Unfortunately, emergency medicine and critical care don’t stop for the holiday season, so we are just sending a little reminder to make sure that your cupboard contains enough EmerAid for any crisis over the holidays.
This free, R.A.C.E.-approved continuing education webinar, Emergency and Critical Care of Rabbits, was presented by Charly Pignon, DVM, DECZM (Small Mammal) on November 7, 2018. Lecture topics of this webinar recording include emergency triage, cardiopulmonary resuscitation, analgesia, fluid therapy, and critical care nutrition.
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Even the most steadfast and seasoned veterinary anesthetist can find themselves intimidated by exotic animal patients. Standard veterinary anesthesia monitors are not designed to read the extremely high (or extremely low) heart rates and respiratory rates of some exotic animal patients. Despite these challenges, valuable information can be gathered from monitoring tools as well as hands-on techniques. Essential vital signs, such as heart rate and rhythm, respiratory rate and depth, body temperature, and mucous membrane color should all be evaluated.
Electrocardiography can be used to detect and diagnose arrhythmias and conduction abnormalities, particularly during long-term anesthesia. How are leads attached to exotic animal patients? And what is the normal appearance of normal electrocardiogram tracings in birds or reptiles?
Heart rate and oxygenation should ideally be monitored during every anesthetic event. Patient size can limit the accuracy of pulse oximetry readings in exotic companion mammals and this technique has not been validated in birds or reptiles, however trends during the course of anesthesia can still provide useful clues to patient clinical status.
Dystocia is defined as the inability of a sow to deliver her litter normally. In breeding colonies, maternal mortality and loss of the pup is an important and common problem in the guinea pig. This review article discusses the pathogenesis of disease, gestation and parturition, important differential diagnoses, diagnostics, therapy, prognosis, neonatal care, and prevention. There is also a brief quiz to reinforce learning.
This learning aid is designed to assist the participant in meeting the needs of VECCS-certified facility. The basics of emergency medicine and critical care universal, however veterinarians face a unique set of challenges when caring for birds, exotic companion mammals, and reptiles. Level 1 of this teaching module reviews the basics of exotic animal critical care. To learn more in Level 2, review the key points on critical care or supportive care for each taxonomic group: birds, exotic companion mammals, and reptiles. Each summary page includes a brief quiz that tests your knowledge and reinforces fundamental principles. Delve deeper into critical care of exotic animal patients in Level 3 by browsing pertinent exotic animal content on LafeberVet.
There is little empirical information available on cardiopulmonary resuscitation in most exotic animals. Fortunately, the basic principles of CPR are the same for all species, however there are important species-specific considerations. This review article explores techniques for establishing airway control, ventilation and cardiac compression recommendations as well as considerations for emergency drug selection.
Although the principles of emergency medicine critical care are universal for all species, this approach must be balanced with an understanding of the unique aspects of small mammal medicine. Use this summary page to review the basic approach to the exotic companion mammal patient and select additional links to supplement your knowledge base.
The approach to analgesia and sedation in exotic companion mammals faces special challenges, including small patient size and unique features of the prey species mentality. Recognition of pain is more difficult in rabbits and rodents because many small mammals are very good at hiding the signs of pain commonly observed in predator species. Instead pain in a rabbit or rodent is often inferred from the patient’s clinical condition as well as the absence of normal behaviors. The diagnostic and therapeutic plan frequently requires some form of chemical restraint in exotic mammal medicine. When compared to general anesthesia, sedation is a safer option for the debilitated or critically ill small mammal.
Test your knowledge after completing the exotic companion mammal portion of the LafeberVet Emergency and Critical Care teaching module.
This presenting problem article reviews the basic approach to the dyspneic ferret beginning with clinical signs of the dyspneic ferret, key points of urgent care, as well as case management. This latter section reviews tips on taking the history, performing the physical exam, important differential diagnoses, as well as the diagnostic/therapeutic approach.
Quality Exotic Small Mammal Anesthesia was reviewed and approved by the American Association of Veterinary State Boards (AAVSB) Registry of Approved Continuing Education (R.A.C.E.) program for 1 hour of continuing education, in jurisdictions which recognize AAVSB R.A.C.E. approval….
The approach to a prey species like the rabbit often calls for a profound paradigm shift for clinicians used to dealing only with cats and dogs. Rabbits can stress very easily in a clinical setting and the challenge of managing a small mammal like the rabbit increases exponentially when they are presented for illness or injury.
Head tilt or torticollis, also known as “wry neck” and uncontrolled or episodic rolling are common presentations in the pet rabbit (Oryctolagus cuniculus). There are two common causes of head tilt or torticollis and rolling in the rabbit…
Exotic small mammals can be challenging to safely induce, maintain and recover from general anesthesia. View the recording of this RACE-approved webinar, which explores clinical anesthesia in exotic companion mammals from patient assessment and anesthetic induction to monitoring and recovery. The use of common premedications, induction agents, maintenance drugs, and post-operative analgesics will be compared and contrasted in exotic companion mammals. Multimodal anesthetic techniques, such as epidural anesthesia and constant rate infusions, will also be discussed.
