT and 14:07 EAT, lasting about 67.25 minutes per shelter (SD: 44.78). Average ambient temperature recorded was 25.5 o C (min 25, max 26) and humidity was 55.8% (min 52, max 65). All shelters were managed by non-governmental organizations (NGOs). The main funding source for all was donations from private individuals or organizations. Shelters operated without regulatory oversight, lacking official guidelines for establishment or standards for premises inspection. With the exception of one facility, all shelters maintained an open-admission policy, receiving all dogs presented to them; the single exception had suspended admissions for the preceding two months on account of financial limitations. The dogs at the facilities were either rescued from the streets by shelter staff or local community members, abandoned at the shelter premises, or relinquished by owners. Animal-based welfare issues of the dogs at the shelters In total, 81 dogs (mean: 21 dogs/shelter, range: 4–40) were individually assessed from 32 pens (mean: 8 pens/shelter, range: 2–13) across the four shelters. Animal-based measures (Fig. 2 ) were assessed at both individual- and pen-level. 43.2% (35/81) of dogs were females and 56.7% (46/81) were males, while 39.5% (32/81) were young, 50.6% (41/81) adults and 9.9% (8/81) geriatrics. Body condition assessments revealed that 59.3% (48/81) of animals appeared too thin, while the rest were of adequate BCS. The reaction-towards-humans (RHS) test showed that 39.1% (32/81) of the dogs exhibited fear or aggression towards a stranger. Skin lesions were present in 45.7% (37/81) of the animals, mainly wounds i.e., pressure ulcers or lacerations (30.86%, 25/81) and hair loss (19.75%, 16/81). Swellings were rare, occurring in 6.17% (5/81) of the dogs. Lameness and a dirty or wet coat were rarely observed in 6.2% (5/81) and 1.23% (1/81) of the dogs respectively. Animal-based measures (ABMs) at pen-level focused on indicators of disease, discomfort and adverse stress. Observations for signs of thermal discomfort showed that 31.3% (10/32) of pens had panting dogs while shivering was noted in 21.9% (7/32) of pens. Signs of diarrhea were present in 46.9% (15/32) of pens, while coughing was rarely recorded in only 3.1% (1/32) of pens. Pain-related behaviors were observed in 56.3% (18/32) of pens. These dogs appeared depressed and nonresponsive to surrounding, remaining quiet on a recumbent position and growling as the assessor approached. 46.9% (15/32) of pens had dogs that displayed stereotypic behaviors, mainly pacing, circling and cage biting and rarely, enclosure wall climbing. Resource-based welfare indicators at the animal shelters. Shelter pens varied in structure; Some facilities had indoor sections with single-unit pens, others had medium-sized wooden kennels, and lastly large-sized pens for group housing (Fig. 3 . G,H,I ). Of the 32 assessed pens, 59.4% (19/32) offered inadequate space per dog while 37.5% were overcrowded (had more dogs than the space could comfortably accommodate). Similarly, 37.5% (12/32) had sharp edges on the enclosure walls. Overall, bedding assessments showed that 68.8% (22/32) of pens had a score of inadequate bedding. (i.e. either lacked bedding, did not offer one bedding per dog, or bedding was not safe and/or dry/clear); 9.4% (3/32) of the pens completely lacking any bedding, 56.3% (18/32) did not offer one bedding per dog, 6.3% (2/32) had unsafe bedding (damaged or could be ingested by the dog) (Fig. 3 . A ), and 3.1% (1/32) with wet/soiled bedding. For the 90.6% (29/32) of the pens that had at least one bedding, ‘other’ bedding type was the most prevalent (53.1%, 17/32), typically comprising of raised horizontal wooden platforms and rarely blankets, followed by ‘kennel’ bedding (40.6%, 13/32), then ‘basket’ bedding at 6.3% (2/32). Water supply was also found to be inadequate in 59.4% (19/32) of the pens (i.e. either drinkers were empty, had sharp or rusted parts, had uncleaned water or lacked it); drinkers were completely absent in 40.6% (13/32) of the pens, and contained unclean water in 31.6% (6/32) of the pens. Similarly, 59.4% (19/32) of the pens were structurally unsound to offer adequate protection against adverse weather conditions. Specifically, 28.1% (9/32) of the pens had leaking roofs, 25% (8/32) lacked lateral barriers to block excess wind, 3.1% (1/32) had a partially covered roof thus exposing dogs to direct sunlight, and 15.6% (5/32) were indoor pens that lacked windows and proper ventilation. Management practices at the animal shelters. Management-based practices varied significantly across several measures. The most popular social housing arrangement in shelters was group housing with more than five dogs per pen, observed in 55% (22/40) of the pens from all the shelters. Single-dog housing (25% (10/40)) was restricted mostly to dogs aggressive towards others, while pair housing was the least used (20%, 8/40). Regarding the measure ‘Exercise’, only one of the shelters (25%, 1/4) provided outdoor access for animals, and none offered leash-walking as part of their exercise program. For maintaining a good human-animal relationship, 25% (1/4) of the shelters had staff with experience in training and rehabilitating dogs with behavioral issues. Under disease and pain control, half of the shelters (50%, 2/4) had dedicated hospital/quarantine pens. Shelters that lacked hospital pens did not isolate new arrivals. while no shelters had operating procedures for post-operative monitoring. Only one shelter reported an analgesia protocol following surgical procedures which comprised a single dose of anti-inflammatory medication administered immediately after the surgery. Nutritional practices were also assessed, revealing that most shelters (75%, 3/4) provided cooked food as the primary diet while one shelter supplemented it with processed dry pellets. Feeding schedules varied, with 50% (2/4) feeding animals once daily and 50% (2/4) providing meals twice daily. Special dietary considerations were evident for specific groups; 50% (2/4) of shelters offered different diets to puppies and hospitalized dogs, but none had such provisions for geriatric dogs. Other management-based welfare practices included; vaccination, parasite control and veterinary presence and sterilization program. Only 25% (1/4) of shelters maintained a regular vaccination schedule (against Rabies and Parvovirosis), while 75% (3/4) vaccinated irregularly (against Rabies only). Ectoparasite control routines varied across shelters, with 25% (1/4) conducting monthly treatments, 50% (1/4) offering irregular treatments, and another 25% (1/4) providing no ectoparasite control at all. For endoparasite control, 25% (1/4) carried out monthly treatments, 50% (2/4) dewormed irregularly, while 25% (1/4) had not dewormed the dogs at all. Only one shelter (25%, 1/4) employed a veterinarian, while the other three (75%, 3/4) utilized mobile veterinary services irregularly. All shelters emphasized surgical sterilization of all dogs. Risk factor identification for poor welfare states. In the final multivariable models (Table 5 ); Dogs were five times more likely to have a skin condition if their pen contained ‘other’ bedding types (Fig. 3 . D ) (p = 0.008, a0R = 5.45), with wounds in particular being significantly associated with ‘other’ bedding types (p = 0.008, aOR = 5.27). Panting was significantly more likely to be observed in pens that were structurally poor at providing adequate air circulation (p = 0.010, aOR = 82.33). Housing multiple (≥ 3) dogs was significantly linked to pain associated behaviors in dogs (p = 0.006, aOR = 11.92). A lack of outdoor access was significantly associated with stereotypic behaviors (p = < 0.001, aOR = 11.71). Table 5 Multivariable analysis showing welfare risk-factors, p-values and adjusted odds ratios. Dependent variable Independent variable aOR (95% CI) P-value Body condition Exercise -Daily outdoor access -No outdoor access Feeding regime -Once daily -Twice daily Ref 2.29(0.61, 8.54)0.217 2.08(0.72, 6.06)0.179 Ref Skin condition Sharp edges -Yes -No Other-type bedding -Yes -No 3.10(0.92, 10.43)0.067 Ref 5.45(1.55, 19.14)0.008* Ref Skin condition: Wounds Sharp edges -Yes -No Kennel-type bedding -Yes -No Other-type bedding -Yes -No 2.73(0.72, 10.40)0.140 Ref 0.37(0.45, 2.70)0.326 Ref 5.27(1.54,18.12)0.008* Ref Presence of panting Adequate air circulation -No -Yes 82.33(2.88, 2352.60)0.010* Ref Signs of diarrhea Housing arrangement -Single/Paired -Multiple Ref 4.37(0.88, 21.68)0.071 Evidence of pain Housing arrangement -Single/Paired -Multiple Sharp edges -Yes -No Protocols for analgesia -Yes -No Ref 11.92(2.04, 69.54)0.006* 5.39(0.86, 33.67)0.071 Ref Ref 11.33(0.54, 238.64)0.118 Stereotypic or repetitive behavior Housing arrangement -Single/Paired -Multiple Exercise -Daily outdoor access -No outdoor access Space allowance -Adequate -Inadequate Ref 2.48(0.52, 11.89)0.257 Ref 20.71(4.11, 104.24) < 0.001* Ref 3.08(0.79, 12.03)0.106 Ref indicates the reference category. Asterisk symbol (*) denotes factors with statistical significance. (Position of Table 5 ) DISCUSSION This study set out to assess the welfare of dogs housed in shelters in central Uganda using a combination of animal-based, resource-based, and management-based measures. Overall, our findings indicate that welfare was generally poor across the surveyed shelters. This was largely attributed to inadequate nutrition, suboptimal health management, and insufficient shelter infrastructure. Animal-based welfare issues among the dogs Analysis of animal-based measures revealed widespread undernutrition among shelter dogs. Across all shelters, 59.3% of dogs were underweight, characterized by prominent bone outlines, low muscle mass, and obvious waist and abdominal tucks. These findings likely reflect chronic undernutrition and may be partly attributed to the group feeding practice employed in all shelters. While logistically convenient for large numbers of dogs, unmonitored group feeding may promote competition and unequal food distribution, allowing dominant individuals to consume disproportionately more while subordinate dogs receive inadequate nutrition ( 32 ). Over time, such disparities can result in chronic undernutrition and emaciation among affected dogs. Emaciation is often associated with immune and metabolic dysfunction, thereby predisposing dogs to health disorders including gastrointestinal and skin conditions ( 33 ). Skin lesions were observed in approximately one-third of dogs, with most being pressure ulcers and the remainder lacerations. These wounds predominated over bony prominences such as the pin bones, carpal, elbow, and calcaneal regions, particularly among underweight dogs. Such lesions suggest prolonged rest on minimally padded surfaces ( 34 , 35 ), reflecting substandard bedding and a gap in attention to comfort at rest. Hair loss, though less common (19.8%), likely signaled untreated ectoparasitic, fungal, or bacterial infections, as well as nutritional deficiencies ( 36 ). Similarly, loose stools in nearly half of the pens were indicative of unaddressed gastrointestinal disease ( 37 ), or stress-associated diarrhea, a condition prevalent among shelter dogs ( 38 ). Further, pain-associated behaviors were recorded in 56.3% of pens, highlighting overlooked disease, injury, or inadequate post-operative pain management ( 39 ). Collectively, these findings point to pervasive gaps in treatment of health issues among shelter dogs. Behavioral observations revealed a high occurrence of stereotypic behaviors, including pacing, circling, cage biting, and repeated jumping at pen walls. While debate persists regarding the reliability of stereotypies as welfare indicators, evidence suggests their expression can result from arousing stimuli, prior experiences, and spatial restriction ( 40 , 41 ). Interpretation of these behaviors in Ugandan shelters warrants further investigation. Notably, one-third of dogs exhibited fear or aggression toward unfamiliar humans. Such reactions may stem from adverse early-life experiences, poor socialization, or previous trauma ( 42 – 44 ). While these behaviors may prolong shelter stays or increase the risk of return after adoption ( 45 , 46 ), it is important to contextualize this within Uganda’s dog ownership culture. Recent evidence indicates that 85% of Ugandan dog owners prioritize security over companionship, and overly friendly or playful dogs are at higher risk of abandonment. ( 30 ). Consequently, aggressive shelter dogs may, paradoxically, have higher adoption prospects in resource-limited settings where security is valued. Infrastructure and resources at the shelters. Shelter infrastructure varied considerably. Some shelters maintained relatively modern facilities with large housing spaces while others had small-capacity housing units and wooden kennels. The shelters expressed that these choices were influenced by their land and financial capacity at the time of establishment. Unfortunately, several pens had leaking roofs and open sides, providing little protection from rain and wind, and potentially exposing dogs to unnecessary cold stress. This was corroborated by observations of shivering dogs during rainy conditions. Similarly, the absence of windows in indoor pens resulted in poor ventilation, which increased the risk of heat stress in dogs housed there ( 47 ). Water deprivation, which was noted across all indoor pens by a lack of drinkers, has also been shown to increase risk of hyperthermia in dogs ( 48 ). This is because dogs require adequate hydration for the activation of heat loss mechanisms like panting ( 49 ). Sharp edges along enclosure walls in 37.5% of pens presented additional physical hazards. Notably, two shelters lacked dedicated treatment or quarantine areas, compromising their ability to manage sick or injured dogs and increasing the risk of unrestricted disease spread. Management practices at the shelters. Shelter management practices were generally suboptimal. Group housing predominated over half of the pens, likely reflecting the prevalence of large-capacity enclosures. However, when coupled with overcrowding - observed in 37.5% of pens - group housing can facilitate pathogen transmission and heighten aggression among unsociable dogs ( 50 – 52 ). In our study, failure to cooperate with other dogs was the main reason for single housing, yet social isolation may contribute to stereotypic behaviors and stress ( 53 , 51 , 40 ). We recommend more appropriate rehabilitation approaches such as desensitizing and counter-conditioning to improve tolerance to other animals ( 52 ). Disease prevention measures were inconsistent. Ectoparasite control, anthelmintic administration, and vaccination were sporadic, and three shelters lacked a resident veterinarian, limiting timely intervention. Perhaps then, it should come as no surprise that poor health markers were prevalent. While all shelters prioritized surgical sterilization, post-operative pain