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.     

Emergency Presentations of Exotic Mammal Herbivores

Companion exotic mammal herbivores may be diagnosed with chronic disease that the owner believes is causing acute clinical illness. It is generally believed that because of the enhanced disease-masking ability of these “prey” species, numerous disease states may go unnoticed for a significant period. A veterinarian should be knowledgeable about this behavior trait and consider its possible effects when assessing the patient's health status. In some cases, the chronic disease condition may respond rapidly to treatment, whereas with other diagnoses, treatment is more frustrating. This article describes a selection of chronic disease conditions that one may diagnose in guinea pigs (e.g., hypovitaminosis C, trixacariasis, urolithiasis, dental disease), chinchillas (e.g., dental disease), and rabbits (e.g., dental disease, renal failure, cranial thoracic mass disease). Gastrointestinal and cardiovascular disease problems diagnosed in companion exotic mammal herbivores are covered elsewhere in this journal issue.     

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.     

Critical Care of the Exotic Companion Mammal (With a Focus on Herbivorous Species): The First Twenty-Four Hours

The number of pet herbivorous exotic mammals is increasing, and their owners are demanding quality medical care. Successful treatment of the critical herbivorous exotic mammal patient is complicated by small patient size, physiological diversity, and a lack of research and clinical data regarding therapeutic response to disease conditions. Despite these impediments, the same principles and techniques used in other domestic animals, such as dogs and cats, can be applied to the herbivorous exotic mammal patient.     

Future directions in training of veterinarians for small exotic mammal medicine: expectations, potential, opportunities, and mandates

Small exotic mammals have been companions to people for almost as long as dogs and cats have been. The challenge for veterinary medicine today is to decipher the tea leaves and determine whether small mammals are fad or transient pets or whether they will still be popular in 20 years. This article focuses on pet small-mammal medicine, as the concerns of the laboratory animal are better known and may differ profoundly from those of a pet. Dozens of species of small exotic mammals are kept as pets. These pet small-mammal species have historically served human purposes other than companionship: for hunting, for their pelts, or for meat. Now, they are common pets. At present, most veterinary schools lack courses in the medical care of these animals. Veterinary students need at least one required class to introduce them to these pets. Currently, there are no small-mammal-only residency programs. This does not correspond with current needs. The only way to judge current needs is by assessing what employers are looking for. In a recent JAVMA classified section, almost 30% of small-animal practices in suburban/urban areas were hiring veterinarians with knowledge of exotic pets. All veterinarians must recognize that pet exotic small mammals have changed the landscape of small-animal medicine. It is a reality that, today, many small-animal practices see pet exotic small mammals on a daily basis.     

Digestive strategies of small hindgut fermenters

Small mammalian herbivores have a limitation in their supply system of nutrients to their energy and protein demands because they need much more energy and protein per unit body mass than larger herbivorous animals. Therefore, small herbivores need to have characteristic strategies in their digestive systems to overcome the limitation of their small body mass compared with larger animals. Although small herbivorous mammals commonly have an enlarged cecum, the pattern of flow and mixing of digesta in the large intestine varies among them. Distinct separation of the larger fiber particles from smaller and liquid contents which are retained in the cecum can be recognized in some species. Coprophagy, practiced by many small herbivores, has nutritional significance providing a source of vitamins, amino acids, and other nutrients which are excreted with feces. Among coprophagous mammals, several species produce two types of feces: soft feces, which are eaten; and hard, which are not eaten. Soft feces contain more water than hard feces and dry matter includes more protein and less fiber. Coprophagic behavior must be supported by the colonic separation mechanism, which operates retrograde transport of fluid and fine particle digesta or bacteria trapped in the mucus, resulting in high density bacteria in the cecum contents, which is successively consumed as cecotroph. These mechanisms must be necessary for small herbivores to survive on the feed in their habitat.     