View the recording of this free, interactive webinar, presented by Neil Forbes, BVetMed DECZM (Avian) FRCVS. Many sick or injured exotic animals are presented in critical condition. More of these patients can be saved by appropriate fluids and nutritional support, than by any single medical or surgical procedure. In practical terms, providing this support is often easier said than done. Dr. Forbes’ presentation serves to demystify some of the challenges encountered; practical solutions for all exotic patients are described and discussed.
Gastric dilatation or “bloat” and gastrointestinal obstruction is an acute and life-threatening condition of pet rabbits commonly caused by an obstruction with pellets of compressed hair. The discussion portion of this Case Challenge reviews onset, clinical signs, and diagnostic test results of obstructive and non-obstructive gastrointestinal disease. This condition is considered a surgical emergency and key points of urgent care strive to stabilize the patient through analgesia, decompression when indicated, and supportive care. Surgery is discussed as well as recommendations for patients that cannot go to surgery due to clinical or financial constraints. Follow-up care as well as homecare recommendations, disease prevention, and prognosis are also explored.
A 5-year old female spayed lop rabbit presents with a history of acute anorexia (<24 hours) and lethargy. Use history, physical examination findings, laboratory results and survey radiographs to solve this case challenge.
Released for National Veterinary Technician Week 2014, Nursing Care for Exotic Companion Mammals is part of an Exotic ICU series providing advice on the management of small exotic companion mammals in a critical care setting. Specific recommendations on caging, medicating, feeding, and monitoring the critical small mammal are explored as well as important potential sequelae to the stress of hospitalization.
Although the overall incidence of urethral obstruction is probably low, this condition is an important reason for emergency presentation of the male ferret. n the United States, urethral obstruction is most frequently caused by…
Urolithiasis is characterized by single or multiple calculi throughout the urinary tract or by the presence of sandy material within the bladder and urethra. Uroliths are fortunately more of a historical disease in the ferret, while calculi are still an important problem in rabbits and rodents.
Antibiotic therapy is a challenge in rabbits. The rabbit digestive system depends upon a healthy population of microbes to function properly. In normal circumstances, normal commensal bacteria completely overwhelm the small numbers of opportunistic pathogenic bacteria present and keep them safely in check. Certain antibiotics, particularly when given by the oral route, however, have the potential to disturb this crucial balance by killing off the commensal bacteria…
As in other species, to manage pain successfully, one must know when pain might occur. Several common medical disorders can result in acute pain such as otitis, conjunctivitis, and acute gastrointestinal disease. Chronic pain can arise from conditions such as arthritis, which commonly develops in older…
Looking for an emergency equipment checklist? Review general recommendations for preparing yourself, your staff, and your practice to special species.
Guinea pigs tend to be shy, sweet-natured creatures. Guinea pigs are prey species. Their survival depends on the ability to be alert and respond quickly, and they possess acute senses of smell and hearing. Approach guinea pigs in a calm, quiet manner…
Rabbits are prey species. Their survival depends on the ability to be alert and respond quickly, and they possess acute senses of smell and hearing. Approach rabbits in a calm, quiet manner. Stressed or critically ill rabbits may not tolerate prolonged handling. Evaluation and treatment may need to proceed slowly in stages.
Diarrhea is the most common clinical sign in ferrets with gastrointestinal disease, with the exception of gastrointestinal foreign bodies where anorexia and weight loss are the primary presenting complaints. Important causes of diarrhea in young ferrets include coccidiosis and rotavirus. Ferrets of all ages may be afflicted with Helicobacter gastritis, ferret enteric coronavirus, and stress-induced diarrhea while middle-aged to older ferrets may suffer from inflammatory bowel disease and intestinal lymphoma. Although signalment, history, and physical exam findings may be sufficient to reach a tentative diagnosis, additional diagnostics may include cytology such as fecal parasite testing, and imaging. Treatment will vary with the specific condition identified but frequently includes…
Lethargy, total or partial anorexia, a reduction in fecal output, or scant fecal size can all indicate critical illness in rabbits. Problems that slow the gut are often uncomfortable, however rabbits tend to mask pain and discomfort, especially when frightened. Signs of fear and pain in the rabbit can include…
Providing nutrition to the hospitalized small mammal is a fairly straightforward process. Encourage owners to bring their pet’s “regular” diet to minimize the risk of food refusal or gastrointestinal upset. Also consider keeping the following food items available…
Abnormal urine in the rabbit typically appears white and chalky or pigmented. These changes can be related to the unique metabolism of calcium in the rabbit. Rabbits absorb nearly all calcium ingested; therefore blood levels vary substantially with the calcium content of the diet…
When Kara Burns, veterinary technician specialist in nutrition, visited Tuskegee University School of Veterinary Medicine during the fall of 2014, her lecture on critical care nutrition made a big impression on the veterinary medical students. This 48-minute presentation explores the basics of nutritional supportive care appropriate for all species before concluding with information on nutritional support of special species like birds, reptiles and exotic companion mammals.
There is no cure for insulinoma. If the ferret lives long enough, eventually it will reach a point where clinical signs cannot be controlled and euthanasia will need to be selected to address quality of life issues.