management was minimal, typically limited to a single dose of anti-inflammatory medication immediately following surgery. These gaps underscore the need for improved prioritization of health management, potentially through partnerships with local veterinarians to deliver subsidized services. Opportunities for exercise were limited. Three shelters confined dogs to pens at all times, with no provision for leash walking or outdoor activity. This restriction likely inhibited species-specific behaviors such as play and exploration, and engagement in stimulating interspecies interaction with humans. These activities are essential for maintaining positive mental states through establishing hierarchies and group cohesion, and dog-human socialization ( 54 – 56 ). Furthermore, record-keeping was inconsistent across all shelters, limiting evidence-based management interventions and undermining long-term welfare planning. Risk factors of poor welfare outcomes in the shelter dogs. Our analysis identified several key risk factors. ‘Other’ bedding type emerged as a determinant of wound development, emphasizing the importance of adequately cushioned resting surfaces. Indoor housing with poor ventilation increased the likelihood of panting dogs by 82 times, highlighting the significance of designing pens that meet the thermal comfort needs of dogs. Pain-associated behaviors were significantly associated with group housing, likely due to higher incidences of disease and dog fights, particularly in overcrowded pens where competition for resources destabilizes hierarchies ( 51 ). Addressing overcrowding through regulated intake policies, as implemented in one shelter, may reduce welfare risks. Prioritizing admissions for dogs with urgent health or behavioral needs could mitigate the compromises created by overcrowding, allowing shelters to deliver optimal care to the dogs ( 26 , 57 ). Stereotypic behaviors were 11 times more likely in dogs confined to pens without outdoor access. Confinement, especially for dogs previously accustomed to free movement, restricts natural behaviors and ability to avoid noxious situations, creating frustration which may manifest as repetitive coping strategies ( 32 , 40 , 58 ). Some reasons cited for restricting outdoor access were limited space and unawareness of the detrimental effects of confinement, underscoring the need for sensitization on evidence-based management practices. In summary, the welfare of dogs in the assessed animal shelters in central Ugandan shelters was poor, characterized by negative physical states, disease indicators, and behavioral abnormalities. These outcomes result from the interplay between resource and infrastructure deficiencies, and inappropriate management practices. Although shelters represent a well-intentioned approach to controlling free-roaming dog populations, their current state of operations in Uganda raises concerns about sustainability and effectiveness. Traditional methods such as mass poisoning with strychnine have proven ethically and practically problematic ( 20 ). Conversely, free surgical sterilization campaigns targeting owned FRD in Uganda have shown promise in population control ( 23 ). However, these sterilization programs do not address the unowned population, which is the focus of shelters. Shelters can complement these interventions by providing care for abandoned, lost, or unowned dogs. However, sustainable operations require stable financial support, technical expertise, and regulatory oversight. Evidence from developed settings demonstrates that shelters managed by animal protection associations or governments achieve higher welfare standards than privately run facilities, potentially owing to more reliable financial support and strict enforcement of welfare regulations (59,60). Intervention from such bodies in Uganda could help strengthen shelter operations and improve compliance with welfare standards, enhancing shelter sustainability and the overall wellbeing of dogs. Study limitations Though this study highlighted several important welfare concerns faced by sheltered dogs in Central Uganda, it had its limitations; The cross-sectional study design utilized only captured welfare concerns at a point in time, limiting causal inference especially for issues like low BCS and stereotypies that develop over an extended period of time. The small sample size of shelters and dogs in our study may have affected the statistical power in our analysis, limiting our ability to detect significant associations that might have allowed us to draw direct connections between the use of different practices and specific welfare concerns. The study relied primarily on behavioral and physical indicators and did not incorporate physiological stress markers (e.g., cortisol), hematology, or parasitological testing. Including such measures could have strengthened conclusions about stress, immune compromise, and disease burden. Our voluntary participation technique may have introduced selection bias, as shelters that refused to participate may have had poorer infrastructure, weaker management practices, or more severe welfare challenges, potentially resulting in underestimation of welfare concerns. Limited contact with the dogs may prevented accurate detection of some concerns such as ecto-parasite presence. Similarly, pain assessments based solely on behavioral cues without physical examination might have limited the validity of those findings. Inconsistent record keeping limited the ability to verify medical histories and length of stay, which may have reduced accuracy when linking management practices to welfare outcomes. CONCLUSION This study provides the first structured assessment of welfare conditions in dog shelters in central Uganda and demonstrates that overall welfare was generally poor, characterized by widespread undernutrition, untreated health conditions, behavioral abnormalities, inadequate infrastructure, and unsound management practices. These findings indicate that while shelters are intended to serve as humane solutions for managing free-roaming dog populations, significant resource, veterinary, and regulatory gaps currently limit their effectiveness as welfare-oriented institutions. By identifying key risk factors such as inadequate bedding, poor ventilation, overcrowding, limited exercise opportunities, this study offers evidence-based priorities for intervention. The findings are particularly relevant for informing policy development, strengthening shelter standards, and guiding sustainable dog population management strategies in resource-limited socioeconomic settings. Abbreviations FRD Free–roaming dogs USPCA Uganda Society for the Protection and Care of Animals DVO District Veterinary Officer SQP Shelter Quality© Protocol ABMs Animal–Based Measures RBMs Resource–Based Measures MBMs Management–Based Measures Declarations Ethics approval and consent to participate All study procedures, including participation of shelter managers, were reviewed and approved by the School of Veterinary Medicine and Animal Resources Institutional Animal Care and Use Committee (SVAR/IACUC) under reference number: SVAR_IACUC /176/2024. All procedures involving shelter managers were conducted in accordance with the principles of the Declaration of Helsinki, ensuring their rights and wellbeing were respected and protected throughout the study period. Participation was voluntary for all shelters, and their anonymity was maintained. Informed consent was obtained from all participant shelter managers prior to the assessments through a detailed consent form that they thoroughly reviewed and voluntarily signed. Consent for publication Informed consent was obtained from participant shelter managers to publish all data and images obtained during data collection in this study, as long as shelter anonymity was maintained. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare no competing interests. Funding This work was funded by the Universities Federation for Animal Welfare (UFAW) through the 2024 Animal Welfare Student Scholarships. Author’s contributions LA, DST and PS conceived of and designed the study. DST, LA and ZH collected field data. LA performed statistical analyses with assistance from ZH. LA wrote the manuscript. All authors read and edited the manuscript and approved submission. Acknowledgements The authors express gratitude to the animal shelters that agreed to participate in this study, without whom this study would not have been possible. Special thanks are extended Mr. Rogers Dankaine for his intellectual input and helpful discussion. Our heartfelt thanks also go to members of the Vetconekt Initiative, Uganda Small Animal Practitioner’s Association, and Veterinary Departments in Wakiso, Kampala, Mityana, Kiboga and Luweero Districts for their invaluable Authors’ information LA: [email protected] ZH: [email protected] PS: [email protected] DST: [email protected] References Galeb LDAG, Borges TD, Santos CJD, Pedernera C, Velarde A, Anater A, et al. Animal welfare assessment in nine dog shelters of southern Brazil. Rev Bras Ciênc Ambient. 2021;57(1):84–92. http://www.rbciamb.com.br/index.php/Publicacoes_RBCIAMB/article/view/1197 Gunter LM, Gilchrist RJ, Blade EM, Barber RT, Feuerbacher EN, Platzer JM, et al. Investigating the Impact of Brief Outings on the Welfare of Dogs Living in US Shelters. Animals. 2021 Feb 19;11(2):548. doi:10.3390/ani11020548 Berteselli G, Messori S, Arena L, Smith L, Dalla Villa P, De Massis F. Using a Delphi method to estimate the relevance of indicators for the assessment of shelter dog welfare. Anim Welf. 2022 Aug;31(3):341–53. doi:10.7120/09627286.31.3.007 Petrean ALB, Popescu S, Csiplo AS. Welfare assessment of a dog shelter using the Shelter Quality Protocol. Cluj Vet J,. 2023;28(3):2–8. https://clujveterinaryjournal.ro/index.php/cvj/article/view/54 Saengthong A, Brown JL, Nganvongpanit K, Punyapornwittaya V, Lampang KN, Pongsumpan J, et al. Assessment of dog shelter management and welfare in Chiang Mai, Thailand: Implications for behavior and health. Appl Anim Behav Sci. 2025 Jul 1;288:106666. doi:10.1016/j.applanim.2025.106666 Chen YH, Chen CI, Lin CY, Teng KT yun. Prevalent and Severe Conditions That Compromise the Welfare of Shelter Dogs: Opinions from the Taiwanese Experts. Animals. 2025 Feb 18;15(4). doi:10.3390/ani15040592 MagliaBatista B. The Effect of Stray Dogs on Urban Arusha Residents and Existing Preventative Measures. Indep Study Proj ISP Collect. 2019 Oct 1;3141. https://digitalcollections.sit.edu/isp_collection/3141 Harhay MO, Olliaro PL, Costa DL, Costa CHN. Urban parasitology: visceral leishmaniasis in Brazil. Trends Parasitol. 2011 [cited 2026 Jan 28];27(9):403–9. https://www.cell.com/trends/parasitology/fulltext/S1471-4922(11)00064-X Pastoret PP, Van Gucht S, Brochier B. Eradicating rabies at source. Rev Sci Tech Int Epizoot. 2014;33:509–19. https://e.itg.be/MTM/advanced/39.pdf Zhang W, Zhang Z, Wu W, Shi B, Li J, Zhou X, et al. Epidemiology and control of echinococcosis in central Asia, with particular reference to the People’s Republic of China. Acta Trop. 2015;141:235–43. https://www.sciencedirect.com/science/article/pii/S0001706X14000977 Shamsaddini S, Schneider C, Dumendiak S, Aghassi H, Kamyabi H, Akhlaghi E, et al. Environmental contamination with feces of free-roaming dogs and the risk of transmission of Echinococcus and Taenia species in urban regions of southeastern Iran. Parasit Vectors. 2024 Aug 23;17(1):359. doi:10.1186/s13071-024-06435-x Kisaka S, Makumbi FE, Majalija S, Bangirana A, Thumbi SM. Epidemiology and preclinical management of dog bites among humans in Wakiso and Kampala districts, Uganda: Implications for prevention of dog bites and rabies. PLOS ONE. 2020 Sep 21;15(9):e0239090. doi:10.1371/journal.pone.0239090 Tayebwa DS, Rashid NK, Eneku W, Ssekandi C, Kyabarongo A, Mutesasira J, et al. Exploration of circumstances surrounding bites from potentially rabid dogs on rampage, and the coping strategies of victims and communities in Central Uganda. J Vet Behav. 2025 Jan 1;77:11–8. doi:10.1016/j.jveb.2024.11.005 Mohanty CR, Radhakrishnan RV, Jain M, Sasmal PK, Hansda U, Vuppala SK, et al. A study of the pattern of injuries sustained from road traffic accidents caused by impact with stray animals. J Emerg Trauma Shock. 2021;14(1):23–7. https://journals.lww.com/onlinejets/fulltext/2021/14010/A_Study_of_the_Pattern_of_Injuries_Sustained_from.5.aspx Totton SC, Wandeler AI, Ribble CS, Rosatte RC, McEwen SA. Stray dog population health in Jodhpur, India in the wake of an animal birth control (ABC) program. Prev Vet Med. 2011 Feb;98(2–3):215–20. doi:10.1016/j.prevetmed.2010.11.011 Martsiv M, Dykyy I, Witek M, Chibowski P, Cimarelli G, Moura AE, et al. Dogs of War: The Effect of War-Inflicted Environmental Damage on Free-Ranging Domestic Dogs. Evol Appl. 2025;18(12):e70182. doi:10.1111/eva.70182 Abuzeid AMI. Studies on ectoparasites of stray dogs in Ismailia City. Egypt Vet Med Soc Parasitol J EVMSPJ. 2015 Dec 5. doi:10.21608/evmspj.2015.210031 Saldanha-Elias AM, Silva MA, Silva VO, Amorim SLA, Coutinho AR, Santos HA, et al. Prevalence of Endoparasites in Urban Stray Dogs from Brazil Diagnosed with Leishmania, with Potential for Human Zoonoses. Acta Parasitol. 2019 Jun 1;64(2):352–9. doi:10.2478/s11686-019-00043-x Ramanujan A. Violent Encounters: ‘Stray’ Dogs in Indian Cities. In: Nagai K, Jones K, Landry D, Mattfeld M, Rooney C, Sleigh C, editors. Cosmopolitan Animals. London: Palgrave Macmillan UK; 2015. p. 216–32. https://doi.org/10.1057/9781137376282_15 doi:10.1057/9781137376282_15 Alobo G, Kahunde MA, Luyckx V, George Okech S, Semakula JR, Agaba D, et al. Culling dogs to control rabies in Uganda–an example of moral distress for a veterinary officer. Berl Münch Tierärztl Wochenschr. 2020;133(5/6):248–55. Zawistowski S, Morris J. Introduction to animal sheltering. Shelter Med Vet Staff. 2012;1–12. Dalla Villa P, Kahn S, Stuardo L, Iannetti L, Di Nardo A, Serpell JA. Free-roaming dog control among OIE-member countries. Prev Vet Med. 2010 Oct;97(1):58–63. doi:10.1016/j.prevetmed.2010.07.001 Tayebwa DS. Roaming dogs in Uganda: Dog ownership practices, public health implications, community attitudes and control strategies in selected urban and rural settings. 2025. https://www.researchgate.net/publication/397533302_Roaming_dogs_in_Uganda_Dog_ownership_practices_public_health_implications_community_attitudes_and_control_strategies_in_selected_urban_and_rural_settings AHU. ANIMAL HOPE UGANDA 2020 Annual Report [Annual Report]. Animal Hope Uganda; 2020. Report No. https://animalhopeuganda.org/wp-content/uploads/2021/11/ANIMAL-HOPE-UGANDA-2020-Annual-Report.pdf Srinivasa D, Mondal R, Von Rentzell KA, Protopopova A. Interviews with Indian Animal Shelter Staff: Similarities and Differences in Challenges and Resiliency Factors Compared to Western Counterparts. Animals. 