What is the major challenge for treating exotic species?
They are pretty much all prey species so will ask clinical signs of illness until they are VERY unwell. So by the time we see them in veterinary practise, they are usually pretty poorly!
What are small animals more susceptible to than dogs and cats?
Stress - will rapidly affect respiration and recovery
Hypothermia - due to increased surface area ratio and fast metabolic rate
Hypocalcaemia - due to fast metabolic rate
Quickly deteriorate if dehydrated, anorexic, hypothermic or ill
What can happen to reptiles when recovering? What do we need to do to combat this?
Very susceptible to stress. Can become hypometabolic which slows recovery. Don’t want recovery to slow down so need to keep stress levels down and metabolic rate up.
What should be considered when housing ectotherms in hospital?
Require a temperature gradient - correct environmental temperature for specific species.
When should feeding interventions occur if a small animal is not eating? Why?
Give nutritional support and appetite stimulants if anorexic for more than 12 hours. To prevent gut stasis.
Small animals are already prone to hypocalcaemia!
When do reptiles require nutritional support?
When the lose 10% of their body weight (even if eaten yesterday!) Ask owner for feeding records.
When are tortoises prone to anorexia? What should we do?
Post-hibernation. May need a ‘kick-start’ when they come out of hibernation. This will require warming and nutritional support (may include a tube feed).
What must an exotic be before nutritional support is given? Why?
Warm and hydrated. If they are cold, they will in a hypometabolic state and be unable to digest food.
What nutritional support can be given and in what order should these methods be tried?
1st - tempt diet (ask owner what patient loves!)
2nd - Syringe feed liquid diet.
3rd - tube feed (if none of the above work or in need of a long-term solution)
Name a syringe feed diet that can be used
Emeraid Intensive Care - has ‘herbivore’, ‘ carnivore’ and ‘omnivore’
Critical Care
What should you do when syringe feeding an exotic?
Take it slow and ensure the animal is swallowing itself.
Wrap the animal up in a nice warm blanket - esp rabbits
Can use mouth gags to keep a reptile mouth open
Name and describe the 4 tube types
- Stomach tube
- good for short-term ‘kick-starting’ - Naso-oesophageal (NO) tube
- good for shorter-term
- tubes are narrow and can be prone to blockage - Oesophagostomy tube
- better for longer term
- easily put in under GA - PEG tube
- same as 3.
What must be taken care with regarding a NO tube?
In obligate nose-breathers, care they still have a clear airway.
Why do we gradually re-feed?
To prevent Hepatic Lipidosis (Rapid conversion of fats affects the function of the liver).
What should we do when providing nutritional support to small animals that haven’t been eating in a few days?
Gradual re-feeding.
Small animals should be re-fed over even longer periods than dogs and cats e.g. over 5/6 days instead of 3
What nutritional support should be given to herbivores
Syringe/tube feed etc
AND
provide indigestible fibres to stimulate gut motility
e.g. Alfafa Hay (good for recovery), grass, dandelion leaves etc.
Why should herbivores be fed indigestible fibres as well as the digestible ones in the syringe feed?
The digestible fibres are smooth to pass through a tube so cannot contain the indigestible chunks, but they must be provided as they are very important for the gut lining.
What should be done initially for exotics to maintain hydration?
Provide a bowl of water
Provide a water bottle
Provide a bathing dish if applicable
Ensure the humidity levels are correct for exotics
What are the 6 possible signs of dehydration?
- Fluffed up (especially in birds)
2.Tacky Mucous Membranes
(may be easier to look for stringy saliva on tongue in reptiles) - Sunken Eyes
- Skin tenting
- Hard abdomen (e.g. in rabbits, abdomen would be harder if gut stasis was occurring)
- Dysecdysis in reptiles (patchy shed)
What is the golden rule for maintaining good nutrition and hydration?
If the gut works, use it!
In reptiles what non-invasive methods can be used to maintain hydration?
Bathing retiles in warm water for short periods a few times per day can help shed (warm water helps avoid hypometabolic state).
(Reptiles can absorb water internally through cloaca and externally through skin).
Spraying reptile, viv, plants in the viv with water to increase humidity.
Describe IV fluid therapy in exotics regarding placement of catheter
Can use cephalic and saphenous veins in most.
In rabbits, best to use marginal ear vein.
In reptiles, can use coccygeal/ tail vein.
Name and describe 2 ways to administer fluids apart from IV
S/C - in reptiles, insert needle cranially under a scale flap and inject near the shoulder region. In birds, insert at same angle underneath shorter feathers.
Intraosseous - inserting a catheter into the medullary cavity of the bone and injecting fluids. Key places: back of the femur or the ulnar bone in birds. Care when doing this in birds not to inject any pneumatic bones!
What should be considered when heating exotics?
Monitor Overheating
Monitor for burns (especially reptiles! as may spend too long on heat if we haven’t got environmental temp correct)
Ensure reptiles can move between hot and cool areas
CARE with recumbent patients
Monitor the patient’s body temperature AND the environmental temperature
What are the 2 methods of heating? Give examples
- Insulating - conserving animals own body temp
e. g. bubble wrap, foil, Guinea pig jumper - Actively heating
e. g. heat pads/mats, bair hugger, incubator
How should oral medications be administered to exotics?
