A Veterinary Technician's Guide To Exotic Animal Care, 2nd Edition

Contents
List of Figures, ix
List of Tables, xv
Foreword, xvii
Preface, xix
Acknowledgments, xxi
Chapter 1. AVIAN 1
Introduction, 1 Microbiology, 21
Husbandry, 1 Radiology, 24
Environmental Concerns, 1 Other Diagnostic Imaging Modalities, 25
Nutrition, 4 Parasitology, 25
Transport, 7 Surgical and Anesthetic Assistance, 27
Grooming, 8 Health Maintenance and Disease, 29
Bird Bands and Microchipping, 10 Respiratory and Gastrointestinal Bacterial/Fungal
History, 12 Infections, 29
Restraint, 13 Feather Picking and Feather Loss, 31
Physical Examination, 15 Trauma, 31
“Put It Down,” 18 Egg-Binding, 32
Diagnostic Sampling, 19 Heavy Metal Toxicosis, 32
Blood Collection, 19 Other Diseases, 33
Bone Marrow Aspiration, 21 Zoonotic Diseases, 34
CHAPTER 2. REPTILES AND AMPHIBIANS 37

Introduction, 37 Transport, 45
Taxonomy, 37 Grooming, 46
Husbandry, 38 History, 46
Environmental Concerns, 38 Restraint, 46
Nutrition, 43 Physical Examination, 49
© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

vi contents
Diagnostic Sampling, 51 Surgical and Anesthetic Assistance, 63

Blood Collection, 52 Health Maintenance and Disease, 63
Microbiology, 60 Husbandry-Related Problems, 67
Radiology, 61 Nutritional Diseases, 69
Parasitology, 61 Infectious Diseases, 70
Therapeutics, 62 Zoonotic Diseases, 74
CHAPTER 3. FERRETS 79
Introduction, 79 Radiology, 93
Anatomy and Physiology, 80 Parasitology, 94
Husbandry, 81 Vaccinations, 94
Environmental Concerns, 81 Therapeutics, 95
Nutrition, 82 Surgical and Anesthetic Assistance, 98
Transport, 83 Health Maintenance and Disease, 99
Grooming, 83 Gastrointestinal Diseases, 99
History, 83 Respiratory Diseases, 99
Restraint, 85 Neoplasia, 100
Physical Examination, 86 Cardiovascular Diseases, 103
Diagnostic Sampling, 89 Reproductive Diseases, 104
Blood Collection, 89 Urogenital Diseases, 103
Bone Marrow Aspiration, 91 Bacterial Diseases, 104
Splenic Aspirate, 92 Emerging Diseases, 104
Urine Collection and Interpretation, 92
CHAPTER 4. RABBITS 107

Introduction, 107 Bone Marrow Aspiration, 120
Anatomy and Physiology, 107 Collection of Cerebrospinal Fluid (CSF), 120
Husbandry, 109 Urine Collection Using Cystocentesis, 121
Environmental Concerns, 109 Microbiology, 122
Nutrition, 112 Radiology, 122
Transport, 114 Other Diagnostic Imaging Modalities, 122
Grooming, 114 Parasitology, 122
History, 114 Therapeutics, 124
Restraint, 115 Lacrimal Duct Cannulation, 124
Physical Examination, 116 Fluid Therapy, 125
Diagnostic Sampling, 117 Critical Care Diet, 125
Blood Collection, 117 Surgical and Anesthetic Assistance, 126
This electronic publication is intended for use only by the original purchaser.
contents vii
Health Maintenance and Disease, 127 Malocclusion, 129

Gastric Stasis or “Wool Block,” 127 “Sore Hocks” or Ulcerative Pododermatitis, 130
Gastroenteritis, 129 Zoonotic Diseases, 130
Pasteurella Multocida “Snuffles,” 129
CHAPTER 5. RODENTS: Guinea Pigs, Hamsters, Gerbils, Rats, and Mice135

Introduction, 135 Health Maintenance and Disease, 157
Husbandry, 140 Scurvy, 157
Environmental Concerns, 140 “Bumblefoot,” 157
Nutrition, 142 “Lumps,” 157
Transport, 143 Malocclusion, 158
Grooming, 143 Antibiotic-Associated Enterotoxemia, 158
History, 143 “Wet-Tail,” 158
Restraint, 144 Neoplasia, 158
Physical Examination, 146 Ocular System, 159
Diagnostic Sampling, 147 Trauma, 159
Blood Collection, 147 “Sore Nose,” 159
Bone Marrow Aspiration, 149 Epileptiform Seizures, 160
Urine Collection, 150 Bacterial and Viral Infections, 160
Microbiology, 150 Tumors, 160
Radiology, 151 Sialodacryoadenitis Virus, 160
Fecal Examination and Anal Tape Test, 152 Barbering, 160
Parasitology, 152 Tumors, 161
Therapeutics, 154 Bacterial and Viral Infections, 161
Surgical and Anesthetic Assistance, 155 Zoonotic Diseases, 161
Rat Intubation, 156
CHAPTER 6. HEDGEHOGS 165

Introduction, 165 Physical Examination, 170
Anatomy and Physiology, 165 Diagnostic Sampling, 171
Husbandry, 167 Blood Collection, 171
Environmental Concerns, 167 Bone Marrow Aspiration, 172
Nutrition, 168 Microbiology, 172
Transport, 168 Urinalysis, 172
Grooming, 168 Radiology, 173
History, 168 Parasitology, 173
Restraint, 169 Therapeutics, 174

viii contents
Surgical and Anesthetic Assistance, 174 Neurologic Disease, 175

Health Maintenance and Disease, 175 Cardiac Disease, 175
Neoplasia, 175 Gastrointestinal Disease, 176
Dermatomycoses, 175 Zoonotic Diseases, 176
Respiratory Disease, 175
CHAPTER 7. SUGAR GLIDERS 179

Introduction, 179 Urinalysis, 184
Husbandry, 181 Radiology, 184
Nutrition, 182 Injection Sites, 184
Grooming, 182 Parasitology, 185
History, 182 Therapeutics, 185
Restraint, 183 Surgical and Anesthetic Assistance, 185
Physical Examination, 183 Health Maintenance and Disease, 185
Diagnostic Sampling, 183 Nutritional Osteodystrophy, 185
Blood Collection, 183 Pasteurella Multocida, 185
Bone Marrow Aspiration, 183 Other Diseases, 187
Microbiology, 183
CHAPTER 8. FISH 189

Introduction, 189 Radiology, 210
Taxonomy, 190 Parasitology , 211
Anatomy and Physiology, 190 Therapeutics, 211
Husbandry, 194 Surgical and Anesthetic Assistance, 212
Environmental Concerns, 194 Health Maintenance and Disease, 214
Nutrition, 203 Bacterial Diseases, 214
Transport, 203 Viral Diseases, 215
History, 204 Parasites, 215
Physical Examination, 205 Water Molds, 215
Diagnostic Sampling, 206 Noninfectious Diseases, 216
Microbiology, 210 Zoonotic Diseases, 216
Index, 221
About the Authors, 234
List of Figures
Chapter 1. AVIAN
Figure 1.1 A typical flight cage used for a breeding Figure 1.14 Companion birds should be transported
pair of parrots, 2 in a modified pet carrier, 8
Figure 1.2 Parrot cages come in many sizes and Figure 1.15 Long claws that need trimming on a
colors, 3 cockatoo, 9
Figure 1.3 Plexiglas cages make good transport Figure 1.16 Recommended length to trim a parrot’s
carriers, 3 claw, 9
Figure 1.4 Natural wood perches, 4 Figure 1.17 A Dremel tool is recommended for claw
Figure 1.5 Many outdoor cages are made from trimming on larger parrot species, 9
galvanized wire and held together with J-clips, 4 Figure 1.18 An electrocautery unit can be used to
Figure 1.6 Pelleted diets are readily available in pet trim claws on birds that weigh <150 grams, 10
stores, 5 Figure 1.19 A blood feather, 10
Figure 1.7 Many companies offer trial sizes that can Figure 1.20 A recommended method for trimming
be provided to avian clients, 5 wing feathers, 11
Figure 1.8 Compacted seed treats, 5 Figure 1.21 Proper technique for holding small caged
Figure 1.9 For many parrot species a diversified diet is bird, 13
recommended, 6 Figure 1.22 Proper technique for holding larger par-
Figure 1.10 Foraging “toys,” 6 rot species, 14
Figure 1.11 Proper placement of a gavage feeding Figure 1.23 A Plexiglas restraint board being used to
tube in a parrot, 7 examine an avian patient, 14
Figure 1.12 Sipper water bottles, 8 Figure 1.24 A foam “pool noodle” can be used to
reduce the “stabbing” danger from long, sharp beaks, 14
Figure 1.13A A cuttlebone provides a calcium source
for smaller birds, 8 Figure 1.25 Smaller birds can be weighed in a
container, 15
Figure 1.13B A mineral block is a calcium source for
larger birds, 8 Figure 1.26 Lice eggs (nits) on the feathers of an
avian patient, 15

x list of figures
Figure 1.27 Bird with self-induced feather damage, 16 Figure 1.38 Endotracheal tube in place on a blue and
Figure 1.28 Instruments and equipment used to gold macaw, 28
properly examine a bird, 16 Figure 1.39 A radiosurgery unit, 28
Figure 1.29 Using an avian beak speculum to exam- Figure 1.40 Conductive thermal heating blanket, 29
ine the choana, 17 Figure 1.41 Convective heating unit, 29
Figure 1.30 Thermal trauma to the crop and surface Figure 1.42 Use of monitoring equipment during
epithelium, 17 avian surgery, 29
Figure 1.31 Normal keel versus thin keel, 18 Figure 1.43 A critical care unit, 30
Figure 1.32 The uropygial gland, 19 Figure 1.44 The upper respiratory system of birds is
Figure 1.33 Proper technique for collecting blood very extensive, 30
from a bird’s jugular vein, 20 Figure 1.45 Components needed to nebulize avian
Figure 1.34 Location of the basilic vein, 21 patients, 31
Figure 1.35 Proximal tibiotarsal bone, 24 Figure 1.46A “Pool noodle” used to make a neck
Figure 1.36A Budgerigar that is infested with Knemi- extender, 32
dokoptes spp. mites, 26 Figure 1.46B Use of pool noodle to prevent avian
Figure 1.36B Mite species that affects the nonfeath- self-trauma, 32
ered areas of the bird, 26 Figure 1.47 Proper placement of an intraosseus
Figure 1.37 Noncuffed endotracheal tube, 28 catheter, 33
Chapter 2. REPTILES AND AMPHIBIANS

Figure 2.1 Variable-wattage incandescent lighting Figure 2.11 Probing snakes is the best method for
provides an appropriate ETR for reptiles, 40 determining the sex of these animals, 52
Figure 2.2 Many different types of substrate are avail- Figure 2.12A Blood cells from a green iguana:
able for reptiles and amphibians, 43 heterophil (red) and monocyte (blue), 54
Figure 2.3 Crickets being fed a commercial Figure 2.12B Blood cells from a green iguana:
cricket chow, 45 lymphocyte, 54
Figure 2.4 Appropriate restraint for a large lizard, 47 Figure 2.13 Blood collection in a green iguana via the
Figure 2.5 Appropriate head restraint for a snake, 47 ventral tail vein, 55
Figure 2.6 Appropriate restraint for a chelonian, 48 Figure 2.14 Blood collection in a green iguana via the
jugular vein, 56
Figure 2.7 Restraining the head of a chelonian for
examination, 48 Figure 2.15 Blood collection from the subcarapacial
vein of a chelonian, 57
Figure 2.8 Appropriate restraint of a crocodilian, 48
Figure 2.16 Blood collection from the heart of
Figure 2.9A Anatomy of a snake, 50
a snake, 59
Figure 2.9B Anatomy of a chelonian, 51
Figure 2.17 Blood collection from the ventral coccy-
Figure 2.10 Femoral pores on the ventral thigh of a geal vein of an axolotl, 60
male green iguana, 52
list of figures xi
Figure 2.18 Blood collection from the heart of Figure 2.21 A well-defined caseous abscess on the
an axolotl, 60 dorsum of a snake, 71
Figure 2.19 Thermal burn in a green iguana, 63 Figure 2.22 Coccidiosis in a bearded dragon, 74
Figure 2.20 Severe articular gout in a gecko, 70
Chapter 3. FERRETS
Figure 3.1 A standard sable ferret, 81 Figure 3.8 The lateral saphenous vein is an excellent
Figure 3.2 An albino ferret, 81 site for collecting blood from a ferret, 91
Figure 3.3A Grasping the nape of a ferret is an excel- Figure 3.9 Ferret cephalic vein, 96
lent way to gently restrain these animals, 86 Figure 3.10 Ferrets can be “masked down” with iso-
Figure 3.3B Most ferrets will yawn when scruffed, 86 flurane or sevoflurane, 98
Figure 3.4 Ferret tattooed with two ink dots in the Figure 3.11 It is important to create an appropriately
right ear, 87 sized sterile field for a surgical procedure, 98
Figure 3.5 Generalized hair loss (alopecia) is one of Figure 3.12 Ferret diagnosed with CDV, 100
the most common clinical signs associated with adre- Figure 3.13 The ferret prostrate, when enlarged can
nal gland disease, 88 easily be palpated, 101
Figure 3.6 Female ferrets with adrenal gland disease Figure 3.14 An enlarged left adrenal gland at
can develop significantly enlarged vulvas, 89 surgery, 102
Figure 3.7 The cranial vena cava is a preferred site for Figure 3.15 Insulinoma in a ferret, 102
collecting blood from a ferret, 90
Chapter 4. RABBITS
Figure 4.1 Soft-Paws diminish a rabbit’s ability Figure 4.7 Proper method for supporting a
to scratch, 109 rabbit’s rear, 116
Figure 4.2A Typical outdoor housing for pet Figure 4.8 A “bunny burrito” can be used to restrain
rabbits, 110 rabbit patients, 116
Figure 4.2B Morant pen, 110 Figure 4.9 Proper method for carrying a rabbit, 116
Figure 4.2C Indoor rabbit housing, 111 Figure 4.10 Rabbits should be transported in a plastic
Figure 4.3 A timothy grass–based pellet diet, 113 pet carrier, 117
Figure 4.4 Grass hay is recommended to maintain the Figure 4.11A A rabbit’s ear, showing the central
overall health of a rabbit, 113 artery and marginal ear vein, 118
Figure 4.5 Water bottles should be cleaned and Figure 4.11B Collecting blood from the marginal ear
refilled on a regular basis, 114 vein, 118
Figure 4.6A A lion-headed rabbit, 115 Figure 4.12A Blood collection from a rabbit’s jugular
vein, with patient in dorsal recumbency, 118
Figure 4.6B A dwarf rabbit, 115

xii list of figures
Figure 4.12B Blood collection from a rabbit’s jugular Figure 4.17 Nasogastric tube in place, 126
vein, with patient in ventral recumbency, 119 Figure 4.18 Rabbit glottis observed through an endo-
Figure 4.12C Collecting blood from the cephalic vein scope prior to intubation, 127
of a rabbit, 119 Figure 4.19A Maloccluded incisors of a rabbit, 130
Figure 4.12D Collecting blood from the saphenous Figure 4.19B Maloccluded rabbit molars, showing
vein of a rabbit, 119 enamel projections and irritated lingual surface, 130
Figure 4.13 Rabbit being induced and maintained Figure 4.20 Examination of a rabbit’s teeth using an
using a face mask, 120 otoscope, 130
Figure 4.14A Typical ear presentation of a rabbit with Figure 4.21A Examining a rabbit’s teeth using an
Psoroptes cuniculi, 123 endoscope, 131
Figure 4.14B A Psoroptes cuniculi mite, 123 Figure 4.21B Trimming a rabbit’s teeth using a
Figure 4.15 Cuterebra spp. larvae removed from a Dremel tool, 131
rabbit, 124 Figure 4.21C Rabbit’s teeth after trimming, 131
Figure 4.16 Flushing a rabbit patient’s nasal lacrimal Figure 4.22 Dental instruments for use with
duct, 125 rabbits, 131
Chapter 5. RODENTS: Guinea Pigs, Hamsters, Gerbils, Rats and Mice

Figure 5.1A A Tort and White guinea pig, 136 Figure 5.10 Proper method for restraining a rat, 145
Figure 5.1B A Red Dutch guinea pig, 136 Figure 5.11 Supporting a rat’s body that is being
Figure 5.2A Gerbils make excellent companion ani- examined off a table, 146
mals, 138 Figure 5.12A A mouse can be grabbed by the tail, 146
Figure 5.2B Gerbil in a typical cage, 138 Figure 5.12B Proper method for capturing and
Figure 5.3 Typical mouse cage, with recycled paper as restraining a mouse, 146
a substrate, 141 Figure 5.12C Proper method for capturing and
Figure 5.4A A typical cage that can be purchased restraining a mouse, 146
from a pet store, 142 Figure 5.13 Examining an animal’s teeth with an
Figure 5.4B An exercise wheel, 142 otoscope, 147
Figure 5.5 Vitamin C supplements, 143 Figure 5.14 Guinea pigs’ claws should be trimmed on
a regular basis, 147
Figure 5.6 Hamster food can be purchased as a pel-
leted diet or with a seed base, 143 Figure 5.15 Guinea pig with alopecia, 147
Figure 5.7A Proper method for restraining a guinea Figure 5.16 Collecting blood from the cranial
pig, 144 vena cava, 148
Figure 5.7B Proper restraint of a guinea pig requires a Figure 5.17 Mice are susceptible to ectoparasites and
firm grasp around the shoulder and neck, 144 often present with alopecia, 154
Figure 5.8 Proper method for restraining a gerbil, 145 Figure 5.18 Maintaining a hamster on gas anesthesia,
using a face mask, 155
Figure 5.9 Skin degloved from a gerbil’s tail, 145
list of figures xiii
Figure 5.19 An induction chamber being used to Figure 5.22 Bite wound abcess in a hamster, 160
induce a rabbit for general gas anesthesia, 155 Figure 5.23 Gerbil presenting with “sore nose,” 160
Figure 5.20 Mouse under general anesthesia, in prep- Figure 5.24 Mammary tumor in older female rat, 161
aration for surgery, 155
Figure 5.25 A rat with a body bandage to prevent
Figure 5.21A Guinea pig presenting with subman- self-trauma, 161
dibular abscess, 158
Figure 5.21B Aspirated purulent material collected
from a submandibular abscess, 158
Chapter 6. HEDGEHOGS
Figure 6.1 The quills of an African hedgehog cover Figure 6.5 Collecting a blood sample from the cranial
only their dorsum, 166 vena cava of a hedgehog, 172
Figure 6.2 Close-up of hedgehog quills, 166 Figure 6.6A Lateral radiograph of a hedgehog, 173
Figure 6.3 Hedgehogs are well suited for a terrestrial Figure 6.6B Dorsoventral radiograph of a
existence, 167 hedgehog, 173
Figure 6.4 Hedgehog vena cava, 171
Chapter 7. SUGAR GLIDERS