2022 Sep 26;12(19):2562. doi:10.3390/ani12192562 Turner P, Berry J, MacDonald S. Animal shelters and animal welfare: Raising the bar. Can Vet J. 2012 Aug;53(8):893–6. PubMed PMID: 23372200; PubMed Central PMCID: PMC3398531. Peng SJL, Lee LYT, Fei ACY. Shelter Animal Management and Trends in Taiwan. J Appl Anim Welf Sci. 2012 Oct;15(4):346–57. doi:10.1080/10888705.2012.709143 Stavisky J, Brennan ML, Downes MJ, Dean RS. Opinions of UK Rescue Shelter and Rehoming Center Workers on the Problems Facing Their Industry. Anthrozoös. 2017 Jul 3;30(3):487–98. doi:10.1080/08927936.2017.1326677 Bradley J, Rajendran S. Increasing adoption rates at animal shelters: a two-phase approach to predict length of stay and optimal shelter allocation. BMC Vet Res. 2021 Feb 5;17(1):70. doi:10.1186/s12917-020-02728-2 Tayebwa DS, Ssekandi C, Nalubwama S, Dankaine R, Lutebemberwa I, Rashid NK, et al. Sociodemographic factors and dog ownership practices that perpetuate the roaming of owned dogs in selected urban and rural settings in Uganda. J Appl Anim Welf Sci. 2024 Oct;0(0):1–13. doi:10.1080/10888705.2024.2411553 PubMed PMID: 39382522. Barnard S, Pedernera C, Candeloro L, Ferri N, Velarde A, Dalla Villa P. Development of a new welfare assessment protocol for practical application in long‐term dog shelters. Vet Rec. 2016 Jan;178(1):18–18. doi:10.1136/vr.103336 Mohan-Gibbons H, Weiss E, Slater M. Preliminary Investigation of Food Guarding Behavior in Shelter Dogs in the United States. Animals. 2012 Sep;2(3):3. doi:10.3390/ani2030331 Pointer E, Reisman R, Windham R, Murray L. Starvation and the Clinicopathologic Abnormalities Associated with Starved Dogs: A Review of 152 Cases. J Am Anim Hosp Assoc. 2013;49(2):101–7. doi:10.5326/JAAHA-MS-5762 Swaim SF, Bradley DM, Vaughn DM, Powers RD, Hoffman CE. The greyhound dog as a model for studying pressure ulcers. Decubitus. 1993 Mar;6(2):32–5, 38–40. PubMed PMID: 8318156. Loerakker S, Baaijens FPT, CWJ O. Aetiology of pressure ulcers. Eindh Univ Technol Dept Biomed Eng Sect Mater Technol Div Biomech Tissue Eng. 2007. Siam MO, El- Sheikh AEK, Attia NE. Alopecia in dogs: Causes, Incidence and Clinical Signs with a Special Reference to Nutritional Alopecia. Zagazig Vet J. 2022 Jun 1. doi:10.21608/zvjz.2022.125735.1175 Sokolow S, Rand C, Marks S, Drazenovich N, Kather E, Foley J. Epidemiologic evaluation of diarrhea in dogs in an animal shelter. Am J Vet Res. 2005 Jul 1;66:1018–24. doi:10.2460/ajvr.2005.66.1018 Fowler M, Shiau DS, Xie H. A randomized controlled study comparing Da Xiang Lian Wan to metronidazole in the treatment of stress colitis in shelter/rescued dogs. Am J Tradit Chin Vet Med. 2017;45–54. https://ajtcvm.scholasticahq.com/article/82233.pdf Mota-Rojas D, Whittaker AL, Lanzoni L, Bienboire-Frosini C, Domínguez-Oliva A, Chay-Canul A, et al. Clinical interpretation of body language and behavioral modifications to recognize pain in domestic mammals. Front Vet Sci. 2025 Oct 15;12. doi:10.3389/fvets.2025.1679966 Denham HD, Bradshaw JW, Rooney NJ. Repetitive behaviour in kennelled domestic dog: Stereotypical or not? Physiol Behav. 2014;128:288–94. https://www.sciencedirect.com/science/article/pii/S0031938414000109 Protopopova A. Effects of sheltering on physiology, immune function, behavior, and the welfare of dogs. Physiol Behav. 2016 May;159:95–103. doi:10.1016/j.physbeh.2016.03.020 Howell TJ, King T, Bennett PC. Puppy parties and beyond: the role of early age socialization practices on adult dog behavior. Vet Med Res Rep. 2015 Apr 29;6:143–53. doi:10.2147/VMRR.S62081 Willen RM, Schiml PA, Hennessy MB. Enrichment centered on human interaction moderates fear-induced aggression and increases positive expectancy in fearful shelter dogs. Appl Anim Behav Sci. 2019 Aug 1;217:57–62. doi:10.1016/j.applanim.2019.05.001 Buttner AP, Strasser R. Extreme life histories are associated with altered social behavior and cortisol levels in shelter dogs. Appl Anim Behav Sci. 2022 Nov 1;256:105693. doi:10.1016/j.applanim.2022.105693 Shore ER. Returning a Recently Adopted Companion Animal: Adopters’ Reasons for and Reactions to the Failed Adoption Experience. J Appl Anim Welf Sci. 2005 Jul;8(3):187–98. doi:10.1207/s15327604jaws0803_3 Wright JC, Smith A, Daniel K, Adkins K. Dog Breed Stereotype and Exposure to Negative Behavior: Effects on Perceptions of Adoptability. J Appl Anim Welf Sci. 2007 Jun 11;10(3):255–65. doi:10.1080/10888700701353956 PubMed PMID: 17645409. Caldas GG, da Silva DOB, Junior DB. Heat stroke in dogs: Literature review. Veterinární Medicína. 2022 Apr 14;67(7):354–64. doi:10.17221/144/2021-VETMED PubMed PMID: 39100130; PubMed Central PMCID: PMC11295878. Nascimento PV do, Veríssimo TN da S, Soares WA de A, Maia MIL, Carvalho LRRA, Saraiva EP. Heat stress in domestic dogs: morphological and environmental risk factors for dog welfare in a warming world. Front Anim Sci. 2025 Dec 4;6. doi:10.3389/fanim.2025.1679377 McKinley M, Trevaks D, Weissenborn F, McAllen R. Interaction between thermoregulation and osmoregulation in domestic animals. Rev Bras Zootec. 2017;46:783–90. doi:https://doi.org/10.1590/S1806-92902017000900011 Pratelli A, Martella V, Elia G, Tempesta M, Guarda F, Capucchio MT, et al. Severe enteric disease in an animal shelter associated with dual infections by canine adenovirus type 1 and canine coronavirus. J Vet Med Ser B. 2001;48(5):385–92. Taylor K, Mills D. The effect of the kennel environment on canine welfare: a critical review of experimental studies. Anim Welf. 2007 Nov;16(4):435–47. doi:10.1017/S0962728600027378 Orihel JS, Fraser D. A note on the effectiveness of behavioural rehabilitation for reducing inter-dog aggression in shelter dogs. Appl Anim Behav Sci. 2008 Aug;112(3–4):400–5. doi:10.1016/j.applanim.2007.10.001 Beerda B, Schilder MBH, Van Hooff JARAM, De Vries HW, Mol JA. Chronic Stress in Dogs Subjected to Social and Spatial Restriction. I. Behavioral Responses. Physiol Behav. 1999 Apr;66(2):233–42. doi:10.1016/S0031-9384(98)00289-3 Smuts B. Social behaviour among companion dogs with an emphasis on play. In: The social dog [Internet]. Elsevier; 2014 [cited 2026 Mar 8]. p. 105–30. Available from: https://www.sciencedirect.com/science/article/pii/B9780124078185000048 Bradshaw JWS, Pullen AJ, Rooney NJ. Why do adult dogs ‘play’? Behav Processes. 2015 Jan 1;New Directions in Canine Behavior110:82–7. doi:10.1016/j.beproc.2014.09.023 Sommerville R, O’Connor EA, Asher L. Why do dogs play? Function and welfare implications of play in the domestic dog. Appl Anim Behav Sci. 2017 Dec 1;197:1–8. doi:10.1016/j.applanim.2017.09.007 Hurley KF. The Evolving Role of Triage and Appointment-Based Admission to Improve Service, Care and Outcomes in Animal Shelters. Front Vet Sci. 2022 Mar 4;9. doi:10.3389/fvets.2022.809340 Nogueira LB, Palme R, Mendonça-Furtado O. Give Them a Toy or Increase Time out of Kennel at Lawn Areas: What Is the Influence of These Interventions on Police Dogs’ Welfare? Anim Open Access J MDPI. 2021 Jul 30;11(8):2264. doi:10.3390/ani11082264 PubMed PMID: 34438722; PubMed Central PMCID: PMC8388378. Berteselli GV, Arena L, Candeloro L, Villa PD, Massis FD. Animal welfare in Italian long-term shelters. Benchmark against an “ideal shelter”. 2018. doi:10.13140/RG.2.2.22428.13446 Arruda EC, Garcia RCM, Oliveira ST. [The welfare of dogs from municipal shelters in the state of Paraná, Brazil, under the Shelter Quality protocol]. Arq Bras Med Veterinária E Zootec. 2020 May 8;72:346–54. doi:10.1590/1678-4162-11323 Additional Declarations No competing interests reported. Supplementary Files Additionalfile1SQPDataCollectionTools.pdf · File name: Additional file 1. · File format: .pdf. · Title of data: SQP Data collection tools. · Description of data: This dataset contains structured data collection checklists used to record Animal-Based Measures (ABMs), Resource-Based Measures (RBMs), and Management-Based Measures (MBMs) adopted from the Shelter Quality® Protocol. The checklists specify the welfare measures observed, recorded, and scored for each shelter. AdditionalFile2Welfaremeasuredescriptions.pdf · File name: Additional file 2. · File format: .pdf. · Title of data: Descriptions and scoring indications of welfare measures. · Description of data: This dataset describes the welfare measures adopted from the Shelter Quality® Protocol, categorized as Animal-Based Measures (ABMs), Resource-Based Measures (RBMs), and Management-Based Measures (MBMs). It includes operational definitions and standardized scoring indications for each measure. The data support consistent assessment and comparison of welfare conditions across shelters. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 12 May, 2026 Reviews received at journal 12 May, 2026 Reviewers agreed at journal 05 May, 2026 Reviewers agreed at journal 04 May, 2026 Reviews received at journal 13 Apr, 2026 Reviewers agreed at journal 13 Apr, 2026 Reviewers invited by journal 08 Apr, 2026 Editor assigned by journal 08 Apr, 2026 Editor invited by journal 04 Apr, 2026 Submission checks completed at journal 02 Apr, 2026 First submitted to journal 02 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9259621","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":622548526,"identity":"898a383f-d64a-49b9-bd5e-295f7aad0c25","order_by":0,"name":"Lewis Ashabahebwa","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Lewis","middleName":"","lastName":"Ashabahebwa","suffix":""},{"id":622548527,"identity":"572d48c6-9148-4b1e-b558-568649cb64e1","order_by":1,"name":"Zozianne Hoareau","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Zozianne","middleName":"","lastName":"Hoareau","suffix":""},{"id":622548528,"identity":"a19d7f9c-be38-490c-be71-aa750c3e9741","order_by":2,"name":"Paul Ssuna","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Paul","middleName":"","lastName":"Ssuna","suffix":""},{"id":622548529,"identity":"e2da6f1e-ea77-4b14-83b7-3fd3c661f002","order_by":3,"name":"Dickson Stuart Tayebwa","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCUlEQVRIiWNgGAWjYJACZjB5GELLgYgDD/Ao50HXYgzWkkCUlgMQOrEBROLTYs9+xvBxYZsdA99x5seGPyrupM8PO/wQaIudnG4DDlt4coyNZ7YlM0geZjNO5jnzLHfj7TQDoJZkY7MDuByWYybNu42ZweAwD/NhxrbDuRtnJ4C0HEjchksL/xvz37zb6sFaDv5sO5xuODv9A34tEjlmzLzbDoO1JPC2HU6Ql84hYMuNZ8XSM/8d5wH5xZjnzGHDDdI5BQcSDHD7hb0/eePngjPVcnznDz+W/FFxWF5+dvrmDx8q7ORwaWFg4DCABAMMGIBVGuBSDrbnASpfvgGf6lEwCkbBKBiJAADSbV7Qm2qB5wAAAABJRU5ErkJggg==","orcid":"","institution":"National Agricultural Research Organisation","correspondingAuthor":true,"prefix":"","firstName":"Dickson","middleName":"Stuart","lastName":"Tayebwa","suffix":""}],"badges":[],"createdAt":"2026-03-29 14:54:35","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9259621/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9259621/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107480840,"identity":"6fb68878-c7a3-40ac-ae84-d19555f96327","added_by":"auto","created_at":"2026-04-22 02:13:48","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":326228,"visible":true,"origin":"","legend":"\u003cp\u003eA map of the study area showing shelter locations in Central Uganda.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9259621/v1/ad9dcb3fe18327272e8c4912.png"},{"id":107061308,"identity":"2d287847-c31b-4c65-aa78-d7a972205346","added_by":"auto","created_at":"2026-04-16 10:18:24","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1243877,"visible":true,"origin":"","legend":"\u003cp\u003ePhysical and behavioral welfare issues observed across 81 dogs from four shelters in central Uganda. (A) Underweight body condition; (B) Hair loss on various body regions, (C) Pressure ulcer marked by black arrow at the calcaneal area, (D) Mild lameness indicated by raised hind limb, (E) Stereotypic behavior of wall bouncing, (F) Signs of pain indicated by dull facial expression and reluctance to move; (G) Passive interaction by assessor, no signs of fear; (H) Active interaction by assessor, fear displayed by receding to the back of the pen; (I) Inter-dog aggression , note the bottom right dog snarling at the top left dog.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9259621/v1/ce57dc0144fc041337c6466e.png"},{"id":107480544,"identity":"5b6afe5e-9e95-4fd6-bba4-866842f32089","added_by":"auto","created_at":"2026-04-22 02:12:03","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":1371348,"visible":true,"origin":"","legend":"\u003cp\u003eHousing resources and infrastructure observed across four dog shelters in central Uganda. (A) Unsafe ‘Kennel’ bedding due to jagged edge of floorboard, (B) ‘Basket’ bedding, (C) and (D) ‘Other’ bedding, (E) Unclean water, (F) Inadequate shelter from rain due to wet floor following rainfall, (G) Small-sized housing units, also see (C), (H) Medium-sized wooden housing units, (I) Large-sized housing units.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-9259621/v1/6ec3a4b5f5a0b6b989d42ed5.png"},{"id":107704879,"identity":"32801c75-f0ca-4c31-88ed-9def2bd2a313","added_by":"auto","created_at":"2026-04-24 09:02:10","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3715157,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9259621/v1/20c14b38-ead4-4780-90ef-19a892809fb2.pdf"},{"id":107480855,"identity":"4a7a9f84-627a-4311-a4d4-1cb7b6a7b7ab","added_by":"auto","created_at":"2026-04-22 02:13:58","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":208184,"visible":true,"origin":"","legend":"\u003cp\u003e· File name: Additional file 1.\u003c/p\u003e\n\u003cp\u003e· File format: .pdf.\u003c/p\u003e\n\u003cp\u003e· Title of data: SQP Data collection tools.\u003c/p\u003e\n\u003cp\u003e· Description of data: This dataset contains structured data collection checklists used to record Animal-Based Measures (ABMs), Resource-Based Measures (RBMs), and Management-Based Measures (MBMs) adopted from the Shelter Quality® Protocol. The checklists specify the welfare measures observed, recorded, and scored for each shelter.\u003c/p\u003e","description":"","filename":"Additionalfile1SQPDataCollectionTools.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9259621/v1/25800c47c271a0fe2cbc4929.pdf"},{"id":107061311,"identity":"d6e37e4a-5c88-4710-94fb-cec8cb274b1b","added_by":"auto","created_at":"2026-04-16 10:18:24","extension":"pdf","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":201678,"visible":true,"origin":"","legend":"\u003cp\u003e· File name: Additional file 2.\u003c/p\u003e\n\u003cp\u003e· File format: .pdf.\u003c/p\u003e\n\u003cp\u003e· Title of data: Descriptions and scoring indications of welfare measures.\u003c/p\u003e\n\u003cp\u003e· Description of data: This dataset describes the welfare measures adopted from the Shelter Quality® Protocol, categorized as Animal-Based Measures (ABMs), Resource-Based Measures (RBMs), and Management-Based Measures (MBMs). It includes operational definitions and standardized scoring indications for each measure. The data support consistent assessment and comparison of welfare conditions across shelters.\u003c/p\u003e","description":"","filename":"AdditionalFile2Welfaremeasuredescriptions.