The Best Nebraska Dog Rescues & Shelters in 2025

Nebraska Humane Society

The Nebraska Humane Society was founded in 1875. It is the fifth oldest humane society in the nation, and, today, is also one of the largest. We offer shelter to animals who have no place to call home and provide vital services to them and to the people who love them. Every year, more than 24,000 animals, including wildlife, find their way to our doors. Through our programs, we touch the lives of more than 200,000 people annually with our message of compassion and humane treatment for all living creatures. We are housed on a 13-acre campus with four buildings, 170 dedicated staff members and 500 volunteers.

Beatrice Humane Society

For many years, BHS (Beatrice Humane Society) has been sheltering abandoned animals, fighting cruelty and neglect, and working to build a caring, compassionate community here in Beatrice, Nebraska. Although we have lots of volunteers and members, we are really nothing more than a single entity saying “Yes, I want to help!” Help us to help you and a pet friend… check out what cats and dogs are available, or find out more about volunteering or donating to help the pets still awaiting families!

Paws & Claws Adoption Center

Epona Horse Rescue

Epona Horse Rescue is located just outside Crete, Nebraska. We are located on roughly 10 acres of pasture land, with a 4 stall barn and plans to add an additional barn soon. "SAVING LIVES OTHERWISE LOST..." Epona Horse Rescue is an organization based on the premise that all equine and other animals should live freely from cruelty, neglect and abuse. Many horses simply end up in a rescue situation due to lack of training or being too young or too old to be of use to mankind. Epona is dedicated to the care and rehabilitation of unbroken or unhandled horses and to the very young and the aged equine that are often rejected. We strive to educate the public on the fate of many of America's horses and ask for the support of the American public. Money is always a pressing need in the rescue. Feed, hay, shelter and veterinary care are the largest of expenses. We also need farrier care, office support and volunteers to continue the work. Your support can help the rescue continue to rescue and rehabilitate these wonderful animals. We are a non-profit organization under the IRS 501 (c)(3) regulations.

Heartland Pet Connection

The Heartland Pet Connection has been serving the homeless animals of south central Nebraska since October 2004. Our facility provides a safe haven for lost and surrendered pets and an opportunity for many families to find the perfect companion. Animal control is provided by the Hastings Police Department and the Adams County Sheriff’s Department. At the shelter, animals are cared for with compassion and kindness. The safety and health of these animals is a priority for staff and the many volunteers that work at the shelter. Each animal receives veterinary care as well as necessary vaccinations and tests to ensure that it is in the best health before ever being put up for adoption. It is our goal to provide the best care possible for the homeless animals that need it the most. Our History The Heartland Pet Connection is owned and operated by the Hastings Animal Shelter Association, Inc., a non-profit 501(c)(3) organization founded in 2001. We are a non-profit organization, not managed by city or county government. The concepts of changing the community’s animal shelter was originally introduced to the community as the WAGS project – Wonderful Animals – Great Space. It was born out of the compassion felt by many of Hastings area residents who wanted to improve the lives of hundreds of animals that passed through the dilapidated city animal shelter. The original WAGS Project was a grassroots effort that has expanded into a variety of avenues all carefully designed to serve the needs of people and animals in this community.

Start Over Rover

Start Over Rover is the only no-kill, non-profit animal rescue and shelter located in Hastings, NE. Rover is operated primarily by volunteers and is beginning it’s 10th year of operation! We rely solely on donations from the general public and local/regional businesses and groups. Our first priority is finding good homes for unwanted companion animals, whether they are abandoned, neglected, abused, strays, puppy mill “cast offs”, or simply unwanted by their current owners. Another priority of Rover’s is reducing the pet overpopulation without euthanization. We pay for the spay or neuter, medical care, vaccinations, and daily care of each animal that enters Rover.