Figure 7.1 Sugar gliders are maintained as companion Figure 7.3 The pendulous testicles of a male
animals, 180 sugar glider, 180
Figure 7.2 Modified sugar glider claws are used as Figure 7.4 Scent glands of a sugar glider are also
grooming tools, 180 found on the cranial ventral body wall, 180
Chapter 8. FISH
Figure 8.1 Fish have both paired and unpaired Figure 8.3C Fish eosinophil (Eo), lymphocyte (L),
fins, 191 and erythrocyte (Er), 195
Figure 8.2A A marine Koran angelfish with severe Figure 8.3D Fish monocyte (M), 195
head and lateral line erosions, 192 Figure 8.4A Synthetic pads serve as the mechanical
Figure 8.2B A freshwater cichlid with severe head and filter, 197
lateral line erosions, 192 Figure 8.4B Ultraviolet radiation serves as a chemical
Figure 8.3A Fish heterophil (H) and filter, 197
thrombocyte (T), 194 Figure 8.4C Plastic balls serve as a biologic filter, 197
Figure 8.3B Fish neutrophil (N) and Figure 8.5 A wide variety of commercial fish food is
erythrocyte (Er), 194 available at local pet retailers, 203

xiv list of figures
Figure 8.6 Goldfish with a swim bladder Figure 8.15 Intracoelomic injections are an excellent
problem, 204 way to provide essential medications to fish, 212
Figure 8.7 A hands-on examination of a fish, 206 Figure 8.16 Fish being anesthetized for examination
Figure 8.8 Gill biopsy in a cichlid, 207 and diagnostic testing, 214
Figure 8.9 A skin scrape in a cichlid, 207 Figure 8.17 Recirculating anesthesia machine
for fish, 214
Figure 8.10 A fin biopsy in a cichlid, 208
Figure 8.18 Severe ulcerative dermatitis in a koi, 205
Figure 8.11 Ventral tail vein venipuncture in
an oscar, 209 Figure 8.19 Dactylogyrus spp. isolated from the gills
of a goldfish, 216
Figure 8.12 Cardiac venipuncture in a goldfish, 209
Figure 8.20 Oranda goldfish with caudal chamber
Figure 8.13 A lateral survey radiograph of an oscar
amputated at surgery, 216
with a renal tumor, 211
Figure 8.21 An osteoma in a royal plecostamus asso-
Figure 8.14 A lateral survey radiograph of an oranda
ciated with the pectoral fin, 217
goldfish with a swim bladder problem, 211
Figure 8.22 An ovarian adenocarcinoma in a koi, 217
List of Tables
Chapter 1. AVIAN
Table 1.1 Avian Hematological Reference Table 1.2 Avian Plasma Biochemical Reference
Ranges, 22 Ranges, 23
Chapter 2. REPTILES AND AMPHIBIANS

Table 2.1 Reptile and Amphibian Taxonomy, 39 Table 2.3 Antiparasitic Agents Used in Reptiles and
Table 2.2 Substrates Commonly Recommended for Amphibians, 63
Reptiles and Amphibians, 43
Chapter 3. FERRETS
Table 3.1 Ferret Basic Information, 80 Table 3.4 Urinalysis Results in the Ferret, 93
Table 3.2 Ferret Hematological Reference Table 3.5 Injectable Analgesic and Anesthetic Dos-
Ranges, 84 ages for the Ferret, 97
Table 3.3 Ferret Serum Biochemistry Reference
Ranges, 85
Chapter 4. RABBITS
Table 4.1 Rabbit Basic Information, 108 Table 4.5 Recommended Amounts of Mixed Critical
Table 4.2 Rabbit Complete Blood Count Reference Care TM Feed, 126
Ranges, 120 Table 4.6 Rabbit Surgery Preparation, 127
Table 4.3 Rabbit Serum Biochemistry Reference Table 4.7 Rabbit Premedication, Sedation, and
Ranges, 121 Chemical Restraint Agents, 128
Table 4.4 Rabbit Normal Urinalysis Values, 122 Table 4.8 Rabbit Injectable Anesthetic Agents, 128

xvi l i s t o f ta b l e s
Chapter 5. RODENTS: Guinea Pigs, Hamsters, Gerbils, Rats and Mice

Table 5.1 Guinea Pig Basic Information, 137 Table 5.12 Gerbil Serum Biochemistry Reference
Table 5.2 Hamster Basic Information, 138 Ranges, 150
Table 5.3 Gerbil Basic Information, 139 Table 5.13 Rat Complete Blood Count Reference
Ranges, 151
Table 5.4 Rat Basic Information, 140
Table 5.14 Rat Serum Biochemistry Reference
Table 5.5 Mouse Basic Information, 141
Ranges, 151
Table 5.6 Guinea Pig Complete Blood Count Refer-
Table 5.15 Mouse Complete Blood Count Reference
ence Ranges, 148
Ranges, 151
Table 5.7 Guinea Pig Serum Biochemistry Reference
Table 5.16 Mouse Serum Biochemistry Reference
Ranges, 148
Ranges, 151
Table 5.8 Retro-Orbital Blood Collection, 149
Table 5.17 Basic Surgery Guidelines for Rodents and
Table 5.9 Hamster Complete Blood Count Reference Pocket Pets, 156
Ranges, 150
Table 5.18 Premedication and Sedation Drug Doses
Table 5.10 Hamster Serum Biochemistry Reference for Rodents, 156
Ranges, 150
Table 5.19 Injectable Anesthesia in Rodents, 156
Table 5.11 Gerbil Complete Blood Count Reference
Table 5.20 Analgesic Doses for Rodents, 157
Ranges, 150
Chapter 6. HEDGEHOGS
Table 6.1 Hedgehog Basic Information, 167 Table 6.4 Hedgehog Complete Blood Count Refer-
Table 6.2 Hedgehog Daily Diet, 169 ence Ranges, 172
Table 6.3 Injectable Anesthetic Agents Used in Table 6.5 Hedgehog Serum Biochemistry Reference
Hedgehogs, 170 Ranges, 172
Chapter 7. SUGAR GLIDERS

Table 7.1 Sugar Glider Basic Information, 181 Table 7.3 Sugar Glider Serum Biochemistry Refer-
Table 7.2 Sugar Glider Complete Blood Count Refer- ence Ranges, 184
ence Ranges, 184 Table 7.4 Dosages of Common Therapeutic Agents
Used for Sugar Gliders, 186
Foreword
As technicians, we are the first to have contact with mation on blood draw and injection sites for
clients and their animals. As with dogs and cats, it administering medications, parasites that are
is important that we gather all necessary informa- most common to the species, and anesthetics that
tion in order to treat exotic animals. Often, we are commonly used with the species.
see clients who have acquired a new and exciting I have been working with exotic animals for
exotic species without having much knowledge many years, and most of my knowledge on the
about the husbandry, diet, and diseases associated subject of exotics has been gained through hands-
with those animals. It is our role as technicians to on training and gleaning information from a
provide that knowledge and guide our clients in variety of resources, each concentrating on one
the care of their new pet. species. This book compiles in one reference
We can also help educate clients before they information on all the common exotic pets seen
make the purchase of that exotic animal. Techni- in private practice. As a technician, I find this a
cians need to know what questions to ask with valuable directory, which helps me either recall
regard to the nutrition, diet, and housing of the or learn new information about the species that I
animal, and A Veterinary Technician’s Guide to might encounter in the clinic.
Exotic Animal Care provides that knowledge base The knowledge and information provided in
in one convenient reference. A Veterinary Tech- this book is invaluable to our practice, as tech-
nician’s Guide to Exotic Animal Care includes nicians work with veterinarians to expand their
specifics on birds, reptiles, amphibians, rodents, exotic animal clientele. I definitely recommend
fish, sugar gliders, rabbits, ferrets, and hedgehogs, adding A Veterinary Technician’s Guide to Exotic
all animals that have become very popular house- Animal Care to your reference library.
hold pets in the last few years. —Dianna Lydick, BS, RVT, CVT
In addition to husbandry, diet, and disease
information, this reference provides great infor-

Preface
This is a much-needed second edition of A Vet- vent one of the most common causes of death in
erinary Technician’s Guide to Exotic Animal Care. pet exotic animals: improper husbandry/nutrition.
Over the past 10 years there has continued to be an Examination of the patient and, more importantly,
evolving body of knowledge as to the proper care education of the owner are the primary objectives of
and treatment of avian and exotic animal species. the first visit. The education process, which often is
While maintaining the foundation of informa- the responsibility of the veterinary technician, may
tion regarding birds, reptiles, ferrets, rabbits, include handouts, educational video, and recom-
rodents, hedgehogs, sugar gliders, and fish found mended Internet websites.
in the first edition, this edition expands in criti- Veterinarians actively seek technicians who
cal areas to elevate the reader’s understanding of have an interest in working with exotic animal
these diverse animal groups. This continues to be species. To gain clinical confidence, veterinary
a basic text covering the most common exotic ani- technicians must initially be motivated to become
mal species treated in small-animal hospitals. The experienced in handling and collecting diagnostic
chapters cover important information required by samples from the animals mentioned in this text.
owners, while focusing on the skills needed by the Basic knowledge learned about dogs and cats will
veterinary technician/nurse (hereafter veterinary serve the interested exotic animal technician well,
technician) who works with these animals. with confidence quickly growing in proportion to
Today’s pet owners demand quality care for the number of animals treated.
their animals and expect both veterinarians and As mentioned, this second edition is more
veterinary technicians to have basic knowledge detailed and up-to-date and provides a signifi-
of handling, diseases, husbandry, and nutrition. cantly increased number of full-color figures, line
This text provides the essential information in a drawings, and tables. Each chapter covers the fol-
systematic formula that covers the basic respon- lowing main topics: husbandry, nutrition, restraint,
sibilities of veterinary technicians; and full-color physical examination, diagnostic sampling, thera-
photos and line drawings improve understanding peutics, and disease. There are references at the
of educational and technical concepts. end of each chapter for individuals who seek more
Exotic companion-animal owners should be detailed information on a particular topic. For the
encouraged to seek veterinary care for their animals reader’s benefit, some products, medications, and
when first purchased and, at least, on a yearly basis manufacturers are listed in the text. These recom-
for health examinations. The initial visit helps pre- mendations are based on what the authors have

xx p r e fa c e
found to work best, but are not meant to endorse What has not changed since the first edition
a particular company. Occasionally, manufactur- was published is that veterinary practices have a
ers aren’tmentioned because a drug is generic and continuing demand for interested and qualified
produced by many companies. This edition con- technicians in the area of avian/exotic animal medi-
tinues to provide the basic guidelines veterinary cine. The authors continue to encourage veterinary
technicians need to perform quality exotic animal technicians to get involved in this exciting, grow-
pet care. ing, and challenging field of veterinary medicine.
Acknowledgments
The authors gratefully acknowledge the assistance The authors would like to thank the review-
of Mr. Michael Broussard. We would also like to ers of the current edition: J. Jill Heatley, DVM,
thank Ms. Bess Maher at AAHA Press for her MS, Dipl. ABVP (Avian), Dipl. ACZM; Dianna
patience and support in successfully guiding this Lydick, BS, RVT, CVT; and Tiffany Wolf, DVM.
much-needed text to completion. Thanks to Susie Many thanks also go to the First Edition
Tully, Claudia Rose Tully, Fiona Elizabeth Tully, Advisory Group: Dr. Laurel Collins, ABVP, Dr.
Lorrie Hale Mitchell, Mary Mitchell, and R. J. Richard Goebel, Dr. Charles Hickey, Dr. Clayton
Mitchell for providing moral support and putting McKinnon, and Dr. Hal Taylor.
up with the authors’ constant emotional demands
while working on this project.

Avian
Chapter 1
INTRODUCTION
There are close to 9,000 different avian species worldwide. These are not
different breeds of the same species, like dogs and cats, but are, in fact,
entirely different animals within the class Aves. Upon first learning of this
difference, it would seem impossible to become qualified to treat so many
different types of birds. With this in mind, a technician must learn and
become knowledgeable about basic avian husbandry, diagnostic sampling,
and patient care. Most veterinary practices see only companion avian spe-
cies (e.g., parrots, macaws, and cockatiels) and caged birds (e.g., finches and
canaries). These are the species that technicians need to become familiar with
and comfortable handling and treating. Through experience and modifica-
tion of technical skills, the transition between avian species is easy to make,
if needed, for wildlife or zoological avian species (e.g., toucans, flamingos,
penguins, and ostriches). Companion avian species need to be examined
yearly, groomed regularly, and vaccinated on a regular schedule. As with
other exotic species, the presentation of the patient in the exam room allows
the technician to provide husbandry and nutritional information to the cli-
ent. Captive-reared companion avian species are excellent pets, with each
species having advantages and disadvantages to ownership—similar to the
physical and personality differences observed in cat and dog breeds. If placed
on a proper diet and maintained on that nutritional regimen, most pet birds
live long, healthy lives.
HUSBANDRY
Environmental Concerns
Many new pet bird owners purchase their pets with a few preconceived
ideas that have been learned from a lifetime of misinformation. One of these

2 A v e t e r i n a r y T e c h n i c i a n ’ s G u i d e t o E x o t i c A n i m a l Ca r e
misconceptions is that birds are sensitive to cold ture of a house rises and falls with the seasons of
and drafts. In reality, avian species are much more the year. Birds should not be moved from an air-
sensitive to heat than they are to cold or drafts. conditioned environment into an outdoor flight
Birds have an ability to acclimatize to almost any during the peak months of summer or winter,
environment over time, especially cooler weather. because they are not acclimatized to the environ-
Although many birds come from arid, tropical, ment. Placing a bird near an air-conditioner’s vent
and subtropical regions of the world, there are is also not advised, because air near a vent is con-
microenvironments within these areas that pro- siderably cooler/warmer than the surrounding air
vide protection from the oppressive heat. Many of temperature, which creates added physical stress
these microenvironments range from 75° to 85°F. on the bird to compensate for the constant change
If parrots are allowed to stay outside in a protected in temperature that occurs as the system shuts off
cage against the prevailing wind with a roof and and on to maintain the thermostat setting. It is
nest box, they will acclimatize to temperatures best to place the cage in a room in which there is
that drop into the lower 30°F range (Figure 1.1). interaction with the other family members, away
If temperatures drop lower than freezing, owners from direct vent airflow.
should be advised to provide a heat lamp for tem- Interaction with members of the family is
perature regulation. important, but also normal sleep can have as
Birds will respond to indoor temperatures much much or more impact on a bird’s psychological
the same as they do to outside seasonal variations. well-being. If a psittacine species (e.g., parrot) is
They will molt feathers in the spring as the hot- housed in a room in which lights and conversa-
ter summer months approach and will molt and tion occur well past dusk, a separate cage should
produce more down feathers in the autumn as the be placed in a quiet part of the house for sleeping.
cooler winter months approach. Although owners On most days psittacine species should be allowed
might complain about the extra feather loss in the sleep time that corresponds to the number of
spring and autumn, this is not an unusual finding. nighttime hours. Inconsistent sleep time has been
Even with air-conditioning, the ambient tempera- associated with psychological disorders in parrots,
including feather picking.
Cage design has been elevated to an art. Many
different cage designs are manufactured from
different products, ranging from brass wire to
Plexiglas (Figures 1.2 and 1.3). Most cages are
designed for indoor use only, and most, if not all,
commercial cages should be used only indoors.
Owners usually buy cages for indoor use based on
individual taste, the ability of the cage to reduce
spread of litter and dust into the surrounding envi-
ronment, and how well the cage blends with the
interior design of their house. The only require-
Figure 1.1 A typical flight cage used for a breeding ment from a health point of view is that the cage
pair of parrots. be of appropriate size for the bird(s) that it will
1 | Av i a n 3
Figure 1.2 Parrot cages come in many sizes and Figure 1.3 Plexiglas cages make good transport carri-
colors. ers and reduce the incidence of cage litter falling on the
floor.
house. When choosing the size of a cage, owners into contact with this abrasive surface. Abrasive
should be advised to take into consideration the perches for larger birds (e.g., scored cement, terra-
addition of perches and toys. There has been a ten- cotta) can dull the tip of the claw, but again,
dency for owners to “love their birds too much” the soft weight-bearing part of the bird’s foot is
by adding too many perches and toys for the size against the rough surface. If an abrasive perch is
of the cage. An abundance of these items increases used for a parrot species, only one of the rough
the chance for injury and does not allow for ade- perches should be in the cage, with the majority
quate exercise space. Perches and toys should be of roosting areas made of natural wood branches.
appropriate for the bird’s size. Budgerigar toys and Newspaper is the substrate of choice to line the
perches are inappropriate for an Amazon parrot. cage bottom. This substrate is cheap and allows the
Natural wood perches, cut from hardwood trees owner to observe the bird’s fecal material, thereby
(e.g., oak, maple, or hickory), are recommended monitoring the pet’s eating habits and gastrointes-
for pet birds (Figure 1.4). The natural wood can tinal system. Newspaper also gets dirty, making it
be readily replaced, and it also provides a variable readily apparent to the owner that routine clean-
diameter and foot surface for the birds to use, ing of the cage is required. Although newspaper is
which helps to exercise their feet. Tell your clients a great substrate in a cage, newspaper with colored
never to use sandpaper on the perches, because inks can be toxic and therefore should be sepa-
this causes irritation to the foot area that comes rated from the bird via a grate. Other substances

calcium source. The anti-mite tin that contains

an insecticide disk to be placed on the outside of
the cage is also not recommended. Pet birds that
are housed inside do not come into contact with
lice or mites, and the insecticide they contain will
not affect the mites that are commonly diagnosed
as infesting budgerigars. Sandpaper perches, grit,
and anti-mite devices are a waste of money for pet
bird owners and, in many cases, will contribute to
health problems.
Figure 1.4 Natural wood perches are recommended Outdoor flights are uniformly manufactured
for their differing diameters and surface structure. through private companies or owners using differ-
ent gauges of hardware cloth and J-clips (Figure
1.5). The outdoor flights are built according to the
bird’s size and the breeding requirements of the
particular species. The main requirements for out-
door flights are appropriate size and wire gauge,
flight maintained off the ground, proper nest box
structure, roof or partial roof, prevailing wind
protection (especially in the winter), and heat
lamp, when applicable. Predator control is essen-
tial in outdoor flights and large aviary buildings;
there have been a number of tragic cases of preda-
tors (especially raccoons) attacking birds housed
Figure 1.5 Many outdoor cages are made from galva- outdoors. In addition, opossums can excrete a
nized wire and held together with J-clips. parasite in their feces, Sarcocystis spp., which is
eaten by cockroaches and deposited (by way of
feces) in the bird food. It is very difficult, but vital,
(e.g., ground walnut shells and corncobs) used as to control vermin and insects in complex aviary
birdcage substrate dry out fecal material and hide structures, because these pests can carry a number
excreta from the owner, giving him or her the of bacterial and parasitic diseases. Any predator-,
impression that the cage is “clean.” There have also insect-, or vermin-control program must take into
been instances of birds ingesting their substrate. account bird exposure to the agent being used for
Most pet birds maintained inside do not need eradication of these pests.
grit to aid in digestion. These birds shell their seed
and, for the most part, grind the kernel, forgo- Nutrition
ing the need for grit. If an owner insists on using This area of companion avian medicine has been
grit, crushed oyster shell or eggshell is recom- one of the most active in advancing the health
mended not only as a mechanical means to grind of companion birds. Twenty years ago the only
the food in the ventriculus, but also as a dietary commercially available feed for parrots was seed.
1 | Av i a n 5
Of course, if an owner has another species of bird

