Behavioral Development of Pediatric Exotic Pets and Practical Applications.

The discovery of epigenetics and the interaction between genes and the environment have moved our understanding of how animal behavior develops from gestation to adulthood, and even throughout generations, to a new level. Studying the natural biology of exotic pets is key to providing them with a rich social and physical environment that will encourage species-specific behaviors. Combining parent-raising with appropriately timed human handling is likely to result in individuals with more resilience to stress. Using operant conditioning techniques early in life to train the animals' basic behaviors gives them control over their environment, empowering them through their social interactions.

Urine Output Monitoring and Acute Kidney Injury in Non-mammalian Exotic Animal Critical Care.

Acute kidney injury (AKI) is a sudden, severe decrease in kidney function which can occur in any species. There are various causes of AKI, some of which are seen in domestic species and some that are unique to birds, reptiles, and amphibians. These species present unique challenges with AKI management, such as differences in anatomy and physiology, intravenous and urinary catheterization, repeated blood sampling, and their tendency to present in advanced states of illness. This article will discuss AKI, diagnosis, treatment, and prognosis for non-mammalian exotic species.

Cerebro-Cardiopulmonary Resuscitation and Postarrest Care in Exotic Animal Critical Care.

Evidence-based recommendations for performing cardiopulmonary resuscitation (CPR) in domestic species provide a foundation for application to nondomestic species. The exotic and zoo practitioner must consider human safety, species anatomy, physiology, and special techniques for performing CPR. Having the hospital and team prepared and trained for a CPR response can improve outcomes. Basic life support includes various techniques for chest compressions and ventilation support. Advanced life support includes means of intravascular and intraosseous access, rescue drug administration, and consideration of the patient presenting circumstances. Team debriefs and support for mental wellness are useful to optimize performance and maintain team resiliency through CPR events.

Urine Output Monitoring and Acute Kidney Injury in Mammalian Exotic Animal Critical Care.

Acute kidney injury (AKI) is a sudden, severe decrease in kidney function which can occur in any species. There are various causes of AKI, some of which are seen in domestic species and some that are unique to exotics. Exotic animals present unique challenges with AKI management such as differences in anatomy and physiology, intravenous and urinary catheterization, repeated blood sampling, and their tendency to present in advanced states of illness. This article will discuss AKI, diagnosis, treatment, and prognosis for exotic companion mammals. The following article will discuss the same in non-mammalian patients.

Coagulation Disorders, Testing, and Treatment in Exotic Animal Critical Care.

Despite poor recognition in the literature, exotic companion animals are affected by many diseases that can result in disordered coagulation and fibrinolysis. This article outlines current knowledge of hemostasis, common diagnostic tests and reviews reported diseases associated with coagulopathy in small mammals, bird and reptiles. A range of conditions affect platelets and thrombocytes, endothelium and blood vessels, and plasma clotting factors. Improved recognition and monitoring of hemostatic disorders will enable targeted therapy and improved case outcomes.

Sedation and Anesthesia in Exotic Animal Critical Care.

Sedation and anesthesia of exotic animals in inherently challenging, but often facilitates the best care for patients. Critical illness or injury adds on another layer of complexity to their management for obtaining diagnostics and providing treatments. This article serves to review some of the more recent literature of sedation and anesthesia within exotics practice, bringing to light some nuances and considerations for when those patients are critically ill or injured.

Point of Care Ultrasound in Exotic Animal Emergency and Critical Care.

Exotic pets are presented to veterinary clinics with increasing frequency for routine, urgent, and emergency needs. With these increased visits, owners' expectations for high-quality veterinary care are also increasing. Many presenting complaints of reptiles, birds, and small mammals can benefit from the use of point of care ultrasound (POCUS) to establish a minimum database, aid in triage, and help guide further diagnostics, treatment, and prognostic discussions with the owner. Hospitalized exotic patients can also have their progress tracked and better assessed with the aid of POCUS.

Temperature Monitoring and Thermal Support in Exotic Animal Critical Care.

Body temperature measurement is one of the most important parameters to assess the health of a patient. In small exotic mammals, rectal temperature is obtained via a similar process as in dogs or cats, with a few specific differences. In reptiles and birds, measurement of body temperature can provide important information, albeit its accuracy may be limited. In most animals, temperature should be taken at the beginning of the examination to not artificially elevate the temperature during the physical exam. Heat support is typically indicated any time a patient's temperature is below the accepted core temperature range and cooling may be indicated whenever a patient's temperature exceeds a critical point.

Fluid Therapy in Exotic Animal Emergency and Critical Care.

Many new concepts are emerging in the understanding of fluid therapy in human and mammalian medicine, including the role of the glycocalyx, increased understanding of fluid, sodium, and chloride overload, and the advantages of colloid administration in the form of albumin. None of these concepts, however, appear to be directly applicable to non-mammalian exotic patients, and careful consideration of their alternate physiology is required when formulating fluid plans for these patients.

Antibiotic usage patterns in exotic pets: A study in Curitiba, Paraná, Brazil.

