- Improper diet and substandard housing are often major contributors to illness in exotic animal patients.
- Some exotic animal species are sexually monomorphic, therefore always determine how gender was identified.
- How long has the animal been in the client’s possession? New arrivals are more likely to suffer from stress and acute problems like infectious disease. Animals kept in a well-established cage setup are more likely to suffer from husbandry-related problems or chronic disease.
- Obtain a detailed dietary history. If the animal is offered a wide variety of food items determine what is offered versus what is actually consumed.
- Husbandry information for the reptile must be particularly detailed, and should include temperature, humidity, and how these parameters are monitored. What is the availability of full-spectrum ultraviolet light or exposure to direct sunlight for omnivorous and herbivorous reptiles?
- If the pet is allowed outside of the cage, identify your patient’s potential exposure to environmental hazards. Is the pet supervised? Does the owner “pet proof” the environment?
- For reptiles: When did the animal last shed? Was that shed normal? And in large reptiles, when did the animal last eat and when did the animal last defecate?
- Collect a thorough history whenever a new patient presents. During follow-up visits, tailor questions to the presenting complaint and any recommendations or changes since the previous visit.
Listen to the podcast
Although patient history is important in all species, improper diet and substandard housing are often major contributors to illness in non-traditional pets. This means that a detailed and accurate history is often one of the most critical diagnostic tools for the exotic animal patient. This review focuses on birds, reptiles, and small exotic companion mammals, beginning with the signalment and presenting complaint, before moving onto the environmental history, dietary history, and of course the medical history.
Obtain as much information as possible about the pet before laying hands on that animal. Of course, when patients are presented for urgent care there may not be time to obtain a history right away. As soon as the animal is stabilized, discuss patient husbandry and the medical history.
History taking is also important because the time spent collecting a thorough history may allow the animal to settle down. Many exotics seen in clinical practice are prey species. When faced with the stress of a strange exam room, most prey animals will instinctively try to appear strong and alert for as long as they possibly can. An acclimation period of 5-10 minutes may allow the animal to relax its guard a bit and display subtle signs of illness. If a prey species appears obviously depressed or sickly in an unfamiliar setting like the exam room, chances are the animal is extremely ill.
Much of history taking is the same for all species. First, address the chief compliant.
- What is the presenting problem?
- When did the owner first notice signs of illness?
- What is the progression and duration of signs?
- Have any treatments, including herbal and nutritional supplements, been provided?
- To rule out any errors of administration: How was the drug used?
- Has there been any response to therapy?
Verify the signalment:
- What is the species ± breed?
- What is the age of the animal?
- What is the sex?
Sexual dimorphism, or an obvious difference in the male and female of the species, exists in many lizard and chelonian species, but there are only a few well-known examples of sexual dimorphism in the bird world. Most companion bird species are sexually monomorphic.
- How was gender determined in the sexually monomorphic species?
Reliable methods of gender identification in the bird include DNA sexing and laparoscopic examination, however the only truly fool-proof method of sexing the bird is egg laying.
- The owner of a female animal that has produced eggs should always be questioned further: When was the last clutch (or collection of eggs) laid? How many eggs are usually laid in a clutch? Have any malformed or abnormally shelled eggs been produced? Have any reproductive behaviors been observed? Broody or reproductive behavior in the bird can include paper shredding, regurgitating to a mirror, or seeking dark places.
- Is the pet intact or neutered?
Most pet ferrets in the US are descented and neutered at a very early age.
- How long has the animal been in the client’s possession?
New arrivals are more likely to suffer from stress and acute problems like infectious diseases. Animals kept in a well-established cage setup are more likely to suffer from husbandry-related problems or chronic diseases like neoplasia or parasites.
- Where was the pet acquired?
- Is the animal captive born or wild caught?
- Has the pet had any exposure—direct or indirect—to other animals currently or in the past?
- Have any animals been newly acquired?
- Are all animals in the household healthy?
- Who is the primary caretaker?
Unfortunately, handling of a small mammal by a young child can increase the odds of trauma.
Video 1. Time stamp 0:00-0:15 is featured in the podcast.
- What foods are fed, in what quantity and what proportions?
- If the animal is offered a wide variety of food items: What is offered versus what is actually consumed?
- How often is the animal fed?
- At what time of day is the animal fed?
- How is the food presented?
- Are any vitamins or mineral supplements provided? If so, how often and in what quantity?
- What treats are provided?