(e.g., pigeons, peafowl, waterfowl, and ratites), the
commercially available feed is recommended.
For companion avian species, which include
parrots, macaws, and caged songbirds, advances
in nutrition have been made in the form of pellets
(Figure 1.6). These pelleted bird diets are manu-
factured by a number of companies and come
in many shapes, sizes, and flavors. The secret to
getting a bird transitioned from a seed diet to a
pelleted diet is to start young and, if possible, to Figure 1.6 Pelleted diets are readily available in pet
stores.
allow the bird to see other birds eating the pel-
lets. There are also commercially manufactured
seed cakes and seed balls that will aid the transi-
tion from loose seed to pellets (Figures 1.7 and
1.8). It is much easier to convert a group of birds
from a seed diet to a pelleted diet than a single
bird. Single cockatiels, one of the most popular
pet birds, might be the most difficult bird to
transition to a pelleted diet. A bird that is being
transitioned to a pelleted diet should be weighed
every two to three days. If there is a consistent
weight loss, the seed diet should be resumed and
another method used for pellet acceptance. Some
birds will not accept a pellet diet, but this is rare. Figure 1.7 Many companies offer trial sizes that can
If the pellets are colored, some birds will eat only be provided to avian clients.
specific colors, which can change the color of the
fecal material and promote food waste. This does
not cause any health problems, but does assure
the owner that the bird is eating the pellets and
not just crushing them in its beak.
Although some feed manufacturers promote
pelleted diets as containing all of the required
nutrients for a complete diet, a diversified diet
with pellets as the foundation is recommended.
This diversified diet should contain seeds, vegeta-
bles, possibly cheese and cooked eggs, and a small
amount of fruit (Figure 1.9). Some pet bird species
that have fruit as a large part of their diet (e.g., Figure 1.8 Compacted seed treats often help birds
lories) require a greater percentage of fruit and transition from a primary seed diet to pellets.

nectar. As always, it is up to the owner to research Pet owners should be guided to make fresh
the nutritional requirements of his or her pet and water available at all times. They should also be
make sure to provide a proper diet. The diversified aware that water containers should be cleaned
diet not only supplements a variety of nutritional daily and refilled with a fresh supply. To prevent
components, it also psychologically stimulates the “poop soup,” sipper bottles that attach to the side
bird with different sizes and textures of the food- of the cage are recommended for parrot species
stuffs that it eats. (Figure 1.12). The birds cannot dump the con-
Foraging is another form of feeding a bird in a tainer in the bottom of the cage or defecate in
stimulating manner. A number of foraging devices their water. Tell owners to touch the bird’s beak
have been manufactured in recent years to chal- and tongue to the tip of the sipper tube when it
lenge parrots to work for their food (Figure 1.10). is first introduced to make sure the animal knows
A significant amount of highly recommended that water is available at the end of this strange
information exists for owners and technicians in stainless steel device.
the form of articles and electronic media on the Tell owners that they may provide stick treats,
advantages of providing a foraging environment but the stick and wire must be removed from the
for companion avian species. A psychologically cage after the bird has finished eating the attached
stimulated bird is a happy bird that might exhibit seeds. Spray millet, millet on the natural seed
fewer vices, such as feather picking and stimulated head, is a welcome treat for smaller psittacine spe-
reproductive activity. cies, such as lovebirds and cockatiels.
Anorexic birds can be fed using a “ball-tipped” Make your pet owners aware that calcium sup-
gavage needle. The stainless steel gavage needle plementation (Figures 1.13A and 1.13B) is a must,
can be easily disinfected but is unyielding when and for smaller birds, a cuttlebone will provide
passed down the esophagus into the crop. It is the source. The soft side faces the bird, and the
very important that one becomes experienced bird eats the bone, as calcium is required in the
using a “ball-tipped” gavage needle before using diet. These are not beak-sharpening devices, but
it to administer food or medicine to a bird (Figure calcium sources. For larger birds, a mineral block
1.11). will provide the calcium supplement, because they
Figure 1.9 For many parrot species a diversified diet Figure 1.10 Foraging “toys” are psychologically stimu-
is recommended. lating for caged birds.
1 | Av i a n 7
Figure 1.11 Proper placement of a gavage feeding tube in a parrot. Illustration by Michael L. Broussard.
can crush a cuttlebone in seconds. If your own- their cage, transport cage, or plastic pet carrier.
ers want to place a vitamin or mineral supplement If the cage is small enough and easily carried,
in the water or on the bird’s food, guide them to this is the best method to transport the bird.
strictly follow the instructions provided with the Having the bird in its own environment creates
product. Often, birds will not drink or eat sub- a sense of familiarity and allows the veterinary
stances that have been tainted, which can reduce technician an opportunity to evaluate the enclo-
the required nutritional intake of these animals. sure. Transportation of the cage in which a bird
If the bird does drink the water and eat the food lives applies to birds that weigh <150 grams
with the supplement, both containers need to be (e.g. finches, canaries, budgerigars, cockatiels).
cleaned daily because of vitamin degradation and A transport cage or plastic pet carrier is recom-
predisposition to bacterial growth. mended for larger birds (e.g., parrots, macaws). A
plastic pet carrier can be modified by attaching a
Transport wooden dowel or branch across the bottom half
Bird owners should be reminded always to trans- of the carrier as a perch (Figure 1.14). Newspaper
port their animal(s) to the veterinary clinic in should be placed on the bottom of a transport

Figure 1.14 Companion birds should be transported

to the veterinary hospital in a modified pet carrier.
cage or pet carrier for easy cleaning and to evalu-

ate/collect fecal samples.
Figure 1.12 Sipper water bottles that hang on the
outside of a cage prevent “poop soup” when used as the
Grooming
source of a bird’s drinking water.
Bird owners are constantly seeking quality health
care for their birds. This health care includes pro-
fessional grooming services. For many veterinary
practices, this is understood for dogs and to a lesser
extent cats, but not for avian species. One of the
most common companion bird presentations to
veterinary clinics is for grooming services. Groom-
ing birds includes beak, feather, and nail trims.
Parrots have a natural overbite, which own-
Figure 1.13A A cuttlebone provides a calcium source ers might consider to be overgrowth. The clinic
for smaller birds. should have a book or reference guide that shows
normal birds, giving the groomer an idea of
proper beak length. Malocclusion of the beak
from trauma, parasites, or developmental abnor-
malities will cause the beak to grow off center,
predisposing the structure to become overgrown.
Using a motor-driven hobby tool, one can shape
the beak back into a normal appearance. The final
result of the beak trim will depend on the anat-
Figure 1.13B A mineral block is a calcium source for omy one has to work with, based on the patient’s
larger birds. history. Normally, the beak will grow from the
1 | Av i a n 9
underlying germinal epithelium covering the

bone that provides the beak its foundation. As
the beak epithelium grows out, it might do so
in an irregular pattern, which, although normal,
might not give the surface a smooth character
that is desirable to the owner. Carefully applying
the stone bit of the motor tool over the irregular
areas will smooth out the beak. If the groomer
puts too much pressure on the beak, the under-
lying vascular layer will be compromised and
bleeding will occur. To smooth the lower beak,
place the tip of the upper beak into the lower Figure 1.15 Long claws that need trimming on a
beak. Apply mineral oil to shine and moisten the cockatoo.
beak surface, which provides a nice presentation
for the owner. Practice and experience will help
to improve beak-grooming techniques, especially
on larger parrots and macaws.
Nail trimming is usually done upon owner
request and not necessarily needed to provide
good health maintenance. Bird nails can become
very sharp, enabling a bird to hold on to the
perch. Some birds, such as cockatoo species, have
Figure 1.16 Recommended length to trim a parrot’s
quick-growing nails that curl around, becom- claw. Illustration by Michael L. Broussard.
ing entangled in the cage bars (Figure 1.15). The
nails should be bluntly trimmed to the level of the
plantar surface of the foot with a motor-driven
hobby tool (Figures 1.16 and 1.17). If bleeding
continues after the trim, silver nitrate–tipped
wooden applicator sticks are recommended for
hemostasis. Young birds’ nails have a tendency to
bleed more often than older birds’ nails. The nails
should be trimmed when the bird is hurting the
owner or when there is excessive overgrowth. For
small birds (e.g., <150 grams) electrocautery units
can be used to reduce the length while providing
hemostasis (Figure 1.18).
Blood feathers are new growing feathers
ensheathed and engorged with blood that is car-
rying nutrient to the developing structure (Figure Figure 1.17 A Dremel tool is recommended for claw
1.19). If a primary or secondary blood feather is trimming on larger parrot species.

Figure 1.18 An electrocautery unit can be used to Figure 1.19 A blood feather. The feather extending
trim claws on birds that weigh <150 grams. out of the sheath can be safely trimmed.
cut or broken, grasp the base of the feather with that will need to be trimmed. The main feathers
hemostats and pull straight out. Digital pressure to be trimmed are the primary flight feathers on
should be applied to the feather follicle for 2 to 3 both wings and, to a lesser extent, the secondary
minutes to aid in hemostasis. flight feathers (Figure 1.20). The feathers should
Owners might have many reasons for want- be trimmed under the dorsal covert feathers so the
ing their bird’s wing feathers trimmed. The main cut feather cannot be seen when the wing is in the
reason is to restrict flight capabilities, thereby pre- normal position. Adequate flight restriction can
venting an unwanted escape. Often, birds that be obtained in short, fat birds (e.g., Amazon par-
are flighted will be more independent, spending rots, African gray parrots) with bilateral trimming
less quality time with the owner and increasing of the primary flight feathers. In young African
the possibility of flying into walls, ceiling fans, gray parrots, this is extremely important, because
and glass doors. The owner should always be cau- they often fall and cut open their chest over the
tioned that trimming a bird’s wing feathers will keel bone. Many Amazon parrots have pretty
restrict flight, but will not prevent it. Precautions orange secondary flight feathers that owners like
against flight should always be maintained when to keep. Long, thin birds (e.g., cockatiels and con-
the bird is outdoors. In recent years, body har- ures) need to have their primary and secondary
nesses have been made for pet birds, and these flight feathers trimmed to achieve adequate flight
should be placed on a bird at an early age to expe- restriction. Many companion avian species need
dite recognition and acceptance of these devices. their wings trimmed twice a year.
The groomer should ask how the owner would
like the wing feathers trimmed and what he or Bird Bands and Microchipping
she wants to accomplish with the restricted flight. Companion birds are required to be identified,
The more restrictions an owner places on a non- as stated by the Wild Bird Conservation Act.
flighted bird, the greater the number of feathers The most common method of identifying pet
11
Figure 1.20 A recommended method for trimming wing feathers on companion avian species. Illustration by
Michael L. Broussard.

and cage birds is by leg bands. Unfortunately, leg (prior to the presenting problem and since it has
bands often become entangled in cage structures been ill), must be determined. If there are any
and toys. A safer option is removing the band and supplements or treats offered, this should be noted
inserting a microchip into the pectoral muscle. on the form. It is important to ask the owner how
This protects against leg injury or possible death, often the water is changed and the source of the
and the bird can still be identified. water. There have been cases of embryonic and
neonatal deaths that were caused by well water
and automatic watering systems that contained
HISTORY
bacteria.
As with other animal species, it is very important A review of the total pet household, including
to get a thorough history from the owner prior to other birds, must be noted in the history. This
examining the avian patient. Identification is the information would incorporate birds that are
first important information that the technician housed together, new bird additions to the aviary
needs to obtain from the owner. Identification or household, recent attendance by the owner at
includes the name of the patient, species of bird, bird shows/fairs, and quarantine procedures.
and the age (if known). Birds can be obtained Once you have the information about the
from a number of sources, so it is important to environment and history, you should review the
know how long the animal has been at that par- patient’s past and current health problems. If the
ticular house and where it was acquired in order bird was recently purchased, the new owner might
to determine the overall patient health. Find out not know the entire patient disease history. An
whether the owner can provide a vaccination his- investigative phone call to the previous owner can
tory, when the bird last molted, and the character give you or the veterinarian important informa-
of feces. Most birds coming into the clinic will be tion that could help make a final diagnosis.
companion animals, but some are breeding birds Before an avian patient is restrained to per-
that are seldom, if ever, handled. Ask the owner if form a physical exam, the technician determines
the bird is a pet bird or a breeding bird and how an overview of the animal’s general disposition
often it is taken out of the cage. Most breeding from a distance. The bird should be examined for
birds are housed in outdoor flights, but a specific perching ability, ease of breathing, awareness of
understanding of where the bird is maintained the surroundings, and stool characteristics. It is
is needed to determine if there has been possible common for birds to have a very liquid stool when
exposure to wild avian species or vermin. Because excited or in unfamiliar surroundings. The owner
most owners will bring the patient in a plastic pet should be asked about any abnormalities in the
carrier, the history should include the type and patient’s fecal color and consistency. Often a bird
size of cage, substrate, toys and perches, disinfec- is presented in the cage in which it is housed and
tants used, and regularity of cleaning the cage. a number of droppings are on the paper substrate
Once the environment has been determined, at the bottom for the veterinarian or technician to
nutrition is the next major area of questioning. evaluate. If possible, this “hands-off” evaluation
The specific brand, type, and amount of food, as is best achieved when looking through a one-way
well as how much the bird eats on a daily basis mirror or a small window in the exam room door.
1 | Av i a n 13
The bird will act more natural when it is alone in When working with large parrots, experience
the room with the owner, rather than with some- and the use of proper capture techniques help alle-
one it does not trust. Any abnormalities should be viate the fear of having fingers crushed by a large
noted in the patient’s record. parrot’s beak. Most injuries occur when the per-
son trying to capture a large parrot is distracted or
hesitates and is not concentrating on the primary
RESTRAINT
goal of properly restraining the patient. For com-
One of the greatest causes of anxiety for many vet- panion birds, capture should always be achieved
erinarians and veterinary technicians in this field through the use of a towel, which allows you to
is the capture and restraint of either a small bird or hide your hand as you maneuver it around the
a large parrot. When catching a small bird, many back of a bird’s neck. If the bird has never been
are afraid of causing a sudden unexplained death;
captured with a towel or is friendly, the towel
on the other hand, handlers of large parrots usu-
should be presented from the front of the animal.
ally have a fear of personal injury. However, it is
The frontal presentation will not scare the bird,
important to emphasize that it is the rare avian
will allow it to see the towel during capture, and
patient that dies from a “heart attack” or fear asso-
might prevent the bird from developing a fear of
ciated with the capture event. The technician must
capture. If the bird is difficult to capture, it is rec-
remember that sick birds are being presented to
ommended that you quickly grasp the back of the
the veterinary clinic for care and treatment. Dur-
bird’s neck with a toweled hand while the bird is
ing the initial assessment and history evaluation,
one must decide if the patient is in a condition to biting the side of the transport carrier. Large birds
be handled for further examination.
When an avian patient, or any exotic animal
patient, is so ill that capture and restraint might
cause death, the owner needs to be fully informed
of the possible consequences. To reduce stress on
small birds during capture, the overhead light
should be turned off after the technician has estab-
lished the location of the bird. In the dark, birds
do not often move or see the hand prior to cap-
ture. The lighting of the room should be returned
to normal once the patient is in the technician’s
hands. This method of capture works extremely
well when a bird is free-flying in the room or with
large, difficult-to-catch parrots. Small birds (<120
grams) can be held in one hand. The head is main-
tained between the forefinger and middle finger,
as the bird rests in dorsal recumbency in the palm
of the hand, with the thumb, ring finger, and pin- Figure 1.21 Proper technique for holding small
kie loosely holding the body (Figure 1.21). caged bird.

should be held in an Elizabethan grip around the

neck, with the thumb and forefinger touching and
pressing up against the mandible, the other hand
holding the feet. With the bird’s head and feet
restrained, the bird is held against the handler’s
body, thereby restricting one wing, while the
other wing is held in place by the index and little
finger of the hand holding the head. A towel can
also be used to restrict the wings while restraining
the avian patient (Figure 1.22). The Elizabethan
grip does not damage the bird’s face and gives the Figure 1.22 Proper technique for holding larger
handler more control over the beak. parrot species.
Once the patient has been captured with a
towel (or in the case of breeder birds, with a net
or gloves), it can be placed in an avian restraint
device for examination or diagnostic testing (e.g.,
radiographs; Figure 1.23). This Plexiglas board
can restrain birds from the size of a budgerigar to
a hyacinth macaw. Typically, birds that are placed
in the device are less stressed than ones held by
veterinary technicians. The veterinary technician
should loosely hold the bird’s wings against its
body to prevent the wings from flapping, poten-
tially causing injury to the patient, while it is
Figure 1.23 A Plexiglas restraint board can be used
being placed in the restraint board. Birds in the
for examination or positioning of patients for diagnos-
restraint device can be examined and diagnostic
tic imaging.
samples obtained, including blood and choanal
and cloacal cultures.
There are many different species of birds that
might present to a veterinary clinic, each of which
provides different obstacles and dangers to the per-
son trying to capture the patient. If you are not
sure how to capture and restrain an animal, please
ask someone who knows the proper technique.
This will help protect you and the patient from
serious injury. Owls, eagles, and hawks have pow-
erful sharp talons that can cause serious puncture
wounds. Raptors need to be captured using leather
gloves, and their feet should be taped prior to an Figure 1.24 A foam “pool noodle” can be used to re-
examination. Herons, cranes, and egrets have long duce the “stabbing” danger from long, sharp beaks.
1 | Av i a n 15
sharp beaks, which they routinely thrust toward the

eyes of someone they perceive as a threat to their
well-being (Figure 1.24). These birds should be cap-
tured and restrained by someone who is wearing
protective eyewear. Again, if you are not sure how
to capture and restrain an avian patient, please ask
an experienced veterinary technician or veterinarian.
PHYSICAL EXAMINATION
The first and most important information the

veterinarian will obtain about the avian patient is Figure 1.25 Smaller birds can be weighed in a
the body weight. All exotic animal patients must container.
be weighed on a digital gram scale that measures
in 1-gram increments. Tame birds can be placed
on a perch that is attached to the base of the
scale with Velcro strips. Untamed birds can be
weighed in a container or in the restraint device
(Figure 1.25).
Once the bird has been examined prior to cap-
ture and it has been determined that the patient
is in a condition to be restrained, the veterinarian
will perform a hands-on physical examination.
The feather quality is the first feature that is
examined on the bird. Feathers are examined for
abnormal molting, development, damage, abnor- Figure 1.26 Lice eggs (nits) on the feathers of an
mal color, ectoparasites, and feather loss (Figures avian patient.
1.26 and 1.27). Next, the veterinarian will start at
the head and look straight at the bird, analyzing
the beak and eyes for asymmetry, and the beak for animal ophthalmoscope. To examine the poste-
abnormal wear. The nares are examined next for rior chamber and retina, a more detailed ocular
any nasal discharge or intranasal growths associ- investigation is required. The more detailed oph-
ated with granulomas. thalmology examinations are required for raptors
Ocular examinations are very important, espe- and pet birds that present with head trauma.
cially on older birds and injured raptor species. Using a beak speculum (Figure 1.28), the
The typical ophthalmology assessment includes veterinarian will observe the oral cavity, includ-
looking for ocular discharge and eyelid, conjunc- ing the choanal slit. The terminus of the upper
tival, corneal, anterior chamber, and lens health. respiratory system, the choanal slit, is lined with
The foregoing parameters can be examined epithelial projections called papilla (Figure 1.29).
without using any equipment, including a small The papilla readily sloughs in the presence of an

tissue. The glottis is located at the base of the tongue

and should also be free of abscesses or epithelial
plaques.
Most pet bird species have a dry oral cavity,
which makes it difficult to determine hydration
status in these species. Hydration status in avian
species should be determined by assessing cor-
neal moisture, globe position in the orbit, skin
elasticity through skin tenting, cloacal mucosal
moisture, and packed cell volume.
The crop, or ingluvies, is positioned at the level
of the thoracic inlet. Crop stasis, or a large doughy
feel to the crop because of undigested food, is
often a sign of bacterial ingluvitis. Foreign bodies
or trauma associated with hand-feeding might be
noted as bruising in this area or by confirmation
of a presentation history provided by the owner. If
the owner feeds food that is too hot, bruising can
occur; or if presentation of the patient is delayed
Figure 1.27 Bird with self-induced feather damage. after the thermal burn, necrosis of the crop and
skin might be observed (Figure 1.30). A fistula can
form at the location of the thoracic inlet, with the
crop adhering to the surface epithelium—causing
ingested food to dribble out onto the feathers. In
this case, owners might complain of “food com-
ing out of the bird’s chest.”
The keel bone is the modified sternum of
flighted birds and is the location of the major pec-
toral muscles. The pectoral muscles on flighted
birds can account for up to 20% of the total body
weight. By palpating the pectoral muscles, one
Figure 1.28 Instruments and equipment used to can determine the general body condition of a
properly examine a bird. companion avian patient. The pectoral muscles
should fill the entire space provided by the keel.
If the keel is prominent, the bird is considered
upper respiratory infection. Evidence of a chronic underweight (Figure 1.31).
upper respiratory infection includes sloughed papilla In the caudal areas of a bird’s body, very few
and a swollen, inflamed choanal slit. The oral cavity diagnostic observations can be made because of the
should be free of any abscesses, plaques, or necrotic large surface area of the keel bone. Palpation of the
1 | Av i a n 17
ers. Any bleeding, inflammation, or asymmetry of

