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Angela M. Lennox, DVM, DABVP (Avian), SPECIAL ECM, ECZM (Small ) FEATURE Avian and Exotic Animal Clinic Indianapolis, Indiana Adding Exotic Companion Mammal Care to the Practice

Birds, small , and are growing in popularity as , with mammals such as , , and representing the largest nontraditional group typically presented for veterinary care.1

November/December 2015 Veterinary Team Brief 31 SPECIAL FEATURE

Specialty designation is now available actually are suitable as pets and under more than a dozen practices dedicated for interested practitioners by the what circumstances. A consensus on exclusively to exotic medicine. American Board of Veterinary Practi- exotic companion mammal (ECM) was tioners’ Exotic Companion Mammal finally reached by the organizing Veterinary practices must commit specialty (ABVP-ECM), the Euro- committee assembled by the Associa- time and resources (eg, continuing pean College of Zoological Medicine’s tion of Exotic Mammal Veterinari- education [CE], in-house training, Small Mammal specialty (ECZM- ans (AEMV) for the formation of the specialized equipment) to care for Small Mammals), and the American ABVP specialty. these patients, and practitioners must College of Zoological Medicine’s be willing to consult with experts or combined Zoological Companion Special Practices refer cases that are outside their indi- Animal Medicine (ACZM-ZCAM) and Practitioners vidual comfort levels. specialty, which covers mammals, Regardless of designation, the demand , reptiles, , and . for high-level care for ECMs has been CE is critical for the veterinary team growing, leading to an increase in to develop and maintain skills for A by Any Other Name? exotic mammal specialists and prac- ECM medicine. Many CE opportu- Determining an ideal official name tices dedicated to treating these pets nities are available from groups such for this group of animals has been a over the past 20 years. The ABVP- as the AEMV and local veterinary subject of debate. The commonly used ECM specialty was created in 2010, associations and colleges, and at term officially adopted by the ABVP and there are currently 21 board- national conferences. is exotic, but some animals, such as the certified specialists worldwide2 and domestic , are not particularly exotic in the strict sense of the word. The European college adopted the Table 1. Specialty and Exotic Animals: 3 term small mammal; however, because Numbers per Household and Population rabbits are often no smaller than Households (in 1,000) Population (in 1,000) or even some dogs, this title is also not completely accurate. A third term, Fish 7,738 57,750 zoological companion animal is also Ferrets 334 748 problematic because some species are Rabbits 1,408 3,210 not intuitively associated with the tra- 877 1,146 ditional understanding of a zoo set- Guinea pigs 847 1,362 ting; the term was originally defined as referring to zoological medicine Gerbils 234 468 and not zoo animals only, but it is Other rodents 391 868 frequently misinterpreted. Zoological 1,320 2,297 companion also suggests less-than-ideal 555 1,150 situations, such as pet or 725 1,119 large , which the 3 specialty Other reptiles 365 732 groups do not encourage. Poultry 1,020 12,591

The problem is compounded by debate Livestock 661 5,045 on exactly which species of mammals Other 246 898

32 veterinaryteambrief.com November/December 2015 PEER REVIEWED

Special Pets & Owners serving ECMs can be found in the tra- supplies that may not be found in a The 2012 American Veterinary Med- ditional, well-equipped practice. Other typical small animal practice. ical Association (AVMA) Pet Own- specialized equipment can be easily ership sourcebook lists rabbits as the modified from existing equipment or Examine With Care most common exotic companion purchased from veterinary suppliers. The examination room should be mammal, followed by hamsters, See Table 2 for useful equipment and quiet, with no cracks, crevices, or guinea pigs, and ferrets,3 all which have been domesticated for many Table 2. Specialized Equipment Useful for ECM Practices years and generally make excellent pets. The sourcebook also cites pet Location in Practice Equipment/Supplies fish as the most commonly owned Front office/ • A special area away from barking dogs and the sights exotic animal, followed by rabbits, reception area and smells of predators, if possible turtles, and poultry (see Table 1).3 • Various safe enclosures (eg, cardboard carriers) for patients not safely caged Some exotic pets are growing in popu- Examination room • Towels of various sizes • A gram scale larity (eg, sugar gliders, ), • Containers or platforms to weigh patients in comfort while others (eg, ferrets) have been doc- • Small otoscopic cones umented as decreasing.4 Clients occa- • Pediatric or neonatal stethoscopes • Human fingernail and toenail clippers sionally present other more unusual mammals, such as various fox species, Treatment room • Smaller needles and syringes (eg, 27G, 1 mL) • Insulin syringes exotic cats, and exotic hybrids. • Smaller catheters (eg, 24G, 26G ) • Syringe pumps Some states allow ownership of native Surgery • Microsurgical instruments wildlife, and although some species • Small noncuffed endotracheal tubes (eg, 2.0 and higher) • Small hemostatic clips make suitable pets others typically do • Transparent drapes not. Animals should be evaluated • Atraumatic towel clamps individually for their quality as a pet; • An ultrasonic Doppler for surgical monitoring for example, in the author’s experience, • A combination monitor that can detect very rapid heart rates (up to 300 bpm) almost never make suitable • Specialized equipment for rabbit and dentistry pets, but opossums have few objection- • Safe warming pads or other devices able behaviors in the captive setting. • Smaller diameter thermometers or temperature probes Hospital • Small animal incubators Exotic pet ownership regulations • Small plastic animal containers with secure lids • Specialized food for commonly encountered patients vary widely from state to state and • Hand-feeding and recovery syringe-feeding formulas for can change frequently. Practitioners herbivores, , and carnivores should also be aware that some prac- • Small feeding-tip syringes in a variety of sizes tice liability policies may not cover Resources • An updated version of an exotic animal formulary5 actions involving illegally kept ani- • At least 2 ECM textbooks published within 5 years • Membership in the Association of Exotic Mammal Veter- mals presented for treatment. inarians (aemv.org), which includes a subscription to the Journal of Exotic Pet Medicine and access to confer- Specialized Equipment ence proceedings and a forum Most equipment required for a practice • Contact information for the nearest specialist (abvp.com)