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9259621/v1/eb080bdc6303f73f20a656f9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Animal Welfare Assessment at Four Dog Shelters in Central Uganda: A Cross-Sectional Study using the Shelter Quality ® Protocol","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eAnimal welfare has gained prominence on the global policy agenda, with a recent focus on the welfare of sheltered animals, particularly dogs (\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). The World Health Organization estimates that over 200\u0026nbsp;million dogs roam freely worldwide (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), with a serious impact on public health through transmission of zoonotic pathogens (\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), environmental contamination (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e), dog-bite injuries (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e), and causing road traffic accidents (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). While the problems caused by free-roaming dogs (FRD) are well documented, the poor health and welfare conditions that plague their lives are less discussed. FRD often suffer from poor diets and starvation (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), and high parasite burden due to lack of veterinary services (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). In some developing countries like Uganda and India, FRD are nuisances in many communities and are therefore at constant risk of retaliatory mob-violence and mass poisoning with strychnine (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). In such incidents, large numbers of dogs are often indiscriminately targeted, including those not responsible for the initial triggering event (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). In an attempt to manage the FRD problem while maintaining welfare standards, governments and animal welfare advocates around the world have established animal shelters as rehabilitation centers, where FRD are housed, treated and cared for until adoption or in some cases euthanasia (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlthough sheltering is the most common method of controlling FRD in some developed nations, it is less utilized by developing countries due to its costly nature (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Until recently, the Uganda Society for the Protection and Care of Animals (USPCA) operated the only animal shelter in the Uganda (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Through a growing interest in animal welfare in the country, sheltering initiatives have increased in recent years (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). However, their exact numbers remain unknown since many are not formally registered. Under resource-poor settings, shelters often depend solely on financial support from donors and well-wishers to run daily activities (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Unfortunately, donations are an unreliable source of funding, prone to fluctuations from seasonal changes in donor income or unexpected events like the COVID-19 pandemic (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). As such, when financial shortfalls arise, they can lead to inability to provide basic health and nutritional needs to the dogs, compromising their welfare (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). In addition, while the target is to rehome the dogs, shelters in developing countries often end up overcrowded due to low adoption rates (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e), imposing further strain on already limited resources.\u003c/p\u003e \u003cp\u003eEnsuring optimal welfare in animal shelters requires a context-specific understanding of the underlying challenges affecting these establishments and the resultant welfare issues among the dogs (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). This information is crucial for informing evidence-based interventions, guiding resource allocation, and strengthening management practices aimed at improving animal wellbeing and adoption outcomes (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Unfortunately, in developing countries particularly on the African continent, there is a paucity of published data on the operational realities of animal shelters. To address this gap, we conducted a welfare assessment using the Shelter Quality\u0026reg; Protocol (SQP) in four dog shelter facilities across Central Uganda. We aimed to identify the animal-based welfare issues faced by the dogs, evaluate the housing and management infrastructure, and determine risk factors of poor welfare states. Our findings offer crucial insight into the nature and extent of animal welfare challenges faced by sheltered dogs in Uganda. This information provides a foundation for developing data-driven strategies to ensure that shelters function as welfare-oriented and sustainable alternatives for managing free-roaming dog populations in the region and similar socioeconomic settings.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy area\u003c/h2\u003e \u003cp\u003eWe conducted this study in Central Uganda. The animal shelters were located across four districts, namely; Kampala (0.3250\u003csup\u003eo\u003c/sup\u003eN, 32.5857\u003csup\u003eo\u003c/sup\u003eE), Mityana (0.4016\u003csup\u003eo\u003c/sup\u003eN, 32.0440\u003csup\u003eo\u003c/sup\u003eE), Luweero (0.8271\u003csup\u003eo\u003c/sup\u003eN, 32.6277\u003csup\u003eo\u003c/sup\u003eE) and Wakiso (0.0630\u003csup\u003eo\u003c/sup\u003eN, 32.4467\u003csup\u003eo\u003c/sup\u003eE) as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The central region is the most densely populated area in Uganda due to its major urban centers including Uganda\u0026rsquo;s capital city, Kampala. This rapidly growing urban environment offers conducive hiding places and feeding grounds for FRD such as abandoned buildings in slum areas and garbage piles. In addition, poor dog ownership practices like allowing dogs to roam freely and breed uncontrollably (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e), support the existence of a substantial population of free-roaming dogs in the region.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy design and animal shelter selection procedure\u003c/h3\u003e\n\u003cp\u003eWe conducted a cross-sectional study between July and August 2024. For inclusion in this study, a shelter was defined as any government, non-government, or privately owned facility that housed stray, lost, abandoned, or surrendered animals and facilitated their rehoming or adoption (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). No minimum number of dogs was set as an inclusion criterion, as the total number of shelters in the study area was unknown, and applying such a threshold could have excluded facilities with small populations. Shelters were identified using a purposive sampling approach. Relevant local animal welfare organizations, including the Vetconekt Initiative, and District Veterinary Offices (DVOs) across the region were consulted to identify facilities meeting the predefined inclusion criteria. This comprehensive search yielded seven shelters, all of which were contacted by telephone to assess eligibility. Six met the criteria, and four ultimately consented to participate.\u003c/p\u003e\n\u003ch3\u003eDog sample size determination\u003c/h3\u003e\n\u003cp\u003eFollowing the SQP guidelines (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e), the sample of dogs to assess per shelter was determined by the total population of housed dogs using the minimum sample required for reliable data as outlined in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The SQP recommended exclusion of sick or hospitalized dogs, those younger than 6 months (puppies), and new arrivals (i.e., those sheltered for less than 2 months) from the shelter population during sample size determination. Puppies may not reliably exhibit welfare issues representative of the general shelter population since they are still-developing physiological and behavioral systems. Similarly, newly admitted dogs may not have spent sufficient time under shelter conditions to manifest welfare-related changes, while sick dogs could bias the findings toward poorer welfare outcomes due to their compromised health status. However, we were unable to conclusively identify and exclude dogs that were less than 2 months old at the shelter because some shelters did not isolate new arrivals while others did so for only about a week.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSample size recommended by the Shelter Quality Protocol \u0026reg; for individual assessment.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal number of housed dogs\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber of animals to assess\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eup to 29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAll dogs\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e90\u0026ndash;139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e140 over\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eWe conducted a three-step welfare assessment using structured checklists adopted from the SQP (see \u003cem\u003eAdditional file 1\u003c/em\u003e), following the sequence of shelter-level, pen-level and individual-level evaluations. These levels corresponded to management-based measures (MBMs), resource-based measures (RBMs), and animal-based measures (ABMs), respectively. Each welfare measure is an indicator for one of the twelve animal welfare criteria across the four principles for assessing animal welfare, as illustrated in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Unless specified, detailed descriptions for how each measure was assessed and scored are available in the additional file 2 (see \u003cem\u003eAdditional file 2\u003c/em\u003e). The assessment team was comprised of three veterinary professionals, who received prior training on how to use the SQP through a preliminary assessment at one of the shelters. We also used this opportunity to identify any limitations of the protocol under our settings, which we outline in the proceeding passages. Further, we utilized this preliminary assessment to establish inter-assessor agreement over certain subjective measurements like behavioral observations in order to maintain consistency during the data collection process. However, no formal statistical analyses were performed because this was a training and harmonization exercise for assessors with a limited number of observations.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eShelter Quality Protocol \u0026reg; welfare principles, criteria and their corresponding measures.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrinciple\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWelfare criteria\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWelfare measure (type)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSub-measures\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLevel of assessment\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGood feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbsence of prolonged hunger\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBody condition score (ABM)\u003c/p\u003e \u003cp\u003eFeeding (MBM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFeeding regime\u003c/p\u003e \u003cp\u003eType of diet\u003c/p\u003e \u003cp\u003eSpecial diet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIndividual\u003c/p\u003e \u003cp\u003eShelter\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbsence of prolonged thirst\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWater supply (RBM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eType of drinkers\u003c/p\u003e \u003cp\u003eAvailability of water\u003c/p\u003e \u003cp\u003eCleanliness of water\u003c/p\u003e \u003cp\u003eSafety of drinkers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePen\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eGood housing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComfort around resting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBedding (RBM)\u003c/p\u003e \u003cp\u003eSafety of pen (RBM)\u003c/p\u003e \u003cp\u003eCleanliness of animals (ABM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eType of bedding\u003c/p\u003e \u003cp\u003eAt least one bed/dog\u003c/p\u003e \u003cp\u003eSafety of bedding\u003c/p\u003e \u003cp\u003eBedding cleanliness\u003c/p\u003e \u003cp\u003eSharp edges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePen\u003c/p\u003e \u003cp\u003ePen\u003c/p\u003e \u003cp\u003eIndividual\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThermal comfort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eThermoregulation (ABM)\u003c/p\u003e \u003cp\u003eShelter from adverse weather conditions (RBM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSigns of thermal discomfort\u003c/p\u003e \u003cp\u003eShelter from excessive sun, wind, rain. Air circulation.