this gland is abnormal.
Most birds project their waste from the body;
therefore, the feathers around the vent are nor-
mally clean. Any soiling or pasting of waste noted
around the vent should be considered abnormal.
The vent and cloaca are examined for papillomas
(cloacal warts), especially in larger parrots and
macaws. A cotton-tipped applicator can be placed
in the cloaca, carefully everting the structure to
observe the mucocutaneous junction. The normal
Figure 1.29 Using an avian beak speculum to exam- appearance should be smooth, but if any rough-
ine the choana.
ness is observed on the tissue surface, further
testing is required. Using 5% acetic acid (vinegar)
applied to a cotton-tipped applicator and placing
the solution on the questionable surface, one can
obtain a tentative diagnosis. If the mucous surface
of the cloaca is intact, the vinegar will not adhere,
but if the surface is compromised by papillomas,
the surface will turn white.
Birds’ lungs are located on the ventral aspect
of the thoracic vertebrae. By locating the head of
the stethoscope on the dorsal body wall in this
area, one may listen for any abnormal respira-
tory sounds. It is also very important to listen for
Figure 1.30 Thermal trauma to the crop and surface
abnormal respiratory sounds from the air sacs. A
epithelium due to feeding of overheated formula.
bird’s body cavity is composed of four paired and
one unpaired air sac. Coelomic fluid and space-
caudal coelomic cavity behind the keel bone might occupying masses (e.g., tumors) can adversely affect
reveal hepatomegaly associated with a tumor, an egg airflow. Therefore, any sound noted when listening
in the reproductive tract, or ascites resulting from to the air sacs along the lateral body wall should be
internal ovulation. Cranial to the insertion of the considered abnormal. The heart is best ausculated
tail feathers on the dorsal midline is the location on the left lateral body wall under the wing in the
of the uropygial, or preen gland (Figure 1.32). axillary region. Ausculated heart murmurs in com-
The uropygial gland is absent in some companion panion avian species, especially cockatoos, have
avian species, for example the Amazon parrot, but been diagnosed with ventricular septal defects.
well developed in waterfowl. The gland is typi- The wings and legs are the last body structures to
cally a bilobed structure with a papilla emanating be examined after the bird is ausculated. The wings
from the center that might include a tuft of feath- and legs are examined for fractures, joint integrity,

Figure 1.31 Normal keel versus thin keel. Pectoral musculature helps determine the body
condition of an avian patient. A full-bodied bird with a well-developed pectoral mass usu-
ally indicates good health. Illustration by Michael L. Broussard.
and range of motion. The nails and plantar surface Use the following criteria to decide whether to put
of the feet are the final areas that are assessed for any off evaluating an avian patient until a later time:1
abnormal physical characteristics.
As with other animals, after the examination is • If the bird is panting or breathing rapidly, first
complete, any abnormal findings are recorded and alter your grip on its head, so the head is free
a list of differential diagnoses is established. Based to move. The bird should immediately begin to
on the top differential diagnoses, diagnostic tests turn its head in search of something to bite. If it
are prioritized to confirm a diagnosis or to deter- does not, PUT IT DOWN.
mine the severity of disease. • A paper towel, or a corner of the towel being
used to restrain the bird, can be placed into its
“Put It Down” mouth. It should immediately begin to bite at
If the bird has an increased respiratory rate, exces- this, demonstrating that it has sufficient oxygen
sive vocalization, or difficulty breathing during reserves to do so. If it lets the material lie lamely
the physical examination, you might have to “put in its mouth, PUT IT DOWN.
it down” until it is able to withstand the rigors of • Have the bird grasp your hand or finger with both
the evaluation process. of its feet. (This should be part of the physical
1 | Av i a n 19
Figure 1.32 The uropygial gland is located at the caudal dorsal aspect of many
avian species. This gland aids in feather grooming and waterproofing. It is very
well developed in aquatic avian species. Illustration by Michael L. Broussard.
examination, to determine symmetry and comfortable and observe it while discussing

strength of grip.) If the bird’s grip is weak or possible etiologies for the bird’s decreased respi-
nonexistent, PUT IT DOWN. ratory capacity with the owner.
• If the bird’s eyes close during the physical
examination, PUT IT DOWN. Conversely, do
DIAGNOSTIC SAMPLING
not be reassured if the bird has its eyes open—
many birds hold their eyes open as they draw Blood Collection
their last breath. Many veterinarians and veterinary technicians
• If in doubt, PUT IT DOWN. Return the bird think that it is nearly impossible to obtain any
to the location (cage, owner) where it is most usable quantity of blood from an avian patient

Figure 1.33 Proper technique for collecting blood from a bird’s jugular vein. Illustration
by Michael L. Broussard.
without compromising its health or killing the Other veins or venous sinuses that can be used for
bird. (See Chapter 2 for additional information blood collection in avian patients are the basilic
on preparation of blood smear, estimate of white vein (Figure 1.34), the median metatarsal vein, or
blood count, and determination of differential the occipital venous sinus. Blood collection tech-
cell count.) This is a totally false assumption that niques used for other animals should be followed
has been perpetuated within the profession. With with avian patients. The right jugular vein can be
the technology available today, blood samples can observed in a featherless tract of epithelium in the
be easily obtained (even from the smallest avian right lateral cervical region. A 3 cc syringe with
patient) that will provide usable diagnostic infor- a 26-gauge needle is recommended as the instru-
mation. Approximately 1% of the bird’s blood ment of choice for birds weighing more than 30
volume can be taken safely for diagnostic testing, grams and less than 2 kilograms. For birds less
or 1 ml/100 grams of body weight. than 30 grams, a 1 cc syringe is recommended,
Each particular avian species has a vein that is because of the low volume of blood that can be
recommended as the choice site for blood collec- safely removed from the patient. Unless the patient
tion. In companion avian species, this is the right is extremely fractious, no general anesthesia is
jugular vein (Figure 1.33). Birds do have a left jug- required when drawing blood. Once the blood has
ular vein, but it is less developed than the right. been retrieved in the syringe, it should be placed
1 | Av i a n 21
Figure 1.34 Location of the basilic vein for blood collection and intravenous administra-
tion of therapeutic agents. Illustration by Michael L. Broussard.
in a Microtainer tube (Becton Dickinson Micro- thetized patient (Figure 1.35). The needle is slowly
biology Systems, Cockeysville, MD) and gently rotated with gentle pressure toward the medullary
agitated to allow exposure to the anticoagulant. cavity. When a sudden reduction of pressure is felt,
This procedure needs to be performed quickly the medullary cavity has been reached, and the tech-
because avian blood has a tendency to coagulate nician then removes the stylet of the spinal needle. A
rapidly. Table 1.1 lists the hematological reference 6 cc syringe is placed on the needle, and bone mar-
ranges for parrot species, and Table 1.2 lists the row is drawn into the needle with short quick pulls
plasma biochemical reference ranges for common on the plunger. In birds the common amount of
parrot species. For hematological testing or com- bone marrow aspirated will fill the hub of the needle.
plete blood counts, a purple top Microtainer tube Pressure is released off the plunger, and the needle
is recommended, and for plasma biochemistries, a removed from the bone. Remove the needle from
green top Microtainer tube should be used.2 the syringe and draw about 4–5 cc of air into the
syringe, place the needle back on the syringe, and
Bone Marrow Aspiration eject needle contents on a clean microscope slide.
The site of choice in avian patients for bone mar-
row aspiration is the proximal tibiotarsal bone. A Microbiology
22-gauge, 1.5" spinal needle is placed at the lateral Microbiological sampling techniques that are
aspect of the proximal tibiotarsal bone of an anes- used on other animals can be applied to the avian

22
Table 1.1 Avian Hematological Reference Ranges2

African
Amazon Eclectus Quaker
Value Gray Budgerigar Cockatiel Cockatoo Conure Lovebird Macaw Pionus
Parrot Parrot Parrot
Parrot
Hematocrit (%) 42–53 43–49 44–54 43–58 42–51 43–56 43–50 43–55 43–54 43–54 n/a
Red Blood Cells

2.80–3.36 2.33–2.95 3.90–4.70 3.8–4.58 2.50–2.95 3.13–3.94 2.7–3.1 2.63–3.50 n/a 2.7–3.5 n/a
(x106/ml)
Hemoglobin (g/dl) 15.1–16.9 14.4–16.7 13.4–15.3 12.1–14.6 12.0–14.8 12.1–14.8 14.1–16.0 11.9–15.1 n/a 14.2–15.5 n/a
Mean Corpuscular
143–155 163–170 115–124 128–142 154–170 135–147 157–170 155–166 n/a 154–164 n/a
Volume (fl)
Mean Corpuscular
32.3–45.6 49.8–58.2 25.9–30.9 24.9–36.0 45.0–55.5 30.0–40.1 51.3–54.2 40–48 n/a 41.4–46.0 n/a
Hemoglobin (g/dl)
Mean Corpuscular
Hb Concentration 23.16–31.78 32.8–35.31 19.80–26.75 18.91–25.61 24.12–32.91 23.5–28.6 31.2–34.0 21.9–29.3 n/a 25.8–28.7 n/a
(g/dl)
White Blood Cells

6.0–13.0 5.0–12.5 3.0–8.0 5.0–9.0 5.0–12.0 4.0–9.0 9.0–15.0 3.0–8.0 7.0–12.0 5.0–13.0 8.0–17.0
(x103/ml)
Heterophils (%) 45–72 32–71 41–67 47–72 45–72 45–72 46–70 41–71 48–72 55–74 47–70
Lymphocytes (%) 25–50 20–65 22–58 27–58 20–50 22–49 23–57 28–52 18–52 19–70 20–63
Monocytes (%) 0–1 0–1 0–2 0–1 0–1 0–1 0–1 0–1 0–1 0–1 0–4
Eosinophils (%) 0–1 0–0.05 0–0.05 0–2 0–2 0–1 0–1 0–1 0–1 0–1 0–4
Table 1.2 Avian Plasma Biochemical Reference Ranges2
African
Amazon Eclectus
Value Gray
Parrot Budgerigar Cockatiel Cockatoo Conure Parrot Lovebird Macaw
Parrot
Albumin (g/dl) 0.2–2.4 0.3–2.4 0.9–1.2 0.8–1.8 0.3–0.9 0.3–0.9 1.1–2 0.3–0.9 0.3–2.4
Alkaline Phosphate
12.0–92.0 8.0–100.0 24.0–96.0 12.0–100.0 24.0–104.0 24.0–104.0 32.0–111.0 n/a 12.0–100.0
(U/L)
Amylase (U/L) 415–626 184–478 302–560 113–870 288–876 192–954 562–684 n/a 239–564
Aspartate
Aminotransferase 112–339 155–380 160–372 130–390 145–346 147–360 144–339 130–343 60–165
[AST] (U/L)
35.0–
Bile Acids (mol/L) 12.0–85.0 35.0–110.0 45.0–105.0 37.0–98.0 35.0–90.0 30.0–110.0 34.0–88.0 30.0–80.0
144.0
Calcium (mg/dl) 8.3–11.7 8.5–13.0 8.5–11.0 8.3–10.9 8.4–11.0 8.4–11.0 8.1–11.9 8.6–11.5 8.3–11.0
Cholesterol (mg/dl) 100–250 150–220 120–220 90–195 90–200 83–190 100–261 125–195 96–264
Creatine Kinase [CK]

120–410 120–410 120–360 167–420 150–400 140–397 132–410 160–320 90–360
(U/L)
Creatinine (mg/dl) 0.1–0.5 n/a n/a 0.1–0.5 0.1–0.8 0.1–0.8 n/a 0.1–0.8 0.1–0.7
Globulin (g/dl) 1.2–3.6 1.6–3.7 1.1–1.7 2.5–3.8 2.5–3.8 2.5–3.8 2.0–3.32 2.5–3.8 2.1–3.8
Phosphorus (mg/dl) 3.5–6.9 n/a 3.7–7.1 4.0–7.7 4.2–7.8 4.0–7.9 n/a n/a 4.0–7.8
Protein, Plasma (g/dl) 2.7–4.4 2.6–4.5 2.1–4.3 2.1–4.8 2.6–2.8 2.4–4.9 3.2–4.3 1.8–3.7 2.4–4.4
Uric Acid (mg/dl) 1.9–9.7 2.3–9.8 4.0–12.2 3.5–10.4 3.6–10.7 2.7–10.2 2.0–11.0 3.2–10.2 1.5–11.0
23
protocol should be followed for fungal and myco-

bacterium isolation and identification.
Common pathogenic bacterial isolates in com-
panion avian species include some E. coli and
Enterobacter spp., Pseudomonas spp., Klebsiella spp.,
and in some cases Mycobacterium avium. Aspergillus
spp. are often diagnosed in raptors and waterfowl
that are stressed through rehabilitation or oil spill
cleanup procedures. Common fungal infections
in companion avian species also include Asper-
gillus spp. (especially African gray parrots) and
Candida albicans (especially in young hand-fed
birds). The first diagnostic test that might be per-
formed is a Gram’s stain on the fecal material. The
Gram’s staining of fecal material or crop contents
will help the veterinarian assess gastrointestinal
health through determination of current flora
within the digestive system. Companion avian
Figure 1.35 Proximal tibiotarsal bone. This is the site
species should have a majority of Gram-positive
of choice for bone marrow aspiration. Illustration by
rods and very few, if any, Candida albicans organ-
isms (oval-shaped Gram-positive organisms). If
any Gram-negative rods are noted on the stain, a
total evaluation of the patient will be performed to
patient. Regular and mini-tipped culturettes are determine the significance of the finding. A patient
used, depending on the size of the orifice being with diarrhea or that is anorexic upon presenta-
sampled. Larger culturettes are recommended tion could be affected by the abnormal percentage
whenever possible, to increase the chances of of Gram-negative organisms and further testing
isolating a pathogenic organism. Common sites will be initiated. Birds showing no abnormal signs
cultured in avian patients include the choana, usually are not affected by an abnormal bacterial
crop, and cloaca (terminus of the digestive tract). population, but should be monitored and tested to
Cultures are also taken of internal lesions through establish baseline data.
an endoscopic cannula or biopsy samples of abnor-
mal tissue. Radiology
Most of the organisms associated with avian Companion avian species, in most cases, should
disease are aerobic, and this is the most common be radiographed under general anesthesia on an
diagnostic growth test. If there is a possibility of an avian restraint board, using isoflurane or sevoflu-
anaerobic organism causing disease in the patient, rane, in order to increase the chances of obtaining
inform laboratory personnel about the differential quality radiographs with minimal stress to the
diagnosis, so they can properly prepare the sample bird. Proper assessment of the patient is required
for isolation of that class of bacteria. The same to determine the animal’s ability to withstand
1 | Av i a n 25
this procedure. Common presentations that are located, length of procedure (particularly for
require radiographs include trauma, fractures, MRI), and the need to monitor the patient from
heavy metal toxicosis, respiratory distress, gas- outside the room when the images are obtained.
trointestinal stasis (proventricular dilatation It is always recommended that you use diag-
disease), swallowing a foreign body, and nonspe- nostic imaging personnel who are familiar with
cific neurologic signs. Digital radiographic units performing examinations on avian patients and
are recommended, but if not available, high- interpreting those results.
detail film is a must when radiographing any
small exotic animal species, especially birds. The Parasitology
same radiology techniques used for other com- External Parasites
panion animals need to be followed with avian As discussed earlier, many new bird owners believe
species. This would include always getting two that all avian species commonly have external
views, on perpendicular planes, of the desired parasites, particularly lice. It is important that vet-
area of interest. Closing the pop-off valve and erinary clinic personnel inform these owners that
maintaining the patient in an inflated state when it is rare for pet avian species to become infested
the radiographic image is acquired will increase with any type of external parasite. Caged birds
the contrast of internal organs and body systems. are seldom exposed to environments where they
would contact the parasites that live on the skin
Other Diagnostic Imaging Modalities or feathers. Outdoor aviaries, where people breed
In recent years there has been an increased usage parrot species, might provide the opportunity for
of ultrasound (US), computed tomography (CT), the transmission of lice or mites from infested
and magnetic resonance imaging (MRI) on avian native birds. Raptors, waterfowl, and other fowl
species. As with traditional radiographic imaging, will commonly present with ectoparasites, at
it is recommended that the avian patient be placed which time the owner should be guided to initiate
under general anesthesia for these alternative diag- treatment of the bird and environment. Most of
nostic imaging procedures. Because of the air sac the external parasites that are mentioned in this
system of birds’ lower respiratory tract, US images section can be treated with ivermectin, with the
are difficult to obtain within the body cavity. The recommended dose being 0.2 mg/kg orally or sub-
liver and heart can be imaged through ultraso- cutaneously for 2 to 3 treatments, 14 days apart
nography, because there is a continuous tissue (Ivomec, Merck AgVet Division, Rahway, NJ), or
window caudal to the keel through the liver into fipronil, spraying on the skin under the wings and
the heart. Because the window is very small, heart repeating in 30 days (Frontline, Merial, Duluth,
assessment using echocardiography is limited. CT GA).3
and MRI procedures can be performed on birds If birds are maintained indoors, there is very lit-
and offer a significant amount of information in tle chance of exposure to external parasites. Aviary
cases for which these diagnostic modalities are birds and other avian species that are maintained
recommended. Preparation of the patient prior to in flights have a better chance of being diagnosed
the MRI and CT procedures is important because with parasitic arthropods. There are two common
of machine platform movement, cool air tem- ectoparasites that infest caged birds: Sternostoma
peratures within the room where the machines tracheacolum and Knemidokoptes spp. Sternostoma

