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The foregoing examples demonstrate the synergy that occurs when shelter health and shelter management practices work in support of each other. The most effective infectious disease control program will address the overall functioning of the shelter as a system, balancing animal intake with the organization's ability to provide appropriate care and find suitable outcomes. The success of this approach has been demonstrated in a shelter management model known as “Capacity for Care,” which has been linked to decreased disease and euthanasia and increased live release rates (Karsten et al. 2017). Though piloted with an emphasis on cats, this model applies equally to dogs and involves optimizing the number of animals housed at any one time; actively managing the LOS of animals in the shelter; providing housing for each animal that meets or exceeds the ASV Guidelines for Standards of Care in Animal Shelters and using methods such as scheduled admission and removing barriers to adoption to maintain the population within the organization's humane capacity without resorting to increased euthanasia (CFHS 2016).

Whether used under the formal umbrella of the Capacity for Care management model or otherwise, these practices, when combined, represent an integrated approach that powerfully supports animal health and limits environmental disease transmission. Under these conditions, it is realistic to expect the spread of serious infectious disease to be a relatively rare event. The shelter practitioner can then turn their attention to the chapters within this text that focus on methods to treat animals that enter the shelter already infected, or to improve the health of animals in the community.

Conversely, when housing is poor, LOS prolonged, or animal care is otherwise compromised because shelter capacity is exceeded, even the best vaccination, segregation and sanitation practices will be insufficient. In the face of repeated outbreaks or high levels of endemic disease, the reader is encouraged to revisit this chapter and access other resources – including the numerous guidelines, texts, and consulting services now available – to bring the shelter population into greater balance with the organization's ability to provide care.