Practice BuildingAre Exotics a Fit for Me?Part 2: Day-to-Day Logistics of Exotics Practice
Angela M. Lennox, DVM, Diplomate ABVP (Avian & Exotic Companion Mammal) & ECZM (Small Mammal)
Avian and Exotic Animal Clinic, Indianapolis, Indiana
To see (exotics) or not to see… that is a very good question.
The quality of exotic pet medicine has increased dramatically over the last decade, which is illustrated by the appearance of board-certified specialists for exotic animals and increasing numbers of high-quality articles in the peer-reviewed veterinary literature. However, the decision whether to incorporate exotic pets into a practice should be made carefully.
The first part of this article (Development of the Exotics Practice, July/August 2016) discussed:
- Whether to add exotics medicine to your practice
- Training existing staff
- Acquisition of equipment and resources
- Developing relationships with mentors and experts.
This article discusses the day-to-day logistics of operating an exotic pet practice.
Read Are Exotics a Fit for Me? Part 1: Development of the Exotics Practice (July/August 2016) at tvpjournal.com.
LEGALITIES OF EXOTIC PET OWNERSHIP
Exotic pet ownership regulations vary from state to state, and certain municipalities may also have laws regarding such ownership. Practitioners must have a working knowledge of how the law affects each species.
Keeping up-to-date on certain legal aspects is particularly difficult as laws frequently change, and often without warning. For example, ferrets are illegal to own as pets in certain states and, in some areas, ownership of native wildlife, such as raccoons, is prohibited. In Indiana (my state), laws regarding ownership of wildlife have changed dramatically, with permits required then not required then required again.
There are also laws regarding vaccination of exotic pets (ie, most states require annual rabies vaccination of pet ferrets). The American Veterinary Medical Association website provides a regularly updated, state-by-state list of laws regarding rabies vaccination that includes, in particular, information on such animals as ferrets: avma.org/Advocacy/StateAndLocal/Pages/rabies-vaccination.aspx.
Liability insurance policies may not cover claims involving illegally owned animals. Each practice should check with their liability insurance carrier for clarification.
The term exotic pets traditionally refers to any pet that is not a dog, cat, or large farm animal, such as pet goats and chickens, parrots, reptiles, rabbits, and rodents. Some practices elect to add exotic companion mammals first, as mammal medicine is generally more familiar than avian and reptile medicine.
ONGOING TRAINING & EDUCATION
Suggestions for acquiring basic skills for exotic pet handling and medical care—for both practitioners and the veterinary team—were provided in Part 1. Regular continuing education is important, as well as in-house training. For instance, in my clinic, the veterinary team receives 2 to 3 hours of mandatory training once weekly.
It is important that team members who work in reception also receive this education and training. Reception staff need to develop the skills that help them identify emergencies on the phone and also allow intelligent communication with exotic pet owners.
Some signs described by owners are often indications of severe disease in certain exotics. For example, clients with anorexic rabbits should be encouraged to come in immediately, whereas a snake that is anorexic but otherwise appears normal may not require immediate emergency intervention. Because of these discrepancies, in some mixed practices, queries regarding exotic pets are only handled by designated support staff with special training.
Exotic Pet Laws
The website bornfreeusa.org provides helpful information on laws governing ownership of exotic animals, including:
- Color-coded U.S. map of state laws governing private possession of exotic animals
- Summary of laws relating to the keeping of wild and exotic animals as pets
- Partial summary of which cities and counties have prohibited the keeping of these animals.
Visit bornfreeusa.org/b4a2_exotic_animals.php to access this information.
THE RECEPTION AREA
A practice that exclusively cares for exotic animals does not need to worry about dogs barking or straining against leashes. In these practices, it should be a requirement that all pets, regardless of size, enter the clinic in a secure carrier, no matter their demeanor or the pet owner’s preferences. This prevents injuries to pets and owners while in the waiting room.
For clinics that see both exotic and traditional pet species, a separate entrance or waiting area for exotic pets is ideal to prevent stress, especially for prey species, such as rabbits. Another option is to escort the exotic pet owner and pet directly into a designated (and quiet) examination room.
Many exotic pets have complicated husbandry needs, which necessitates more time for the initial examination. For this reason, appointments for exotic pets are often lengthier. In my clinic, the average wellness examination for a new bird is scheduled for 1 hour. In addition to the discussion of care and feeding, practitioners who are new to exotic pets need more time to research disease conditions and treatment options.
Because of the wide variety of husbandry requirements and the overwhelming information (and misinformation) from various sources, it is often useful to ask owners to bring a picture of their housing set-up as well as all foods offered to the pet (in the original packaging). Reptile owners should also be asked to bring in any supplements offered and UV bulbs, which can be tested with a meter to confirm that adequate UV light for the species in question is being produced.
