Ferret, rabbit, and rodent anesthesia.

Ferrets, rabbits, and rodents are increasingly being presented to veterinarians for evaluation and treatment. The owners of these animals expect high-level medical and surgical care. Consequently, veterinarians are more often required to provide intensive anesthetic management of these animals. The variability of anesthetic agents used and patient responses are addressed. The consequences of size for anesthetic management are discussed. Successful small mammal anesthesia requires following general anesthetic principles, awareness of limitations, and maintenance of high standards of care.     

Blood Collection Techniques in Exotic Small Mammals

Blood collection from small exotic pocket pets can be difficult to achieve. The individual collecting the blood must know both the anatomy and behavior of the species to obtain suitable amounts of blood for diagnostic testing. Given the animals' small size, it is often difficult to collect large volumes of blood. A clinician serious in developing an exotic small mammal practice should understand the limitations of blood sample collection and the risks involved with the procedure. Unlike domestic animals, these pets are often not comfortable with being handled and are often prone to induced complications when presented to a veterinary clinic and restrained for examination. For some cases, the clinician will have to determine if the risk of getting the sample is better achieved by anesthetizing the patient, and if doing so will have a detrimental effect on the animal. One will also need to consider the effect of the anesthetic versus the stress the restraint may have on the blood results.     

Safe Sedation and Immobilization of Unusual Exotic Species Encountered in Practice

Safe handling techniques for traditional exotic companion mammals (e.g., ferrets, rabbits, and rodents) have been well described. However, some uncommon species, including various wild animals maintained as pets, should not be manually restrained because of the nature of the animal and the potential for injury to both the pet and the handler. Sedation and immobilization techniques are useful to enhance safety and to facilitate diagnostic and treatment procedures. Sedatives are best administered to these animals with the aid of a squeeze cage.     

Reproductive medicine of rabbits and rodents.

The small animal practitioner is likely to be called upon to help nontraditional pets such as rabbits, rodents, and ferrets. The more information veterinarians have regarding normal anatomy, physiology, reproduction, medicine, anesthesia, and surgery of these unusual pets, the more likely they will be able to help their owners. This article presents an overview of routine and emergency reproductive concerns that the small animal practitioner may face when presented with nontraditional mammalian patients.     

Common rodent procedures.

Rodents are commonly owned exotic animal pets that may be seen by veterinary practitioners. Although most owners presenting their animals do care about their pets, they may not be aware of the diagnostic possibilities and challenges that can be offered by rodents to the veterinarian. Understanding clinical anatomy, proper hand-ling technique, realistic management of emergency presentations,correct and feasible diagnostic sampling, anesthesia, and humane euthanasia procedures is important to enhancing the doctor-client-patient relationship, especially when financial constraints may be imposed by the owner.     

Skin diseases of rodents and small exotic mammals.

Small exotic mammals and rodents are becoming popular pets in the United States. Like most other exotics, the popularity of these animals has vastly preceded the accumulation of practical husbandry and veterinary information available about them. Several dermatologic conditions have been described in most rodents and small exotic mammals; however, the practitioner can assume that more exist that have not yet been diagnosed or documented. It is not unreasonable to assume that rodents and small exotic mammals could be affected by many of the same dermatologic conditions well described in other animals. Veterinarians are encouraged always to apply the same diagnostic protocols used to work up skin problems in dogs and cats when presented with an exotic pet with a dermatologic disease.     

Emergency Presentations of the Exotic Small Mammalian Herbivore Trauma Patient

Trauma is a common complaint by owners of small exotic mammalian herbivores (e.g., rabbits, rodents) presented to veterinary hospitals. The term “trauma” is a broad disease category applied to patients with physical debilitation associated with injury often classified as “blunt,” “penetrating,” or “burn” in origin. Because many small exotic mammalian herbivores are prey animals, clinical signs of trauma may be masked until the effects of the injury outweigh the innate nature to survive. Small exotic mammalian herbivores are disproportionately sensitive to stress; thus, pain management and supportive care are extremely important during the initial stages of trauma management. Small exotic mammals differ slightly from other companion animals (e.g., dogs, cats) in regard to common trauma presentations. However, with a few therapeutic modifications (e.g., antibiotic selection, avoidance of corticosteroids, preventing self-trauma), treatment of small exotic mammalian herbivore trauma cases follows the same conventional guidelines used for other companion animals.     