The names are derived from the irritation of the

surface epithelium that causes a hyperkeratosis of
the affected skin and beak. Budgerigars are the
most common pet birds to be diagnosed with
Knemidokoptes spp., although other species can
be susceptible, particularly eclectus parrots and
canaries. As with tracheal mites, ivermectin is the
treatment of choice for Knemidokoptes spp.
Chewing lice of the order Mallophaga and
domestic poultry mites, Dermanyssus gallinae and
Ornithodoros sylviarum, can affect parrot species
that live outdoors in breeding flights. Environmen-
Figure 1.36A Budgerigar that is infested with tal cleaning is very important in the prevention of
Knemidokoptes spp. mites. reinfestation of the lice and mites. A 5% carbaryl
powder can be used in conjunction with ivermec-
tin therapy to treat infested birds.
Internal Parasites
As with external parasites, internal parasites are
uncommon in companion birds that are hand-raised
and maintained indoors. Birds that live in breeding
flights, and especially birds that have access to the
ground, have a better chance of exposure to internal
parasite eggs and larvae. All birds should have direct
fecal and fecal flotation examinations as part of a
complete health check. Psittacine species infected
Figure 1.36B This mite species affects the nonfeath- with the protozoan parasite Giardia psittaci will
ered areas of the bird. present with chronic to intermittent watery diar-
rhea and with loose, malodorous mucoid stools.3
Another protozoan parasite that is diagnosed in
tracheacolum is also known as the tracheal/air sac avian patients (particularly doves, pigeons, and rap-
mite, and it mainly affects canaries and finches. tors) is Trichomonas gallinae. Whereas giardiasis is
Birds diagnosed with the tracheal mite show signs of associated with the intestinal tract, trichomoniasis
respiratory distress and make a clicking sound when is found as white plaques or necrotic masses in the
breathing. Ivermectin is the treatment of choice for mouth and esophagus.4 Metronidazole (Flagyl, G.
birds infested with Sternostoma tracheacolum. D. Searle Co., Chicago, IL; this is a generic product
Knemidokoptes spp. lives in the featherless sold by many companies) can be used to treat both
areas around the face and legs (Figures 1.36A Giardia psittaci and Trichomonas gallinae.
and 1.36B). Common names for these arthro- Two coccidian parasites can be diagnosed in
pod parasites are scaly face and scaly leg mites. caged birds. Atoxoplasma spp. organisms are diag-
1 | Av i a n 27
nosed in canaries, finches, and mynah birds. The (Droncit, Haver/Diamond Scientific, Shawnee, KS;
diagnosis is usually made during a pathology this is a generic product sold by many companies).
examination of a dead juvenile bird that has died Nematodes, as with most of the parasites that
shortly after appearing depressed and fluffed. affect avian species, commonly affect birds that live
Atoxoplasma spp. organisms are shed in the feces in outdoor environments. Ascarids have a direct life
of adults that show no signs of infection. Treat- cycle, in which simply ingesting eggs can infect a
ment of any coccidian disease is difficult; often bird, whereas Capillaria spp. and Syngamus trachea
the best outcome is a reduction of shedding and need earthworms as an intermediate host. Ascarids
exposure to unaffected birds. Trimethoprim/sul- and Capillaria spp. live in the intestinal tract, and
fadiazine (Roche Pharmaceuticals, Nutley, NJ; Syngamus trachea are found in the oral cavity and
this is a generic product sold by many companies) esophagus. Birds infested with intestinal parasites
is the recommended treatment for avian coccid- will be depressed and emaciated. In most cases,
ian parasitic diseases. Sarcocystis falcatula is the nematode eggs are shed in the feces and can be seen
other coccidian parasite diagnosed in companion in a fecal flotation exam. It is important to treat the
avian species. This parasite usually affects aviary bird and, if possible, the environment.
birds housed outdoors in breeding flights. The life
cycle of Sarcocystis falcatula involves the opossum
SURGICAL AND ANESTHETIC
(Didelphis virginiana) and cockroaches. As with
ASSISTANCE
Atoxoplasma spp., Sarcocystis falcatula is usually
diagnosed during a pathology examination of a Surgical preparation techniques for birds are
dead bird. The extensive life cycle requirements similar to those for other species treated at a small-
of the parasite make environmental management animal hospital. There are a few main differences
extremely important if the owner wants to prevent regarding avian species, and they will be covered
exposure and infection within an aviary. in this section. The normal body temperature for
Hemoproteus spp., Plasmodium spp., and Leuko- birds ranges from 103° to 105°F. To maintain this
cytozoon spp. are parasites that might be noted in high body temperature, birds eat often, and the
red blood cells of wild-caught psittacine species, food rapidly passes through the digestive tract.
raptors, doves, and pigeons. These parasites are For this reason, fasting is recommended only
transmitted through the bite of infected arthro- for 2 hours prior to surgery. For isoflurane or
pods. Unless there is an overwhelming infestation sevoflurane anesthesia, birds are induced via a
of these parasites, treatment is not recommended. face mask and then intubated with a noncuffed
Before the Wild Bird Conservation Act was endotracheal tube (Figure 1.37). A noncuffed
passed in the early 1990s, a vast number of large endotracheal tube is recommended because most
psittacine species were being imported into the avian species have complete tracheal rings and an
United States. Wild-caught cockatoo species and inflated cuff could induce pressure necrosis on
African gray parrots were often diagnosed with the epithelium lining of the trachea. The glot-
tapeworms. With the passage of the conservation tis is readily observed at the base of the tongue
act, the number of these species being diagnosed once this anatomical structure is extended using
with cestodes has diminished. Treatment of cestode hemostats (Figure 1.38). The neck should be
infestations can be accomplished with praziquantel extended when placing the endotracheal tube

into the recommended position, about the mid-

cervical region. It must be remembered that the
syrinx, or voice box, of avian species is located at
the tracheal bifurcation. With the syrinx located
at this level in the respiratory tract, a patient can
still vocalize—even with proper placement of the
endotracheal tube. If head surgery needs to be
performed or if there is a blockage of the trachea,
an air sac cannulation can take place to provide
oxygen or anesthesia into the respiratory system.
Isoflurane anesthesia has a side effect of respira-
Figure 1.37 Noncuffed endotracheal tube, recom- tory depression; therefore, bagging the patient 2
mended for avian species. to 3 times a minute will help offset any problems
caused by the anesthetic gas.
The surgical plane of anesthesia and patient sta-
tus can be monitored by the palpebral and pedal
reflexes, heart and respiration rate, and plucking
feathers. To prepare a surgical site on the body,
feathers must be plucked in the direction oppo-
site of the way they lie (against the grain). A wide
area must be plucked and feathers removed from
the surgical field with a handheld vacuum device.
Feathers have the amazing tendency to reappear
in the surgical field if not properly removed.
Once feathers are removed from the surgical site,
Figure 1.38 Endotracheal tube in place on a blue
the skin is well exposed for the procedure. Site
and gold macaw.
preparation is much less involved for birds than
for mammalian species that have been clipped.
Surgical scrub should involve two scrubs, using
a commercial surgical scrub product and sterile
saline. Often radiosurgical units are used in avian
surgical procedures (Figure 1.39). If alcohol is
used as part of the scrub procedure, the bird will
be in flames when the surgeon initiates the inci-
sion. Alcohol also contributes to hypothermia in
the patient, increasing surgical complications for
the anesthetist. To monitor body temperature,
an esophageal thermometer works much better
Figure 1.39 A radiosurgery unit is an essential piece than a cloacal probe. To maintain heat, a veteri-
of equipment for an avian/exotic animal practice. nary conductive fabric warming unit (Hot Dog,
1 | Av i a n 29
Augustine Biomedical & Design, Eden Prairie,

MN) is placed under the patient and a convective
air heating device placed around the patient (Bair
Hugger Arizant Health Care, Eden Prairie, MN)
(Figures 1.40 and 1.41).
Clear plastic drapes help the anesthetist moni-
tor the patient during surgery. The plastic drapes
help in observing the bird’s respiration, but could
contribute to hyperthermia. Any change in the
patient’s temperature is best monitored with a
thermometer, and actions should be quickly taken Figure 1.40 Conductive thermal heating blankets
to stabilize the body temperature into the normal have replaced the traditional warm water blanket.
range. A respiratory monitor that is attached to
the tracheal tube and the tube extending from
the anesthesia machine will put out sounds with
each breath. These monitors can be used on birds
that are as small as budgerigars to birds that
are as large as ostriches. The respiratory moni-
tor will help the anesthetist determine if the bird
is going into a deeper plane of anesthesia or is
becoming “light.” Recent years have seen sig-
nificant advances in surgical monitoring devices
that allow patient assessment while under general
anesthesia (DVM Solutions, San Antonio, TX). Figure 1.41 Convective heating units help stabilize
These new monitoring devices can measure respi- a bird’s body temperature during surgery and critical
ration, heart rate, body temperature, and exhaled presentations.
CO2, among other parameters (Figure 1.42).
Birds should recover quickly from gas anes-
thesia. Once the vaporizer is turned off, oxygen
should be administered until the patient shows
signs of recovery. During recovery, the bird must
be maintained in a critical care unit to help with
body temperature stabilization (Figure 1.43).
HEALTH MAINTENANCE AND DISEASE
Respiratory and Gastrointestinal Bacterial/

Fungal Infections Figure 1.42 It is very important to use magnification
Birds have a well-developed respiratory system and monitoring equipment when performing avian
that is composed of 4 paired and 1 unpaired air surgery.

result, many pet birds are fed a diet deficient in

vitamins, especially vitamin A. Because vitamin
A is an integral component of epithelial health,
a companion bird that is suffering from hypovi-
taminosis A will have a compromised respiratory
and gastrointestinal epithelium. The compro-
mised epithelial surface provides an environment
for microorganisms to adhere to and infect the
bird. External stress factors affect the immune sys-
tem of birds, which reduces their internal ability
to fight the infection or aid antibiotic treatment.
Figure 1.43 A critical care unit is an essential piece of Birds that are immature, old, being transported,
equipment for clinics that treat avian patients. quarantined, or in shows are the most susceptible
to bacterial and fungal infections. Some avian
sac(s) and an extensive upper respiratory sinus species are able to handle external stresses better
(infraorbital) (Figure 1.44). Most people assume than others. The gyrfalcon and red-tailed hawk
that the only diet a bird should eat is seed. As a commonly become infected with Aspergillus spp.
Figure 1.44 The upper respiratory system of birds is very extensive. Illustration by Michael L. Broussard.
1 | Av i a n 31
infections, whereas other raptors are less suscep- treatable medical problems before making a diag-
tible to this often-fatal fungal infection. nosis of psychological feather picking.
It is essential to identify the organism and find A number of parasitic, infectious, and noninfec-
out what drug(s) will effectively treat bacterial tious diseases can initiate and perpetuate feather
and fungal infections (Figure 1.45). Stabiliza- loss in a pet bird. It is only through the thorough
tion of the patient and boosting its physiologic and diligent understanding of a case that the cor-
status through supportive care will aid in the suc- rect treatment can be provided to the patient. If it
cessful treatment of these cases. If birds are not is determined that the problem is psychological,
diagnosed or treated properly for the appropriate environmental and nutritional changes can be rec-
length of time, the bacterial and fungal infec- ommended to the owner for a possible resolution
tions can kill them or cause irreversible anatomic of the problem. If the initial recommendations
damage. are unsuccessful, veterinarians can prescribe psy-
chotropic, antidepressant, or antihistamine drugs.
Feather Picking and Feather Loss Researchers are investigating the possibility of
One of the most frustrating avian case presenta- hypersensitivity reactions in pet birds and agents
tions for veterinarians to treat is a bird suffering that might cause allergic reactions.
from feather loss or self-inflicted feather picking. Elizabethan collars have been used with some
If the head feathers are intact, this usually means success in preventing birds from pulling feath-
that the animal is pulling or traumatizing its own ers. An alternative to Elizbethan collars are “neck
feathers. If the head feathers are also affected, stretchers” that are made out of foam “pool noo-
this often indicates a generalized health problem. dles” or hexalite cast material (Figures 1.46A and
The veterinarian will give a bird with feather loss 1.46B). Though helpful, both of these alternatives
a complete physical examination, incorporating are just physical barriers and do not actually treat
a good owner history, to make sure there are no the underlying cause of feather picking. The pri-
mary cause should be identified and treated for
long-lasting resolution of this frustrating disease.
Trauma
There are many situations in which birds can
become injured through traumatic accidents. Fly-
ing into ceiling fans, sliding glass doors, walls,
and cars; getting burned in water or being burned
by hand-feeding formula; and being bitten by a
cagemate (or other animal such as a dog or cat)
are the most common causes of traumatic injury
to avian patients. Upon presentation, a trau-
matized patient should be quickly assessed and
stabilized. Only when the patient is stabilized
Figure 1.45 Components needed to nebulize avian should extensive treatment or diagnostics take
patients. place. Maintaining hydration status and treating

shock, parasites, and infection are required for

serious injuries (Figure 1.47). Educating owners
about common household hazards and trimming
a bird’s wings will reduce the incidence of trau-
matic injury.
Egg-Binding
Dystocia, or egg-binding, is the inability of a hen
to complete the process of laying an egg. The egg
usually is caught in the shell gland of the oviduct
and needs to be removed by the veterinarian.
Figure 1.46A A foam “pool noodle” can be used to Cockatiels are one of the most common pet bird
make a neck extender. species that present with this problem. Treatment
for egg-binding includes heat, humidity, calcium,
oxytocin, and propulcid. After the hen has been
stabilized and the therapeutic agents have been
given an appropriate length of time to take effect,
a slow, gentle push on the egg toward the cloaca
often aids in its expulsion from the vent, usu-
ally with the bird under general anesthesia for
increased relaxation of the abdominal muscles
and cloaca. Aspiration of the egg contents and
subsequent collapse of the shell might aid in the
passage of misshapen or abnormally large eggs.
In birds that have a history of egg-binding or lay-
ing a large number of eggs, a salpingectomy is
advised to prevent a possible future life-threaten-
ing condition.
Heavy Metal Toxicosis

Lead and zinc are the most common heavy metal
toxins that affect pet birds. Companion birds
come into contact with lead from peeling paint,
weights, toys, solder, wine caps, and lead-headed
Figure 1.46B Pool noodles can be used to prevent nails. Zinc exposure is usually through galvanized
self-trauma. wire and containers and toys. If a bird presents
with neurologic signs, a heavy metal screen should
be performed. Zinc toxicity is more nonspecific,
usually presenting as gastroenteritis. Radiographs
1 | Av i a n 33
Figure 1.47 Proper placement of an intraosseus catheter. Illustration by Michael L. Broussard.
often identify heavy metal foreign bodies within patient’s condition until the danger is over, which is
the gastrointestinal tract. Chelation therapy can often more than a six-month period.
be initiated immediately if heavy metal toxicosis is
suspected. The use of calcium disodium ethylene- Other Diseases
diaminetetraacetate should be carefully monitored, There are many other diseases that infect compan-
because it has been reported to cause gastrointes- ion avian species. Common viral diseases include
tinal and renal toxicosis.5 Removal of the foreign polyoma virus, psittacine beak, and feather dis-
body(ies) through the use of laxatives or surgery ease. It is believed that bornavirus might be
will accelerate the treatment process. Uptake of associated with proventricular dilatation disease. A
the serologic heavy metal by bone tissue will often herpesvirus may be the underlying etiologic agent
cause a relapse of the disease after the initial treat- responsible for causing papillomatosis in large par-
ment, because the body will absorb the dead bone rot species and macaws, an idea not universally
cells containing the material. The relapse condition accepted. Reputable diagnostic laboratories have
must be mentioned to the owner—noting that peri- tests to identify polyoma virus, psittacine beak
odic rechecks and blood testing will monitor the and feather disease, and bornavirus. A vaccine

for polyoma virus is available to protect birds from respiratory secretions and fecal material from
this devastating disease. It is important to vacci- infected birds. If an owner develops spiking temper-
nate both young and older birds to maintain aviary ature episodes and a chronic respiratory condition,
health and protect the reputation of bird breeders. a physician must be notified of the ownership of
birds. The Compendium of Measures to Control
Chlamydophila psittaci Infection Among Humans
ZOONOTIC DISEASES
(Psittacosis) and Pet Birds (Avian Chlamydiosis),
The primary zoonotic disease associated with pet 2010, is published by the public health veterinar-
birds is Chlamydia psittaci. Avian chlamydiosis is an ians in conjunction with the Centers for Disease
intracellular bacterium that presents as a number of Control and Prevention, and outlines human and
disease conditions in birds, but is a respiratory con- avian disease conditions, diagnostic methods, and
dition in humans. The organism is spread through treatment regimes.6
SELF-STUDY QUESTIONS
1. Describe basic husbandry recommendations for a pet bird. Include cage size, location, cage
environment, and recommended ambient temperature of the area in which the cage is placed.
2. Describe the recommended diet for most companion avian species.
3. What is the recommended technique for capturing and restraining a large parrot? A canary?
4. How is the hydration status of a bird evaluated?
5. Describe the proper method of performing a physical examination on an avian patient.
6. For most pet birds, how is the body condition evaluated?
7. If a bird gets stressed during the physical examination, what are the five criteria used to “put it
down” and place it in a critical care unit?
8. How much blood can be safely collected from an avian patient?
9. Describe blood collection techniques used for avian patients.
10. What common anatomical sites are bacterial cultures collected from and what pathogenic
organisms are often isolated?
11. Describe the common diagnostic imaging modalities used for avian species. List advantages and
disadvantages of each regarding avian patients.
12. Describe how to intubate a bird.
13. How do you assess depth of anesthesia in an avian patient?
1 | Av i a n 35
14. Describe grooming techniques used for birds.
15. What methods are used to individually identify birds?
16. What are common disease presentations in avian patients?
17. What is avian chlamydiosis and what are the consequences if humans are infected by the bacterial
organism?
REFERENCES
1.
Lightfoot T. Avoiding disaster in the critical patient. Proceedings of the Annual Conference, Asso-
ciation of Avian Veterinarians, 1998:265–71.
A ltman RB, Clubb SL, and Dorrestein GM. Hematologic and plasma biochemical reference ranges
2.
of common psittacine species. In: Quesenberry KE, ed. Avian medicine and surgery. Philadelphia:
WB Saunders; 1997:1005–7.
Carpenter JW. Exotic animal formulary, 3rd ed. St. Louis, MO: Elsevier/Saunders; 2003:564.
3.
4.
Clyde VL, and Patton S. Diagnosis, treatment, and control of common parasites in companion and
aviary birds. Seminar in Avian and Exotic Pet Medicine 1996;5(2): 52–64.
McDonald SE. Lead poisoning in psittacine birds. In: Kirk RW, ed. Current veterinary therapy IX,
5.
small animal practice, Philadelphia: WB Saunders; 1988:713–18.
Centers for Disease Control and Prevention. Compendium of measures to control Chlamydophila
6.
psittaci infection among humans (psittacosis) and pet birds (avian chlamydiosis); 2010.
Further Reading
age LJ, and Duerr RS. Hand-rearing birds. Ames, IA: Blackwell Publishing; 2007.
G
Tully TN, Dorrestein GM, and Jones AK. Handbook of avian medicine, 2nd ed. Oxford, UK: Saunders/
Elsevier; 2009.

