The nurse appears crisply turned out and totally professional while at work in the hospital. When she goes home, she walks into gagging squalor.

She is a hoarder.

For some reason no one is quite sure of, a large percentage of those who hoard animals in Rhode Island are nurses, says E.J. Finocchio. Their professional lives are all about antiseptic efficiency. Their private lives are all about desperate, lonely, filthy isolation.

The nurses are just one of the strange and tragic twists in a tale of animal cruelty carried out by people convinced they are doing the caring thing.

“These are intelligent people,” Finocchio says. “But their stories are unbelievable.”

Finocchio, director of the Rhode Island SPCA, says animal hoarding is far too prevalent in Rhode Island. It is, he says, the dirty little secret that is too often swept under the rug. And his agency can no longer be the one that is always called. The SPCA will help, he says, but cities and towns and public agencies have to do more.

It is a sad, perplexing problem clouded with mental health issues and tricky legal challenges. There is no clear solution. There is no way to know how prevalent it is because it occurs behind pulled shades, drawn curtains and closed blinds. That appearance of shutting out the world is one of the signs — that and a messy, ill-kept yard, a car in the driveway full of all manner of stuff, trash cans overflowing with pet food containers, perhaps a cat on a window sill and, of course, the stench of ammonia coming from the house.

Finocchio has seen 25 cases of animal hoarding, and he says it is impossible to describe the conditions. The stench from the waste is enough to make the dwelling uninhabitable to anyone except the person who lives there and who has somehow developed a tolerance.

“I defy you to stay in there for five minutes,” he says.

There are animals everywhere in “semi-feral” states. There are cats, birds, small dogs. There are skeletal remains under beds and in closets. There are dead animals in refrigerators and freezers. There are cases of feline leukemia and feline AIDS. And there are piles of other things — newspapers, magazines, unopened bottles of detergent — that betray the hoarder’s acquisitive obsession.

“It’s an unbelievable dilemma,” says Finocchio. “It’s a human and an animal tragedy.”

Two years ago, Finocchio organized a seminar on animal hoarding. He opened it up to anyone and everyone who might have an interest — human services, elderly affairs, public safety.

“There was no response,” he says.

So the cruel, demeaning, disease-spreading practice continues. In his years dealing with it, Finocchio has put together a loose profile of the likely hoarder. It is a woman over 50 — single, separated or divorced with serious traumatic experiences in her past.

“These people need help,” he says.

But they often don’t get it. And even when their animal-filled houses are revealed, there is no set procedure to deal with them. Local ordinances dealing with the problem are inconsistent. Finocchio says sometimes regulations on spaying and neutering and rabies vaccine can be used to at least gain entrance to a house.

But even if a hoarder house is cleaned out — the animals taken away to probable euthanasia and the house either condemned or scrubbed clean — it does not put an end to it. Experience has shown, says Finocchio, that the hoarder will probably just start all over again.

bkerr@projo.com