Bayesian Decision Analysis: An Underutilized Tool in Veterinary Medicine.

Bayesian inference and decision analysis can be used to identify the most probable differential diagnosis and use those probabilities to identify the best choice of diagnostic or treatment among several alternatives. In this retrospective case analysis, we surveyed three experts on the prior probability of several differential diagnoses, given the signalment and history of a ferret presenting for lethargy and anorexia, and the conditional probability of different clinical findings (physical, bloodwork, imaging, etc.), given a diagnosis. Using these data and utility estimates provided by other clinicians, we constructed a decision tree to retrospectively identify the optimal treatment choice between exploratory laparotomy and medical management. We identified medical management as the optimal choice, in contrast to the original clinical team which performed an exploratory laparotomy. We discuss the potential cognitive biases of the original clinical team. We also discuss the strengths, e.g., shared decision making, and limitations of a Bayesian decision analysis in the veterinary clinic. Bayesian decision analysis can be a useful tool for retrospective case analysis and prospective decision making, especially for deciding on invasive interventions or end-of-life care. The dissimilarity of expert-derived probability estimates makes Bayesian decision analysis somewhat challenging to apply, particularly in wide-ranging specialties like zoological medicine.

Geriatric Ferrets.

Ferrets are considered geriatric at 3 years of age. Twice-yearly physical examinations with additional testing finds problems and leads to prompt treatments that extend quality of life for the ferret. Bloodwork, urinalysis, dental examination, and imaging including radiographs and ultrasonography should be performed at least annually. Specialized testing includes echocardiography, electrocardiology, blood pressure, computed tomography scanning, and dental radiography depending on the ferret. Common problems include dental disease, cardiomyopathy, renal disease, musculoskeletal disorders, chronic gastrointestinal disorders, and neoplasias. Insulinoma, adrenal neoplasia, lymphoma, and skin tumors are commonly found neoplasias. Medical and surgical treatments and adjunctive complimentary therapies are discussed.

Reproductive Disorders of Marsupials.

Marsupial reproduction differs significantly in anatomy and physiology from that of placental mammals. The gastrointestinal and urogenital tracts empty into a cloaca. Reproductive parameters include gestation and pouch time, as the fetus develops outside of the uterus. Captive marsupials discussed include sugar gliders), short-tailed opossums, Virginia opossums, and Tammar and Bennett's wallabies. Common disease conditions include joey eviction, pouch infections, mastitis, metritis, prostatitis, penile necrosis, and neoplasia. Common surgeries include penile amputation, castration, and ovario-vaginal-hysterectomy or ovario-hysterectomy. Therapeutics used for these conditions are presented.

Anatomy and Disorders of the Oral Cavity of Ferrets and Other Exotic Companion Carnivores.

Exotic companion carnivores such as ferrets, skunks, fennec foxes, coatimundis, raccoons, and kinkajous presented in clinical practice share similar dental anatomy, function, and diseases. The domestic ferret serves as the representative species for this group with its anatomy, diseases, and conditions described in detail. Dog and cat guidelines for veterinary and home care seem to be relevant and applicable, including dental endodontic procedures. Annual or biannual dental examinations and prophylaxis are recommended. The most common dental and oral problems are tooth wear, plaque and calculus, teeth fractures, gingivitis and periodontitis, tooth loss, abscesses, oral ulceration, tonsillitis, and neoplasia.

Captive marsupial nutrition.

Marsupials comprise an interesting group of mammals, which are increasingly being kept as pets. Few actual feeding trials have been published, although many anecdotal diets have years of usage with good success. Marsupials have dental and digestive tract adaptations that allow them to use specific niches in their environments. Knowing the diet in the wild is instrumental in designing diets used in captivity.

Ferret nutrition.

The domestic ferret (Mustela putorious furo) is a strict carnivore, also referred to as an obligate carnivore. Its dentition and gastrointestinal tract are adapted to a carnivorous diet. Its ancestor, the European polecat (Mustela putorius), feeds on birds and other small vertebrates. Domesticated ferrets have been fed mink feeds, cat foods, and now mostly subsist on commercial ferret diets formulated specifically to meet their needs.

Mycoplasmosis in ferrets.