McCook Humane Society

The McCook Humane Society was formed in 1983 by a group of citizens concerned by the housing that was being used by the City of McCook to house and care for stray animals. The first efforts focused on finding new homes for the strays and making their stay a bit more comfortable while impounded. Through a lot of diligent efforts, donations of money and many hours of volunteer labor the Animal Shelter was built on South Street and a lease agreement with the City of McCook was established. The shelter has been improved through the years and is a facility to be proud of. These improvements have been possible through donations and other fund raising projects throughout the years. The effort continues to insure that neglected and unwanted animals of the area are taken care of and new homes provided. MHS is a nonprofit organization supported by voluntary donations and remains an independent organization dedicated to finding permanent, loving homes for abused, neglected, and abandoned animals in Southwest Nebraska and Northwest Kansas. Three Memory Boards are on display at the shelter: • One has the names and or businesses that have been donors or volunteers that have been instrumental in the construction and continuing operation of the Animal Shelter. • Another is in memory of deceased animal lovers that have either left monies in their wills or instructed their loved ones to donate to the humane society. • A third has the names of beloved pets that the owners have given memorials in their name to be remembered. Visitors and volunteers are always welcome. The McCook Humane Society is located at 100 South Street. Please find our current open hours at the bottom of every page in the footer. If you need to surrender an animal, please call first during business hours to set up an appointment to bring the animal in.

Animal Shelter of Northeast Nebraska

The Animal Shelter of Northeast Nebraska* (ASNN) was founded in 1995 in Northeast Nebraska by a group of dedicated volunteers. These volunteers created a network of foster homes and caring families to care for the abandoned animals in the area. All expenses are paid by the donations from the community and local businesses. There was a general lack of facilities in our five-county area (Madison, Pierce, Wayne, Stanton and Cuming counties) to respond to the issues of unwanted or abandoned dogs and cats. Because of the rural nature of our environment many of these animals were simply turned free near farms where they were not wanted. Farmers or people living in the country, for their part, and understandably, did not have a shelter near them and were forced to either take the animals to a shelter farther away or have them euthanized or even kill them themselves. As a response to this urgent need we began the foster/adoption program as a stopgap to meet the critical current need. We finally opened the doors to our shelter in March of 2016 and, for the most part, stopped our foster program and now house an average of 100 cats and dogs at a time with a few exotics on the side. We currently average 70 adoptions per month and, thanks to our community, can and will continue to grow. * The Animal Shelter of Northeast Nebraska is formerly known as Northeast Nebraska Humane Society - we have no affiliation with the Humane Society of the United States.

Scatter Joy Acres

In 2005 Scatter Joy Acres (SJA) was founded by Joy Bartling as Soby Ranch Ministries in 2006 near Fort Calhoun, Nebraska to provide a new home, new life, and new meaning by rescuing abused or neglected animals. Bartling’s first loves were the animals who became her closest childhood friends and confidants when she felt she had no one else to turn to during a painful part of her journey to adulthood. Understanding that there are often deep pains in life and the many times that human beings were not able to touch them, she realized she was not alone in that aspect. At the ranch, the animals serve as an integral part of the on-going mission of providing therapeutic interaction for developmentally disabled and autistic children, seniors, veterans, and at-risk children. Many of us, like Joy, have found comfort, solace, peace and even joy in the company of animals. Joy embraced her passionate gift in life which also would be a significant way to “give back” to the community. Thus, “Scatter Joy Acres” was created to scatter God’s joy across all of his acres. On the ranch, each animal has a name, a story and a significance, which is demonstrated in warmth and love they share with every person they encounter. The interactions animals share as they meet with people are simply amazing. In 2013, SJA relocated to a sprawling, lush, 26-acre site within Omaha at 49th & Newport. Here it provides a surprisingly quiet inner-city sanctuary for both humans and animals. In 2022 SJA had the opportunity to move the ranch to a 15 acre country setting in Murray, NE . This has allowed to be able to grow our programs. In addition to the therapy and rescue, the ranch is available for birthday parties, corporate outings and other events. There is an ample parking, picnic areas, a playground, hayrack rides, bonfires, and plenty of room for fun and games. Our ranch in Murray serves as headquarters for the ever-expanding Scatter Joy Acres organization. The ranch is presently home to more than 65 animals like alpacas, sheep, rabbits, goats, horses, cows, and a camel, a variety of fowl, pigs, and peacocks. SJA provides animal therapy for the developmentally disabled, seniors and veterans both at the ranch at on-site at many other facilities in and around the metro Omaha area. Additionally, SJA is one of the regions only authorized education sites for the widely acclaimed Cowboy Ethics, curriculum, teaching young people to be responsible adults using the Code of the West. Scatter Joy Acres provides an experience unlike any other for those it serves. Animal rescue and therapy, an urban ranch, real life – hands on STEM education, and animal interaction makes. Scatter Joy Acres an incredible organization and place to visit.