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePen\u003c/p\u003e \u003cp\u003ePen\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEase of movement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSpace allowance (RBM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePen\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eGood health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbsence of injuries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSkin condition (ABM)\u003c/p\u003e \u003cp\u003eLameness (ABM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePresence of wounds; swellings; hair loss\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIndividual\u003c/p\u003e \u003cp\u003eIndividual\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbsence of disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEvidence of pain (ABM)\u003c/p\u003e \u003cp\u003eSigns of diarrhea (ABM)\u003c/p\u003e \u003cp\u003eCoughing (ABM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePen\u003c/p\u003e \u003cp\u003ePen\u003c/p\u003e \u003cp\u003ePen\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbsence of pain induced by management procedures\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSurgeries and pain control (MBM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePresence of operating procedures for post-surgical monitoring\u003c/p\u003e \u003cp\u003ePresence of hospital pens\u003c/p\u003e \u003cp\u003ePresence of protocol of analgesia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eShelter\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAppropriate behavior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExpression of social behaviors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSocial housing (MBM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSingle housing pens\u003c/p\u003e \u003cp\u003ePair housing pens\u003c/p\u003e \u003cp\u003eGroup housing pens (\u0026le;\u0026thinsp;5 and \u0026gt;\u0026thinsp;5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eShelter\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExpression of other behaviors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAbnormal behavior (ABM)\u003c/p\u003e \u003cp\u003eBarking (ABM)\u003c/p\u003e \u003cp\u003eExercise (MBM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRepetitive and compulsive behaviors\u003c/p\u003e \u003cp\u003eExercise in outdoor areas\u003c/p\u003e \u003cp\u003eWalking at leash\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePen\u003c/p\u003e \u003cp\u003ePen\u003c/p\u003e \u003cp\u003eShelter\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood human-animal relationship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eReaction to human (ABM)\u003c/p\u003e \u003cp\u003eTraining and rehabilitation (MBM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePresence of training personnel for activities with dogs, and specialized personnel in behavioral rehabilitation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIndividual\u003c/p\u003e \u003cp\u003eShelter\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive emotional state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEmotional state (ABM)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eQualitative Behavioral Assessment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePen\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWe began by filling out the management questionnaire through an interview with the shelter manager (see \u003cem\u003eAdditional file 1, Table\u0026nbsp;2\u003c/em\u003e). We obtained information on the following management-based measures; social housing, exercise, training and rehabilitation, surgeries and pain control, and feeding (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Because shelters either lacked or had inconsistent records on mortalities, intakes and adoptions, these were unreliable and thus not reported in this study. In line with recommendations from (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e), we supplemented the management checklist with additional relevant questions reported under the \u0026lsquo;notes\u0026rsquo; section at the end of the assessment. The additional measures included; the sources of funding, presence of vaccination and parasite control schedules, surgical sterilization information and presence of a veterinarian at the shelter.\u003c/p\u003e \u003cp\u003eFollowing the shelter-level assessment, a dog sample size to assess was determined (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e), along with a\u003c/b\u003e corresponding sample of pens for pen-level assessments by dividing the dog sample size by 3 (since 3 is the recommended maximum number of dogs to assess from each pen, or 4 for pens housing 5 or more dogs). Pens were selected from different modules of the shelter to offer a representative sample of the various housing facilitates, animal groups and ages, for instance; single-housed, group housed, adult, young, geriatric and so on.\u003c/p\u003e \u003cp\u003eDuring the pen-level assessment, the assessor stood outside of the selected pen, still, passive, making no loud noise and not interacting with the animals unless required by the protocol. When interacting with the animal, the assessor kept a neutral, relaxed posture, if the animal was showing excessive fear or distress the assessor interrupted the assessment. We collected data on the following RBMs; space allowance, sharp edges, bedding, water supply and shelter from adverse weather conditions (see \u003cem\u003eAdditional file 1, Table\u0026nbsp;3\u003c/em\u003e). Some ABMs were evaluated at the pen-level; During the development of the SQP, the latter measures had a very low prevalence at individual level and a consensus was reached to assess them at pen-level since they were too relevant to exclude entirely from the protocol (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). The measures in question are; thermoregulation, abnormal behavior, signs of diarrhea, coughing, evidence of pain. We did not collect data on the emotional state as indicated in the SQP because assessors were unable to accurately distinguish the different emotional states, for instance, anxious from hesitant or fearful or nervous.\u003c/p\u003e \u003cp\u003eAt the end of each pen-level assessment, we randomly selected dogs from each pen to observe for the individual-level assessment. We observed dogs individually and recorded data on the following ABMs; reaction toward human (fear or aggression test), body condition score (BCS), cleanliness of the animals, skin condition, and lameness (see \u003cem\u003eAdditional file 1, Table\u0026nbsp;3)\u003c/em\u003e Age class was estimated with the help of the shelter manager and categorized as young (6months-2years), adult (3\u0026ndash;6 years), and geriatric (over 7 years). Close physical interaction with the dogs from inside the pens was prohibited by some shelters as a safety precaution and to prevent excessive arousal or agitation among the dogs. Therefore, we were unable to accurately assess ectoparasite presence by observation alone, hence thus this measure from the assessment.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eWe analyzed the data using STATA version 15.0. Descriptive statistics were employed to explore variations in welfare standards across shelters through MBMs and RBMs, and the most relevant welfare issues were summarized using ABMs. To assess associations between welfare issues and potential risk factors, we used Firth\u0026rsquo;s penalized logistic regression, with ABMs as the dependent variables and RBMs and MBMs as independent variables. Firth\u0026rsquo;s method was selected due to issues observed with standard maximum likelihood logistic regression, including convergence failures, extremely high odds ratios, and wide confidence intervals. To account for clustering within shelters and ensure more reliable estimates, we included \u0026ldquo;shelter\u0026rdquo; as a fixed effect in all regression models.\u003c/p\u003e \u003cp\u003eBivariate analysis was first used to select candidate variables for the multivariable models, with those having p\u0026thinsp;\u0026le;\u0026thinsp;0.25 considered for inclusion. Multivariable analysis was conducted using manual backward elimination, allowing decisions to be guided by both theoretical relevance and statistical significance, with p\u0026thinsp;\u0026le;\u0026thinsp;0.05 considered statistically significant. Each ABM was modeled with multiple RBMs and/or MBMs. To limit overestimation of odds ratios, we assessed confounding at each elimination step, considering a variable a potential confounder if its inclusion changed the main exposure\u0026rsquo;s odds ratio by more than 20%.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e(Position of Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/h2\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003e \u003cb\u003eGeneral information.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe total population of dogs across all the shelters was 141 (mean: 45.3, range: 4\u0026ndash;84), housed in 40 pens (mean: 10, range: 2\u0026ndash;17). On average, all the assessments were carried out between 13:00 EAT and 14:07 EAT, lasting about 67.25 minutes per shelter (SD: 44.78). Average ambient temperature recorded was 25.5\u003csup\u003eo\u003c/sup\u003eC (min 25, max 26) and humidity was 55.8% (min 52, max 65). All shelters were managed by non-governmental organizations (NGOs). The main funding source for all was donations from private individuals or organizations. Shelters operated without regulatory oversight, lacking official guidelines for establishment or standards for premises inspection. With the exception of one facility, all shelters maintained an open-admission policy, receiving all dogs presented to them; the single exception had suspended admissions for the preceding two months on account of financial limitations. The dogs at the facilities were either rescued from the streets by shelter staff or local community members, abandoned at the shelter premises, or relinquished by owners.\u003c/p\u003e\n\u003ch3\u003eAnimal-based welfare issues of the dogs at the shelters\u003c/h3\u003e\n\u003cp\u003eIn total, 81 dogs (mean: 21 dogs/shelter, range: 4\u0026ndash;40) were individually assessed from 32 pens (mean: 8 pens/shelter, range: 2\u0026ndash;13) across the four shelters. Animal-based measures (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e were assessed at both individual- and pen-level. 43.2% (35/81) of dogs were females and 56.7% (46/81) were males, while 39.5% (32/81) were young, 50.6% (41/81) adults and 9.9% (8/81) geriatrics. Body condition assessments revealed that 59.3% (48/81) of animals appeared too thin, while the rest were of adequate BCS. The reaction-towards-humans (RHS) test showed that 39.1% (32/81) of the dogs exhibited fear or aggression towards a stranger. Skin lesions were present in 45.7% (37/81) of the animals, mainly wounds i.e., pressure ulcers or lacerations (30.86%, 25/81) and hair loss (19.75%, 16/81). Swellings were rare, occurring in 6.17% (5/81) of the dogs. Lameness and a dirty or wet coat were rarely observed in 6.2% (5/81) and 1.23% (1/81) of the dogs respectively.\u003c/p\u003e \u003cp\u003eAnimal-based measures (ABMs) at pen-level focused on indicators of disease, discomfort and adverse stress. Observations for signs of thermal discomfort showed that 31.3% (10/32) of pens had panting dogs while shivering was noted in 21.9% (7/32) of pens. Signs of diarrhea were present in 46.9% (15/32) of pens, while coughing was rarely recorded in only 3.1% (1/32) of pens. Pain-related behaviors were observed in 56.3% (18/32) of pens. These dogs appeared depressed and nonresponsive to surrounding, remaining quiet on a recumbent position and growling as the assessor approached. 46.9% (15/32) of pens had dogs that displayed stereotypic behaviors, mainly pacing, circling and cage biting and rarely, enclosure wall climbing.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eResource-based welfare indicators at the animal shelters.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eShelter pens varied in structure; Some facilities had indoor sections with single-unit pens, others had medium-sized wooden kennels, and lastly large-sized pens for group housing (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003cb\u003eG,H,I\u003c/b\u003e). Of the 32 assessed pens, 59.4% (19/32) offered inadequate space per dog while 37.5% were overcrowded (had more dogs than the space could comfortably accommodate). Similarly, 37.5% (12/32) had sharp edges on the enclosure walls. Overall, bedding assessments showed that 68.8% (22/32) of pens had a score of inadequate bedding. (i.e. either lacked bedding, did not offer one bedding per dog, or bedding was not safe and/or dry/clear); 9.4% (3/32) of the pens completely lacking any bedding, 56.3% (18/32) did not offer one bedding per dog, 6.3% (2/32) had unsafe bedding (damaged or could be ingested by the dog) (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003cb\u003eA\u003c/b\u003e), and 3.1% (1/32) with wet/soiled bedding. For the 90.6% (29/32) of the pens that had at least one bedding, \u0026lsquo;other\u0026rsquo; bedding type was the most prevalent (53.1%, 17/32), typically comprising of raised horizontal wooden platforms and rarely blankets, followed by \u0026lsquo;kennel\u0026rsquo; bedding (40.6%, 13/32), then \u0026lsquo;basket\u0026rsquo; bedding at 6.3% (2/32).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eWater supply was also found to be inadequate in 59.4% (19/32) of the pens (i.e. either drinkers were empty, had sharp or rusted parts, had uncleaned water or lacked it); drinkers were completely absent in 40.6% (13/32) of the pens, and contained unclean water in 31.6% (6/32) of the pens. Similarly, 59.4% (19/32) of the pens were structurally unsound to offer adequate protection against adverse weather conditions. Specifically, 28.1% (9/32) of the pens had leaking roofs, 25% (8/32) lacked lateral barriers to block excess wind, 3.1% (1/32) had a partially covered roof thus exposing dogs to direct sunlight, and 15.6% (5/32) were indoor pens that lacked windows and proper ventilation.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eManagement practices at the animal shelters.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eManagement-based practices varied significantly across several measures. The most popular social housing arrangement in shelters was group housing with more than five dogs per pen, observed in 55% (22/40) of the pens from all the shelters. Single-dog housing (25% (10/40)) was restricted mostly to dogs aggressive towards others, while pair housing was the least used (20%, 8/40).\u003c/p\u003e \u003cp\u003eRegarding the measure \u0026lsquo;Exercise\u0026rsquo;, only one of the shelters (25%, 1/4) provided outdoor access for animals, and none offered leash-walking as part of their exercise program. For maintaining a good human-animal relationship, 25% (1/4) of the shelters had staff with experience in training and rehabilitating dogs with behavioral issues. Under disease and pain control, half of the shelters (50%, 2/4) had dedicated hospital/quarantine pens. Shelters that lacked hospital pens did not isolate new arrivals. while no shelters had operating procedures for post-operative monitoring. Only one shelter reported an analgesia protocol following surgical procedures which comprised a single dose of anti-inflammatory medication administered immediately after the surgery.\u003c/p\u003e \u003cp\u003e Nutritional practices were also assessed, revealing that most shelters (75%, 3/4) provided cooked food as the primary diet while one shelter supplemented it with processed dry pellets. Feeding schedules varied, with 50% (2/4) feeding animals once daily and 50% (2/4) providing meals twice daily. Special dietary considerations were evident for specific groups; 50% (2/4) of shelters offered different diets to puppies and hospitalized dogs, but none had such provisions for geriatric dogs.\u003c/p\u003e \u003cp\u003eOther management-based welfare practices included; vaccination, parasite control and veterinary presence and sterilization program. Only 25% (1/4) of shelters maintained a regular vaccination schedule (against Rabies and Parvovirosis), while 75% (3/4) vaccinated irregularly (against Rabies only). Ectoparasite control routines varied across shelters, with 25% (1/4) conducting monthly treatments, 50% (1/4) offering irregular treatments, and another 25% (1/4) providing no ectoparasite control at all. For endoparasite control, 25% (1/4) carried out monthly treatments, 50% (2/4) dewormed irregularly, while 25% (1/4) had not dewormed the dogs at all. Only one shelter (25%, 1/4) employed a veterinarian, while the other three (75%, 3/4) utilized mobile veterinary services irregularly. All shelters emphasized surgical sterilization of all dogs.