Monitoring Vital Signs in Exotic Animal Species

[…] +/- 52.9 22 HR: Heart rate RR: Respiratory rate   Temperature An important priority for every anesthetist is to maintain normothermia.31 A fall in body temperature, or hypothermia, is extremely common during anesthesia, but is of particular concern in young, growing animals, patients in poor body condition, and in small patients with a high […]

Spotlight on Anesthesia & Analgesia in Reptiles

[…] Induction Maintenance Examples VIII. Injection sites IX. Intubation X. Patient monitoring Reflexes Heart rate Respiratory rate Temperature XI. Cardiovascular support IV access IO access XII. Temperature support Hypothermia Preventing hypothermia XIII. Recovery Wean off gas before the end of procedure Maintain O2 at low flow rate KEEP WARM!!!!!!!!!!!!!!!! Breathing stimulus XIV. Keys to success […]

Physical Examination of the Chick

[…] 2a). Some species, such as Eclectus parrots, normally have pigmented skin. Dry, hyperemic, tacky skin indicates dehydration (Fig 2b), and pale skin may indicate anemia, shock, or hypothermia (Fig 2c).   Figure 2a. In most chicks, normal skin is beige-pink in color, warm, and soft although some species normally have pigmented skin. Photo credit: […]

Exotic ICU: Nursing Care for Reptiles

[…] move, then heat must be provided more cautiously as the animal will not be able to thermoregulate. A focal heat source can lead to either overheating or hypothermia if the patient is moribund. Therefore provide an even heat source such as an incubator or brooder. A temperature setting of 28-29.4°C (82-85°F) is suitable for […]

Exotic ICU: Nursing Care for Exotic Companion Mammals

[…] animal studies show poor agreement between rectal temperature and noncontact infrared values (Chen 2006, Devalle 2005, Saegusa 2003). Most small mammals that present in hypovolemic shock demonstrate hypothermia or a temperature less than 36.6°C (98°F). These patients must be actively warmed using methods that warm not only the external surface of the patient but […]

Understanding Shock: Ten Important Facts

Rewarming is an important part of the resuscitation plan for small patients. As body temperature falls, adrenergic receptors are theorized to become refractory to catecholamine release. Therefore active rewarming is indicated for patients with moderate to severe hypothermia. Use forced warm air blankets, incubators, circulating warm water blankets, and/or…

Supplemental Heat for the Avian Patient

Small birds face an enormous task in maintaining their body temperature, especially in a cold environment, but fortunately plumage provides an effective barrier to heat loss. Down feathers trap air and allow little convective movement of heat to occur. Fluffing feathers increases insulation and…

General Principles of Reptile Venipuncture

Hematology and biochemistry results serve as an important part of the minimum database for all veterinary patients. Although collection of blood samples can be a clinical challenge in reptiles, the method of patient handling, blood collection and sampling techniques are all critical for proper interpretation of laboratory results. This brief video or slideshow with still images reviews the basic principles of reptile venipuncture that should be considered before, during, and after the procedure.

Presenting problem: Burns in Snakes and Lizards

[…] has occurred within hours, cold water lavage can help to release heat from skin and limit the depth of injury. Obviously it is important to prevent iatrogenic hypothermia in the reptile. Minimize the risk of hypothermia by submerging only the affected area in a cold-water bath, by wrapping the area in cool towels, or […]

Reptile Emergency & Critical Care Summary Page

[…] patient with subcutaneous or intracoelomic fluids and cool, but not cold, water. If signs of coma or cerebral edema are observed, then steroids are indicated (Antinoff 2016). Hypothermia Hypothermia can develop with power failures or when a reptile escapes. The hypothermic reptile is extremely lethargic and evidence of gastrointestinal stasis or bloating may be […]

Fluid Administration in Exotic Companion Mammals

[…] and/or severe acid-base disturbances. Clinical signs of hypovolemic/hemorrhagic/septic shock Altered mentation Prolonged capillary refill time Pale mucous membrane color Weakness Weak or thready pulse Tachycardia or bradycardia Hypothermia (appendages cool to the touch) Blood volume in small mammals like the ferret (Mustela putorius furo) and rabbit (Oryctolagus cuniculus) is approximately 50-60 ml/kg. Therefore the […]

Heatstroke in Exotic Companion Mammals

[…] gradually, while closely monitoring rectal or esophageal temperature. Discontinue cooling methods as body temperature approaches 103°F (39.4°C).   DO NOT… Cool the patient to the point of hypothermia as this will worsen prognosis. Immerse your patient in cold water or ice baths since this will cause severe peripheral vasoconstriction, thereby inhibiting the patient’s ability […]