Wag N Train Terrier Rescue

We are a 501(c)3 non-profit organization located in Omaha, Nebraska. Adoption donations and donations made by generous individuals represent our sole source of funding. With these funds, our rescue dogs are brought up-to-date on vaccinations, are spayed or neutered, and are provided with ongoing veterinary care as needed. What sets us apart from other rescue organizations? Our "Sanctuary Sweethearts" - dogs that will stay in rescue for the remainder of their lives because of advanced age or serious health issues. Wag N Train provides all medications, supplements, dog food and required therapy for these dogs so that they may spend the rest of their lives in comfort. Private donations are the only source of funding for our "Sanctuary Sweethearts." We do adopt outside our state, but require the adopter to travel to Omaha, Nebraska to pick up their newly adopted dog. We do not transport or fly our rescue dogs. Our volunteers are available to help you from start to finish by offering: • Counseling before adoption • Training recommendations throughout your pet's lifetime • Grief counseling when that time does come

The Good Life Bulldog Rescue

We are dedicated to the rescue and care of bulldogs (English and Olde English) until a loving, adoptive home can be found with a focus on breed education. We work paw in paw with rescues, vets and shelters throughout the Midwest and in cooperation with the Bulldog Club of America Rescue Network (BCARN).

Midwest Misfits Animal Rescue

The Midwest Misfits is a volunteer driven, non-profit 501c3 created to reduce the number of animals euthanized in shelters in the midwestern states through loving foster care, medical treatment and behavioral modification. We are a state licensed rescue. ​We aim to educate and assist the public in effective means of controlling the pet population. We will resist breed specific legislation, embrace animal welfare reform and work to strengthen society's bond between animal and owner. We are the last line of defense and the voice for the voiceless about to lose their lives through no fault of their own.

MidAmerica Rottweiler Rescue

MidAmerica Rottweiler Rescue (MARR) was founded in March 1999. This rescue organization was formed because we saw a need for a rescue network in Illinois, Indiana, Iowa, Kansas, Kentucky, Missouri, Nebraska, Oklahoma and Wisconsin. While some of these states have strong and successful rescue groups, there are gaps in area coverage and some states have no rescues at all. MARR is supported solely through charitable donations and the fundraising efforts of its members and is a nonprofit corporation, recognized as a public charity with federal nonprofit 501(c)(3) status. All donations are fully tax-deductible allowable by federal income tax code. We are always looking for Rottweiler enthusiasts of all experience levels who are interested in breed and a desire to help. There is something for everyone to do!

Great Plains Pointer Rescue

Great Plains Pointer Rescue was founded in 2008. Here at Great Plains Pointer Rescue, we take pride in helping German Shorthairs in many situations. All of our dogs receive full vet care in our program from minor to major medical issues. We provide all vetting records to adopters. Our main goal is to find loving and committed homes for our dogs. We take adoption seriously. Most of the dogs that enter our program have already been abandoned, bounced from home to home, or from different shelters. Our rescue program consists of foster homes where the dogs live indoors with families and receive training, social skills, and love. Adopters are able to ask questions and understand how a dog is in a home environment.

Hands, Hearts and Paws

The Phoenix Remix Animal Rescue

The Phoenix Remix is a 501c3, state licensed volunteer rescue designed to protect and preserve the lives of jeopardized, neglected and at-risk domesticated animals. Where it all began Phoenix was found emaciated, dying from disease on the side of the road in the middle of nowhere, Tennessee, in the spring of 2002. She was somewhere around five months old. Local veterinarians suggested that she be euthanized, given the severity of her condition. That could have been the end of her story- a truncated life of misery, hunger and loneliness. But that was nowhere near the end. Phoenix healed. She spent a decade and a half reveling in extraordinary health, athleticism and compassion. She touched the lives of every person that met her with her gentle demeanor, her love of the outdoors and her loyalty to people- something she didn’t owe us, but humans certainly owed her. It is the mission of this rescue to give every lost soul the chance to be loved and honored beyond its lifetime, like Phoenix is. It is our goal to ensure these animals are placed in homes that will stay as dedicated to the animals as they are to us, and our wish to provide every animal we touch with the opportunity to change your life forever, the way Pheenie changed ours.

