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Stray animals are a reservoir for disease. This can not only affect humans, but also other animals.
One of the many stray/feral cats who hang around my properties was found to have feline leukemia a couple of years ago. I suspect he was not a feral and rather had strayed or been abandoned, since he approached us and happily spent 2 days in my office while I tried to feed and hydrate him (he was almost skeletal) and treat his abscess, and waited for the diagnosis from my vet. Upon receiving it, I had him euthanized at the Humane Society; cheaper than my vet, and wise to let the HS know about the presence of the disease.
I have four cats (all strays), neighbours have cats, and we have an "official" feral cat colony on the block, with a varying population of usually somewhere around half a dozen; I offer them my garage for food and shelter, and other neighbours feed them, adopt them when possible, etc. One of my neighbours' cats, who had been a stray, was diagnosed with FIV (cat AIDS) some years ago. Both sick cats could indeed have infected others. And of course they breed, creating more problems. We seldom have female ferals, but my neighbour adopted and spayed one a couple of years ago, and I'm waiting for next time I see Ms. Kitty, who had a kitten with her last fall so I couldn't remove her then, to nab her and get her to the spay-neuter clinic; the Humane Society has promised to cooperate by donating vaccinations if we catch any of the ferals.
As far as "letting nature take its course" in the case of dogs and cats, that doesn't actually mean leaving them to their own devices. Dogs and cats are bred to be domestic animals. Leaving a sick or hungry dog or cat "in the wild" is not natural at all, and can be simply cruel, as well as endangering domestic pets and the rest of the fauna in the ecosystem, where dogs and cats are unnatural predators. If the ferals here weren't being taken care of, it would truly be kinder to euthanize them. In fact, it would be one of those hard responsibilities, in this case a responsibility that human beings took on when they domesticated the species.
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