For decades, the practice of veterinary medicine operated under a relatively simple paradigm: diagnose the physical pathology, prescribe the pharmaceutical, and perform the surgery. The animal was viewed largely as a biological machine—a collection of organs, bones, and systems to be repaired.
A dog is not a liver with a tail attached. A cat is not a kidney wrapped in fur. They are sentient, emotional creatures whose mental state dictates their physical resilience.
Shelters are factories of stress. Kennel cough is a medical problem; kennel distress (pacing, bar biting, self-mutilation) is a behavior problem that creates the medical problem via immunosuppression. Shelter veterinarians now conduct "behavioral euthanasia" assessments. This is not a judgement of the animal's soul, but a medical decision based on quality of life and public safety.