Reptiles
Chapter 2
and
Amphibians
INTRODUCTION
For the past decade, reptiles and amphibians have been considered one of
the fastest-growing segments of the pet trade. Those that have a fear of these
animals might find this hard to believe, but the numbers don’t lie. The most
recent American Veterinary Medical Association pet survey statistics sug-
gest that there was a 25.5% increase in the number of reptiles being kept as
pets in the United States between 2001 and 2007. This increased number of
animals being maintained in captivity has expanded the need for qualified
veterinarians and veterinary technicians to provide the quality medical and
surgical care that pet owners have come to expect from our profession. A cer-
tified veterinary technician with experience in working with these animals
will prove to be valuable in the employment market.
Taxonomy
Proper identification of a reptile or amphibian is essential to case manage-
ment. As a veterinary technician, you might be expected to provide your
client with information about the natural history of an animal and to make
suggestions regarding the environmental and nutritional needs of that ani-
mal. Unfortunately, many reptiles and amphibians have been assigned 3 to
4 different common names, depending on who collected or sold a particular

animal. It is not uncommon to enter different pet handling the animal or working in its environ-
stores and find the same species being sold under ment); this might be beyond the scope of young
different names. Clients can become frustrated children and explains why these animals don’t
while researching the particular needs of an ani- make good first pets. The other reason is that
mal if they are searching for literature under an pet reptiles and amphibians require significantly
uncommon (nonscientific) name. The scientific more attention regarding their husbandry and
classification of animals (taxonomy: genus and management than do other pets, such as birds,
species) is an important tool that can be used dogs, and cats. Many of the successes and failures
to determine the needs of a particular animal, experienced by your clients are directly related to
because it provides a “real identity” to the ani- their ability to accommodate their pet reptile’s
mal. Of course, with more than 8,000 different nutritional, psychological, and environmental
species of reptiles and 5,000 species of amphib- requirements.
ians, learning all of these scientific names would The single most important factor in maintain-
be impossible. Fortunately, the number of reptiles ing a healthy reptile or amphibian in captivity is
and amphibians available through the pet trade is providing an appropriate environmental tempera-
closer to 200, and most pet retailers carry only 15 ture range (ETR). Reptiles and amphibians are
to 30 different species. Because the actual num- ectotherms and depend on their environmental
ber of reptiles and amphibians that are likely to temperature to regulate their core body tempera-
present to a veterinary hospital is not overwhelm- ture. Establishing an appropriate ETR for a reptile
ing, it should be possible for individuals working or amphibian requires knowledge of the animal’s
with these animals to develop a resource library native environment and living habits.
to become familiar with both their scientific and Reptile and amphibian species are found
common names. The scientific classification of throughout much of the world’s temperate and
animals is dynamic and can change, so keeping tropical climates. To survive within these climates,
up with new and updated literature is recom- reptiles and amphibians have adapted to specific
mended. A list of scientific and common names niches. An arboreal lizard (such as a green iguana)
can be found in Table 2.1. and a burrowing lizard (such as a skink) from Cen-
tral America might be found in the same geographic
location, but they are exposed to different ETRs
HUSBANDRY
because of their different behavioral patterns. A
Environmental Concerns green iguana might experience temperatures greater
It is interesting that reptiles and amphibians have than 100°F in the trees and 85°–90°F in the shade,
been marketed as first pets for children. There are whereas a subterranean animal might experience
two primary reasons this should be discontinued. temperatures less than 85°F in its burrow. Research-
First, reptiles and amphibians can harbor poten- ing the origin and specific needs of a reptile will
tially zoonotic pathogens (e.g., Salmonella spp.) as improve one’s ability to care for these animals in
a component of their indigenous intestinal micro- captivity. Providing an appropriate ETR for a reptile
flora. Fortunately, the potential for exposure to or amphibian can be accomplished using a number
these pathogens can be minimized by practicing of commercially available products. Recommenda-
standard disinfection (e.g., hand washing after tions for heating products should be based on the
39
Table 2.1 Reptile and Amphibian Taxonomy
Class Reptilia
Order Crocodylia Order Squamata

(Alligators, Caimans, Crocodilians, Gharials) (Lizards and Snakes)
American Alligator Alligator mississipiensis Bearded Dragon Pogona vitticeps

American Crocodile Crocodylus acutus Bosc’s (Savannah) Varanus exanthematicus
Monitor
Speckled Caiman Caiman crododilus
Chinese Water Dragon Physignathus cocincinus
Order Chelonia Green Anole Anolis carolinensis
(Turtles, Tortoises, and Terrapins) Green Iguana Iguana iguana
Lizards
Box Turtle Terrapene carolina Green Plumed Basilisk Basiliscus plumifrons
Red-Ear Slider Trachemys scripta elegans Jackson’s Chameleon Chamaeleo jacksonii
Gopher Tortoise Gopherus polyphemus Leopard Gecko Eublepharis macularius
Desert Tortoise Gopherus agassizii Panther Chameleon Furcifer pardalis
Leopard Tortoise Geochelone pardalis Prehensile-Tailed Skink Corucia zebrata
Mata-Mata Chelus fimbriatus Veiled Chameleon Chamaeleo calyptratus
Red-Footed Tortoise Geochelone carbonaria Ball Python Python regius
Snapping Turtle Chelydra serpentina Boa Constrictor Boa constrictor constrictor
Sulcatta Tortoise Geochelone sulcatta Burmese Python Python molurus bivittatus
Snakes
Corn Snake Pantherophis guttata guttata

Garter Snake Thamnophis spp.
King Snake Lampropeltis getulus
Reticulated Python Python reticulatus
Class Amphibia
Order Anura Order Urodela

(Frogs and Toads) (Salamanders and Newts)
African Clawed Frog Xenopus laevis Axolotl Ambystoma mexicanum
American Bullfrog Lithobates catesbeiana Hellbender Cryptobranchus spp.
Argentine Horned Frog Ceratophrys ornata Mudpuppy Necturus maculatus
Cane Toad Anaxyrus marinus Tiger Salamander Ambystoma tigrinum
Leopard Frog Lithobates pipiens
Poison-Arrow Frog Phyllobate spp., Dendrobates spp.
Order Gymnophiona
(Caecilians)
Aquatic Caecilian Typhlonectes natans
Indonesian Caecilian Ichthyophis kohtaoensis

anatomy and natural behaviors of the reptile or eters are those that have a thermal probe that can
amphibian. For example, the large surface area be moved within the vivarium to assess tempera-
of the turtle’s carapace serves as a heat collection ture. The “stick-on” thermometers commonly used
device when the animal basks under radiant light. for aquariums are not recommended because they
Therefore, the use of substrate heat sources (e.g., provide only limited information regarding the
hot rocks and undertank heating pads) will be of temperature in a limited area within the vivarium.
limited value. Historically, “hot rocks” have been recom-
The preferred method of providing heat for rep- mended for reptiles; however, these heating
tiles and amphibians is radiant light. Reptiles and elements have been associated with severe ther-
amphibians naturally bask under the radiant light mal burns and are not typically recommended. In
of the sun to store heat, which serves to maintain many cases, the hot rock was the only source of
their core body temperature. Variable-wattage heat for the reptile in its enclosure. Reptiles will
incandescent bulbs can be used to provide an gravitate to environmental heat to regulate their
appropriate ETR (Figure 2.1), and although reptiles core temperature. Many hot rocks can generate
and amphibians both regulate their core body tem- excessively high temperatures (>110oF) or “hot
peratures from their environmental temperature, spots” that can severely burn an animal. Large
amphibians do not require the higher temperature reptiles that can actually cover a hot rock can
sought by reptiles and thus require lower-wattage trap the heat and develop a significant burn. This
bulbs to set their temperatures. Always provide a problem is not exclusive to hot rocks. Snakes given
barrier between the light source and the animal to direct contact with an incandescent bulb (e.g.,
prevent contact with the heat source. Thermom- radiant heat) in an environment where the tem-
eters should be used to measure the temperature perature is not regulated have also been known
and ensure that the ETR is appropriate for that to wrap themselves around the bulb and severely
particular species. The best types of thermom- burn themselves. The veterinary technician should
be able to make recommendations for clients that
would prevent these disasters from occurring.
Newer-generation hot rocks are offered for sale
and claim not to generate the excessive tempera-
tures observed in the past. Another disadvantage
of the hot rock is that it provides only a single
point source of heat. Hot rocks have been used
successfully with other heat sources (e.g., radiant
light) to provide a basking area for “sun-loving”
species. Hot rocks should be used only for basking
lizards that do not “cover up” the hot rock, and
the surface temperature of the hot rock should
Figure 2.1 Variable-wattage incandescent lighting can
be monitored closely. Burying the hot rock in the
be used to provide an appropriate ETR for any reptile.
Typically, a higher-wattage bulb will be placed on one substrate within the vivarium can also minimize
side, with a lower-wattage bulb on the other. A ther- any potential complications. Hot rocks should
mometer is essential to confirm the temperature range. never be recommended for amphibians.
2 | reptiles and amphibians 41
Undertank heating pads are commonly used wild, and is the preferred method for providing
for snakes and lizards. Undertank heating sources heat for these animals in captivity.
can be placed on one side of an animal’s enclo- Full-spectrum lighting has received a great deal
sure, leaving the other area unheated. This will of attention in the reptile and amphibian litera-
effectively provide the animal with an appropriate ture because of its role as an “artificial sun” in the
ETR. When these devices are placed under a glass management of captive animals. Captive reptiles
enclosure, the heat generated can be much higher and amphibians are typically housed indoors,
than on the pad’s surface, leading to burns. The which limits the benefits they can obtain from
temperatures generated by these heating devices the sun. For this reason, it is important that they
should be monitored closely. have an artificial source of “sunlight.” It is impor-
The reptile’s and amphibian’s metabolism, tant to note that not all forms of artificial light are
immune system, and behavior are directly related similar. Veterinary personnel working with reptile
to their ability to maintain their core body tem- and amphibian patients need to develop a work-
perature. A reptile or amphibian maintained at an ing understanding of the important components
inappropriate ETR will become hypothermic and of sunlight and the types of artificial lights that
have a decreased metabolism, resulting in inactiv- are best for these animals, to ensure that techni-
ity and limited growth. A reptile or amphibian cians can make the appropriate recommendations
with decreased immune function will be unable to to their clients regarding the care of their pets.
mount an effective immune response against bac- Reptiles and amphibians depend on the sun
terial, viral, and fungal pathogens. Many of these to provide them with three different sources
animals are classified as “poor-doers.” Successful of radiation: ultraviolet (290–400 nm), visible
treatment (e.g., antibiotics) of infectious diseases (400–700 nm), and infrared (>700 nm). Visible
in reptiles requires that the animal be maintained light is important because it amplifies the colors
at an appropriate ETR for their metabolism to that reptiles and amphibians see, which can have
effectively distribute the medication to the target an effect on feeding behaviors and reproduction.
tissues. The quality of visible light varies among different
Recommendations for providing a reptile or types of lightbulbs. For example, fluorescent bulbs
amphibian with an appropriate ETR will depend typically produce a better-quality visible light
on the species, so it is important to research the than incandescent bulbs. Infrared radiation gen-
specific needs of an animal to ensure the most erates the “environmental heat” that is important
appropriate recommendation is being made. In to ectothermic reptiles and amphibians. Incandes-
general, temperate species of reptiles and amphib- cent and metal halide bulbs are typically the best
ians thrive at temperature ranges between 75° at generating infrared radiation.
and 85°F and 70° and 78°F, respectively; tropical Ultraviolet radiation can be divided into ultra-
species of reptiles and amphibians at 78° to 90°F violet A (320–400 nm), ultraviolet B (290–320
and 74° to 80°F, respectively; and desert species of nm), and ultraviolet C (<290 nm) wavelengths.
reptiles at 85° to 95°F. Radiant light (e.g., incan- Ultraviolet A has been associated with managing
descent lamps or ceramic heat emitters) most different behaviors in reptiles and amphibians;
closely resembles the radiant heat generated by the however, there is much we still don’t know about
sun that reptiles and amphibians encounter in the it. Ultraviolet C is a potent form of irradiation.

It does not play a direct role in the management be replaced every 9–12 months because they lose
of captive reptiles and amphibians, but is used in their effectiveness over time. It is important to
ultraviolet sterilizers (germicidal) for aquatic sys- research the different bulbs available commer-
tems. Ultraviolet B (UVB) plays an important role cially, because the quality of the bulbs can vary.
in the endogenous synthesis of vitamin D in ver- The bulbs that typically produce UVB include
tebrates that possess the photochemical structures fluorescent tubes, compact fluorescent bulbs, and
in their skin capable of initiating the process. metal halide bulbs.
Not all vertebrates have the ability to do this. Environmental humidity is often overlooked
Cats, for example, do not synthesize vitamin D by pet reptile owners. Most recommendations for
using this process, but instead acquire their vita- relative humidity in captive settings are based on
min D through the consumption of prey. It has the climate that an animal originates from: tropi-
been speculated that carnivorous reptiles must do cal 80%–95%, temperate 60%–70%, and desert
the same, but some researchers have shown that 40%–50%.3 Many reptiles are dependent on envi-
“meat-eating” reptiles have the capacity to synthe- ronmental moisture to aid with shedding and to
size vitamin D when exposed to UVB radiation.1,2 maintain hydration. When animals are predis-
An animal that derives its vitamin D from pho- posed to low relative humidity, they are prone
tochemical synthesis requires regular exposure to to dysecdysis (difficulty shedding), dehydration,
UVB radiation to ensure that it will synthesize respiratory infections, and behavioral anomalies.
adequate levels of vitamin D. Humidity can be maintained or increased in an
Vitamin D serves several functions in the body, enclosure by using large-surface-area water bowls,
including the absorption of calcium at the level bubbling or heating water in a mason jar, covering
of the intestine and maintaining cardiovascular the enclosure lid with a plastic sheet, and routine
health. To date, there has been limited research to misting. A hygrometer should be placed in the cage
assess the role of UVB in the endogenous synthesis to closely monitor the relative humidity. Envi-
of vitamin D in reptiles (e.g., <15 species studied ronmental humidity levels are considered more
out of >3,000 species) and amphibians; therefore, important in amphibians because they are more
it is best to assume that reptiles and amphibians susceptible to desiccation than reptiles. Humid-
require exposure to UVB radiation to synthesize ity levels for temperate and tropical amphibians
vitamin D and provide it to them. should be maintained between 60% and 80% and
To ensure that a captive reptile or amphib- 70% and 90%, respectively.
ian is provided the maximal UVB radiation, the Reptiles and amphibians have developed vari-
bulb should be positioned within 12–18 inches ous behaviors that enable them to fill a certain
of the animal and not directed through glass. niche in their environment. Attempts should be
Glass refracts short-wavelength light, effectively made to provide the animal with “cage furniture”
inhibiting UVB radiation penetration. Reptiles that encourages these behaviors. For example,
should be provided a 12-hour light, 12-hour dark- green iguanas are arboreal (tree-climbing) ani-
ness cycle under normal conditions; however, mals that naturally climb into tree branches to
individuals interested in breeding these animals bask under radiant sunlight. When these animals
should establish photoperiods that mimic natural are placed in an enclosure that does not contain
seasonal cycles. Full-spectrum lightbulbs should branches, they are more likely to be stressed. Stress
can initiate a cascade of physiologic changes in

the body that can affect metabolism and immune
function. Pet owners should be made aware of the
importance of fully researching the specific needs
of their new pet and providing them a suitable
captive environment. Cage furniture should be
safe, noningestible, and easy to clean.
There are a number of different substrates
available in the pet retail market. Every sub-
strate has potential advantages and disadvantages
related to its use (Table 2.2). Recommendations Figure 2.2 There are many different types of substrate
to the owner should always include providing the available for reptiles and amphibians. Substrate selec-
pet with a substrate that is safe, easy to clean, tion should be based on the specific animal’s needs. In
and aesthetic (Figure 2.2). Substrates should be most cases, reading up about its life history can pro-
vide insight on what would be best (e.g., grass hay for
cleaned regularly; all fecal material and urates
tortoises).
should be removed daily to prevent possible con-
tact dermatitis.
of reptiles and amphibians and having an under-
Nutrition standing of the nutritional value of commercially
In the wild, reptiles and amphibians have the available foods, a technician can educate clients
opportunity to select from a diverse array of and ensure their success with managing their pet
food items in their environment to meet their reptile or amphibian.
daily needs, but with more than 12,500 species Reptiles can be classified into one of three
of reptiles and amphibians in the world, it can dietary categories: carnivores, omnivores, and
be difficult to re-create these diets in captivity. herbivores. Adult amphibians are all carnivo-
By researching the specific dietary requirements rous, whereas larval forms might be carnivorous
Table 2.2 Substrates Commonly Recommended for Reptiles and Amphibians

Substrate Advantages Disadvantages
Newspaper Inexpensive Aesthetically unpleasing

Easy to clean Affords no cover to reptile
Easy to monitor feces, urine
Orchid Bark Aesthetically pleasing Predisposes to foreign body
Natural Reduces relative humidity
Dusty (respiratory signs)
Calcium Carbonate Sand Aesthetically pleasing Costly
Easy to clean Foreign bodies in eye, mouth, GI tract
Aspen Wood Shavings Aesthetically pleasing Reduces relative humidity
Easy to clean Splinters/foreign bodies

(e.g., salamanders) or herbivorous (e.g., tadpoles). thyroidism. A rapidly growing insectivore, such as
Carnivores are the easiest animals to accommo- a leopard gecko, will develop muscle tremors and
date, because they will accept whole prey such as seizures and possibly die when offered a calcium-
other reptiles, amphibians, birds, and mammals, deficient diet. This problem can be prevented by
which are a nutritionally balanced food resource. properly preparing the feeder invertebrate. Many
A common mistake that pet owners make when pet retailers offer invertebrates apples or potatoes,
feeding carnivores is to offer live prey. When a believing that they are providing the prey items a
reptile or amphibian is not hungry, it will rarely balanced diet; however, these foods provide little
kill the prey item. If left unattended, the prey more than carbohydrates and moisture and do not
could become hungry and feed on the reptile or correct the mineral deficiency. A solution to this
amphibian, which could prove fatal. To prevent problem is to offer a balanced commercial inver-
this from occurring, recommend to your clients tebrate diet. Research evaluating these diets has
that they offer only prey items that are not alive. proven that they can significantly improve the
Snake owners are the most likely to complain that nutritional value of the prey item.4 Recommend
their snake won’t feed on prekilled prey; however, that your clients offer the commercial diet for a
because snakes use olfaction to detect their prey minimum of 24 hours prior to feeding the prey
items they can be trained to eat prekilled prey. items to the reptile or amphibian (Figure 2.3). This
Another common group of carnivores—the should ensure that the invertebrate will be “gut-
insectivores—feed exclusively on invertebrates. Six loaded.” There are also mineral supplements that
invertebrates are commercially available, including can be used to “dust” the prey items and increase
the domestic cricket (Acheta domestica), mealworm their nutritional value. These mineral supplements
(Tenebrio molitor), superworm (Zoophobias morio), should be used according to label recommenda-
earthworm (Lumbricus terrestris), greater wax moth tions.
larva (Galleria mellonella), and soldier fly larva Herbivores are the hardest group of reptiles to
(Hermetia illucens). These invertebrates are often accommodate in captivity because of the limited
offered for sale without having been nutritionally availability of quality vegetables and fruits. In the
prepared. All living creatures require energy, and wild, herbivorous reptiles select their diet from a
if feeder invertebrates are not offered food, they variety of available resources, whereas in captivity
will provide little nutritional value to the reptile they are limited to what is available.
or amphibian they are fed to. Commercially avail- Romaine lettuce and mustard and collard
able invertebrates are adequate in protein and fat, greens are most frequently recommended as the
but are deficient in specific amino acids, vitamins, base diet for captive herbivores. Other plant prod-
and minerals (especially calcium). One exception ucts, such as spinach, broccoli, green beans, kale,
is soldier fly larvae, which have more than ade- squash, dandelion leaves, and other dark leafy veg-
quate calcium levels. Unfortunately, if the reptile etables, can be used to further diversify the diet.
or amphibian eating them doesn’t penetrate their Certain plant products, such as kale and spinach,
cuticle, they won’t gain access to any real nutri- should be limited in the diet because they contain
tion and will tend to pass the dead larvae intact. oxalates and can bind valuable dietary calcium in
The most common nutritional disorder observed the digestive tract and increase the likelihood of a
in insectivores is secondary nutritional hyperpara- mineral deficiency.5 Other plant products, such as
As noted, little is known about the specific dietary

requirements of reptiles and amphibians. In the
past, many of the nutritional problems diagnosed
in reptiles and amphibians were associated with
vitamin and mineral deficiencies and the need for
supplements was apparent. More recently, diseases
associated with excessive vitamin and mineral
supplements have been reported and a concern has
arisen regarding how much of these supplements
to provide.6 Clients should be made aware of the
risks of vitamin and mineral oversupplementa-
tion. Veterinary personnel should make specific
Figure 2.3 Live foods should be provided appropriate dietary recommendations based on the reptile’s
nutrition prior to offering them to a reptile or amphib-
or amphibian’s age and physiological status (e.g.,
ian. These crickets are being fed a commercial cricket
chow. gravid).
Transport
broccoli, contain goitrogens, which can alter thy- Reptiles can elicit quite an array of emotions in
roid metabolism and should likewise be limited. people. Clients with dogs or cats might not appre-
The key to success with herbivore diets is to pro- ciate sharing a waiting room with a large reptile. To
vide a diverse selection of food products to increase prevent potential disaster in your veterinary hospi-
the nutritional value offered to the animal. Fruits tal, recommend that reptile and amphibian owners
should not constitute more than 10%–15% of the transport their pets in a closed, secured enclosure.
animal’s diet, because they are devoid of protein Snakes and lizards travel well in ventilated burlap
and essential minerals. or cotton bags (e.g., pillow cases). Larger snakes,
In recent years, commercial herbivore diets have lizards, and tortoises may be transported in large
been manufactured that improve our ability to plastic boxes or garbage cans with airholes. Semi-
provide a more balanced diet. Many of these diets aquatic reptiles (e.g., red-eared slider turtles) and
are marketed as complete and recommended as a amphibians (e.g., bullfrog) should be transported
sole source of nutrition; however, little is known in a plastic box (with airholes) with a level of water
about reptile nutrition and a more diverse diet that covers the animal’s feet. Semiaquatic animals
should be recommended. A diet that combines maintained in deep water for transport are prone
a commercial product (25%–40%) with high- to drowning. Totally aquatic amphibians (e.g.,
quality plant sources, such as romaine lettuce and Surinam frog) should be transported in a plas-
mustard and collard greens, may be used. tic enclosure with sufficient dechlorinated water
There are a number of commercially available to cover the animal. Recommend to your clients
nutritional supplements for reptiles and amphib- that they not change the bedding of the enclosure
ians. The available supplements might contain before transporting the animal, so that the veteri-
calcium, calcium and phosphorus, vitamins, nary technician can examine the fecal and urine
amino acids, or a combination of these nutrients. material.