Feeding the Hospitalized Bird of Prey

[…] often continued for 3–5 days after feeding is initiated. Blood transfusion is also an option for the select critical patient with severe anemia and hypoproteinemia. Supplemental heat Hypothermia is very common in debilitated, emaciated raptors. Provide supplemental heat to prevent the bird from expending energy on thermoregulation. Warmed intraosseous or intravenous fluids and a […]

Avian Nutrition Glossary

[…] among avian species but normally includes duodenal reflux in those species studied (i.e. parrots, fowl, ostrich, petrels, raptors). Reflux appears to improve intestinal digestion of nutrients. Controlled hypothermia Small birds in cool climates may decrease their energy needs overnight by reducing body temperature between 25 to 35°C. See torpor. Copper Trace element absorbed by […]

Behavior Essentials: Clinical Approach to the Rabbit

[…] for clinicians used to dealing only with cats and dogs (Fig 1). Rabbits can stress very easily in a clinical setting. Stress-related catecholamine release causes tachycardia, tachypnea, hypothermia, and renal ischemia (Bays 2006). As a result, excessive stress can prevent a positive response to medical and surgical therapy and interfere with normal anesthesia and […]

Presenting problem: Cardiac Dysrhythmia in the Ferret

[…] hypoxia, uremia, acid-base disturbances or end-stage systemic disease. Sinus bradycardia is sometimes associated with hypoglycemia. Severe bradycardia can also result from systemic disease, drug therapy, anesthesia or hypothermia. Ventricular arrhythmias have also been documented in the dog with insulinoma or hypoglycemia, and some episodes of syncope were determined to be due to ventricular tachycardia […]

Sea Turtle Physical Examination: Part 2

[…] in the conscious turtle at 24ºC (75ºF) ranges from 30 to 60 beats per minute. Bradycardia is common in partially or fully submerged sea turtles, those with hypothermia, after administration of injectable anesthetics, and in a variety of disease states including neurologic loggerhead syndrome. The left and right cervicobrachial acoustic windows can also be […]

Fluid Administration in Reptiles

[…] blood loss, septic shock, and/or severe acid-base disturbances. Box 1. Clinical signs of hypovolemic/hemorrhagic/septic shock Prolonged capillary refill time Pale mucous membrane color Weakness Tachycardia or bradycardia Hypothermia (appendages cool to the touch) Evaluation of pallor can be problematic in reptiles, because mucous membranes may normally be pale or variably colored in many reptiles. […]

Wound Management in Exotic Animals

Patient evaluation Trauma sufficient to cause a wound often results in other injuries, which must be assessed (Fig 1). Concurrent conditions may include: Shock Hypoglycemia Hypothermia Dehydration Anemia Infection Figure 1. Any trauma sufficient to cause a wound can also cause systemic damage, and the patient’s overall condition must be evaluated. Once stabilization therapy has been initiated, wound assessment and management can proceed. Carefully examine injured tissue and assess the integrity of nerves, bones, and muscles. Routine function tests used for domestic animals may not be useful in non-domestic species as they often have unpredictable or decreased responses from stress. Also evaluate the practicality of long-term care. Wounds may require daily management over weeks to months, which may result in patient morbidity. Wound assessment Determine wound location, extent, type, and duration. Note any involvement of underlying bony structures as well as evidence of bruising in the tissue surrounding the wound. Bruising indicates wound duration of at least 2 to 3 days. Bruises in birds are greenish due to the accumulation of biliverdin pigment in the tissues subsequent to hemoglobin breakdown. Open wounds range from abrasions and lacerations to those resulting in skin loss. Closed wounds occur secondary to crushing injuries or contusions and result in hemorrhage and bruising in deeper tissues. An important association exists between wound duration and bacterial contamination (Box 1). Most wounds seen in wildlife patients are chronic and should be treated as infected. Box 1. Correlation between the duration of a wound and bacterial contamination Wound duration (hours) Degree of bacterial contamination 6-8 Minimal (clean) 6-12 Significantly contaminated >12 Large degree of contamination (infected) Initial therapy Initial wound care should focus on hemostasis and temporary bandaging to prevent further trauma or wound contamination until definitive therapy is […]

Exotic Small Mammal Anesthesia

[…] Was the patient on inhalant gas? If the patient was severely hypothermic, that reduces MAC. We can also potentially overdose patients, which can be made worse by hypothermia. Finally both ketamine & dexmedetomidine can cause a decent level of unresponsiveness. What I would do in this situation if I was worried about the patient […]

2022 AEMV Veterinary Medical Student Case Report Contest

[…] obstruction due to lymphoma in a rabbit (Oryctolagus cuniculus) A 2-year-old female spayed rabbit (Oryctolagus cuniculus) was presented with sudden-onset anorexia and lethargy. Physical examination findings included hypothermia, a distended stomach, and a firm mass in the abdomen caudal to the stomach. Radiographs showed severe gastric dilation and distension of the intestines with gas, […]