Evidence-based Medicine in Small Mammals

Evidence-based medicine in small exotic mammals is often considered challenging because of a lack of information related to reference data, validated diagnostic tests, treatment outcome, side effects, long-term prognosis, and financial constraints of the owner. However, despite this lack of information, it is still possible to provide good medical care to small exotic mammals and confirm a disease diagnosis that can be properly treated. With many small exotic mammal cases, the condition of the animal and, ultimately, the disease diagnosis, may not be familiar to the attending veterinarian, and in some cases the disease itself may not have ever been described in that species in the scientific literature. This article describes the process of diagnosing hyperthyroidism in a guinea pig using a recommended patient assessment, diagnostic, and treatment protocol.     

Nonreproductive surgery in small mammals.

The sophistication of soft-tissue surgery techniques in small mammals is increasing rapidly. Exotic animal practitioners must be familiar with the diseases, conditions, and anatomic variations of each small-mammal species. The small size of these patients should not preclude the use of technologic advances available for other small animals. Despite these challenges, successful resolution of surgical problems in small exotic mammals is not only possible but also should be the expected result of veterinarians' efforts in such cases.     

Vitamin D and Ultraviolet B Radiation Considerations for Exotic Pets

Vitamin D is an essential hormone that regulates many different functions in vertebrates and can have a protective effect against various disease conditions. Providing exotic pets appropriate access to vitamin D, through the diet, ultraviolet B (UVB) exposure, or a combination of both, is important for veterinarians and exotic pet owners to consider. Although it is commonly thought that most animals derive the vitamin D they need through their diet, there are a number of species that appear to benefit more from UVB exposure. In addition, there has been minimal study to investigate appropriate dietary levels of vitamin D for many of our exotic pets. Although the recommendation of providing UVB lighting has been primarily limited to captive reptiles, research with other species (e.g., birds and small mammals) suggests that these animals may also benefit from this type of lighting. However, the provision of UVB is not without its potential side effects. The purpose of this article is to review the important roles of vitamin D in animals, the different methods animals use to acquire this hormone, the potential clinical signs associated with hypovitaminosis or hypervitaminosis D, the role of artificial UVB lighting in the synthesis of vitamin D, and the potential side effects associated with UVB radiation.     

Gastrointestinal Disease in Exotic Small Mammals

Exotic small mammal medicine is a relatively new specialty area within veterinary medicine. Ferrets, rabbits, and rodents have long been used as animal models in human medical research investigations, resulting in a body of basic anatomic and physiologic information that can be used by veterinarians treating these species. Unfortunately, there is a paucity of veterinary articles that describe clinical presentation, diagnosis, and treatment options of gastrointestinal (GI) disease as it affects exotic small mammals. Although there is little reference material relating to exotic small mammal GI disease, patients are commonly presented to veterinary hospitals with digestive tract disorders. This article provides the latest information available for GI disease in ferrets (Helicobacter mustelae gastritis, inflammatory bowel disease [IBD], GI lymphoma, systemic coronavirus, coccidiosis, and liver disease), rabbits (GI motility disorders, liver lobe torsion, astrovirus, and coccidiosis), guinea pigs (gastric dilatation volvulus [GDV]), rats (Taenia taeniaeformis), and hamsters (Clostridium difficile). Both noninfectious diseases and emerging infectious diseases are reviewed as well as the most up-to-date diagnostics and treatment options.     

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.     

Exotic mammal renal disease: causes and clinical presentation.

Renal disease is not uncommon in exotic mammals, with degenerative,infectious (bacterial, viral, parasitic), metabolic, nutritional,neoplastic, anatomic, and toxic causes all represented. This article discusses the clinical presentation for the various renal diseases affecting exotic mammals. Anatomic pathology at the gross and microscopic level is reviewed, as is disease pathophysiology unique to the species under discussion.     