Dilute in water and syringe or put in water bottle
Put in food
When should topical medications be administered?
More effective when the problem is topical e.g. wound or a lesion, these are more effective.
Not effective in reptiles for internal problems as their metabolism is so slow
Where should s/c/ injections be given in Chelonia?
Cranial direction in loose skin near shoulder region
Describe I/M injections in exotics?
Similar to in cats and dogs.
May use neck or leg muscle.
In reptiles ad chelonias, the metabolism is so slow, vets may want to inject small amounts over longer periods of time.
What plans need to put in place for reptile wound management and why?
Reptiles and chelonian skin heals so slowly compared to dogs and cats. A plan needs to be agreed with the owner because a lot of the recovery process will take place at home. Need to make sure that the environmental conditions are correct.
Why do we need to be more careful when injecting small animals?
Their skin is more fragile and elastic and can be damaged more easily
What can be done to reduce infection to wounds in exotics?
Changing the substrate to something more sterile e.g. newspaper, kennel liners etc. (temporary!)
Strictly cleaning the water in aquatic species (may be easier to reduce size of tank temporarily)
What dressings are appropriate for exotic species?
Adhesive dressings or tie-on dressings can be useful as skin can be difficult to attach to. Silicon, all-over sticky dressings can be used also. Dressings can be ties on using sutures.
Topical medicants that act as a barrier can also be useful e.g. manuka honey. These are good at keeping the wounds immediate environment in the correct conditions for healing. (Only beneficial at certain stages of healing).
What is helpful when monitoring exotic species?
Knowledge of Normal vital values. (use research to find specifics - especially reptiles!)
Palpation and observations are key as monitors may not be as effective in reading some of these species as they are in dogs and cats.
How can temperatures be monitored in exotic species?
Digital thermometer (ensure correct size)
Rectal/ cloacal probe
Infrared readers can also be used
How can pulse rate and heart rate be monitored in exotics?
Pulse at femoral and coccygeal artery
Paediatric stethoscope
Doppler probe
What can be one of the first indications of a problem in exotic species? How can we monitor this?
Respiration Changes
Observations of chest (or sternum in birds)
Use of paediatric stethoscope
How can we avoid respiratory problems in exotics?
Care when handling not to restrict lungs (especially in birds)
Always try and get another person to monitor respiration when you’re doing any checks on the patient.
What are the criteria for transporting small animals around the hospital?
Secure! - escape-proof, gnaw-proof
Large enough for the animal to turn around, but small enough to make catching easy.
Give a hiding place
Cover the cage
Ensure they’re not subjected to extreme temperatures
Clear of faeces and urine
What causes most reptile visits to hospital?
Poor husbandry causing health issues therefore nurse is the main provider of the cure!
What are signs of pain in reptiles?
General aggression and striking at glass
Acute may be indicated by excessive movement and motor rigidity
Describe the things you would do when presented with a reptile etc that wasn’t well?
- ensure best diet, correct handling and appropriate housing
- attend quickly to wounds and illnesses - cleaning ocular discharge, hand feeding etc
- administer analgesics
- administer chemotherapeutic agents
- consider euthanasia
What can you do to decide if an animal is in pain
- Be subjective
- if you think human would be in pain, animal probably is - Clinical indications - recognise signs of pain
- Response
- see how animal responds to an analgesic
How would a Chelonia be euthanised?
I/M with 100-200mg/kg ketamine
I/V with 200mg/kg ketamine
Destroy the animals brainstem by using a needle through the foramen magnum or roof of the mouth.
Describe how a bird should be housed in hospital?
More stressed than mammals so keep away from other animals and noise. Place towel over cage Well-ventilated room vertical bars only Removeable floor trays Social with other birds Perches Bathe and spray Recommended ambient temperature of 26 as body temperature about 40 and hard to maintain. Mimic daylight hours
Describe the nursing of birds?
Wear PPE
Feed very frequently
Help them maintain their body temperature
S/C and I/M injections should be given over the pectoral muscles.
I/V injections should be given in the Right Jugular vein (it is larger than the left)
Assume ill birds are 5-10% hydrated
Each 1% dehydration needs only 10ml/kg of body weight in addition to maintenance.
Crop tube can be used to give supplementary nutrients
Use butterfly catheters in birds and spinal needles for intraosseous placement.
Elizabethan collar for birds
Can use critical care for birds, polyaid and hills a/d etc
Euthanasia by IV injection of pentobarbitone.
How would you determine the volume of food to feed via a tube in birds? Give examples
Dependant on species and size
Examples: Budgie – 0.5 – 1ml Cockatiel- 2.5 – 5ml Cockatoo – 10ml Macaw – 10 – 15ml
Describe the specifics of the use of perches in birds
Varying sizes
Don’t put above water as will cause faeces to fall into water
Place at vantage point for food bowls
Wide enough to prevent nails curling right round digging into the soft pad of the foot - can lead to bumblefoot
If has bumblefoot already, can wrap in something soft to take the pressure off
What should also be considered when housing snakes in hospital?