Grooming or outdoors; if it has supervised or unsupervised

There are rarely situations in which reptiles are run of the house; the cage size and material; the
groomed. But in some cases with lizard species, cage location in the house; temperature, humid-
owners may complain about sharp claws that cause ity, lighting, light cycle, and substrate used in
painful scratches. Lizard (e.g., green iguana) claws the cage; types of cage furniture; if the reptile/
can be blunted with similar techniques described amphibian is housed with another animal; and
for bird claws/nails, that of using a Dremel® tool how often the cage is cleaned and type of disinfec-
or the tip of an electrocautery unit. An alternative tant used. Questions about the animal’s nutrition
to trimming the claws is to use plastic nail caps for are also important and should include type of food
dogs and cats. (natural or commercial), amount offered daily, fre-
quency, supplements, water source, and how often
the food and water are changed.
HISTORY
Finally, the questions should focus on the ani-
A thorough history is essential to making an mal’s health status, including medical history,
appropriate diagnosis for any exotic animal case, current presenting problem, and duration of the
because many of the problems identified in exotic complaint. Although it is natural to want to focus
animals are directly related to inappropriate on the presenting problem first, a great deal of
husbandry. A veterinary technician should first information could be lost if the animal’s history is
collect the signalment, including age, breed, and not collected using a systematic approach.
sex, if they are known. Knowledge of the ani-
mal’s age and sex can be useful when developing
RESTRAINT
a differential diagnosis list. For example, an adult,
intact female green iguana with a history of weak- Using appropriate techniques for handling an
ness and lethargy during the months of December animal for an examination is essential to protect
through March might be suffering from a repro- the technician, the veterinarian, the client, and
ductive problem (e.g., follicular stasis or dystocia), the patient. A working knowledge of the ani-
whereas an adult male would not. mal’s anatomy and physiology is an important
After collecting the signalment, focus on back- consideration. First, determine what weapons the
ground information, including where the animal animal might use to defend itself. For example,
was acquired, length of time owned, if the cli- a green iguana might use its tail to “whip” the
ent has other pets or reptiles/amphibians, if he technician, use its teeth to bite, or use its claws
or she recently acquired another animal, and the to climb away or on the technician. Identifying
interaction between the owner and the pet (e.g., these weapons prior to restraining the animal
frequency of handling). This information should will reduce the likelihood of injury for both the
provide the technician with an initial understand- technician and the patient. Reptiles and amphib-
ing of the client’s knowledge of the pet reptile or ians lack a diaphragm, and if they are grasped
amphibian. tightly around the rib cage, they could literally
The next set of questions should focus on how suffocate. Chelonians should never be held upside
the animal is managed at home (husbandry), down for extended periods, because the viscera
including whether the animal is housed indoors can place extra pressure on the lungs, again lead-
ing to difficulty breathing. Appropriate training

and practice will enable a technician to safely
manage a wide range of nonvenomous reptiles.
Lizards
For small specimens, place your thumb and
index finger on either side of the ramus (man-
dible), allowing the animal’s body to rest in the
palm of your hand. Never constrict the animal’s
body when you are restraining it, because reptiles,
except crocodilians, lack a diaphragm and you
can suffocate them. For larger specimens, again
place your index finger and thumb on the cor-
ners of the mandible and use your second hand to
hold the rear legs against the animal’s tail (Figure
2.4). Never grab a lizard by the tail. Some species
(e.g., green iguana) have the ability to “drop” their Figure 2.4 Appropriate restraint for a large lizard.
tail (tail autotomy) as a defense mechanism that
allows the animal to avoid capture by a predator.
Clients are not impressed when their pet lizard’s
tail is broken because of poor restraint technique.
SNAKES
Place your index finger and thumb under the
mandible and use your other hand to support the
snake’s body (Figure 2.5). One person is required
for every 2–3 feet of snake. Large constrictor spe-
cies should never be handled without assistance.
Although it is rare, these large, powerful snakes Figure 2.5 Appropriate head restraint for a snake.
are capable of seriously injuring a careless indi-
vidual. Only trained professionals should handle the shell (Figure 2.7). Do not exert excessive force
venomous snakes, and access to antivenom should when restraining chelonians, because you could
be arranged at a local hospital. easily damage their cervical spine. In those cases
when the animal cannot be physically managed,
CHELONIANS the veterinarian can provide an appropriate seda-
Most chelonians can be handled by grasping the tive or anesthetic.
middle of the shell (Figure 2.6). Many of the biting
turtles (e.g., snapping turtles) should be grasped at CROCODILIANS
the rear of the shell. For a physical examination, Crocodilians are lightning-fast and can inflict a
the head and neck can be gently withdrawn from nasty bite. They can also use their tail as a weapon.

Crocodilians should be restrained only by experi-

enced professionals. Getting control of the mouth
is important when restraining a crocodilian. The
muscles used to close a crocodilian’s jaws are very
powerful, whereas the muscles used to open the
jaws are not as powerful. Therefore, once the
mouth of a crocodilian is closed it can be held
securely with minimal effort. When restraining a
crocodilian, first grasp the head at the base of the
skull. Once that is done, pressure can be placed on
the upper jaw to close the mouth. The mouth can
Figure 2.6 Appropriate restraint for a chelonian.
then be held closed and taped (e.g., with duct tape)
to keep it closed. Be careful not to wrap the tape
around the nares when securing the jaws. Once
the mouth is appropriately restricted, a crocodil-
ian can be restrained in a manner similar to that
described for large lizard specimens (Figure 2.8).
AMPHIBIANS
Amphibians have a very delicate and sensitive
integument. The epidermis is covered by a protec-
tive mucous barrier, similar to that of fish, which
protects these animals against pathogens. There
are also amphibians, such as poison-dart frogs,
Figure 2.7 Restraining the head of a chelonian for that produce toxins in these mucous secretions.
examination. This animal has an aural abscess. To prevent danger to yourself and the animal,
wear a pair of examination gloves that have been
moistened with dechlorinated water or distilled
water to prevent both damage to the animal’s
protective mucous barrier and toxic exposure to
the handler. Large amphibians (e.g., Argentine
horned frogs and hellbenders) can inflict a nasty
bite, and precautions should be taken when man-
aging these large specimens. Most amphibians
can be grasped in the palm of the hand and exam-
ined. Anurans can be restrained by grasping them
with your index finger and thumb in the axillary
region. Some salamanders can detach their tail, as
described with lizards and, therefore, should never
Figure 2.8 Appropriate restraint of a crocodilian. be grasped by the tail.
PHYSICAL EXAMINATION gently pry open a chelonian’s jaws. Aggressive

reptiles might gape as a defensive or offensive
The physical examination of a reptile or amphib-
measure, which facilitates examination of the oral
ian will relay a great deal of information to the
cavity. The oral cavity should be clear and free of
veterinarian and direct the selection of diagnostic
discharge, parasites, and abscesses. The mucous
tests and initial treatment options. Reptiles and
membranes should be moist and pale pink. The
amphibians have evolved to mask their illnesses to
glottis (airway) should be free of discharge and
prevent predation. Therefore, the veterinarian will
parasites.
perform a hands-off examination of the animal
The skin should be clean and free of defects.
in its enclosure before a routine hands-on exami-
Imported animals are often covered with ecto-
nation. The veterinarian will closely observe the
parasites and the veterinarian will examine them
animal’s general disposition, respiratory rate, and
closely, especially in the gular fold (under the
locomotion and record his or her findings before
chin), mouth, and around the eyes. The limbs will
proceeding to a hands-on examination.
be evaluated for range of motion and palpated for
The veterinarian will always perform a hands-on
any skeletal deformities. The veterinarian will pal-
physical examination in a thorough and consis-
pate the coelomic cavity and assess it for pain and
tent manner. Some prefer to start at the head and abnormal masses. The internal organs of reptiles
work their way back, whereas others start from and amphibians are consistent across species, and
the tail and work to the head. A basic understand- a basic understanding of reptilian and amphib-
ing of what is normal for that animal is also an ian anatomy is necessary to interpret abnormal
important prerequisite. For example, chameleons findings (Figures 2.9A and 2.9B). Reptiles (e.g.,
typically have bright yellow mucous membranes. leopard geckos) and amphibians (e.g., frogs) with
If this was not known, one might misclassify the white or light pigmented ventrums can be fur-
animal as being icteric. It is important to maintain ther examined using a transilluminator. Placing
a resource library that will allow identification of the light source along the lateral body wall of the
specific differences among species. animal will help outline several internal organs.
An animal’s eyes should be clear and free of Cystic calculi and gastrointestinal foreign bodies
discharge. The nares and external ears (tympanum in reptiles and amphibians have been diagnosed
in chelonians, lizards, and amphibians; absent in using this technique.
snakes) should be free of discharge and ectopara- A physical examination should include
sites (e.g., ticks and mites). Some reptiles possess auscultation of the animal’s heart and lungs. Aus-
salt glands in the nares that can produce a clear, cultation in reptiles is especially difficult because
crystalline secretion. the scales or carapace can inhibit one’s ability to
The oral cavity should be opened with care, fully assess the heart and lung fields. A thin, damp
because aggressive manipulation can lead to bro- paper towel can be placed on the animal’s skin to
ken teeth or tomia (chelonians) or damage to the reduce friction between the bell of the stethoscope
mucous membranes. A rubber spatula or folded and the scales. The veterinarian might not be able
piece of radiographic film can be gently inserted to hear the heart and lungs, even when using this
into the mouth of a lizard or snake to aid in view- technique. Nevertheless, when a pathology (e.g.,
ing the oral cavity. A paper clip can be used to pneumonia, pulmonary edema) is diagnosed,

Figure 2.9A Snake anatomy. Knowledge of a reptile’s anatomy is essential to interpreting the physical examination
findings. Illustration by Michael L. Broussard. Illustration adapted from Reptile Medicine and Surgery (Elsevier
2005).
it helps direct additional testing. Although rep- heart of most reptiles and amphibians is located
tiles are difficult to auscult, it is important to be within the pectoral girdle. For lizards, salaman-
thorough and consistent with every patient and ders, and frogs/toads, the Doppler should be
perform this assessment. placed in the axillary region and directed medi-
An ultrasonic Doppler is the best way to mea- ally. Monitor lizards are an exception; their heart
sure heart rate in reptiles and amphibians. The is located more distally in the chest. A snake
Attempts to determine the sex

of the reptile should also be made
during the physical examina-
tion. Some reptiles are sexually
dimorphic (e.g., have physical
characteristics that help deter-
mine sex), whereas others are not.
For example, some lizards, such as
green iguanas (Figure 2.10) and
bearded dragons, have pores on
the ventrum of their legs (thighs
only in iguanas; thighs and ventral
pelvis in bearded dragons) that
can be used to determine their
sex. The pores are larger in the
males than in females. Terrestrial
chelonians can often be sexed by
looking at their plastron (ventral
shell). Males have an indentation
(concavity) that allows them to
mount the female. Aquatic che-
lonians do not have this same
structure, although they might
have others. For example, female
red-eared slider turtles (Trache-
mys scripta elegans) are larger than
Figure 2.9B Chelonian anatomy. Illustration by Michael L. Broussard. males, and the males have longer
Illustration adapted from Reptile Medicine and Surgery (Elsevier 2005). front claws. Sex determination in
snakes is best done by probing the
heart is typically found one-third to one-quar- base of the tail for the presence/absence of hemi-
ter the distance from its head. When a snake is penes (Figure 2.11).
placed in dorsal recumbency, its heartbeat can be
visually observed. A Doppler probe placed over
DIAGNOSTIC SAMPLING
a snake heart allows for not only measuring the
heart rate, but also listening for abnormal heart Veterinarians use the information gathered from
sounds (murmurs). The chelonian heart is located a detailed history and thorough physical exami-
in the proximal third of the coelomic cavity. To nation to develop a list of differential diagnoses.
listen to its heart, place the Doppler probe in the The veterinarian will then use available diagnostic
area between the head and forelimb (right or left) tests—such as hematology, plasma chemistry analy-
and direct it caudally. sis, radiographs, microbiological isolation, cytologic

examination, and parasitologic examination—to

determine the cause of the animal’s illness.
Blood Collection (and Interpretation)

Reptiles and Amphibians
Reptiles and amphibians mask their illnesses,
making diagnosis difficult. Hematologic sampling
provides a veterinarian with insight into possible
physiologic changes and the disease status of an
animal. Samples are routinely collected and sub-
Figure 2.10 Femoral pores on the ventral thigh of a mitted to evaluate the red and white blood cells
male green iguana. (complete blood count), plasma enzymes, and
electrolytes. The volume of blood that can be
safely collected from a reptile is 0.5%–0.8% of its
body weight or 0.5–0.8 ml/100 g body weight.7
It is important to consider the animal’s history
and physical examination when determining the
volume of blood that can be collected. An ani-
mal that has experienced an acute blood loss (e.g.,
trauma) cannot afford to have large volumes of
blood collected. Fortunately, most laboratories
can perform a complete blood count (CBC) and a
plasma chemistry analysis on ≤1 ml of blood.
Blood samples should be placed in appropri-
ate collection tubes immediately after collection.
Microtainers (Becton Dickinson, Franklin Lakes,
NJ) are useful for this purpose, because they use
dry anticoagulants, which are less likely to dilute
small-volume samples. Laboratories vary in their
preference for type of collection tubes, so it is
important to contact them prior to submitting
samples. It used to be thought that some anti-
Figure 2.11 Probing snakes is the best method for de- coagulants were more apt than others to cause
termining the sex of these animals. Stainless steel probes erythrocyte or leukocyte lysis; however, more
with a blunt end or round tip are preferred. The probe recent work suggests that this is not necessarily the
should be lubed with an appropriate gel to minimize case. In general, blood being used for CBC should
tissue trauma. The probe is inserted slightly lateral and
be mixed with ethylenediaminetetraacetic (EDTA)
caudal to the vent (A). If the probe can be inserted for
>5–7 scales, it is a male, confirming the presence of a acid purple top tube or lithium heparin (green top
hemipenis (B). If the probe is inserted <2–4 scales, it is tube). Blood samples for plasma chemistries should
a female. also be placed in lithium heparin. When dealing
with small blood volumes, lithium heparin might and minimize “smudgeocytes.” To do this, add
be the best choice, because it can be used to store 1 drop of bovine albumin and 5 drops of whole
the sample for both a CBC and plasma chemistry blood into a test tube. Mix the solution by gently
analysis. If serum is to be used for the chemistry rotating/rocking it. Once the solution is mixed,
analysis, no anticoagulant is needed. use a hematocrit tube to collect some blood from
Red blood cell estimates are not typically done the tube and make your smears using standard
for reptiles and amphibians unless there is a prob- glass microscope slides. Blood smears can also be
lem. This is because manual counts need to be made using coverslips (without bovine albumin).
performed and standard hematologic machines In reptiles, there has been no significant difference
cannot count nucleated erythrocytes. Fortunately, in the number of “smudgeocytes” noted between
most veterinarians are comfortable reviewing samples premixed with albumin and made with
packed cell volume (PCV) to get an appreciation slides and those made with coverslips, although
of the erythrocyte numbers; PCV values for rep- both techniques had significantly fewer “smud-
tiles and amphibians are typically between 20% geocytes” than smears made using glass slides that
and 40%. When veterinary technicians read man- were not pretreated with albumin.8
ual differentials for white blood cell counts, they Once the slides/coverslips are made, the sim-
should note what they see with the erythrocytes. plest way to estimate the white blood cell (WBC)
Immature erythrocytes in reptiles and amphib- count is the following:
ians, as with those of fish and birds, are smaller,
have a higher nuclear to cytoplasmic ratio, and 1. Count the number of WBCs on 10 fields at
have a basophilic cytoplasm, compared with 400× (10× eyepiece and 40× objective). The
mature erythrocytes. It is important to document fields should represent a section of the blood
and consider large differences (3–4+) that are smear where the cells fill (but don’t overfill)
noted in color (polychromasia) or size (anisocyto- the slide and are evenly distributed.
sis) of erythrocytes when interpreting the overall
2. Take the total number of WBCs counted and
erythrocyte status of a patient.
divide that number by 10 to get an average
CBC in reptiles and amphibians requires special
number of cells per field.
care. Because all of the blood cells are nucleated
in reptiles and amphibians, standard hemato- 3. Take the average number of cells per field and
logic equipment cannot be used. Instead, manual multiply that by 2,000 to get an estimated
counts must be done. To perform a manual count WBC count.
in these animals, start by making a high-quality
blood smear, using standard microscope slides or After the WBC estimate has been completed,
coverslips. Blood cells from reptiles and amphib- perform a differential to determine the represen-
ians are more fragile than those of mammals; tative WBCs. The WBC types found in reptiles
therefore, it is important to use caution when include the heterophil and monocyte (Figure
making blood smears to minimize the likelihood 2.12A), and lymphocyte (Figure 2.12B), eosino-
of cell rupture (“smudgeocytes”). Premixing a phil, and basophil. The azurophil is an azure
blood sample with 22% bovine albumin (Gamma staining cell that is within the monocyte lineage.
Biologics, Houston, TX) can stabilize the cells With the exception of the heterophil, the reptilian

and amphibian WBCs are similar in appearance

and function to mammalian WBCs. The hetero-
phil is considered analogous to the mammalian
neutrophil; however, its appearance and function
are slightly different. The reptilian and amphib-
ian heterophil has a round to oval nucleus and
red-orange, rod-shaped granules. Beginners often
misinterpret a heterophil as an eosinophil. The
following is a standard method for performing a
differential count in reptiles and amphibians.
Perform a 100- or 200-cell differential to deter-
mine the proportions of WBCs. The more cells Figure 2.12A Blood cells from a green iguana: hetero-
counted (200 vs. 100), the tighter the results will phil (red) and monocyte (blue).
be. These proportions can then be multiplied by
the estimated WBC count (see 3, estimated white
blood cell count, above) to estimate absolute val-
ues of the different cell types.
heterophil % × WBC estimate =

## estimated absolute heterophil count
lymphocyte % × WBC estimate =

## estimated absolute lymphocyte count
eosinophil % × WBC estimate =

## estimated absolute eosinophil count Figure 2.12B Blood cells from a green iguana:
lymphocyte.
monocyte/azurophil % × WBC estimate = ##
estimated absolute monocyte/azurophil count animal is required, one should avoid the hemi-
penes by collecting the sample distal to the
basophil % × WBC estimate = hemipenal bulges. Clean the venipuncture site
## estimated absolute basophil count with an appropriate disinfectant (e.g., betadine
or chlorhexidine) to remove any excess organic
Lizards debris. A 22- to 25-gauge needle fastened to a 3 ml
Blood samples are routinely collected from the syringe should be used to collect the sample. For
ventral coccygeal vein or jugular vein in lizards. large animals, a longer needle (1.5–2") might be
The ventral tail vein is located on the ventral required to collect the sample. The needle should
midline of the tail. The blood sample should be be inserted perpendicular to the skin and to the
collected from within the proximal one-quarter point of the caudal vertebrae (Figure 2.13). Gen-
of the tail. When a sample from an adult male tly apply negative pressure as the needle-syringe is
withdrawn off the caudal vertebrae. In some cases, (ear) and shoulder. The jugular vein can typically
the venipuncturist must “walk the bone” to iden- be found along an imaginary line drawn between
tify the blood vessel. Always be conscientious of those two sites. The vessel is generally shallow, 3–6
your patient when collecting a sample and be as mm in depth from the surface of the skin. Again,
“quick and kind” as possible. Some lizard species clean the venipuncture site with an appropriate dis-
use tail autotomy as a defense mechanism against infectant to remove any excess organic debris. A
predators and will drop their tail if handled inap- 22- to 25-gauge needle fastened to a 3 ml syringe
propriately. should be used to collect the sample. The needle
The jugular vein is an excellent site for col- should be inserted parallel to the skin (Figure 2.14).
lecting larger volumes of blood from lizards. The The ventral abdominal vein is a vessel still used
jugular vein of lizards, like that of birds, is located by some veterinary personnel to collect blood sam-
on the lateral aspect of the neck. The jugular vein ples from lizards, but it is more difficult to sample
is not typically visible in a lizard, but knowing the from and generally provides smaller sample vol-
landmarks will help ensure success with collecting umes than the jugular or ventral tail veins. The
blood from this site. The primary landmarks to ventral abdominal vein is located on the ventral
use for jugular venipuncture are the tympanum midline within the body cavity. The site should
Figure 2.13 Blood collection in a green iguana via the ventral tail vein. Illustration by Michael L.
Broussard.

coccygeal veins, femoral vein, and brachial vein.