Advances in Exotic Mammal Clinical Therapeutics

It is imperative that the veterinarian treating exotic companion mammals stay abreast of the latest developments relating to medications and drug delivery approaches for safety and efficacy. Sustained-release formulations of commonly used drugs, as well as newer routes for administration of therapeutic agents, allow the veterinarian treating exotic companion mammals to reduce the stress associated with drug administration. Interactions can occur between vehicle and drugs when formulations are compounded; therefore, research studies are warranted regarding potential problems associated with these formulations. However, newer studies have been published that provide the basis for exploring the use of different vehicles, frequency of dosing, and drug delivery techniques for various classes of drugs in exotic mammals. The goals of this review are to not only evaluate new medications or uses for medications in companion exotic mammal patients but also review new methods of drug delivery that might be useful to the veterinarian who treats these animals.     

Analgesia of small mammals.

Small mammals receive analgesics much less frequently than more familiar species such as dogs and cats. This is probably related to the greater difficulty of recognizing pain in these species, and the uncertainty as to the most appropriate analgesic regimen to implement when the presence of pain is suspected. However, the same principles of pain assessment and analgesic use that are applied when dealing with other companion animals can be used to manage pain effectively in small mammals. All of the commonly used analgesic agents can be used safely and effectively in small mammals, although the size of many of these animals limits the use of techniques such as epidural administration or transdermal drug delivery systems. As with other species, it is important to integrate an analgesic regimen with the overall scheme of perioperative care, and to try to implement preemptive and multi-modal analgesic therapy.     

Equipping the exotic mammal practice.

Many tools used in small animal practice can be adapted for use with exotic mammals. For those veterinarians with a strong interest in exotic mammals, specific equipment and supply needs need to be taken under consideration. Initial investment need not be great to get started with special species, and as the practice develops more specialized equipment can be added. Starting with equipment that aids in patient husbandry, diagnostic sampling, and routine hospital medical and surgical care is very helpful in creating confidence and expertise with these species. As the practice case load grows more sophisticated, equipment can be added, allowing for better diagnostic workups, medical treatment, and surgical care. The right equipment for the right job makes for a more rewarding and efficient exotic mammal practice. The author describes equipment and products (Table 1) he routinely uses in his private practice, and has provided a list of available sources. Readers should keep in mind that this list is not all-inclusive, and that in many instances products discussed can be found from multiple veterinary distributors or vendors. The author does not promote or recommend one supplier or manufacturer over another.     

Critical care monitoring.

Critical care monitoring in exotic practice is limited by the small size and the physiologic diversity of many patients. However, many of the principles applied to humans and other mammals can be extrapolated to monitoring in exotic animals. Advances in the monitoring of human patients offer the potential for more practical, low-cost monitoring in critical exotic patients in the future.     

Transfusion medicine in exotic pets

The decision to transfuse a patient should always be based on the packed cell volume and clinical status of the patient. This article discusses indications for transfusion and blood substitutes in exotic animal patients. The administration of blood products requires careful donor selection, knowledge of blood groups, cross-matching, and use of anticoagulants. Collection sites, volume, and administration techniques are given for different species of animals including birds, rabbits, and ferrets. Blood-transfusion therapy is not without risk. The frequency with which transfusion reactions occur in exotic pets is unknown. The most common transfusion reactions seen in small animals, along with suggested treatment, are discussed. The availability of blood products is limited in exotic pet medicine; therefore, the use of blood substitutes (Oxyglobin) has the advantage of long storage potential, no need for cross-matching, and no potential for disease transmission. General principles of blood substitutes and administration techniques will be discussed.     

Small mammal critical care.

In emergency situations, veterinarians often are presented with critical patients of any species. The principles for critical care in traditional species such as the dog or cat can be applied to other small mammals. Although there are many unique aspects of the anatomy and physiology of different species, emergency care of small mammals can be instituted with the adaptation of products found in many general practices. Careful assessment of the patient, prioritization of the injuries, and rapid intervention can be life saving in any species.     

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.     

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.