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.     

Anesthesia and Analgesia in Rabbits and Rodents

Rabbits and rodents are popular pets and are often presented to veterinarians for evaluation and medical treatment. Anesthesia in exotic pets is required for many diagnostic and surgical procedures and is associated with a higher perioperative risk in rabbits and rodents when compared with dogs and cats. Inhalation anesthetic agents are commonly used as the sole source of anesthesia in small rodents, whereas injectable agents in combination with inhalation anesthesia are often used for rabbits and larger rodents. Analgesia is an important component of exotic pet medicine. Although it may be difficult to recognize signs of pain in companion exotic mammals, adequate pain management should always be provided. Opioid and nonsteroidal antiinflammatory drugs are the analgesic medications of choice, but others should be considered (e.g., local anesthetic agents). This article provides an update of the current literature regarding anesthesia and analgesia in rabbits and rodents.     

Preparation and equipment useful for surgery in small exotic pets.

Because many exotic pets are so small, the instrumentation and equipment used for surgery are different from in larger animals. Magnification greatly improves the surgeon's ability to accomplish surgeries in small patients and helps to provide hemostasis because small amounts of blood are significant in these tiny patients. Microsurgical instrumentation is important to allow for proper tissue handling and suture placement. Various other considerations, instrumentation, and equipment are useful when performing surgery on small exotic pets.     

Toxic exotics.

The purpose of this article is to familiarize the reader with the basic venom components, the pathophysiologic responses of envenomated dogs and cats, and some brief treatment guidelines for envenomations by various exotic "pets." Representative toxic species of reptiles, amphibians, and arthropods are included. The growing trend toward the collection of exotic animals by private owners increases the likelihood that veterinarians will face the challenge of treating an exotic envenomation.     

Common procedures in other avian species.

Although psittacine species represent the majority of avian patients seen in most exotic animal practices, nonpsittacine species such as passerines and galliformes may be presented as pets, as members of zoo collections, or as injured or ill wildlife. Many features of handling, restraint, sample collection, medicine, and surgery are similar in psittacine and nonpsittacine species. In many cases, the equipment required will be similar as well, with a few modifications.     

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.     

An overview of restraint and blood collection techniques in exotic pet practice

As more data about blood test results become available, blood sampling becomes increasingly important as a diagnostic tool. The increased availability of biochemistry analyzers that sample small volumes of blood has made it possible to get diagnostic profiles and hematology results from pets that have only small volumes of blood to contribute. This article describes techniques for restraint, phlebotomy, and sample preparation of several of the more popular exotic animals in the pet trade. The species covered include birds, lizards, chelonians, snakes, frogs, salamanders, fish, rabbits, ferrets, guinea pigs, mice, rats, hamsters, gerbils, hedgehogs, sugar gliders, and giant spiders (tarantulas).     

Common laboratory artifacts caused by inappropriate sample collection and transport: how to get the most out of a sample

Clinicians are frequently presented with laboratory test results that are not consistent with preconceived expectations for a given case. One important reason for such results is the occurrence of preanalytical errors. In this article preanalytical errors are discussed in 2 parts. The first part covers the steps of sample collection, preparation, and transportation, in which preanalytical errors often occur. This part would be most useful if read in full before collecting a sample. The second part of this article includes a systematic review of preanalytical errors divided according to individual analytes or parameters or, when appropriate, groups of analytes and parameters that represent the same biological system. This part will hopefully serve the clinician as a quick and user friendly guide for identification of possible pitfalls when presented with unexpected laboratory test results for a given case. This article is limited to errors that can affect the complete blood count, chemistry, and coagulation panels.     

Clinical hematology of rodent species

Pet rodents, such as rats, guinea pigs, and chinchillas, differ from more traditional companion animal species in many aspects of their hematologic parameters. Animals within this order have much diversity in size, anatomy, methods of restraint, and blood collection technique. Appropriate sample collection is often the most challenging aspect of the diagnostic protocol, and inappropriate restraint may cause a stress response that interferes with blood test results. For many of these patients, sedation is required and can also affect results as well. In most cases, however, obtaining a standard database is necessary and very possible when providing medical care for this popular group of pets.     

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.     