November/December 2015 Veterinary Team Brief 33 SPECIAL FEATURE

Table 3. Commonly Encountered ECMs and Their Illnesses*

Species Condition Comments

Rabbits Rabbit Gastrointestinal Syndrome Not generally a primary condition but often secondary to other underlying (RGIS) disorders Acquired Dental Disease (ADD) Requires a full workup, including radiographs and possibly CT, for accurate diagnosis Respiratory disease Can be upper or lower; multiple organisms can be implicated Uterine neoplasia Commonly seen in intact female rabbits Ectoparasites Most commonly Cheyletiella (ie, walking dandruff) Encephalitozoon cuniculi Varied manifestations (eg, neurologic signs, renal diseases, cataracts) Traumatic spinal injury Caused by jumping and sudden twisting in sedentary animals; can occur during restraint for handling and examination Guinea pigs Respiratory disease Can be upper or lower; pneumonia can be difficult to treat Ovarian cystic disease Can present with alopecia, but often only with weight loss and lethargy Traumatic injuries Limb and incisor fractures are most common Mites (Trixacarus caviae) May cause seizure-like activity Dermatophytosis Often is nonpruritic

Rats Mammary neoplasia Incidence is greatly decreased in females with early ovariectomy Respiratory disease Usually is a complex of bacterial and other organisms and difficult to eradicate Subcutaneous abscesses Most commonly seen in hairless rats or rats housed with companions

Ferrets Adrenocortical diseases (ACD) Often presents as symmetrical alopecia; vulvar enlargement is common in females Insulinoma Often presents as hindlimb weakness Lymphoma Multiple forms and locations have been reported Chronic GI disease Most commonly presents as inflammatory bowel disease, with underlying infection the likely origin GI foreign body Rubber objects are most common, with a higher incidence seen in younger animals

Hedgehogs Neoplasia Neoplasms of all types and affecting many tissues are very common Sugar gliders Nutrition-related diseases Obesity and hypocalcemia are most common

*Seen in the author’s practices furniture in case the small patient will not return if he or she witnesses from the sights and sounds of other escapes and tries to hide. Team inexperienced or uncertain restraint patients (eg, cats, dogs). This can be members must learn handling tech- and handling. All equipment should difficult, so some practices usher niques for each species and feel be ready and accessible to allow for a potentially stressed exotic pets directly comfortable and competent before quick, efficient examination that into a consultation room. A variety of approaching an exotic pet. This is reduces patient stress. caging that can accommodate patients important for their own safety and as small as a or as large as a 3-kg the patient’s safety, and to instill Prepare the Practice rabbit is now available. Smaller patients confidence in the client, who likely The practice should be quiet and free can be housed in small, secure plastic

34 veterinaryteambrief.com November/December 2015 PEER REVIEWED

containers with lids that are partially in textbooks and professional jour- Editor’s note: Dr. Angela M. Lennox, a graduate of Purdue University, has practiced exotic animal medi- positioned on warming devices when nals (eg, Journal of Exotic Pet Medi- cine exclusively for more than 20 years, frequently lec- necessary, with monitoring to prevent cine, Journal of the American Veterinary tures nationally and internationally, and has authored exotic animal medicine books and book chapters. overheating. Large rabbits can be kept Medicine Association) that publish in cages suitable for small to medium- articles related to ECMs. References sized dogs. Small mammal incubators 1. Non-traditional pets. Animal Welfare Information Center. USDA National Agriculture Library. https:// or critical care units are ideal for circu- Conclusion awic.nal.usda.gov/companion-animals/pet-species/ lating warmth and delivering oxygen. ECM medicine can be an interesting non-traditional-pets. Accessed August 2015. 2. Find an ABVP Specialist. American Board of Keep ECMs on clean, light-colored and rewarding addition to a tradi- Veterinary Practitioners. http://www.abvp.com. Accessed August 2015. towels to help identify the quantity tional practice. The addition requires 3. 2012 U.S. Pet Ownership and Demographic and character of urine and feces. significant investment in team train- Sourcebook. American Veterinary Medical Associa- tion. https://www.avma.org/kb/resources/ ing and CE and should not be taken statistics/pages/market-research-statistics-us- See Table 3 for some of the com- lightly, but the increasing knowledge pet-ownership-demographics-sourcebook.aspx. Accessed August 2015. monly encountered ECM illnesses. about standards of care, access to 4. 2007 U.S. Pet Ownership and Demographic experts and specialists, and quality of Sourcebook. American Veterinary Medical Association. https://www.avma.org/kb/resources/ Improvements in Care available resources make it an attain- statistics/pages/market-research-statistics-us-pet- Improvements in the quality of ECM able goal. ownership.aspx. Accessed August 2015. 5. Carpenter JW. Exotic Animal Formulary. 4th ed. medicine are reflected in the increase St. Louis, MO: Elsevier Saunders; 2013.

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