Diarrhea is the most common problem in pet hamsters. In a recent survey of two large American commercial breeding facilities, approximately 3% of shipped hamsters develop diarrhea. Diarrhea caused by enterocolitis can occur in hamsters of any age or breed and is commonly known as “wet-tail”. Clinical signs in weanlings usually include diarrhea, anorexia, ruffled hair, dehydration, weight loss, and death. The mortality rate is often highest in…
The principles of fluid therapy are basically the same in exotic companion mammals as in other species. The biggest difference is that changes can occur very rapidly in these tiny patients. For instance, fluids should almost always be warmed or your patient will cool down quickly. Intraosseous or intravenous fluids can be heated with…
The ferret is a carnivore with a short, simple gastrointestinal tract and a relatively rapid gastrointestinal transit time. Diarrhea is the most common clinical sign in ferrets with gastrointestinal disease, with the exception of gastrointestinal foreign bodies where anorexia and weight loss are the primary presenting complaints.
Rhinitis or sinusitis, sometimes called “snuffles” in laymen’s terms, is usually characterized by unilateral or bilateral, mucopurulent nasal discharge, sneezing, and congestion. A subtle sign of upper respiratory tract disease can be discharge matted on the paws or the medial aspect of the forelimbs. Discharge may collect here as the rabbit fastidiously cleans its face with its forepaws. In the early stages of disease, discharge may not be evident on the nose or even on the paws, however close examination of…
The average small animal veterinarian may easily become comfortable with ferrets. Ferrets are hardy and relatively stoic, and as members of the order Carnivora, ferrets are predator species that approach the world in a manner similar to cats and dogs. A relatively small number of medical problems are seen very commonly in ferrets. Careful study of these conditions and attention to the unique aspects of ferret anatomy and behavior will prepare the veterinarian for basic emergency care of the ferret.
Have you ausculted an arrhythmia in a ferret. Now what? Cardiac dysrhythmias can encompass a wide range of clinical syndromes that vary in significance and signs.
Do you consider ferret arrhythmias a cinch? Take our quiz to confirm you’re ready to auscult in a pinch!
Unfortunately respiratory disease is common in pet rats. Although most cases of respiratory disease in the rat are multifactorial, the most significant and serious bacterial pathogen is Mycoplasma pulmonis. Institute medical therapy as soon as possible in rats with respiratory disease since this improves…
Urethral obstruction is an important reason for emergency presentation of the male ferret. If not corrected, obstruction can result in severe metabolic disturbances, coma, and death.
Signs of complete urethral obstruction are usually not very subtle. Ferrets may strain violently or cry when attempting to urinate. Owners may misinterpret the straining observed as “constipation”, and tenesmus may even lead to diarrhea in some cases. Occasionally, a ferret with blockage will present for lethargy, weakness, anorexia, and even collapse without obvious signs of dysuria although the urinary bladder will be…
This brief article was created to serve as a synopsis of LafeberVet’s longer, more detailed “Analgesia in Small Mammals” authored by veterinary anesthesiologist, Dr. Paul Flecknell.
Gastrointestinal problems are common in the pet rabbit. A thorough history, including a detailed dietary history, can provide invaluable clues to the problem at hand. Signs of gastrointestinal discomfort in the rabbit may include bruxism, reluctance to move, and anorexia. If there is a history of anorexia, it is imperative to differentiate whether the rabbit is not eating because it has no interest in food, or if it is showing an interest in food but unable to eat. A complete lack of appetite is most commonly seen with physiological problems such as renal failure, whereas a reluctance to eat is a classic presentation in rabbits with dental disease.
Disseminated idiopathic myofasciitis (DIM) is a severe inflammatory disease that primarily affects skeletal, smooth, and cardiac muscles as well as surrounding connective tissues. This recently identified disease typically affects young ferrets, less than 18 months of age. The cause of DIM is unknown, but this condition is suspected to be an acquired immune-mediated disease. The onset of DIM is usually acute to subacute, followed by a rapid decline over 12-36 hours. The most prominent clinical signs include a high fever ranging from…
It is critical to approach the dyspneic rabbit quietly, carefully, and gently. Many rabbits with respiratory disease are unstable upon presentation, given the stress of their condition compounded by the stress of transport and the strange smells, sights and sounds of the veterinary clinic. In many cases, it is prudent to delay handling the patient. Transfer the rabbit to…
Clinical signs of upper respiratory tract disease in the ferret can include congestion, sneezing, oculonasal discharge, and non-specific signs of illness, such as reduced appetite, lethargy, and weight loss. If disease extends lower into the respiratory tract, cough, tachypnea, and…
Pet ferrets are routinely vaccinated against canine distemper virus and rabies virus. Anecdotally, hypersensitivity reactions to vaccines are common in the ferret, and can potentially be fatal.
Conjunctivitis is a common clinical problem in chinchillas. Ocular irritation can arise from excessive dust bathing, inadequate cage ventilation and/or…
Unfortunately, neurologic disease is a common presenting problem in the ferret. Neurologic deficits may include an altered level of consciousness, paresis, ataxia, or even pelvic limb paralysis or collapse.