Exotic emergencies for general practitioners

Is treating emergencies in exotic species outside your comfort zone? If so, you are not alone. Many small animal general practitioners can be hesitant to see these cases due to exotic species’ unique physiology, the limited exposure to exotic species medicine in veterinary school, and higher mortality rates than in cats and dogs, even with veterinary treatment.

I asked Kristen Turner, DVM, founder of The Exotic Vet Consultant, to provide practical advice and shed some light on the many resources available for general practitioners who want to be better prepared to treat emergencies in exotic species.

Turner has been treating exotic species alongside dogs and cats for over 10 years, with about 65% of her caseload being exotic species, under an ABVP diplomate in exotic companion mammals. She recently founded The Exotic Vet Consultant to provide consultation services to other veterinarians who wish to treat exotic patients, and she plans to seek ABVP certification herself.

“The exotic pet population is growing exponentially in the US,” Turner said, which includes rabbits, guinea pigs, bearded dragons, birds, and other species. In some cases, owners of exotic pets may have access to a practice that either specializes in exotics or at least sees them regularly. In other cases, however, clients may not have many options near them and may turn to their local general practitioner for assistance.

To help veterinary professionals feel more comfortable treating these emergency cases when they do come in, Turner has assembled some pearls of wisdom. She said, “I think the main mistake is failing to slow down and provide stabilization before proceeding with a full physical exam, diagnostics, and treatments.”

She has summarized some of the most common emergent cases by species type to guide initial triage and stabilization.

Small mammals

These species most commonly present with lethargy and/or inappetence. Turner stresses that with such vague signs, the history becomes extremely important. This should include a thorough assessment of diet.

“When triaging these patients, it is important to first do a quick visual assessment and obtain vitals,” Turner said.

Important abnormalities to treat include:

• Hypothermia (with heat support)
• Stress (with an intramuscular anxiolytic such as midazolam)
• Pain (with an opioid, for example)

Reptiles and amphibians

Turner said these species have few true emergencies, since they typically decline slowly over a long period of time. Exceptions to that can include hemorrhage and tissue prolapse.

In general, important steps to stabilize sick reptiles and amphibians include:

• Minimizing stress
• Providing heat support and an appropriate thermal gradient
• Providing fluid support

Birds

Turner reports that birds often present in respiratory distress and/or with evidence of trauma. Just as with small mammals, she recommends heat support, anxiolytic medication, and pain control before completing a physical exam. (See my recent article on avian emergencies.)

Other tips for treating exotics in general practice

• While heat support is often appropriate, chinchillas can overheat easily. They must be monitored closely if heat support is used.
• Exotic species tend to be very steroid sensitive. This doesn’t mean that steroids are never used, but only in specific circumstances.
• Certain antibiotics must be avoided in rabbits and rodents. Turner uses the acronym PLACE (penicillins, lincosamides, amoxicillin, cephalosporins, and erythromycin) to remember which ones to avoid.
• There are three books that she recommends having on hand for reference when treating exotic species:
  • Clinical Veterinary Advisor: Birds and Exotic Pets
  • Exotic Animal Emergency and Critical Care Medicine
  • Carpenter’s Exotic Animal Formulary

Turner is also available for consultations with veterinarians, where she can provide more specific recommendations and make exotics medicine less daunting for those who practice it.

“I know being a veterinarian is tough, and the goal of my practice is to make your life a little easier,” Turner said.

“Just because something was hard for previous generations doesn’t mean it needs to be hard for you.”

Further reading

LafeberVet online resource for articles, information sheets, and webinars on many different topics.
https://lafeber.com/vet/

Oxbow Vet Connect for dosage charts for their critical care products, online product ordering, and an extensive video library covering a variety of exotic companion mammal topics.
https://oxbowanimalhealth.com/vet-connect/

Reptifiles.com, a great resource to learn more about different species husbandry/diet needs.
https://reptifiles.com

The Exotic Vet Consultant website for literature reviews, recommended resources, tips/tricks and practice pearls, and consultation services.
http://www.theexoticvetconsultant.com/

 

Emily Singler, VMD, is a 2001 graduate of Penn State University and a 2005 graduate of University of Pennsylvania School of Veterinary Medicine. Her career in veterinary medicine has included experience in shelter medicine, private practice, and as a relief veterinarian. She currently works as a veterinary writer, consultant, and mentor and enjoys writing for both pet owners and veterinary professionals. Her writing interests include public health, preventive medicine, the human-animal bond, and life as a working mom. She is the author of Pregnancy and Postpartum Considerations for the Veterinary Team, which is out now and available at www.emilysinglervmd.com.

Photo credit: © Light Field Studios E+ via Getty Images Plus 

Disclaimer: The views expressed, and topics discussed, in any NEWStat column or article are intended to inform, educate, or entertain, and do not represent an official position by the American Animal Hospital Association (AAHA) or its Board of Directors.