Little White Dog Rescue

Little White Dog Rescue (LWDR) is a non-profit dog rescue organization that consists entirely of foster homes rather than a shelter. Founded in 2007, LWDR originally began as a West Highland Terrier rescue group – thus the name! These days, we take in small dogs of all kinds. Like all rescue groups, our goal is to find loving, forever homes for small dogs who have been displaced through no fault of their own. Our dogs come to us from city shelters, commercial breeding facilities, and owners who can no longer care for them. We are an all-volunteer group deeply committed to offering a chance at a good life to the dogs in our care. We provide a loving foster home, medical care, and quality food to each of our little dogs and begin training them to become beloved house pets. As a final gift to each of our dogs, we work diligently to make the best match for them with a new family. Little White Dog Rescue is a 501c3 organization that relies solely on donations to fund our mission to rescue, rehabilitate and re-home small dogs. There are many other ways individuals and corporations can help us in our mission! Please see the Volunteer Page to find out how you can become involved with LWDR.

Capital Humane Society

Our History What is known today as the Capital Humane Society began in 1902 as the Lancaster County Humane Society. The first shelter was located in a shed near the West 'O' Street viaduct. The Society's mission focused on the prevention of cruelty to children and horses. Around 1907 the services expanded to include a variety of animals. In September, 1924 the Society acquired a three acre tract of land at Park Boulevard and Hatch Street, a gift in the Sawyer-Snell Estate. The current shelter is the third to sit at this location and was erected in 1966. A renovation was completed at the facility in 1997. In the Spring of 2004, renovation was completed on the new Spay/Neuter Vet clinic at the shelter. We are now able to spay and neuter all cats, dogs and rabbits going into the adoption program. On July 2nd, 2013 the Pieloch Pet Adoption Center opened it's doors at 6500 S. 70th Street. The center handles adoptions and humane education at this beautiful facility at 70th and Hwy 2. Our original location on Park Boulevard is still in operation and now functions as our Admissions & Assessment Center. Today, Capital Humane Society serves the community by sheltering homeless pets, advocating for animal welfare, and educating the public about responsible pet care. Our Purpose We exist because we believe animals need human advocates both in and out of the shelter. By advocating for them, we can help our community experience the connection, companionship, and love that comes with pet ownership. Our Core Values Communication: We are committed to a culture of open dialogue and transparency. We speak honestly and respectfully. We ask questions and collaborate to find solutions. We foster connection by consistently and efficiently sharing information, expectations, and successes. Compassion: We work to alleviate distress through judgment free access to care and resources. We recognize emotional intelligence is essential to effectively care for ourselves and others. We give ourselves and others the grace to make mistakes and the opportunity to learn from them. Teamwork: We take initiative and help where help is needed. We are considerate of how our behavior and actions impact others. We believe our success as a whole is a result of the contributions of each individual. Respect: We talk to each other, not about each other. We acknowledge that each person and animal have different experiences that shape them into unique individuals. Although we may not always agree with the outcome, we trust decisions are made with the best information available at the time. Accountability: We approach our work with a proactive mindset, taking pride in completing each task to the best of our abilities. We have confidence in our knowledge and skills. We embrace full responsibility for our decisions, errors, and achievements. We believe mistakes provide opportunities for personal ownership & professional development.

Haven Animal Rescue Nebraska

Haven Animal Rescue Nebraska is located in Omaha, NE with approved foster homes in surrounding areas. We do not have a physical facility, so potential adopters are able to meet our available animals through appointments after their applications are approved. Our organization is composed entirely of dedicated volunteers. We are always looking to add committed volunteers and fosters to the Haven family that are like minded in their passion for saving animals! We value honesty, integrity, and respect for all living creatures as well as transparency in throughout our entire organization. Please see our volunteer tab to join the Haven family!