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRisk factor identification for poor welfare states.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIn the final multivariable models (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e5\u003c/span\u003e); Dogs were five times more likely to have a skin condition if their pen contained \u0026lsquo;other\u0026rsquo; bedding types (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003cb\u003eD\u003c/b\u003e) (p\u0026thinsp;=\u0026thinsp;0.008, a0R\u0026thinsp;=\u0026thinsp;5.45), with wounds in particular being significantly associated with \u0026lsquo;other\u0026rsquo; bedding types (p\u0026thinsp;=\u0026thinsp;0.008, aOR\u0026thinsp;=\u0026thinsp;5.27). Panting was significantly more likely to be observed in pens that were structurally poor at providing adequate air circulation (p\u0026thinsp;=\u0026thinsp;0.010, aOR\u0026thinsp;=\u0026thinsp;82.33). Housing multiple (\u0026ge;\u0026thinsp;3) dogs was significantly linked to pain associated behaviors in dogs (p\u0026thinsp;=\u0026thinsp;0.006, aOR\u0026thinsp;=\u0026thinsp;11.92). A lack of outdoor access was significantly associated with stereotypic behaviors (p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001, aOR\u0026thinsp;=\u0026thinsp;11.71).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariable analysis showing welfare risk-factors, p-values and adjusted odds ratios.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDependent variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndependent variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eaOR (95% CI) P-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBody condition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExercise\u003c/p\u003e \u003cp\u003e-Daily outdoor access\u003c/p\u003e \u003cp\u003e-No outdoor access\u003c/p\u003e \u003cp\u003eFeeding regime\u003c/p\u003e \u003cp\u003e-Once daily\u003c/p\u003e \u003cp\u003e-Twice daily\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003e2.29(0.61, 8.54)0.217\u003c/p\u003e \u003cp\u003e2.08(0.72, 6.06)0.179\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkin condition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSharp edges\u003c/p\u003e \u003cp\u003e-Yes\u003c/p\u003e \u003cp\u003e-No\u003c/p\u003e \u003cp\u003eOther-type bedding\u003c/p\u003e \u003cp\u003e-Yes\u003c/p\u003e \u003cp\u003e-No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.10(0.92, 10.43)0.067\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003e5.45(1.55, 19.14)0.008*\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkin condition: Wounds\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSharp edges\u003c/p\u003e \u003cp\u003e-Yes\u003c/p\u003e \u003cp\u003e-No\u003c/p\u003e \u003cp\u003eKennel-type bedding\u003c/p\u003e \u003cp\u003e-Yes\u003c/p\u003e \u003cp\u003e-No\u003c/p\u003e \u003cp\u003eOther-type bedding\u003c/p\u003e \u003cp\u003e-Yes\u003c/p\u003e \u003cp\u003e-No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.73(0.72, 10.40)0.140\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003e0.37(0.45, 2.70)0.326\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003e5.27(1.54,18.12)0.008*\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePresence of panting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdequate air circulation\u003c/p\u003e \u003cp\u003e-No\u003c/p\u003e \u003cp\u003e-Yes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82.33(2.88, 2352.60)0.010*\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSigns of diarrhea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousing arrangement\u003c/p\u003e \u003cp\u003e-Single/Paired\u003c/p\u003e \u003cp\u003e-Multiple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003e4.37(0.88, 21.68)0.071\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvidence of pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousing arrangement\u003c/p\u003e \u003cp\u003e-Single/Paired\u003c/p\u003e \u003cp\u003e-Multiple\u003c/p\u003e \u003cp\u003eSharp edges\u003c/p\u003e \u003cp\u003e-Yes\u003c/p\u003e \u003cp\u003e-No\u003c/p\u003e \u003cp\u003eProtocols for analgesia\u003c/p\u003e \u003cp\u003e-Yes\u003c/p\u003e \u003cp\u003e-No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003e11.92(2.04, 69.54)0.006*\u003c/p\u003e \u003cp\u003e5.39(0.86, 33.67)0.071\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003e11.33(0.54, 238.64)0.118\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStereotypic or repetitive behavior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousing arrangement\u003c/p\u003e \u003cp\u003e-Single/Paired\u003c/p\u003e \u003cp\u003e-Multiple\u003c/p\u003e \u003cp\u003eExercise\u003c/p\u003e \u003cp\u003e-Daily outdoor access\u003c/p\u003e \u003cp\u003e-No outdoor access\u003c/p\u003e \u003cp\u003eSpace allowance\u003c/p\u003e \u003cp\u003e-Adequate\u003c/p\u003e \u003cp\u003e-Inadequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003e2.48(0.52, 11.89)0.257\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003e20.71(4.11, 104.24)\u0026thinsp;\u0026lt;\u0026thinsp;0.001*\u003c/p\u003e \u003cp\u003eRef\u003c/p\u003e \u003cp\u003e3.08(0.79, 12.03)0.106\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eRef indicates the reference category. Asterisk symbol (*) denotes factors with statistical significance.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e(Position of Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e5\u003c/span\u003e)\u003c/h2\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study set out to assess the welfare of dogs housed in shelters in central Uganda using a combination of animal-based, resource-based, and management-based measures. Overall, our findings indicate that welfare was generally poor across the surveyed shelters. This was largely attributed to inadequate nutrition, suboptimal health management, and insufficient shelter infrastructure.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eAnimal-based welfare issues among the dogs\u003c/h2\u003e \u003cp\u003eAnalysis of animal-based measures revealed widespread undernutrition among shelter dogs. Across all shelters, 59.3% of dogs were underweight, characterized by prominent bone outlines, low muscle mass, and obvious waist and abdominal tucks. These findings likely reflect chronic undernutrition and may be partly attributed to the group feeding practice employed in all shelters. While logistically convenient for large numbers of dogs, unmonitored group feeding may promote competition and unequal food distribution, allowing dominant individuals to consume disproportionately more while subordinate dogs receive inadequate nutrition (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Over time, such disparities can result in chronic undernutrition and emaciation among affected dogs. Emaciation is often associated with immune and metabolic dysfunction, thereby predisposing dogs to health disorders including gastrointestinal and skin conditions (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSkin lesions were observed in approximately one-third of dogs, with most being pressure ulcers and the remainder lacerations. These wounds predominated over bony prominences such as the pin bones, carpal, elbow, and calcaneal regions, particularly among underweight dogs. Such lesions suggest prolonged rest on minimally padded surfaces (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e), reflecting substandard bedding and a gap in attention to comfort at rest. Hair loss, though less common (19.8%), likely signaled untreated ectoparasitic, fungal, or bacterial infections, as well as nutritional deficiencies (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Similarly, loose stools in nearly half of the pens were indicative of unaddressed gastrointestinal disease (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e), or stress-associated diarrhea, a condition prevalent among shelter dogs (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Further, pain-associated behaviors were recorded in 56.3% of pens, highlighting overlooked disease, injury, or inadequate post-operative pain management (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). Collectively, these findings point to pervasive gaps in treatment of health issues among shelter dogs.\u003c/p\u003e \u003cp\u003eBehavioral observations revealed a high occurrence of stereotypic behaviors, including pacing, circling, cage biting, and repeated jumping at pen walls. While debate persists regarding the reliability of stereotypies as welfare indicators, evidence suggests their expression can result from arousing stimuli, prior experiences, and spatial restriction (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). Interpretation of these behaviors in Ugandan shelters warrants further investigation. Notably, one-third of dogs exhibited fear or aggression toward unfamiliar humans. Such reactions may stem from adverse early-life experiences, poor socialization, or previous trauma (\u003cspan additionalcitationids=\"CR43\" citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). While these behaviors may prolong shelter stays or increase the risk of return after adoption (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e), it is important to contextualize this within Uganda\u0026rsquo;s dog ownership culture. Recent evidence indicates that 85% of Ugandan dog owners prioritize security over companionship, and overly friendly or playful dogs are at higher risk of abandonment. (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). Consequently, aggressive shelter dogs may, paradoxically, have higher adoption prospects in resource-limited settings where security is valued.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInfrastructure and resources at the shelters.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eShelter infrastructure varied considerably. Some shelters maintained relatively modern facilities with large housing spaces while others had small-capacity housing units and wooden kennels. The shelters expressed that these choices were influenced by their land and financial capacity at the time of establishment. Unfortunately, several pens had leaking roofs and open sides, providing little protection from rain and wind, and potentially exposing dogs to unnecessary cold stress. This was corroborated by observations of shivering dogs during rainy conditions. Similarly, the absence of windows in indoor pens resulted in poor ventilation, which increased the risk of heat stress in dogs housed there (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). Water deprivation, which was noted across all indoor pens by a lack of drinkers, has also been shown to increase risk of hyperthermia in dogs (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). This is because dogs require adequate hydration for the activation of heat loss mechanisms like panting (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e). Sharp edges along enclosure walls in 37.5% of pens presented additional physical hazards. Notably, two shelters lacked dedicated treatment or quarantine areas, compromising their ability to manage sick or injured dogs and increasing the risk of unrestricted disease spread.\u003c/p\u003e \u003cp\u003e \u003cb\u003eManagement practices at the shelters.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eShelter management practices were generally suboptimal. Group housing predominated over half of the pens, likely reflecting the prevalence of large-capacity enclosures. However, when coupled with overcrowding - observed in 37.5% of pens - group housing can facilitate pathogen transmission and heighten aggression among unsociable dogs (\u003cspan additionalcitationids=\"CR51\" citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e). In our study, failure to cooperate with other dogs was the main reason for single housing, yet social isolation may contribute to stereotypic behaviors and stress (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). We recommend more appropriate rehabilitation approaches such as desensitizing and counter-conditioning to improve tolerance to other animals (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDisease prevention measures were inconsistent. Ectoparasite control, anthelmintic administration, and vaccination were sporadic, and three shelters lacked a resident veterinarian, limiting timely intervention. Perhaps then, it should come as no surprise that poor health markers were prevalent. While all shelters prioritized surgical sterilization, post-operative pain management was minimal, typically limited to a single dose of anti-inflammatory medication immediately following surgery. These gaps underscore the need for improved prioritization of health management, potentially through partnerships with local veterinarians to deliver subsidized services.\u003c/p\u003e \u003cp\u003eOpportunities for exercise were limited. Three shelters confined dogs to pens at all times, with no provision for leash walking or outdoor activity. This restriction likely inhibited species-specific behaviors such as play and exploration, and engagement in stimulating interspecies interaction with humans. These activities are essential for maintaining positive mental states through establishing hierarchies and group cohesion, and dog-human socialization (\u003cspan additionalcitationids=\"CR55\" citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e). Furthermore, record-keeping was inconsistent across all shelters, limiting evidence-based management interventions and undermining long-term welfare planning.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRisk factors of poor welfare outcomes in the shelter dogs.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eOur analysis identified several key risk factors. \u0026lsquo;Other\u0026rsquo; bedding type emerged as a determinant of wound development, emphasizing the importance of adequately cushioned resting surfaces. Indoor housing with poor ventilation increased the likelihood of panting dogs by 82 times, highlighting the significance of designing pens that meet the thermal comfort needs of dogs. Pain-associated behaviors were significantly associated with group housing, likely due to higher incidences of disease and dog fights, particularly in overcrowded pens where competition for resources destabilizes hierarchies (\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e). Addressing overcrowding through regulated intake policies, as implemented in one shelter, may reduce welfare risks. Prioritizing admissions for dogs with urgent health or behavioral needs could mitigate the compromises created by overcrowding, allowing shelters to deliver optimal care to the dogs (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStereotypic behaviors were 11 times more likely in dogs confined to pens without outdoor access. Confinement, especially for dogs previously accustomed to free movement, restricts natural behaviors and ability to avoid noxious situations, creating frustration which may manifest as repetitive coping strategies (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e). Some reasons cited for restricting outdoor access were limited space and unawareness of the detrimental effects of confinement, underscoring the need for sensitization on evidence-based management practices.