Background: The link between the reckless use of antimicrobials with the increasing development of multidrug-resistant strains of antibiotics is well established. To control the spread of antimicrobial resistance (AMR), action plans, recommendations and guidelines on the prudent use of antibiotics have been developed for food-producing animals and companion animals but appear to be lacking in exotic pets due to the scarcity of data and information on the use of antibiotics in these species. Aim: The purpose of this study is to bring qualitative and quantitative data regarding the use of antimicrobials in exotic pets in a veterinary center in southern Brazil, seeking to measure the consumption of these animals to determine and guide future actions to combat AMR. Methods: A retrospective observational study was conducted by surveying 2,190 open care records in a specialized clinic of wildlife medicine in 2018. Data evaluation was performed in a descriptive, qualitative, and quantitative way, and the analysis of antimicrobial consumption was performed by calculating the daily dose/g of animal ml/day/kg by animal order, condition and active principle, adaptation to DDDVet. For statistical analysis, Levene´s, ANOVA followed by Tukey´s tests were used. Results: Approximately 57% (1250/2190) of the visits made use of one or more antimicrobials in the treatment of animals referred to the clinic. Of these, 67% (n = 839) were birds, 26% (n = 327) were mammals, and 7% (n = 84) were reptiles. In 2018, the total consumption of antimicrobials prescribed was 2.21 l for a total biomass of 129.24 kg. The relation between the dosages of the main antimicrobials used and the conditions treated showed that there is no variation between the treatments by disease and by animal class, due to the great variation within each group. Conclusion: The antimicrobial prescription in exotic pets requires a multifaceted and dynamic approach applied to safeguard the efficacy of the antimicrobials, optimizing consumption, minimizing the emergence of AMR and other possible adverse effects, and considering the physiological differences present within each species. The doses between the different classes and conditions do not obtain a significant difference, reflected in a possible nonstandardization of the dosages used, requiring further investigation of the recommended dosages for each animal species, avoiding the over or underdosing of these drugs. It is worth highlighting that professionals must always make rational use of antimicrobials in these species.

Diagnostic Use of Lactate in Exotic Animals.

Monitoring blood lactate concentrations with a handheld, point-of-care (POC) meter is an efficient and inexpensive method of monitoring critically ill or anesthetized exotic patients. Serial monitoring of lactate allows early recognition of hypoperfusion, allowing for prompt implementation of resuscitative efforts. Reference ranges for exotic animals are currently sparse and often gathered from field studies of wild animals. In the absence of reference ranges, extrapolations can be made regarding mammals and birds, but may be more difficult in reptiles and amphibians.

The Utility of Bile Acids for the Diagnosis of Liver Disease in Exotic Animals.

The synthesis of bile acids occurs during the degradation of cholesterol in hepatocytes. Thus, this analyte is expected to be a sensitive indicator of hepatocellular dysfunction or alterations in portal circulation. Bile acids can be quantified via an enzymatic reaction to a highly conserved moiety across species. The evidence for the clinical utility of bile acids for the diagnosis of liver disease is strongest in birds and ferrets with equivocal evidence in rodents, rabbits, and reptiles. Current limitations to the interpretation of bile acids in exotic animal species include a paucity of species-specific reference intervals and incomplete understanding of bile acid metabolism in nonmammalian species and the diversity of bile acids synthesized by vertebrates.

Viscoelastic Coagulation Testing in Exotic Animals.

Whole blood viscoelastic coagulation testing (VCT) allows global assessment of hemostasis and fibrinolysis. Although not widely used in exotic animal practice, VCT has been used in exotic animal research settings. Differences in patient demographics and analytical variables can result in dramatically different results with the same analyzer. To improve the utility of VCT in exotic animal medicine, standardization of protocols is necessary to facilitate the establishment of reference intervals. Despite these challenges, the quantitative/qualitative nature of VCT has already proved its real-world value to some clinicians.

Endocrine Diagnostics for Exotic Animals.

Endocrine disease in exotic species is less common than in small animals. Nevertheless, the diagnostic principles used in small animals can be adapted to evaluate endocrine disease in many of the exotic species although species-specific aspects need to be considered. This article covers important diseases such as thyroid dysfunction in reptiles and birds, hyperthyroidism in guinea pigs, and hyperadrenocorticism in ferrets. Glucose metabolism in neoplasms affecting normal physiology, such as insulinoma in ferrets and gastric neuroendocrine carcinoma in bearded dragons, is discussed. Calcium abnormalities, including metabolic bone disease in reptiles and hypocalcemia in birds, are also covered.

Digital Cytology in Exotic Practice: Tips to Optimize Diagnosis.

Digitization has enhanced the utility of cytology in private practice by allowing for rapid sample receipt and analysis, leading to better informed real-time patient care. Despite many advantages of digital cytology, understanding its limitations is required to avoid common pitfalls. A strong foundation in sample preparation and imaging techniques is also required to obtain high-quality diagnostic samples. By optimizing these factors, the benefits of digital cytology are maximized, allowing for the practice of high-quality point-of-care medicine that best addresses the needs of the patient and pet owner in a rapid time frame.