We report an outbreak of severe respiratory disease associated with a novel Mycoplasma species in ferrets. During 2009-2012, a respiratory disease characterized by nonproductive coughing affected ≈8,000 ferrets, 6-8 weeks of age, which had been imported from a breeding facility in Canada. Almost 95% became ill, but almost none died. Treatments temporarily decreased all clinical signs except cough. Postmortem examinations of euthanized ferrets revealed bronchointerstitial pneumonia with prominent hyperplasia of bronchiole-associated lymphoid tissue. Immunohistochemical analysis with polyclonal antibody against Mycoplasma bovis demonstrated intense staining along the bronchiolar brush border. Bronchoalveolar lavage samples from 12 affected ferrets yielded fast-growing, glucose-fermenting mycoplasmas. Nucleic acid sequence analysis of PCR-derived amplicons from portions of the 16S rDNA and RNA polymerase B genes failed to identify the mycoplasmas but showed that they were most similar to M. molare and M. lagogenitalium. These findings indicate a causal association between the novel Mycoplasma species and the newly recognized pulmonary disease.

Rabbit respiratory system: clinical anatomy, physiology and disease.

Rabbits are obligate nose breathers due to their epiglottis positioned rostrally to the soft palate. Any obstruction within the nasal cavity will produce a respiratory wheeze with increased respiratory effort. Respiratory diseases are a major cause of morbidity and mortality in rabbits. This article focuses on these diseases and their causative pathogens.

Ferret respiratory system: clinical anatomy, physiology, and disease.

The upper and lower respiratory tracts of ferrets have several similarities to humans, and therefore have been used as a research model for respiratory function. This article describes the clinical anatomy and physiology, and common respiratory diseases of the ferret.

Emerging Ferret Diseases.

There are a number of newly described and emerging disease syndromes affecting the domestic ferret, and the purpose of this article is to make veterinarians aware of these diseases. A recently described systemic coronavirus infection appears to be a variant of the ferret enteric coronavirus and is currently termed "ferret infectious peritonitis." Disseminated immunopathologic myositis, aplastic anemia/bone marrow aplasia, acute hemorrhagic syndrome, and oral ulcerations are also described, although the exact etiologies for these diseases have yet to be determined. There appears to be at least 2 important amino acid metabolism deficiencies in ferrets: hindlimb weakness in older ferrets (L-carnitine) and cysteine urolithiasis. Ferrets have recently been found to be susceptible to H1N1 influenza, so knowledge regarding this zoonotic disease is essential for veterinarians working with these animals. A novel Mycoplasma spp. has also recently been identified in ferrets with chronic respiratory problems that originated from one breeding colony. Because these diseases are still being investigated, practitioners who treat a ferret patient exhibiting clinical signs consistent with any of the conditions mentioned are encouraged to contact people who are knowledgeable of that particular illness.

Parasites of captive nonhuman primates.

Parasites of captive nonhuman primates generally are more limited than those reported for field studies and in wild-caught primates. Captive primates include those in zoos, laboratory animal facilities, and private collections or pets. Primates kept indoors generally have few parasites, and those are easily eliminated. Outdoor housing presents problems in breaking life cycles of parasites, particularly those with invertebrate intermediate hosts. Decontamination of soils and substrates also makes total elimination of parasites nearly impossible. For outdoor-housed primates and those in social settings, control can be achieved through regular examination and appropriate administration of antiparasite medication. Because many of the parasites have zoonotic potential, practitioners must be vigilant and educate caretakers about the parasite life cycle and sanitation procedures.

Common procedures in hedgehogs, prairie dogs, exotic rodents, and companion marsupials.

Nondomesticated species are commonly being kept as companion animals. These include the African pygmy hedgehog (Atelerix albi-ventris), the North American black-tailed prairie dog (Cynomys lu-dovicianus), and exotic rodents such as the degu (Octodon degus)and duprasi or fat-tailed gerbil (Pachyuromys duprasi). Common companion marsupials include the sugar glider (Petaurus breviceps),Bennett's or Tammar (Dama) wallabies (Macropus rufogriseus rufo-griseus and Macropus eugenii, respectively), the Brazilian or South American gray short-tailed opossum (Monodelphis domestica), and the North American Virginia opossum (Didelphis virginiana). Although many of these animals are now bred domestically and are fairly docile when human-raised, they are essentially wild animals and hence have strong instincts to hide illness and pain.

Safety issues in the exotic pet practice.

Small animal practitioners are well versed in the potential zoonoses from dogs and cats. Although these account for the vast majority of documented cases of zoonotic disease in humans, there are documented as well as potential zoonotic diseases that the nontraditional companion animal is capable of transmitting. This article is a compilation of potential disease risks to veterinarians, staff, and owners of nontraditional companion animals. In addition, the article may serve as a training tool for veterinary practices.

Reproductive medicine of companion marsupials.

Marsupials have recently become popular as exotic pets. Marsupial reproduction is considerably different than that of placental mammals. The reproductive parameters and artificial milk formulations specific for marsupials are discussed.