\u003c/p\u003e \u003cp\u003eIn summary, the welfare of dogs in the assessed animal shelters in central Ugandan shelters was poor, characterized by negative physical states, disease indicators, and behavioral abnormalities. These outcomes result from the interplay between resource and infrastructure deficiencies, and inappropriate management practices. Although shelters represent a well-intentioned approach to controlling free-roaming dog populations, their current state of operations in Uganda raises concerns about sustainability and effectiveness. Traditional methods such as mass poisoning with strychnine have proven ethically and practically problematic (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Conversely, free surgical sterilization campaigns targeting owned FRD in Uganda have shown promise in population control (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). However, these sterilization programs do not address the unowned population, which is the focus of shelters. Shelters can complement these interventions by providing care for abandoned, lost, or unowned dogs. However, sustainable operations require stable financial support, technical expertise, and regulatory oversight. Evidence from developed settings demonstrates that shelters managed by animal protection associations or governments achieve higher welfare standards than privately run facilities, potentially owing to more reliable financial support and strict enforcement of welfare regulations (59,60). Intervention from such bodies in Uganda could help strengthen shelter operations and improve compliance with welfare standards, enhancing shelter sustainability and the overall wellbeing of dogs.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eStudy limitations\u003c/h2\u003e \u003cp\u003eThough this study highlighted several important welfare concerns faced by sheltered dogs in Central Uganda, it had its limitations; The cross-sectional study design utilized only captured welfare concerns at a point in time, limiting causal inference especially for issues like low BCS and stereotypies that develop over an extended period of time. The small sample size of shelters and dogs in our study may have affected the statistical power in our analysis, limiting our ability to detect significant associations that might have allowed us to draw direct connections between the use of different practices and specific welfare concerns. The study relied primarily on behavioral and physical indicators and did not incorporate physiological stress markers (e.g., cortisol), hematology, or parasitological testing. Including such measures could have strengthened conclusions about stress, immune compromise, and disease burden. Our voluntary participation technique may have introduced selection bias, as shelters that refused to participate may have had poorer infrastructure, weaker management practices, or more severe welfare challenges, potentially resulting in underestimation of welfare concerns. Limited contact with the dogs may prevented accurate detection of some concerns such as ecto-parasite presence. Similarly, pain assessments based solely on behavioral cues without physical examination might have limited the validity of those findings. Inconsistent record keeping limited the ability to verify medical histories and length of stay, which may have reduced accuracy when linking management practices to welfare outcomes.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis study provides the first structured assessment of welfare conditions in dog shelters in central Uganda and demonstrates that overall welfare was generally poor, characterized by widespread undernutrition, untreated health conditions, behavioral abnormalities, inadequate infrastructure, and unsound management practices. These findings indicate that while shelters are intended to serve as humane solutions for managing free-roaming dog populations, significant resource, veterinary, and regulatory gaps currently limit their effectiveness as welfare-oriented institutions. By identifying key risk factors such as inadequate bedding, poor ventilation, overcrowding, limited exercise opportunities, this study offers evidence-based priorities for intervention. The findings are particularly relevant for informing policy development, strengthening shelter standards, and guiding sustainable dog population management strategies in resource-limited socioeconomic settings.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFRD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFree\u0026ndash;roaming dogs\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUSPCA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eUganda Society for the Protection and Care of Animals\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDVO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDistrict Veterinary Officer\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSQP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eShelter Quality\u0026copy; Protocol\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eABMs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAnimal\u0026ndash;Based Measures\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRBMs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eResource\u0026ndash;Based Measures\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMBMs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eManagement\u0026ndash;Based Measures\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eAll study procedures, including participation of shelter managers, were reviewed and approved by the School of Veterinary Medicine and Animal Resources Institutional Animal Care and Use Committee (SVAR/IACUC) under reference number: SVAR_IACUC /176/2024.\u0026nbsp;All procedures involving shelter managers were conducted in accordance with the principles of the Declaration of Helsinki, ensuring their rights and wellbeing were respected and protected throughout the study period.\u0026nbsp;Participation was voluntary for all shelters, and their anonymity was maintained. Informed consent was obtained from all participant shelter managers prior to the assessments through a detailed consent form that they thoroughly reviewed and voluntarily signed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from participant shelter managers to publish all data and images obtained during data collection in this study, as long as shelter anonymity was maintained.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis work was funded by the Universities Federation for Animal Welfare (UFAW) through the 2024 Animal Welfare Student Scholarships.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthor\u0026rsquo;s contributions\u003c/p\u003e\n\u003cp\u003eLA, DST and PS conceived of and designed the study. DST, LA and ZH collected field data. LA performed statistical analyses with assistance from ZH. LA wrote the manuscript. All authors read and edited the manuscript and approved submission.\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eThe authors express gratitude to the animal shelters that agreed to participate in this study, without whom this study would not have been possible. Special thanks are extended Mr. Rogers Dankaine for his intellectual input and helpful discussion. Our heartfelt thanks also go to members of the Vetconekt Initiative, Uganda Small Animal Practitioner\u0026rsquo;s Association, and Veterinary Departments in Wakiso, Kampala, Mityana, Kiboga and Luweero Districts for their invaluable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLA: \u0026nbsp; [email protected]\u003c/p\u003e\n\u003cp\u003eZH: [email protected]\u003c/p\u003e\n\u003cp\u003ePS: [email protected]\u003c/p\u003e\n\u003cp\u003eDST: [email protected]\u003cbr clear=\"all\"\u003e \u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eGaleb LDAG, Borges TD, Santos CJD, Pedernera C, Velarde A, Anater A, et al. Animal welfare assessment in nine dog shelters of southern Brazil. Rev Bras Ci\u0026ecirc;nc Ambient. 2021;57(1):84\u0026ndash;92. http://www.rbciamb.com.br/index.php/Publicacoes_RBCIAMB/article/view/1197\u003c/li\u003e\n \u003cli\u003eGunter LM, Gilchrist RJ, Blade EM, Barber RT, Feuerbacher EN, Platzer JM, et al. Investigating the Impact of Brief Outings on the Welfare of Dogs Living in US Shelters. Animals. 2021 Feb 19;11(2):548. doi:10.3390/ani11020548\u003c/li\u003e\n \u003cli\u003eBerteselli G, Messori S, Arena L, Smith L, Dalla Villa P, De Massis F. Using a Delphi method to estimate the relevance of indicators for the assessment of shelter dog welfare. Anim Welf. 2022 Aug;31(3):341\u0026ndash;53. doi:10.7120/09627286.31.3.007\u003c/li\u003e\n \u003cli\u003ePetrean ALB, Popescu S, Csiplo AS. Welfare assessment of a dog shelter using the Shelter Quality Protocol. Cluj Vet J,. 2023;28(3):2\u0026ndash;8. https://clujveterinaryjournal.ro/index.php/cvj/article/view/54\u003c/li\u003e\n \u003cli\u003eSaengthong A, Brown JL, Nganvongpanit K, Punyapornwittaya V, Lampang KN, Pongsumpan J, et al. Assessment of dog shelter management and welfare in Chiang Mai, Thailand: Implications for behavior and health. Appl Anim Behav Sci. 2025 Jul 1;288:106666. doi:10.1016/j.applanim.2025.106666\u003c/li\u003e\n \u003cli\u003eChen YH, Chen CI, Lin CY, Teng KT yun. Prevalent and Severe Conditions That Compromise the Welfare of Shelter Dogs: Opinions from the Taiwanese Experts. Animals. 2025 Feb 18;15(4). doi:10.3390/ani15040592\u003c/li\u003e\n \u003cli\u003eMagliaBatista B. The Effect of Stray Dogs on Urban Arusha Residents and Existing Preventative Measures. Indep Study Proj ISP Collect. 2019 Oct 1;3141. https://digitalcollections.sit.edu/isp_collection/3141\u003c/li\u003e\n \u003cli\u003eHarhay MO, Olliaro PL, Costa DL, Costa CHN. Urban parasitology: visceral leishmaniasis in Brazil. Trends Parasitol. 2011 [cited 2026 Jan 28];27(9):403\u0026ndash;9. https://www.cell.com/trends/parasitology/fulltext/S1471-4922(11)00064-X\u003c/li\u003e\n \u003cli\u003ePastoret PP, Van Gucht S, Brochier B. Eradicating rabies at source. Rev Sci Tech Int Epizoot. 2014;33:509\u0026ndash;19. https://e.itg.be/MTM/advanced/39.pdf\u003c/li\u003e\n \u003cli\u003eZhang W, Zhang Z, Wu W, Shi B, Li J, Zhou X, et al. Epidemiology and control of echinococcosis in central Asia, with particular reference to the People\u0026rsquo;s Republic of China. Acta Trop. 2015;141:235\u0026ndash;43. https://www.sciencedirect.com/science/article/pii/S0001706X14000977\u003c/li\u003e\n \u003cli\u003eShamsaddini S, Schneider C, Dumendiak S, Aghassi H, Kamyabi H, Akhlaghi E, et al. Environmental contamination with feces of free-roaming dogs and the risk of transmission of Echinococcus and Taenia species in urban regions of southeastern Iran. Parasit Vectors. 2024 Aug 23;17(1):359. doi:10.1186/s13071-024-06435-x\u003c/li\u003e\n \u003cli\u003eKisaka S, Makumbi FE, Majalija S, Bangirana A, Thumbi SM. Epidemiology and preclinical management of dog bites among humans in Wakiso and Kampala districts, Uganda: Implications for prevention of dog bites and rabies. PLOS ONE. 2020 Sep 21;15(9):e0239090. doi:10.1371/journal.pone.0239090\u003c/li\u003e\n \u003cli\u003eTayebwa DS, Rashid NK, Eneku W, Ssekandi C, Kyabarongo A, Mutesasira J, et al. Exploration of circumstances surrounding bites from potentially rabid dogs on rampage, and the coping strategies of victims and communities in Central Uganda. J Vet Behav. 2025 Jan 1;77:11\u0026ndash;8. doi:10.1016/j.jveb.2024.11.005\u003c/li\u003e\n \u003cli\u003eMohanty CR, Radhakrishnan RV, Jain M, Sasmal PK, Hansda U, Vuppala SK, et al. A study of the pattern of injuries sustained from road traffic accidents caused by impact with stray animals. J Emerg Trauma Shock. 2021;14(1):23\u0026ndash;7. https://journals.lww.com/onlinejets/fulltext/2021/14010/A_Study_of_the_Pattern_of_Injuries_Sustained_from.5.aspx\u003c/li\u003e\n \u003cli\u003eTotton SC, Wandeler AI, Ribble CS, Rosatte RC, McEwen SA. Stray dog population health in Jodhpur, India in the wake of an animal birth control (ABC) program. Prev Vet Med. 2011 Feb;98(2\u0026ndash;3):215\u0026ndash;20. doi:10.1016/j.prevetmed.2010.11.011\u003c/li\u003e\n \u003cli\u003eMartsiv M, Dykyy I, Witek M, Chibowski P, Cimarelli G, Moura AE, et al. Dogs of War: The Effect of War-Inflicted Environmental Damage on Free-Ranging Domestic Dogs. Evol Appl. 2025;18(12):e70182. doi:10.1111/eva.70182\u003c/li\u003e\n \u003cli\u003eAbuzeid AMI. Studies on ectoparasites of stray dogs in Ismailia City. Egypt Vet Med Soc Parasitol J EVMSPJ. 2015 Dec 5. doi:10.21608/evmspj.2015.210031\u003c/li\u003e\n \u003cli\u003eSaldanha-Elias AM, Silva MA, Silva VO, Amorim SLA, Coutinho AR, Santos HA, et al. Prevalence of Endoparasites in Urban Stray Dogs from Brazil Diagnosed with Leishmania, with Potential for Human Zoonoses. Acta Parasitol. 2019 Jun 1;64(2):352\u0026ndash;9. doi:10.2478/s11686-019-00043-x\u003c/li\u003e\n \u003cli\u003eRamanujan A. Violent Encounters: \u0026lsquo;Stray\u0026rsquo; Dogs in Indian Cities. In: Nagai K, Jones K, Landry D, Mattfeld M, Rooney C, Sleigh C, editors. Cosmopolitan Animals. London: Palgrave Macmillan UK; 2015. p. 216\u0026ndash;32. https://doi.org/10.1057/9781137376282_15 doi:10.1057/9781137376282_15\u003c/li\u003e\n \u003cli\u003eAlobo G, Kahunde MA, Luyckx V, George Okech S, Semakula JR, Agaba D, et al. Culling dogs to control rabies in Uganda\u0026ndash;an example of moral distress for a veterinary officer. Berl M\u0026uuml;nch Tier\u0026auml;rztl Wochenschr. 2020;133(5/6):248\u0026ndash;55.\u003c/li\u003e\n \u003cli\u003eZawistowski S, Morris J. Introduction to animal sheltering. Shelter Med Vet Staff. 2012;1\u0026ndash;12.\u003c/li\u003e\n \u003cli\u003eDalla Villa P, Kahn S, Stuardo L, Iannetti L, Di Nardo A, Serpell JA. Free-roaming dog control among OIE-member countries. Prev Vet Med. 2010 Oct;97(1):58\u0026ndash;63. doi:10.1016/j.prevetmed.2010.07.001\u003c/li\u003e\n \u003cli\u003eTayebwa DS. Roaming dogs in Uganda: Dog ownership practices, public health implications, community attitudes and control strategies in selected urban and rural settings. 