- Many reptile patients like large snakes eat relatively infrequently: When was the animal’s last meal? When did the animal last defecate?
Feces should pass within ~1 week of feeding in the large reptile.
- What is the cage type?
- What is the cage size or dimensions?
- How is the enclosure ventilated?
- What is the cage flooring or substrate?
- For pets with wire-bottom cages: Does the animal have access to areas away from the wire?
- What cage furniture or cage accessories are present? Climbing structures? Hiding places? Bathing or soaking containers? Perches? Toys?
Check out LafeberVet’s “Parrot Toys & Toy Safety” client education handout for guidelines on companion bird toys.
- What is the frequency of cage cleaning and what cleaning methods are used?
- Where in the household is the cage located? Is the cage ever moved?
- Is the pet always confined to a cage? If the answer is yes, has the pet ever escaped from its enclosure?
- If the pet is allowed time outside of the cage, how much time per day or week is the animal out of the cage?
Ask open-ended, non-leading questions to identify your patient’s potential exposure to environmental hazards. A history of free roaming without supervision or “pet proofing” the environment greatly increases the index of suspicion for gastrointestinal foreign bodies, toxic exposure, or trauma.
- Is the pet sometimes taken outdoors? Or is the animal strictly indoors?
- What is the normal photoperiod provided?
Husbandry information must be particularly detailed for reptile patients.
- Is there a temperature gradient? What heating elements are used?
- What is the humidity? How is cage humidity managed?
- Is there a basking spot and what is the temperature at this site?
- How are temperature and humidity measured?
- What type of light is provided?
- What is the availability of full-spectrum ultraviolet light (UV) or exposure to direct sunlight for herbivorous and omnivorous reptiles? When was the last time a UV light source was changed? What is the distance between the reptile and the UV light source?
Don’t forget to ask about the water supply.
- What is the water source?
- What types of water containers are used? Does the animal drink from a water bottle or water bowl? This is important if the patient needs to be hospitalized.
- How often is water changed?
- If the animal is soaked or bathed, how often is this done?
The medical component of the exotic animal history is similar to that for all species. Has sneezing, oculonasal discharge, coughing, or respiratory noise been observed? If respiratory signs have been observed in the bird: Has voice change been noted?
Voice change in the avian patient localizes the problem to the trachea, or more specifically the syrinx or “voice box” of the bird.
Has vomiting or diarrhea been observed? Remember rabbits are normally unable to vomit because of the anatomic arrangement of their cardia and stomach.
Nausea in the ferret can manifest as copious drooling or ptyalism and vigorous pawing at the mouth. Loud teeth grinding or bruxism can be seen with abdominal pain in both the ferret and the rabbit.
When did the reptile last shed? Was the shed (ecdysis) normal?
Has the animal been screened for any infectious diseases? Has the animal been vaccinated? There are vaccines approved for use in the ferret against rabies virus and canine distemper virus. Some birds can be vaccinated against avian polyomavirus. In the United Kingdom and Australia, rabbits can be vaccinated against viral hemorrhagic disease. A vaccine is also available in some nations for the rabbit pox virus, myxomatosis. At present, there are no vaccines required or licensed for use in rabbits in North America, although some zoos do vaccinate hutch rabbits against rabies virus when they are public contact animals.
Note: The podcast does not cover previous medical history. As in all species, the previous medical history of your patient should be explored.
The history should also include an open-ended question: “Have there been any changes”? More specific questions may include:
- Have any behavioral changes been observed?
- Are there ANY environmental changes that the owner thinks could be stressful?
- Are there any changes in the diet or dietary preferences?
- Have there been any changes in appetite or water intake?
- Are there new food or water dispensers?
- And what about changes in eliminations?
How to deal with diversity
One of the many challenges of exotic animal medicine, is the incredible diversity of husbandry requirements. Before you enter the exam room and ask the owner many questions about their pet, ideally you want to know what the answers “should be”. And yet as clinicians we cannot know it all.
When you encounter a novel species, the first step is to determine the taxonomy or classification for your species of interest. This will allow you to identify familiar or common species that are most closely related to your species of interest. This will help guide your approach. Also determine the nutritional strategy seen in your species of interest.
Collect a thorough patient history whenever a new patient presents. During follow-up visits, tailor questions to the presenting complaint and any recommendations or changes since the previous visit.
Check out LafeberVet’s collection of exotic animal history forms.
Visit LafeberVet’s Ten Tips for Evaluating the Chick in the Exam Room for information on obtaining a history in the chick.