Presenting problem: Bite Wounds

[…] for life threatening internal trauma such as penetration of the coelom, shock, anemia, and/or sepsis. Screen the patient for serious concurrent conditions such as severe malnutrition, hypoglycemia, hypothermia, or dehydration. Control hemorrhage:  In most instances, applying direct pressure followed by a temporary pressure bandage can control active hemorrhage. Placing a blood pressure cuff proximal […]

Rabbit Nutrition and Critical Care Feeding

[…] veterinary team to recognize and manage pain promptly. Stress can lead to physiologic changes that promote gastrointestinal stasis, shock, and even death. In critical rabbits, dehydration and hypothermia must be addressed before beginning nutritional support. Monitor body weight and eliminations closely, and offer familiar food items ad libitum. In the rabbit, nutritional support relies […]

Decision Making in Rabbit Gastrointestinal Syndrome

[…] interventions. On top of a full clinical history and physical examination, complete bloodwork, urinalysis and abdominal radiography are considered baseline diagnostic investigations in RGIS. Clinical findings including hypothermia, hypotension, anemia, hyperglycemia, hepatic enzyme elevation, BUN elevation, acidosis, and a dilated stomach with a gas cap should alert the clinician to potentially life-threatening diseases, such as intestinal obstruction and liver lobe torsion. These conditions can be further defined using abdominal imaging studies, including serial radiographic studies, ultrasonography and/or contrast-enhanced computed tomography. Treatment is dependent on the underlying etiology. Fluid therapy and analgesia are considered cornerstones in the management of gastrointestinal disease in rabbits, but other specific treatments such as active warming, intestinal promotility agents, anti-microbials, and nutritional support may also be warranted. Surgery may indicated for some conditions, such as intestinal obstruction, liver lobe torsion, and appendicitis.   Outline Overview of rabbit gastrointestinal anatomy and physiology Hindgut adaptations “Wash-back” colonic separation Cecotrophy Intestinal motility Rabbit gastrointestinal syndrome Definition Encompassed conditions Possible sequelae Diagnosis Relevant clinical history Clinical examination Bloodwork Urinalysis Fecal examination Abdominal imaging Radiography Ultrasonography Computed tomography Clinical findings of significant concern Management strategies Fluid therapy Analgesia Active warming Nutritional support Anti-enterotoxemics Intestinal promotility agents Antimicrobials Other medications Surgery Management of specific conditions Intestinal obstruction Liver lobe torsion Appendicitis   About the presenter Jo Sheen is an associate veterinarian at Sydney Exotics and Rabbit Vets.  Dr. Sheen consults as a primary accession and referral exotic animal medicine veterinarian at Veterinary Specialist & Emergency Centre North Shore in New South Wales, Australia. She graduated from the University of Edinburgh in 2004, and gained her postgraduate qualification in zoological and exotic medicine in 2008. In 2017, she became a Diplomate of the American Board of Veterinary Practitioners in Exotic Companion Mammal Practice. She is only the second Australian veterinarian to achieve these credentials.   Webinar recording   Post-test Complete the brief quiz. With a passing grade of 80% or higher*, you can download your continuing education (CE) certificate for 1 hour of CE credit in jurisdictions that recognize American Association of Veterinary State Boards (AAVSB) Registry of Approved Continuing Education (RACE) approval. *Since there are only five questions, a passing grade must be 80%.   Test your knowledge     Expert Q&A Dr. Sheen generously created a pre-recording, so answers to many attendee questions were typed live and are posted below.   ENCOMPASSED CONDITIONS What about rabbits who are passing lots of mucous and have a large cecum? This would tend to suggest a cecal dysfunction. If this is an adult rabbit, I would start with looking at husbandry closely.   DIAGNOSTICS Is measurement of urine specific gravity (USG) in rabbits useful for assessing renal concentrating ability? Do you recommend urine culture and a urine protein/creatinine (UPC) ratio? USG is invaluable together with other biochemical parameters (blood urea nitrogen, creatinine, K+, phosphorus, etc.) for assessment of renal concentrating ability. Culture and sensitivity and UPC will depend on the case and whether I am concerned about disease(s) associated with the urinary system. Given the huge range of urine specific gravity (USG) in the rabbit at what USG do you consider loss of concentration? Good question! Published ranges are super wide! I would interpret that together with bloodwork and clinical status of animal. For example, if the rabbit is azotemic and showed USG = 1.005, I would probably consider this significant. However, if the rabbit is azotemic and you have diagnosed intestinal obstruction and the rabbit has been receiving intravenous fluids for the past 12 hours, then a USG of 1.010 is likely to be less concerning. When taking a series of x-rays to access the progression of the obstruction how much time should be allowed between each of those? The exact interval will depend on the clinical status of the rabbit. If stable, I usually aim for every 2 hours or so.   MANAGEMENT STRATEGIES Is maropitant dosing/administration the same as in dogs or cats? I use the same dose as for dogs/cats:  1 mg/kg SC Ozawa SM, Hawkins MG, Drazenovich TL, Kass PH, Knych HK. Pharmacokinetics of maropitant citrate in New Zealand White rabbits (Oryctolagus cuniculus). Am J Vet Res. 2019 Oct;80(10):963-968. doi: 10.2460/ajvr.80.10.963. PMID: 31556710. Can you share a dose for opioids…? What opioid(s) are you thinking specifically? There are doses published for a number of them (buprenorphine, fentanyl, etc. Visit the Exotic Animal Formulary for specific doses and view the RACE-approved webinar recording Sedation and Pain Management in Exotic Companion Mammals for useful clinical information.   Regarding ranitidine discontinuation – we now get cimetidine compounded and use this adjunctively to cisapride. Do you have any thoughts on this? Go right ahead 🙂 Just bear in mind the pro-motility effects of H2 receptor blocks ranitidine > famotidine > cimetidine Does famotidine have pro-kinetic effects, or do you use it as a gut protectant? It is believed to have both. Given the complexity of rabbit GI […]