Sedation and anesthesia of pet rabbits

Pet rabbits frequently become stressed when handled and may require sedation or chemical immobilization for procedures such as blood collection, IV catheter placement, radiography, deep ear cleaning, and dentistry. Common surgical procedures requiring general anesthesia include spay, castration, gastrotomy, cystotomy, and orthopedic procedures. Rabbits may be difficult to safely sedate or anesthetize. Individual rabbits may have varying sensitivity to the depressant effects of anesthetics. The apparent sensitivity of the rabbit's respiratory center to anesthetic drugs and the narrow range between anesthetic and toxic doses in this species add to the unpredictable character of rabbit anesthesia. Furthermore, mortality following anesthesia and surgery in sick rabbits is common. Strategically, safe anesthesia of rabbits must include the planning of procedures so that anesthetic time is minimized. Clinicians must be on guard for individual variation in response to drugs. Minimizing the use of cardiovascular depressant agents, use of agents with a high therapeutic index, and careful titration of doses to effect, along with thorough cardiorespiratory monitoring, will permit attainment of appropriate anesthetic depth with the widest margin of safety. This article presents several injectable and inhalant anesthetic protocols that may assist in effective management of many types of rabbit patient.     

Pain management and regional anesthesia for the dental patient

Current standards of care in veterinary medicine dictate an adequate level of pain control for our patients. Effective pain control uses a proactive, multimode approach that starts with preoperative medications, includes the anesthetic protocol selected, and continues into the postoperative period. A basic understanding of the physiology of pain assists in selecting those agents and modalities best suited for individual patients. Analgesic drug selection and local anesthesia are both integral parts of pain control when performing surgery in the oral cavity. Local (regional) anesthesia plays an important part in the pain control of oral surgical patients. Regional anesthetic techniques are used for many common oral procedures, including extractions, periodontal flap surgery, treatment of traumatic injuries of the oral cavity, tumor removal, palatal surgery, periodontal therapy, and root canal therapy. This presentation will cover strategies for analgesia and the techniques and materials used in local/regional anesthesia in the oral cavity. Anatomic landmarks and guidelines for effective regional blocks will be covered.     

Survey of Zoonotic Dermatoses in Client‐Owned Exotic Pet Mammals in Southern Italy

Several ‘exotic’ mammalian species (e.g. rabbits, rodents, ferrets and hedgehogs) live in close proximity to humans as companion pets. Skin diseases (SD) are frequent causes of morbidity in exotic pet mammals, and most of those SDs have a zoonotic potential. The purpose of this study was to determine the frequencies and types of zoonotic dermatosis (ZD) in client‐owned, exotic pet mammals in Southern Italy. Six‐hundred and fifty‐five medical records of exotic pet mammals examined between 2011 and 2012, across twenty private practice veterinary clinics around the Naples area (Italy), were retrospectively evaluated and screened for animals diagnosed with SDs (rabbits n = 455, guinea pigs n = 93, ferrets n = 64, hedgehogs n = 19, chinchillas n = 13 and rats n = 11). The records of animals diagnosed with SD, whose causative agents had a zoonotic potential, were selected for analysis. The Mann–Whitney independent test was used for statistical analysis. A P value ≤0.05 was considered statistically significant. Eighty‐two records (12.5%) of animals with ZD were identified. Of those, 56.1% (46/82) were affected by fungal infections and 42.7% (35/82) by parasitic infections. No zoonotic bacterial or viral infections were diagnosed. Dermatophytosis was significantly diagnosed more frequently in younger animals. The results of this survey indicate that exotic pet mammals may serve as active carriers for many highly contagious pathogens with zoonotic potential. Awareness and vigilance by the veterinary practitioner is crucial in the prevention of occurrences of ZDs. Children frequently come in close contact with exotic pets. To prevent the unplanned transmission of pathogen from pet to human, an active routine screening examination and preventative treatments are strongly recommended for every newly purchased pet mammal.     