Brave Animal Rescue

Founded in 2020 by a group of animal advocates in Lincoln, Nebraska, Brave Animal Rescue is a nonprofit 501(C)(3) volunteer-based animal welfare organization dedicated to rescuing homeless kittens, cats, dogs, and puppies. By working with a network of volunteer advocates, foster caregivers, local veterinarians, and shelters, Brave Animal Rescue is able to help hundreds of animals every year by pulling animals from high-kill shelters, by working hands-on rescuing orphaned kittens, by aiding in local Trap-Neuter-Return (TNR) efforts, and by helping those who are no longer able to care for their pets. We provide these animals with care and temporary homes until we are able to place them in permanent homes. Brave also aims to serve as a resource to our community by providing information about pet ownership, spaying and neutering, veterinary care, and TNR. The founders of Brave Animal Rescue are life-long animal advocates who have several years of experience working with other nonprofit animal groups throughout the Midwest. Through these experiences on the forefront of rescue, the founders quickly began to recognize a need in the community for a neonatal-focused rescue. The vast majority of animals that are surrendered to animal shelters are under the age of 18 months old. According to The Humane Society of the United States, 80% of kittens are born outside. Without intervention, these kittens go on to procreate, get killed (by disease, vehicles, predators, etc.), or end up in shelters. Unfortunately, kittens and puppies under 8 weeks old are the population most at-risk for being euthanized in shelters due to a lack of resources and foster homes. With a passion for newborn kittens and puppies, and drive to help the community, the founders of Brave Animal Rescue aim to end the cycle of unwanted companion animals through education, rescue, and spaying and neutering.

Revolution Rescue

Revolution Rescue is a volunteer & foster-based company out of Lincoln, NE, and is a registered 501(c)3 non-profit group. Our Story The backbone of this rescue started as a small network of friends who were determined to help end and prevent cruelty by lessening the number of animals in need, especially the ones in the shelter systems. The euthanasia statistics are staggering. Far too many animals are not given a chance, mainly due to lack of space, and we are changing that...one by one. We will continue to fight Breed Specific Legislation (BSL) towards the many dogs that carry the unfair stigma of being a “bully breed”. If more people can open their minds and their hearts, and give these amazing animals a chance, we can reduce the number being held (and not making it out of) our shelters. We are a team devoted to each other and to animal rescue. To learn a bit about our members, click on "Board" below! Our Promise We are dedicated to making a positive difference for any and all animals that come into Revolution Rescue, so that the transition to their forever home will go as smoothly as possible. We encourage everyone to save the life of a shelter pet by adopting. Supporting breeders by purchasing animals from pet stores, etc…only adds to the problem and is how so many end up facing certain death. We promise you won’t be sorry. Rescue is the best breed! Revolution Rescue. Raising the bar for shelter animal rescue.

Catz Angels Care, Inc

Catz Angels CARE, Inc is a volunteer, no-kill cat rescue located in Fremont, NE. We take in stray and abandoned cats and kittens in Fremont, NE and the surrounding communities. CARE was started in 2016 by a group of cat lovers who saw a need for management of the community cat population in Fremont. Out of their own pocket, they began to trap-neuter-release (TNR) these local cats. Over the years, CARE has grown in size, budget and services in order to meet the needs of the community.

Nebraska No Kill Canine Rescue

Nebraska No Kill Canine Rescue (NNKCR) is a 501(c)3 non-profit organization that was originally formed in 2010 by a handful of volunteers who wanted to provide a foster-based no-kill option for all dogs regardless of breed. We utilize a network of foster homes who volunteer their time. To date, Nebraska No Kill has rehomed more than 800 dogs, with a success rate of 97 percent on adoptions. We are inspired and affirmed on a daily basis by the support received from the Lincoln community, where most of our fosters and adopters reside. Nebraska No Kill Canine Rescue strives to collaborate with other local rescues and has developed a strong relationship with the Capital Humane Society and other shelters across the state, often working together on hard-to-place dogs. Our rescue group is striving for the day when every dog has a safe and loving home. It’s pretty simple. The more fosters and funding we have, the more dogs we can save! Those two factors are the keys to our whole operation. Our network is growing, but the influx of dogs in need of a foster home continues. Fostering is a great way to help a dog along in his or her life’s journey with no long-term commitments and little or no financial obligation. Foster dogs are fully vetted prior to placement, and medical expenses are paid for by Nebraska No Kill Canine Rescue until an adopter is found. Consider opening your home and your heart to a foster dog, and we’ll work hard to find a great match!

