SFSPCA's community clinic approach reflects principles drawn from shelter medicine and community-based veterinary care, including resource optimization, empiric therapy, and population-level thinking. Cases are managed using incremental care strategies, which support the development of medically sound, flexible treatment plans tailored to each client’s financial, emotional, and logistical situation. Clients are included as partners through shared decision-making and nonjudgmental communication, fostering trust and long-term engagement. This model improves access to care, supports better outcomes for patients, and contributes to a more equitable and sustainable veterinary care system. Contextualized approaches to treatment of parvovirus, feline urethral obstruction, pyometra and congestive heart failure will be discussed, in addition to other common case presentations.