Clinical Anesthesia and Analgesia in Fish

Fish have become a popular experimental model and companion animal, and are also farmed and caught for food. Thus, surgical and invasive procedures in this animal group are common, and this review will focus on the anesthesia and analgesia of fish. A variety of anesthetic agents are commonly applied to fish via immersion. Correct dosing can result in effective anesthesia for acute procedures as well as loss of consciousness for surgical interventions. Dose and anesthetic agent vary between species of fish and are further confounded by a variety of physiological parameters (e.g., body weight, physiological stress) as well as environmental conditions (e.g., water temperature). Combination anesthesia, where 2 anesthetic agents are used, has been effective for fish but is not routinely used because of a lack of experimental validation. Analgesia is a relatively underexplored issue in regards to fish medicine. However, recent studies have investigated opioid agents, nonsteroidal antiinflammatory drugs, and local anesthetics to determine their efficacy in minimizing pain and discomfort. The opioid morphine and the local anesthetic lidocaine do have significant effectiveness in reducing pain-related responses in rainbow trout (Oncorhynchus mykiss). Studies aimed at developing reliable analgesic protocols should explore a wide range of analgesic drug classes in several fish species.     

Anesthesia for the acute abdomen patient

Patients with acute abdomen often have marked physiologic and pathologic changes, making anesthesia both challenging and potentially hazardous for the patient. A thorough understanding of the pathophysiologic mechanisms of cardiovascular function under anesthesia and selection of appropriate anesthetic protocols are critical to a successful anesthetic outcome. The goal is to produce anesthesia while minimizing depression of the cardiovascular system. Monitoring and management of acid-base and cardiovascular function serve to ensure appropriate oxygen delivery to the tissues during anesthesia. Postoperative management can significantly influence patient outcome following anesthesic recovery, and must therefore be considered in the anesthetic plan. Finally, pain management in all patients is an important aspect of case management, and should not be overlooked. This article serves to educate the clinician in the above-described areas in regard to the acute abdomen patient.     

Clinical nutrition of exotic pets

SUMMARY Successful nutritional management requires knowledge of the natural history of exotic pets, nutrient contents of foods, and roles of water, calories, and nutrients in optimal health. Unestablished dietary requirements, lack of balanced commercial diets and mismanagement by owners cause nutritional problems that affect health and recovery from illness and trauma. When presented with a sick exotic pet, veterinarians should check for provision of appropriate wholesome water and food in optimal amounts. Malnutrition and dehydration are common in exotic pets and often result from mismanagement. Starvation is common in carnivores eating whole vertebrate prey, whereas specific nutrient deficiencies are more common in herbivores and insectivores. The more common nutritional deficiencies are calcium and vitamin D₃, vitamin A, thiamin, and vitamin E. When treating sick exotic pets, nutrition and fluid support may be critical to recovery.     

The Feeding of Live Food to Exotic Pets: Issues of Welfare and Ethics

Live food items are often fed to exotic pet species whether they are birds, amphibians, reptiles, or mammals. This raises issues of welfare, both of the animals fed live prey items and the prey itself. Concerns over live food welfare are particularly marked in the feeding of vertebrate prey items and evidence presented here shows the prolonged time taken for rodents to die. However, the welfare of all exotic pets relies both on providing optimal nutrition to the predator and ensuring, as much as possible, that their natural behaviours can be expressed. Does that mean that predatory species must be fed live prey? This article discusses this problem and seeks potential solutions.     

Other potentially useful new injectable anesthetic agents.

Ultrashort barbiturates are not ideal injectable anesthetic agents, and new agents continue to be released as investigators pursue the goal of finding a more ideal agent. Of the new injectable agents discussed, propofol seems to be the most promising drug. Propofol should find a place in veterinary practice as an outpatient anesthetic agent because it has a rapid, smooth, and complete recovery even after repeated or continuous administration. Midazolam does not induce anesthesia in healthy, small animals and, as such, can only be used in combination with other injectable agents, such as ketamine or the thiobarbiturates. In our practice, Telazol has found a place in the anesthetic management of feral cats and aggressive dogs, where it is used for heavy sedation or to induce anesthesia. The role of flumazenil, as a reversal agent, in veterinary practice remains to be determined; however, the role in small domestic animals is unlikely to be significant.     