2025. https://www.researchgate.net/publication/397533302_Roaming_dogs_in_Uganda_Dog_ownership_practices_public_health_implications_community_attitudes_and_control_strategies_in_selected_urban_and_rural_settings\u003c/li\u003e\n \u003cli\u003eAHU. ANIMAL HOPE UGANDA 2020 Annual Report [Annual Report]. Animal Hope Uganda; 2020. Report No. https://animalhopeuganda.org/wp-content/uploads/2021/11/ANIMAL-HOPE-UGANDA-2020-Annual-Report.pdf\u003c/li\u003e\n \u003cli\u003eSrinivasa D, Mondal R, Von Rentzell KA, Protopopova A. Interviews with Indian Animal Shelter Staff: Similarities and Differences in Challenges and Resiliency Factors Compared to Western Counterparts. Animals. 2022 Sep 26;12(19):2562. doi:10.3390/ani12192562\u003c/li\u003e\n \u003cli\u003eTurner P, Berry J, MacDonald S. Animal shelters and animal welfare: Raising the bar. Can Vet J. 2012 Aug;53(8):893\u0026ndash;6. PubMed PMID: 23372200; PubMed Central PMCID: PMC3398531.\u003c/li\u003e\n \u003cli\u003ePeng SJL, Lee LYT, Fei ACY. Shelter Animal Management and Trends in Taiwan. J Appl Anim Welf Sci. 2012 Oct;15(4):346\u0026ndash;57. doi:10.1080/10888705.2012.709143\u003c/li\u003e\n \u003cli\u003eStavisky J, Brennan ML, Downes MJ, Dean RS. Opinions of UK Rescue Shelter and Rehoming Center Workers on the Problems Facing Their Industry. Anthrozo\u0026ouml;s. 2017 Jul 3;30(3):487\u0026ndash;98. doi:10.1080/08927936.2017.1326677\u003c/li\u003e\n \u003cli\u003eBradley J, Rajendran S. Increasing adoption rates at animal shelters: a two-phase approach to predict length of stay and optimal shelter allocation. BMC Vet Res. 2021 Feb 5;17(1):70. doi:10.1186/s12917-020-02728-2\u003c/li\u003e\n \u003cli\u003eTayebwa DS, Ssekandi C, Nalubwama S, Dankaine R, Lutebemberwa I, Rashid NK, et al. Sociodemographic factors and dog ownership practices that perpetuate the roaming of owned dogs in selected urban and rural settings in Uganda. J Appl Anim Welf Sci. 2024 Oct;0(0):1\u0026ndash;13. doi:10.1080/10888705.2024.2411553 PubMed PMID: 39382522.\u003c/li\u003e\n \u003cli\u003eBarnard S, Pedernera C, Candeloro L, Ferri N, Velarde A, Dalla Villa P. Development of a new welfare assessment protocol for practical application in long‐term dog shelters. Vet Rec. 2016 Jan;178(1):18\u0026ndash;18. doi:10.1136/vr.103336\u003c/li\u003e\n \u003cli\u003eMohan-Gibbons H, Weiss E, Slater M. Preliminary Investigation of Food Guarding Behavior in Shelter Dogs in the United States. Animals. 2012 Sep;2(3):3. doi:10.3390/ani2030331\u003c/li\u003e\n \u003cli\u003ePointer E, Reisman R, Windham R, Murray L. Starvation and the Clinicopathologic Abnormalities Associated with Starved Dogs: A Review of 152 Cases. J Am Anim Hosp Assoc. 2013;49(2):101\u0026ndash;7. doi:10.5326/JAAHA-MS-5762\u003c/li\u003e\n \u003cli\u003eSwaim SF, Bradley DM, Vaughn DM, Powers RD, Hoffman CE. The greyhound dog as a model for studying pressure ulcers. Decubitus. 1993 Mar;6(2):32\u0026ndash;5, 38\u0026ndash;40. PubMed PMID: 8318156.\u003c/li\u003e\n \u003cli\u003eLoerakker S, Baaijens FPT, CWJ O. Aetiology of pressure ulcers. Eindh Univ Technol Dept Biomed Eng Sect Mater Technol Div Biomech Tissue Eng. 2007.\u003c/li\u003e\n \u003cli\u003eSiam MO, El- Sheikh AEK, Attia NE. Alopecia in dogs: Causes, Incidence and Clinical Signs with a Special Reference to Nutritional Alopecia. Zagazig Vet J. 2022 Jun 1. doi:10.21608/zvjz.2022.125735.1175\u003c/li\u003e\n \u003cli\u003eSokolow S, Rand C, Marks S, Drazenovich N, Kather E, Foley J. Epidemiologic evaluation of diarrhea in dogs in an animal shelter. Am J Vet Res. 2005 Jul 1;66:1018\u0026ndash;24. doi:10.2460/ajvr.2005.66.1018\u003c/li\u003e\n \u003cli\u003eFowler M, Shiau DS, Xie H. A randomized controlled study comparing Da Xiang Lian Wan to metronidazole in the treatment of stress colitis in shelter/rescued dogs. Am J Tradit Chin Vet Med. 2017;45\u0026ndash;54. https://ajtcvm.scholasticahq.com/article/82233.pdf\u003c/li\u003e\n \u003cli\u003eMota-Rojas D, Whittaker AL, Lanzoni L, Bienboire-Frosini C, Dom\u0026iacute;nguez-Oliva A, Chay-Canul A, et al. Clinical interpretation of body language and behavioral modifications to recognize pain in domestic mammals. Front Vet Sci. 2025 Oct 15;12. doi:10.3389/fvets.2025.1679966\u003c/li\u003e\n \u003cli\u003eDenham HD, Bradshaw JW, Rooney NJ. Repetitive behaviour in kennelled domestic dog: Stereotypical or not? Physiol Behav. 2014;128:288\u0026ndash;94. https://www.sciencedirect.com/science/article/pii/S0031938414000109\u003c/li\u003e\n \u003cli\u003eProtopopova A. Effects of sheltering on physiology, immune function, behavior, and the welfare of dogs. Physiol Behav. 2016 May;159:95\u0026ndash;103. doi:10.1016/j.physbeh.2016.03.020\u003c/li\u003e\n \u003cli\u003eHowell TJ, King T, Bennett PC. Puppy parties and beyond: the role of early age socialization practices on adult dog behavior. Vet Med Res Rep. 2015 Apr 29;6:143\u0026ndash;53. doi:10.2147/VMRR.S62081\u003c/li\u003e\n \u003cli\u003eWillen RM, Schiml PA, Hennessy MB. Enrichment centered on human interaction moderates fear-induced aggression and increases positive expectancy in fearful shelter dogs. Appl Anim Behav Sci. 2019 Aug 1;217:57\u0026ndash;62. doi:10.1016/j.applanim.2019.05.001\u003c/li\u003e\n \u003cli\u003eButtner AP, Strasser R. Extreme life histories are associated with altered social behavior and cortisol levels in shelter dogs. Appl Anim Behav Sci. 2022 Nov 1;256:105693. doi:10.1016/j.applanim.2022.105693\u003c/li\u003e\n \u003cli\u003eShore ER. Returning a Recently Adopted Companion Animal: Adopters\u0026rsquo; Reasons for and Reactions to the Failed Adoption Experience. J Appl Anim Welf Sci. 2005 Jul;8(3):187\u0026ndash;98. doi:10.1207/s15327604jaws0803_3\u003c/li\u003e\n \u003cli\u003eWright JC, Smith A, Daniel K, Adkins K. Dog Breed Stereotype and Exposure to Negative Behavior: Effects on Perceptions of Adoptability. J Appl Anim Welf Sci. 2007 Jun 11;10(3):255\u0026ndash;65. doi:10.1080/10888700701353956 PubMed PMID: 17645409.\u003c/li\u003e\n \u003cli\u003eCaldas GG, da Silva DOB, Junior DB. Heat stroke in dogs: Literature review. Veterin\u0026aacute;rn\u0026iacute; Medic\u0026iacute;na. 2022 Apr 14;67(7):354\u0026ndash;64. doi:10.17221/144/2021-VETMED PubMed PMID: 39100130; PubMed Central PMCID: PMC11295878.\u003c/li\u003e\n \u003cli\u003eNascimento PV do, Ver\u0026iacute;ssimo TN da S, Soares WA de A, Maia MIL, Carvalho LRRA, Saraiva EP. Heat stress in domestic dogs: morphological and environmental risk factors for dog welfare in a warming world. Front Anim Sci. 2025 Dec 4;6. doi:10.3389/fanim.2025.1679377\u003c/li\u003e\n \u003cli\u003eMcKinley M, Trevaks D, Weissenborn F, McAllen R. Interaction between thermoregulation and osmoregulation in domestic animals. Rev Bras Zootec. 2017;46:783\u0026ndash;90. doi:https://doi.org/10.1590/S1806-92902017000900011\u003c/li\u003e\n \u003cli\u003ePratelli A, Martella V, Elia G, Tempesta M, Guarda F, Capucchio MT, et al. Severe enteric disease in an animal shelter associated with dual infections by canine adenovirus type 1 and canine coronavirus. J Vet Med Ser B. 2001;48(5):385\u0026ndash;92.\u003c/li\u003e\n \u003cli\u003eTaylor K, Mills D. The effect of the kennel environment on canine welfare: a critical review of experimental studies. Anim Welf. 2007 Nov;16(4):435\u0026ndash;47. doi:10.1017/S0962728600027378\u003c/li\u003e\n \u003cli\u003eOrihel JS, Fraser D. A note on the effectiveness of behavioural rehabilitation for reducing inter-dog aggression in shelter dogs. Appl Anim Behav Sci. 2008 Aug;112(3\u0026ndash;4):400\u0026ndash;5. doi:10.1016/j.applanim.2007.10.001\u003c/li\u003e\n \u003cli\u003eBeerda B, Schilder MBH, Van Hooff JARAM, De Vries HW, Mol JA. Chronic Stress in Dogs Subjected to Social and Spatial Restriction. I. Behavioral Responses. Physiol Behav. 1999 Apr;66(2):233\u0026ndash;42. doi:10.1016/S0031-9384(98)00289-3\u003c/li\u003e\n \u003cli\u003eSmuts B. Social behaviour among companion dogs with an emphasis on play. In: The social dog [Internet]. Elsevier; 2014 [cited 2026 Mar 8]. p. 105\u0026ndash;30. Available from: https://www.sciencedirect.com/science/article/pii/B9780124078185000048\u003c/li\u003e\n \u003cli\u003eBradshaw JWS, Pullen AJ, Rooney NJ. Why do adult dogs \u0026lsquo;play\u0026rsquo;? Behav Processes. 2015 Jan 1;New Directions in Canine Behavior110:82\u0026ndash;7. doi:10.1016/j.beproc.2014.09.023\u003c/li\u003e\n \u003cli\u003eSommerville R, O\u0026rsquo;Connor EA, Asher L. Why do dogs play? Function and welfare implications of play in the domestic dog. Appl Anim Behav Sci. 2017 Dec 1;197:1\u0026ndash;8. doi:10.1016/j.applanim.2017.09.007\u003c/li\u003e\n \u003cli\u003eHurley KF. The Evolving Role of Triage and Appointment-Based Admission to Improve Service, Care and Outcomes in Animal Shelters. Front Vet Sci. 2022 Mar 4;9. doi:10.3389/fvets.2022.809340\u003c/li\u003e\n \u003cli\u003eNogueira LB, Palme R, Mendon\u0026ccedil;a-Furtado O. Give Them a Toy or Increase Time out of Kennel at Lawn Areas: What Is the Influence of These Interventions on Police Dogs\u0026rsquo; Welfare? Anim Open Access J MDPI. 2021 Jul 30;11(8):2264. doi:10.3390/ani11082264 PubMed PMID: 34438722; PubMed Central PMCID: PMC8388378.\u003c/li\u003e\n \u003cli\u003eBerteselli GV, Arena L, Candeloro L, Villa PD, Massis FD. Animal welfare in Italian long-term shelters. Benchmark against an \u0026ldquo;ideal shelter\u0026rdquo;. 2018. doi:10.13140/RG.2.2.22428.13446\u003c/li\u003e\n \u003cli\u003eArruda EC, Garcia RCM, Oliveira ST. [The welfare of dogs from municipal shelters in the state of Paran\u0026aacute;, Brazil, under the Shelter Quality protocol]. Arq Bras Med Veterin\u0026aacute;ria E Zootec. 2020 May 8;72:346\u0026ndash;54. doi:10.1590/1678-4162-11323\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-veterinary-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Veterinary Research](http://bmcvetres.biomedcentral.com/)","snPcode":"12917","submissionUrl":"https://submission.nature.com/new-submission/12917/3?","title":"BMC Veterinary Research","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Free-roaming dogs, canine welfare, animal shelters, shelter management, Central Uganda.","lastPublishedDoi":"10.21203/rs.3.rs-9259621/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9259621/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: In Central Uganda, animal welfare advocates are increasingly promoting the establishment of animal shelters as a humane alternative to poisoning for controlling free-roaming dog (FRD) populations. However, dogs at these facilities face a number of welfare challenges arising from insufficient resources and substandard management practices. We aimed to assess the welfare of sheltered dogs in Central Uganda by identifying the animal-based welfare issues faced by the dogs, evaluating the housing and management infrastructure, and determining risk factors of animal welfare compromise. \u0026nbsp;We conducted a cross-sectional study in four animal shelters, between July and August 2024. We used structured checklists from the Shelter Quality® protocol (SQP) to collect data on animal-based measures (ABMs), resource-based measures (RBMs) and management-based measures (MBMs).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Overall, the shelters housed 141 dogs (average 35.3, range 4-84) across 40 pens (average 10, range 2-17). A total sample of 32 pens were selected from which 81 dogs were assessed. Fifty-seven of the dogs were housed in groups, fourteen in pairs, and ten alone. 35 dogs were females and 46 males, with 32 young, 41 adults and 8 geriatrics. The most prevalent ABMs were; too thin BCS, skin lesions and fear/aggression, reported among 59.3%, 45.7% and 39.1% of the dogs respectively. At pen-level, signs of diarrhea, pain-associated behavior, and stereotypies were commonly seen in 46.9%, 56.3%, and 46.9% of the pens respectively. Multivariable firth’s logistic regression revealed several risk factors of poor welfare outcomes; Skin conditions, especially wounds were significantly associated ‘other’ bedding type (aOR=5.27, p=0.008). Panting was highly associated with poorly ventilated pens (aOR=82.33, p=0.010). Pain-related behaviors in dogs were significantly linked to group housing (aOR=11.92, p=0.006), while a lack of outdoor access was a risk factor for stereotypic behaviors (aOR=20.71, p=\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Our findings indicate that the welfare of the majority of shelter dogs was suboptimal, largely due to inadequate resources, poor housing conditions, and questionable management practices. Improving dog welfare in Ugandan shelters requires regulating intakes and implementing evidence-based management interventions. Collaboration with veterinary providers and intervention from animal protection agencies or government bodies can ensure sustainable, high-welfare operations.\u003c/p\u003e","manuscriptTitle":"Animal Welfare Assessment at Four Dog Shelters in Central Uganda: A Cross-Sectional Study using the Shelter Quality ® Protocol","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-16 10:18:13","doi":"10.21203/rs.3.rs-9259621/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"24873866963198255922848528865919905083","date":"2026-05-12T14:19:51+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-12T06:54:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"197269332048880801846435132038213515863","date":"2026-05-05T09:40:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"187093944663765288738526742155229389709","date":"2026-05-05T00:12:29+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-13T14:03:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"283311148002376236766980385014094904806","date":"2026-04-13T13:23:12+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-08T16:03:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-08T16:00:23+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-04T17:24:31+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-02T18:32:24+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Veterinary Research","date":"2026-04-02T18:27:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-veterinary-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Veterinary Research](http://bmcvetres.biomedcentral.com/)","snPcode":"12917","submissionUrl":"https://submission.nature.com/new-submission/12917/3?","title":"BMC Veterinary Research","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f488ec19-72a2-4c2d-aaea-0849eba87db1","owner":[],"postedDate":"April 16th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"24873866963198255922848528865919905083","date":"2026-05-12T14:19:51+00:00","index":88,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-12T06:54:58+00:00","index":87,"fulltext":""},{"type":"reviewerAgreed","content":"197269332048880801846435132038213515863","date":"2026-05-05T09:40:21+00:00","index":84,"fulltext":""},{"type":"reviewerAgreed","content":"187093944663765288738526742155229389709","date":"2026-05-05T00:12:29+00:00","index":82,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-16T10:18:13+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-16 10:18:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9259621","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9259621","identity":"rs-9259621","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}