Heartland German Shepherd Rescue (HUGS)

Heartland German Shepherd Rescue (HUGS) is a Nebraska-licensed, all-volunteer, 501c3 non-profit dog rescue organization founded May 7th, 2015. We operate out of the Omaha-Lincoln, Nebraska area. Our focus is to save German Shepherd dogs at risk of being euthanized in shelters or other dire situations. We also help Australian Cattle Dogs and other herding breeds and mixes in need, as much as we are able to. While our focus is on purebred German Shepherds, we also help other injured dogs, puppies and/or moms with their litters, who are out of time at overcrowded shelters or small rural shelters with a high euthanasia rate. Many are sick or injured. Many of them are Shepherd mixes or other herding breeds including Australian Shepherds (Aussies) and Australian Cattle Dogs (Heelers). And these adorable, forgotten pups couldn't be more needy or deserving of our compassion and help. You can help too by opening your heart and fostering, adopting or donating. German Shepherds are highly intelligent, yet sensitive and intuitive dogs. We firmly believe that they respond best to positive reinforcement and a firm but always kind hand. German Shepherds thrive on structure, consistency, and mutual respect. They respond very well to reward-based training (treats, praise). Being heavy-handed, rough, or using force or inappropriate training tools is not only unkind, but it can often lead to distrust and can result in behavioral issues.

Doberman Rescue of Nebraska, Inc.

Harbor of Hope Dog Rescue

We are a non-profit dog rescue that is comprised entirely of dedicated and compassionate foster homes ready to provide a safe haven from life’s storms. We cannot stop the world from being cruel, but we can offer a safe, loving and restorative place where dogs are protected from the harshness of life and given a chance to recover and heal. We promise to provide them with complete vet care, nutritious food, enrichment and training opportunities, all while surrounding them with love and hope. When we look at their faces, we see endless possibilities. We offer them love to show them that life isn’t always about merely surviving. It is about thriving. We offer them time to let their guard down long enough to learn how to be loved.

Town and Country Animal Rescue

MidAmerica Boston Terrier Rescue

MABTR takes in Boston Terriers and Boston mixes of any age, gender, and physical/mental condition across 13 states. Dogs are placed in foster care until they are adopted. Prior to adoption, we provide complete medical care, behavior evaluation, and microchipping. Run by volunteers with caring hearts, MABTR is funded completely by donations, and we can't achieve our mission alone. Generous donations from kind people like you sustain us with the financial support necessary to care for the hundreds of homeless Bostons we rescue every year.

Second Chance Pups

Second Chance Pups is a 501(c)3 corporation supported ENTIRELY by adoption fees and private donations. We select dogs from local shelters and rescues and match them to carefully selected volunteer inmate/handlers from the Nebraska State Penitentiary. Dogs then live at the penitentiary while handlers provide nine weeks of intense training and love. It is a great rehabilitative measure for the inmates, offering them an opportunity to give back to society in a positive manner and contribute to a solution for the growing problem of uncared-for and unwanted animals. Otherwise overlooked dogs get a second chance at a lifelong relationship with a loving family. The first rotation of dogs started in September of 2004 in an effort to help more homeless animals find their way into forever homes. To date, SCP has adopted out 349 dogs and 220 inmates have participated in the program. Inmate trainers work together with a professional trainer, prison staff and SCP volunteers to provide dogs with basic obedience training, socialization, behavior modification, grooming and daily 1 on 1 attention. The dogs involved in the program graduate with a wealth of valuable skills that help give them a paw up on finding a home. Prison training programs like ours dramatically increase the number of shelter dogs adopted by providing them with a little help. The impact of similar programs throughout the United States is universally positive. Inmates learn training skills that support their own successful rehabilitation and reentry into society. Morale of both inmates and prison staff is greatly enhanced. Adoptable dogs who would otherwise be left to languish or be at risk for an uncertain future due to lack of socialization or training receive a second chance for a good life.

Dolly's Legacy Animal Rescue

Dolly’s Legacy Animal Rescue is a foster-based rescue in Lincoln, NE. Our mission is to save orphaned and abandoned pets from overcrowded shelters and find them loving, forever homes. Dolly's Legacy Animal Rescue's mission is to save orphaned and abandoned pets from overcrowded shelters where they are out of time & out of hope to make it out alive. Far too many pets are facing a cruel death at high-intake, high-kill animal control facilities, some still using a gas chamber as a means of euthanasia. We rescue dogs, puppies, cats & kittens, and place them into loving foster homes while they receive all the vet care needed, including spay/neuter, heartworm testing & treatment, vaccinations, microchipping, treatment for parasites, surgical intervention, and hospitalization.