Anesthesia for patients with head trauma.

Patients undergoing anesthesia soon after head trauma are at great risk for further neural damage during the anesthetic, especially if the head injury is severe or the anesthetic technique is suboptimal. Secondary complications of the anesthetic that are often lethal include hypoventilation, increases in ICP, airway obstruction, and brain-stem herniation. Anesthetic management of patients with head injury must include intravenous induction with barbiturates or narcotics, smooth endotracheal intubation, controlled ventilation with oxygen, and minimal amounts of inhalational agents. It is important to position the patient so that jugular veins are not occluded, in about 10 degrees head up position, and to avoid inducing patient coughing and straining. Recovery from anesthesia should be quiet and rapid, with the maintenance of a clear airway and the use of as little depressant medication post-operatively as possible. Oxygen should be provided.     

Anesthetic depth: the undefinable.

With many modern anesthetic drugs and combinations, the traditional signs of anesthetic depth as a continuum of increasing depression are often incorrect. The concept of "adequate anesthetic depth" is difficult to define because it depends on the end points chosen to define "adequate." Because both central nervous system excitant and depressant drugs can induce a stage of anesthesia, it is vital that those using these agents be keenly aware of the specific type of anesthetic agent or agents being used, and their effects.     

Evaluation of the use of anesthesia and analgesia in reptiles

OBJECTIVE: To determine anesthetic techniques and the drugs used to provide anesthesia and analgesia to reptiles. DESIGN: Mail-out questionnaire. SAMPLE POPULATION: 367 members of the Association of Reptile and Amphibian Veterinarians. PROCEDURE: 1,091 members listed in the 2002 directory of the Association of Reptile and Amphibian Veterinarians were asked to complete a questionnaire regarding anesthesia and analgesia. RESULTS: 367 of 1,091 (33.6%) individuals completed the questionnaire; 88.8% used inhalants (particularly isoflurane) for anesthesia, and ketamine, propofol, and butorphanol were the most commonly used injectable agents. Intubation, fluids, and having a dedicated anesthetist were most commonly used for patient support, and pulse oximetry and Doppler ultrasonography were most commonly used for monitoring. Respiratory depression, difficulty monitoring anesthetic depth, prolonged recovery, and hypothermia were the most frequent complications. Nearly all respondents believed that reptiles feel pain, but analgesics were used infrequently for many reasons. CONCLUSIONS AND CLINICAL RELEVANCE: Providing anesthesia in reptiles is difficult, especially regarding anesthetic depth and vital parameters, and methods of support are used less frequently than in domestic species. Provision of analgesia is uncommon. Research regarding pain and its assessment, response to analgesics, and drug pharmacokinetics is needed. Dissemination of this information to practitioners needs to be improved for enhancement of the standard of care for reptiles.     

Clinical Anesthesia and Analgesia in Invertebrates

Invertebrates are an expansive and diverse group of animals that have had little attention regarding anesthesia and analgesia. Economic use, environmental awareness, laboratory research, and increasing demand for invertebrates as pets has lead to a greater desire for knowledge for these animals in the veterinary medical community. With the increasing number of animal welfare regulations, various scientific studies have improved the overall knowledge of invertebrate medicine, but much more research is required to fully understand anesthesia techniques in the different species treated by veterinarians. Analgesia is a controversial and often neglected topic with invertebrates because of the common belief that invertebrates do not feel pain. Recently, the idea that invertebrates do not feel pain has been challenged with the discovery of nociceptive pathways similar to those in vertebrates. This article presents a general overview of anesthetics and analgesics used in selective invertebrate taxa.     

Surgical sterilization in small mammals. Spay and castration.

The intrinsic physiologic and anatomic differences between small exotic mammals and the species that are more familiar to veterinary practitioners (i.e., dogs and cats) are substantial. This discussion is limited to rabbits, mice and rats (murid rodents), hamsters and gerbils (cricetid rodents), and guinea pigs and chinchillas (hystricomorph rodents). In addition to their anatomic and physiologic differences, differences in behaviors, such as their reaction to stress and pain, exist. Preoperative and postoperative care, basic surgical techniques unique to these species, and useful materials are discussed.