Practices serving exotic pets should be capable of offering wellness examinations, which require a thorough understanding of the most up-to-date diet, husbandry, and enrichment recommendations for each species. To complicate matters, recommendations change as new research and information emerge.
Certain exotic species can be vaccinated.
As mentioned earlier, rabies vaccination of a ferret is required in most states. Currently there is only a single product licensed for use in ferrets. It is important to note that it is not appropriate to substitute another product when a licensed product for the species in question is readily available. Use of unapproved rabies vaccines in ferrets may not protect those patients from rabies testing and euthanasia in cases of human bite exposure.
Vaccines are recommended for a number of other species as well, including exotic pet carnivores, such as foxes and raccoons, as well as miniature pigs. Vaccines are also available for pet birds, but these have limited application. Practitioners must understand and be able to explain the risks and benefits of each vaccine for each patient.
Basic services can also include elective neutering for certain exotic species. For some, gonadectomy is an important preventive health measure (eg, spaying female rabbits to prevent uterine neoplasia). Neutering may also be selected to improve pet behavior or prevent reproduction. It is important to understand the indications for spay/castration in each exotic species in order to help clients make informed decisions for each pet.
Practitoners must be aware of current standards for euthanasia of exotic pets, which require modifications of techniques typically used in traditional pet practice. The 2013 edition of the AVMA Guidelines for the Euthanasia of Animals (avma.org/KB/Policies/Documents/euthanasia.pdf) contains a wealth of information for avian, exotic mammal, and reptile species and also includes information on fish and handling of viable eggs.
Practices that accept exotic patients must be able to provide advanced medical and surgical care or have the ability to refer patients to a specialist or a colleague with more experience. This care includes diagnostic testing, diagnostic imaging, and surgical services. Of these, imaging and surgery often require referral to a clinician and facility that can provide this specialized care.
Many large veterinary reference laboratories accept exotic animal samples. However, the ability to handle certain important tests, such as evaluation of a complete blood count, requires experience and training. Before choosing a reference laboratory, be certain the laboratory has significant experience with exotic animal samples.
A few private and university-based reference laboratories have an exotics focus, while a number of specific pathogen tests are only offered by limited facilities. While it may be more economical to send samples directly to these laboratories rather than through a larger reference laboratory, the larger laboratories, such as Antech Diagnostics (antechdiagnostics.com) and IDEXX (idexx.com), can direct samples to the appropriate laboratory quickly and easily.
The size of the patient often severely limits diagnostic capabilities. Many exotics practitioners rely on in-house biochemistry analyzers capable of producing results from a very small but high-quality whole blood sample. The Abaxis VetScan (abaxis.com) offers a biochemistry panel that can be run on as little as 0.13-mL whole blood, which makes analysis feasible even in small rodents, birds, and lizards.
In principle, fees for services for any exotic animal should be similar to those for traditional pet species. There is a temptation to reduce fees for exotic pets based on the incorrect perception that some pets are less valuable than a dog or cat and, in some cases, fees are reduced because the clinician feels less competent in evaluating exotic pets.
In actuality, veterinarians often spend more time during exotic pet consultations than during those for dogs and cats. This may be because of husbandry needs that are often unfamiliar and complex and, in many cases, clinicians further invest in the patient by searching the literature and exotic animal databases for information on diagnostic and treatment options. In some cases, significant effort and resources are spent on continuing education and specialized equipment. For these reasons, some advocate that exotic pet examination fees should actually be higher than those for traditional pet species.
AFTER HOURS & EMERGENCY CARE
Any practice that accepts exotic pets needs a plan for clients who experience after-hours emergencies. If local emergency clinics will not evaluate exotic patients, then the regular practice must be willing to do so, or have an arrangement with another clinic that will.
My clinic’s on-call staff frequently receive calls from owners whose primary veterinarian is unavailable, and the practice’s after-hours message recommends referral to emergency clinics that do not accept exotic pets. This situation often causes anxiety and resentment. The great majority of clients who present to us for emergencies (especially postsurgical complications) elect not to return to the primary veterinarian.
ADDING A BOARD-CERTIFIED SPECIALIST
Practitioners wishing to offer the highest level of care for exotic patients should strongly consider either adding a board-certified specialist to the practice or becoming one. Boarded specialists are listed on the American Board of Veterinary Practitioners (abvp.com) and American College of Zoological Medicine (aczm.org) websites.
Exotic animal medicine and surgery are exciting and interesting components to any practice. The increasing demand for high quality of care provides incentive to take the time and effort to learn more about these special pets.