Presenting problem: Trauma in Ferrets

[…] ongoing or preexisting physiologic disturbances (Ford 2006). Clinical signs of decompensation: Weak peripheral pulse Cool peripheral extremities Cyanosis, gray, or pale mucous membranes Prolonged capillary refill time Hypothermia (hyperthermia) Confused or inappropriate mentation, depression Tachycardia, bradycardia, arrhythmia* Declining hematocrit Distended, painful abdomen Increased respiratory effort, dyspnea Hematochezia, hematemesis *Remember that a prominent sinus arrhythmia […]

Zoonotic concern: Rabies in Terrestrial Small Mammals

[…] period of 4-5 days. Common clinical signs included ascending paralysis, anorexia, cachexia, bladder atony, tremors, and paresis. Symptoms that varied somewhat by virus strain included pyrexia versus hypothermia, and lethargy versus hyperactivity. Cases of naturally occurring rabies in pet ferrets are rare (Table 1), probably due to a combination of lack of opportunities for […]

Basic Information Sheet: Virginia Opossum

[…] July 5, 2018). Older, furred joeys covered in hair may survive but still present a substantial time commitment. Initiate hand-rearing once immediate supportive care for dehydration and hypothermia has been provided. Marsupials cannot thermoregulate and are not immunocompetent until about. halfway through pouch life and the neonatal marsupial is at a higher risk for […]

Pulse Oximetry in Exotic Animal Species

[…] A fall or loss of the oxygen saturation signal can be caused by a decrease in tissue perfusion due to cardiovascular failure, a fall in blood pressure, hypothermia, vasoconstriction caused by anesthetic agents, particularly alpha-2 agonists, as well as shock.8,12 Table 2. Causes of false SpO2 readings 7 Falsely low Falsely normal Falsely high […]

Blood Pressure Monitoring in Exotic Animal Species

[…] instrument may fail to obtain any readings at all.1,3,48,9,27 Oscillometric techniques can also fail to obtain measurements with rapid heart rates (>200 bpm), small patient size, and hypothermia.9,27 DOPPLER ULTRASOUND BLOOD PRESSURE MONITOR To measure blood pressure with the Doppler, an ultrasonic probe is placed over the artery and a pressure cuff is placed […]

Exotic Companion Mammal Emergency & Critical Care Summary Page

[…] painful conditions in small mammals. Go to the review article Analgesia and Sedation in Exotic Companion Mammals for additional information.   Nutritional support Always address dehydration and hypothermia before beginning nutritional support. Monitor body weight and eliminations closely, and offer familiar food items ad libitum. Ferrets are relatively easy to syringe feed. An esophagostomy […]

Avian Emergency & Critical Care Summary Page

[…] a treatment cage door. Dim light levels as needed to calm the nervous patient. A rapid metabolic rate means that small birds have a greater susceptibility to hypothermia. Debilitated birds should be kept warm. Target incubator temperatures range between 80-90°F (26-32°C) for most avian patients. Carefully observe the patient for signs of overheating, such […]

Fluid Administration in Amphibians

[…] associated with fluid retention and loss of electrolytes. Transdermal fluid delivery should always be the first step in supportive care of the amphibian. Pre-warm fluids to prevent hypothermia. Signs of dehydration in amphibians can include: dry ropy mucus in the mouth, sunken eyes, weight loss, oliguria or anuria, and wrinkled, tacky or discolored skin […]