Are they arboreal species and therefore will require some branches etc to climb
What is PBT?
Preferred Body Temperature - the temperature in reptiles where their physiology functions optimally.
This should be the temperature aim when trying to maintain heat under anaesthesia.
What is an important nursing aspect in ALL species?
Regular weighing!
What else should you follow in animals housed with artificial lighting?
Daylight cycles
What disease must be careful about developing in Tortoises?
Metabolic Bone Disease - need UVB light so they can synthesize Vit D
Ensure to check the expiry dates on bulbs because although they may still work, they may not emit the right wavelengths for that species anymore
What should you protect your rabbit from?
Environment - extreme temperatures
Disease - Vaccinations, neutering etc
What is a disease to be aware of in guinea pigs?
Scurvy - caused by a vitamin C deficiency
To avoid, can ensure there’s lots of veg in diet (vit c doesn’t last long so veg must be fresh)
Can also supplement to be sure - if in water, be wary that vit C is rendered inactive by stainless steel so ensure to change the water regularly if in a bottle with a stainless steel mouthpiece
What questions should you ask an owner upon admittance of an exotic animal?
Medical history? Usual behaviour? Normal accommodation? Normal diet? Normal elimination habits? Normal cleaning routine and products used? Normal exercise? Indoor or outdoor? Neutered/ vaccinated? Last shed? Last fed? Temperament/ are they handled?
lots of these things can be the reason for the illness so important to ask
What should be considered before handling an exotic species?
Is the animal okay with being handled?
Is there a risk of zoonotic disease? PPE
Need any equipment? e.g. snake hook
Remove the cage furniture
Observe behaviour and reaction to you
Observe respiration (is it necessary to handle?)
Care when handling is have metabolic bone disease
Why are small furries particularly prone to hypothermia?
High metabolic rate
Low weight to high body surface area
Why does hypothermia occur in small animals under gaseous anaesthetic?
No muscle movement
Breathing in cool air
What can be used to keep small animals warm?
Can use heat pads, hot water bottles etc. Observation is key because these things can be chewed.
Can also increase ambient room temperature
What should we be observed in small mammals?
Weight Food and fluid intake Urination/defaecation Respiration HR (dependant on species) MM colour and tackiness Behaviour (changes: posture, exercise - gives you an indication of how they're feeling)
What is the main problem in assessing whether an animal is in pain in small mammals?
Mask their symptoms to prevent being eaten
What are some signs of pain in small mammals ?
Teeth grinding
Stop eating
Abdominal guarding
Overgroom/feather plucking OR no grooming/preening
Behavioural changes: less active, isolate themselves
May see increase in aggression
May get some noise when handled
Weight loss
Birds may be fluffed-up and look depressed, isolated
What are some signs of pain in reptiles?
Very difficult!!
Main one is Not eating
Not moving around
Uneven shed
E.g. chameleons go dark in colour; snakes tend to adopt an S-shape
Describe the signs of dehydration in small animals?
Can skin tent (in some spp) Sunken eyes Tacky MM Dysecdysis Fluffed up/depressed appearance
How can you correct dehydration in exotics?
Can bathe reptiles in water - absorb via cloaca
Can syringe water or use crop tube
Easiest in small mammals and birds is S/C fluids (if mild dehydration)
If want quick rehydration, use I/V fluids!
What vein should be used for blood sampling in Rabbits?
Lateral Ear Vein
25-27G needle
Warm ear slightly before to coax blood into vein
What vein should be used for blood sampling in Rats and Mice?
Lateral Tail Vein
25-27G needle
What vein should be used for blood sampling in Ferrets?
Jugular
23-25G needle
What vein should be used for blood sampling in Guinea Pigs/ Chinchillas?
Jugular 23-25G
What vein should be used for blood sampling in Birds?
Right jugular in most species - right is bigger than left
Can use brachial vein in large birds
What vein should be used for blood sampling in Chelonia?
Dorsal tail vein or jugular vein care with retracting
What vein should be used for blood sampling in snakes?
Ventral tail vein
Describe the fasting time pre-anaesthetic in:
- Rabbits?
- Rats, mice, gerbils, hamsters?
- Guinea Pigs and chinchillas?
- Ferrets?
- Birds?
- Reptiles?
Rabbits - have very tight cardiac sphincter so cant vomit, just need to ensure there’s no food in the mouth so fast for 30-60 mins prior
Rats, Mice, Gerbils and Hamsters - 45mins
Guinea Pigs - 3-6 hours to ensure a relatively empty stomach and reduce the pressure on the diaphragm
Ferrets - 2-4- hours prior
Birds - 1 -3 hours dependant on size. Can be dangerous to starve- just want to ensure crop is empty to prevent reflux.
Reptiles - nothing for 2 days prior to ensure no pressure on lungs or heart and prevent regurgitation. Chelonia do not regurgitate so wont require as much fasting.
How would you calculate the fluid support for reptiles?
Recommended fluid volumes are 20-25ml/kg per 24 hours
Do not exceed 2- 3% of body weight.