ASAS Centennial Paper: The future of teaching and research in companion animal biology in departments of animal sciences

Departments of animal sciences must be relevant to a society in which a small number of people can raise almost all the food animal products needed. The declining number of people involved in animal agriculture has decreased enrollment of students interested in food animals in many departments of animal science. However, several departments welcomed students from a diverse background and began research on animals other than food animals. In many states, the undergraduate enrollment is made up primarily of students interested only in companion animals. A benefit of this is that we have recruited new students into animal agriculture and they have gone on to excellent careers. We have a new challenge now: how to maintain and expand the efforts in teaching, research, and outreach of companion animal science. Departments wishing to expand in teaching have examples of successful courses and curricula from other departments. Some departments have expanded their teaching efforts across their own university to teach about pets to a wider audience than their own majors; other departments can follow. In research, a small number of faculty have been able to establish extramurally funded projects on pets, including horses. But it will be difficult for more than a handful of departments to have a serious research effort in dogs, cats, birds, fish, or exotic animals. Departments will have to make a concerted effort to invest in such endeavors; joint ventures with other universities and colleges of veterinary medicine (or medicine) will probably be required. Funding sources for "traditional" efforts in nutrition, reproduction, and physiology are small and inconsistent; however, with the progress of the equine, canine, and feline genome projects, there should be opportunities from federal funding sources aimed at using animal models for human health. In addition, efforts in animal behavior and welfare can be expanded, perhaps with some funding from private foundations or animal-supportive organizations.     

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.     

Promoting the exotic pet practice.

The marketing and promotion of an exotic pet veterinary practice allows the use of strategies that are not necessarily available in other veterinary disciplines. The advantage that an exotics practice enjoys is that it is able to capitalize not only on the unique nature of the species being attended but also on the specialized features of the hospital itself that make it specifically appropriate in caring for exotic pets. Before marketing, however, comes the responsibility that the practice live up to the claims made in promotional materials. A practice cannot ethically be presented as an "exotics" practice if it is nothing more than a dog and cat facility that is willing to attend to exotic pets. It is the competence of the veterinary staff and the appropriateness of the facility that determines the suitability of the practice for exotics management.     

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.     

Emergency and Critical Care Procedures in Sugar Gliders (Petaurus breviceps), African Hedgehogs (Atelerix albiventris), and Prairie Dogs (Cynomys spp).

Less common exotic pet mammals are gaining in popularity. The Australian Sugar Glider, African Hedgehog, and prairie dog are seen regularly in exotic animal practices. They are subject to the same types of medical emergencies as more traditional pets, with the unfortunate addition of all too common underlying nutritional and husbandry-related disorders. Emergency stabilization and critical care are important first steps before collection of diagnostic test samples and administration of definitive medical care.     

Principles of neurological imaging of exotic animal species.

Because the central nervous system (CNS) is encased almost entirely in bone, the means by which the clinician can evaluate it are limited. Additionally, the small size of many exotic companion animals further complicates diagnostic evaluation of the brain and spinal cord. Knowledge of the advantages and limitations of different imaging modalities, along with the neuroanatomical localization and assessment of likely causes of disease, will permit the clinician to choose the most appropriate imaging method for the patient. This article discusses the basic imaging principles of radiology, myelography, CT, and MRI of the nervous system of companion exotic animals to aid exotic animal clinicians in selecting imaging modalities and interpreting the results.     

Adjuvant chemotherapy for sarcomas and carcinomas

The use of adjuvant chemotherapy appears to offer many advantages to the patient with cancer. However, objective information is difficult to compile. Clinical trials all too often have only a small number of patients. In order to best demonstrate the usefulness of adjuvant chemotherapy, many of the cases discussed here had bulky disease. Based on the known principles of chemotherapy, animals with minimal residual disease following surgery would most likely benefit from adjuvant chemotherapy. By using the principles discussed at the beginning of this article and information from clinical trials, veterinarians will better be able to inform clients of possible benefits and risks in treating their pets with chemotherapy.     

Suture Materials and Suture Selection for Use in Exotic Pet Surgical Procedures

Exotic animals are becoming increasingly popular and more exotic pet owners are seeking veterinary care. This has led to a demand for properly trained veterinarians who are capable of providing quality, up-to-date medical and surgical treatments. Many surgeries are now performed on exotic pets, and selection of the appropriate suture material is an important part of the treatment protocol. An understanding of different available suture materials, healing times of different tissues, and knowledge of different anatomic and physiologic characteristics in different species is important in the selection of the most appropriate suture material. This review will summarize important aspects of suture selection in exotic animals.     

Cytology in food animal practice.

Diagnostic cytology can greatly aid the clinician in determining a more refined diagnosis, prognosis, and treatment plan to serve the client and patient better. Sample collection is not difficult and can be done in the field as well as in a hospital setting. The collection and sample handling procedures described in this article can help the clinician to obtain diagnostically valuable samples. In many cases, preliminary cytologic evaluation can be performed by the general practitioner. Additional diagnostic evaluation and interpretation are readily available from trained pathologists at diagnostic laboratories.     

Increasing efficiency and profitability of the exotic pet practice.

Recent surveys indicate the percentage of households owning exotic pets has increased dramatically. Practitioners interested in the development of an exotic animal practice can take advantage of the increased popularity of these pets and apply proven meth-ods that have benefited traditional companion animal practices.This article examines exotic animal practice in light of these changes and tries to determine ways to increase efficiency and profitability as they relate to this unique practice situation.