The preferred site for blood collection in cheloni-
ans is the jugular vein, because the other sites have
higher likelihoods of providing lymph-diluted
samples. Lymph-diluted samples will have a watery
appearance. Holding the sample for 2–3 minutes
will help determine whether there is lymph dilu-
tion, because an “oil and vinegar” appearance to
the sample will develop (clear fluid over cells). If
a lymph-diluted sample is suspected, it should be
discarded, because it will be impossible to interpet.
Blood collection in chelonians might require seda-
Figure 2.14 Blood collection in a green iguana via
the jugular vein. tion if the animal does not tolerate restraint of its
head or limbs. Placing excess strain on the neck
be aseptically prepared. Again, a 22- to 25-gauge or limbs during restraint can lead to broken cervi-
needle fastened to a 3 ml syringe should be used. cal vertebrae or limbs. A 22- to 25-gauge needle
The bevel of the needle should face up, and the fastened to a 3 ml syringe can be used to collect
needle inserted at an approximately 15°–30° blood samples at any of the prescribed sites. The
angle, practically parallel to the body wall. Nega- venipuncture sites should be aseptically prepared
tive pressure should be applied once the needle is to remove any excess organic debris. The right
inserted. Do not “fish around” when performing jugular vein is generally more prominent than the
this technique; being overly aggressive can lead to left and is located on the lateral aspect of the neck,
visceral damage. approximately at the level of the tympanum. The
There has been some discussion over the value technician should gently retract the head to facili-
of collecting blood samples for diagnostic testing tate exposure. An index finger should be placed on
from toenail clips. Many do not recommend this the neck to assist with jugular vein visualization.
procedure because it produces longer-term pain In some cases, the jugular vein cannot be seen and
than simple needle insertion, can affect behavior a “blind-stick” needs to be attempted.
(e.g., animals that dig might not do so because The subcarapacial vein (azygous vein) is located
of pain), and, most importantly, can affect sam- dorsal to the cervical vertebrae. This vein/sinus
ple quality. Blood collected from toenail trims is is an excellent site for collecting blood samples,
diluted with lymph, which can affect biochem- although there is a higher likelihood of lymph
istry values and WBC parameters. Because it is dilution than there is when drawing from the
not possible to know to what extent the lymph jugular vein. Needle selection for this technique
dilution affects the quality of the samples, it is will vary based on the size of the chelonian. A
impossible to interpret the value of the samples. 25-gauge, 5/8" needle is generally sufficient for
chelonians <500 grams, whereas a 22-gauge, 1.5"
Chelonians needle will be needed for larger animals. The nee-
Blood samples are routinely collected from the dle should be inserted at a 45° angle over the head
jugular vein, subcarapacial vein, ventral and dorsal of the chelonian (Figure 2.15). The technician can
Figure 2.15 Blood collection from the subcarapacial vein of a chelonian. Illustration by Michael L.
Broussard.
place a finger or spatula/tongue depressor over the performed without sedation. The technician should
head of the animal to hold it in place if it is not withdraw the leg and place one or more fingers prox-
holding still. The technician should apply nega- imal to the elbow to facilitate exposure. The needle
tive pressure as he or she inserts the needle and should be inserted perpendicular to the posterior
should monitor the hub of the needle closely. If aspect of the biceps tendon and negative pressure
a clear fluid enters the hub, lymph is being col- applied immediately after penetrating the skin. This
lected. In this case, replace the needle and start venipuncture site is a “blind-stick.” One drawback
again. Because there are a number of spinal nerves of this site is that the brachial vein is closely associ-
and soft tissues and the spinal cord in the vicinity ated with lymph, and if a diluted or “mixed” sample
of the subcarapacial vein, the technician should is collected, it cannot be used for hematologic eval-
use caution when inserting and redirecting the uation. The femoral vein is located on the ventral
needle. surface of the thigh. This vessel is often accessible in
The brachial vein is located on the posterior tortoises that have pulled into their shell. A 22- to
aspect of the forelimb. This venipuncture site has 25-gauge needle of varying length (depending on
been used with great success with tortoises, espe- the size of the animal) can be used to collect the
cially the giant tortoises, and collection can be sample. The site should be prepared using standard

asepsis. The needle should be inserted perpendicu- be pumped into the syringe with each heartbeat.
lar to the thigh over the femur. Once inserted, the If a blood sample is not collected after inserting
needle might need to be “walked” over the femur the needle, it is important to withdraw the needle
to locate the vessel. If the blood that is collected is and start over. Do not be overly aggressive when
bright red, the sample likely came from the femoral collecting a blood sample from the heart, because
artery. If this is the case, apply direct pressure to it is possible to lacerate the heart or large vessels
the injection site for 2 minutes to ensure proper and cause significant bleeding or death.
hemostasis is achieved. The ventral coccygeal vein is located on the ven-
The dorsal coccygeal vein is located on the dor- tral midline of the tail. Collection of blood from
sal midline of the tail. The tail should be extended this site is usually possible only in larger snakes (>1
and a 25-gauge needle inserted on the dorsal meter). The snake’s body should be supported by
midline in a cranial direction. Again, this site is a set of hands every 3–4 feet of body length. The
closely associated with lymph, and a mixed sample tail should be grasped by the individual collecting
could be collected. The ventral coccygeal vein can the sample. The sample should be collected in the
be approached using the same strategy outlined in proximal one-third of the tail. Care should be taken
the lizard section. not to damage the hemipenes of a male by staying
on the midline. A 22- to 25-gauge needle should
Snakes be inserted at a 45° angle under a ventral scale and
Blood samples are routinely collected from the advanced to the caudal vertebrae. Negative pressure
heart, ventral coccygeal vein, and jugular vein of should be applied and the needle retracted until
snakes. Cardiocentesis is the preferred method blood is visualized in the hub of the needle.
and provides large volumes of blood if necessary. Jugular veins are typically recommended only as
The heart is located approximately one-third to sites for intravenous (IV) catheterization in snakes;
one-quarter the distance from the head. This pro- however, some have found that these vessels can
cedure is routinely performed on snakes weighing also be used for venipuncture. The landmarks for
more than 200 grams without sedation. It is essen- the jugular veins are the interior edges of the right
tial that there be enough assistance to restrain the or left ribs approximately 6–9 (ventral) scales cra-
snake during the procedure to prevent injury to nial to the heart. The venipuncture site should be
the animal and the handlers. The animal should prepared using standard asepsis. A 25-gauge needle
be positioned on its dorsum and the heart local- can be used to collect the sample.
ized by visual inspection or palpation. Snakes are The palatine vessels are often identified as
quite capable of moving their heart cranially or potential venipuncture sites in snakes; however,
caudally, so it is important to “immobilize” the experienced phlebotomists do not use them
heart by inserting an index finger cranial to the because sample volumes are typically small, there
heart, and the thumb caudal to the heart. A 22- is potential for accidental bites, and it is possible
to 25-gauge needle of variable length, based on to damage the oral cavity of the snake when col-
the size of the snake, should be inserted under the lecting from them. Rottweilers have large lingual
scale at the most distal point of the beating heart vessels that can be used for blood collection, but
(ventricle) (Figure 2.16). Apply negative pressure technicians don’t use that site for the same reasons
once the needle is inserted. The blood will literally that were just mentioned.
Figure 2.16 Blood collection from the heart of a snake. Illustration by Michael L. Broussard.
More on Amphibians gauge needle. It is a good idea to heparinize the

Blood samples can be collected in amphibians from needle prior to blood collection to prevent clotting.
the ventral abdominal vein, ventral coccygeal vein The ventral abdominal vein is often readily visible
(salamanders, newts, caecilians, and tadpoles), in larger amphibians by direct viewing or through
heart, femoral vein, and lingual plexus. Restrain- transillumination of the body wall (e.g., placing a
ing an amphibian for blood collection can be tricky transilluminator/penlight near the lateral body
because the animals can be quite slippery. Every- wall). Blood collection techniques are similar to
one involved in collecting the samples should wear those described for lizards.
moistened examination gloves to prevent damag- Blood can be collected from the ventral coccygeal
ing the animal’s skin. Anesthesia (tricaine methane vein in larger salamanders and newts, caecilians, and
sulfonate; MS-222) might be required to sedate the tadpoles (Figure 2.17). The approach to this vein is
animal for venipuncture. A 25- to 27-gauge nee- similar to that described for lizards. Some salaman-
dle fastened to a 3 ml syringe should be used for ders and newts, like lizards, have tail autotomy and
blood collection in amphibians. One should expect can drop their tail as a natural defense mechanism
increased cellular destruction using the smaller- if handled inappropriately.

Cardiocentesis should be used with caution in

amphibians. There are some reports of animals
dying after having blood collected from their
heart. Some veterinarians have had good experi-
ence using cardiocentesis in amphibians; however,
a rare death has been known to be associated with
the procedure. The heart of most amphibians is
located within the pectoral girdle; therefore, the
needle should be directed medially through the
axillary region to collect the sample (Figure 2.18).
A 25- to 27-gauge needle should be used to collect
the sample. No more than one to two attempts Figure 2.17 Blood collection from the ventral coccy-
should be made using this technique, to limit the geal vein of an axolotl.
likelihood of inducing pathology. Some suggest
using this method of venipuncture only as a last
resort.
The femoral vein can be used to collect samples
from larger frogs and toads. The technique used
to collect blood from this site is similar to that
described for chelonians.
The lingual plexus can be used for larger amphib-
ians. The lingual plexus is a complex of blood
vessels located under the fleshy tongue. A soft, rub-
ber speculum should be used to gently open the
animal’s mouth. The skeletons of these animals are
fragile in comparison with those of reptiles, and Figure 2.18 Blood collection from the heart of an
axolotl.
special care should be taken to prevent fractures.
Once the mouth is open, a cotton-tipped applica-
tor can be used to displace the tongue and facilitate negative) and can be further differentiated based on
exposure to the venous plexus. A needle (with no their biochemical needs: aerobic or anaerobic, lac-
syringe attached) can be inserted into the venous tose fermenting or nonlactose fermenting, and so
plexus, and blood can be collected out of the hub on. Both Gram-positive and Gram-negative bacte-
of the needle using a microhematocrit tube. Sample ria have been associated with infections in reptiles
contamination from saliva and food material in the and amphibians, although opportunistic Gram-
oral cavity is likely when using this technique.9 negative bacteria are more commonly isolated.
Reptiles and amphibians are ectotherms, and
Microbiology their core body temperature is regulated based on
Bacteria are ubiquitous in the environment. These the environmental temperature and their behav-
organisms are commonly differentiated by stain- ioral activities (e.g., basking). Most commercial
ing characteristics using a Gram stain (positive or microbiologic incubators are set at 37°C because
they were developed to grow pathogenic bacteria radiographs can be used to collect images of small
from humans. Because reptile core body tempera- reptiles and most amphibians. The introduction
tures can vary from this standard (37°C), it has of digital radiography has simplified collecting
been suggested that different temperatures be used images for reptiles and amphibians, allowing mul-
to isolate bacteria from reptiles and amphibians. tiple images to be taken and processed in seconds
Unfortunately, establishing an incubator tem- to minutes. Individuals with this capacity can
perature that parallels a reptile’s or amphibian’s use this method to take as many images as are
body temperature would be difficult. One possible necessary in a short period of time to obtain the
solution would be to place one sample in a 37°C information they need to direct their cases.
incubator and another at the animal’s body tem- It is important always to collect at least two
perature to accommodate organisms that thrive at radiographic images when evaluating a reptile
lower temperatures. Regardless of the technique or amphibian patient. This will help to resolve
selected, one should always consider a negative the fact that these animals are three-dimensional
culture from a contaminated wound the possible and that the images are each only two-dimen-
result of human inability to provide the organism sional. The most common radiographic images
an appropriate temperature. taken are via the dorsoventral (ventrodorsal) and
lateral approaches. In chelonians, a third image,
Radiology the anterior-posterior or cranial-caudal approach,
Radiographs serve as an important diagnostic tool should also be collected. This allows for inde-
in reptile and amphibian medicine. Radiographs pendent review of the lungs, which is especially
are routinely used to assess a variety of health con- important in chelonian cases with suspected
ditions in these animals, including reproductive pneumonia.
(e.g., dystocia), skeletal (e.g., fracture), gastrointes-
tinal (e.g., foreign body), renal (e.g., renomegaly), Parasitology
and respiratory (e.g., pneumonia) problems. Stan- External Parasites
dard safety protocols should be employed when Imported reptiles routinely have ectoparasites,
radiographing reptiles and amphibians. The such as mites, ticks, and leeches. These para-
animal might need to be anesthetized for the pro- sites survive by ingesting blood from their host.
cedure, although some animals will remain still Heavily parasitized juvenile animals can develop
if placed in a darkened room, given blinders, or life-threatening anemia. Many of these ecto-
placed in a tube (e.g., snakes). parasites also serve as vectors for other diseases,
A radiographic technique chart should be including bacterial and possibly viral infections.10
established based on the capacity of a facility’s radio- The diagnosis of an ectoparasite infestation can
graphic machine. A high-capacity radiographic unit be made during a thorough physical examination.
capable of producing 300-milliampere exposures at Leeches are readily identifiable on aquatic reptiles
times of at least 1/60th of a second is recommended. and amphibians. These large ectoparasites should
The kVp settings should be adjustable by incre- be grasped with forceps and gently separated from
ments of two to provide finite detail. A thorough the host. The open lesion where the leech was
understanding of reptile and amphibian anatomy attached should be cleaned and disinfected (e.g.,
is essential to radiographic interpretation. Dental 0.5% chlorhexidine).

Ticks are typically not as large as leeches, Animals and parasites have evolved to “live
but are readily identified on external examina- together,” even though the parasite steals nutri-
tion. There are three primary life stages of the tion from the host. In captivity, when a reptile or
tick: larva, nymph, and adult. The nymphal and amphibian is exposed to the stress of an inadequate
adult stages are differentiated from the larval environment and diet, parasites can become more
stages based on the number of appendages (lar- problematic. Parasites will continue to acquire
val: 6; nymphal and adult: 8). The tick burrows energy from the host, regardless of the host’s
its mouthparts into the host to facilitate feeding. change in appetite. In these cases, the parasites
Tick removal can be accomplished by grasping can become life-threatening. A fecal examination
the mouthparts where they insert into the host should be performed to identify potential parasites
and pulling them out perpendicular to the rep- so that an appropriate treatment can be initiated.
tile’s skin. Once the parasite is removed it should A fecal saline direct smear and a fecal flotation
be properly disposed of. should be performed on all fecal samples. The
Mites are the smallest of the ectoparasites (1–2 direct smear will enable the reviewer to identify
mm) and can be easily overlooked; a magnifying bacteria and protozoa, and the fecal float is used
glass or loupe might be helpful in some cases to to identify larger parasite ova (e.g., roundworms).
spot the mites. Mites can be found anywhere on A fecal examination should always be repeated in
the reptile host, although they tend to accumulate 2 weeks, and again in 4 weeks, to determine if
around the eyes, mouth, and gular fold (snakes). A the animal is really negative (because shedding
cotton-tipped applicator soaked in mineral oil can can be transient). There are a number of treatment
be used to remove a mite to confirm the diagno- protocols that have been established for treating
sis. The treatment protocols for ectoparasites vary parasites in reptiles and amphibians (Table 2.3).
(Table 2.3). Neither ivermectin nor its derivatives
should be given to chelonians, as it may be fatal.
THERAPEUTICS
Internal Parasites There are no approved therapeutics for reptiles in

Endoparasites are common in reptiles and amphib- the United States. Routes of administration for
ians. The same groups of endoparasites commonly therapeutics and fluids include per os (PO), sub-
identified in domestic species are also routinely cutaneous (SC), intramuscular (IM), intraosseus
identified in reptiles and amphibians, including (IO), intracoelomic (ICO), and intravenous (IV).
protozoa, nematodes, trematodes, and cestodes. Animals that are in critical condition require
Many reptiles presented to veterinary hospitals routes of administration that provide rapid drug
are imported and should be assumed to have par- delivery, such as IM, IO, or IV, whereas less criti-
asites until proven otherwise. It is also important cal animals can be given therapeutics PO or SC.
to consider that many captive-born reptiles are IV injections should be administered through
also infested with parasites, because of the meth- an IV catheter. The preferred site for IV cath-
ods used for raising these animals. Most of the eterization in chelonians, lizards, and snakes is
popular captive-raised reptiles are held under high the jugular vein. The cephalic vein can also be
densities with limited/no quarantine, a perfect sit- used in lizards. IO catheters can be placed in the
uation for the dissemination of parasites. femur or tibia of lizards. Some veterinarians pre-
Table 2.3 Antiparasitic Agents Used in Reptiles and Amphibians

Drug Dose Comments
Fenbendazole 25–100 mg/kg PO Nematodes21

Repeat in 7–14 prn
Ivermectin 0.2 mg/kg IM, SC Nematodes22
NEVER USE IN CHELONIANS
5 mg/L Water Topical spray to treat mites23
Levamisole 10–20 mg/kg Nematodes24
Metronidazole 25–100 mg/kg PO Protozoa22
Repeat in 2 weeks Uracoan rattler, milk snakes, tricolor king
snakes, and indigo snakes at 40 mg/kg
Praziquantel 5–8 mg/kg IM, SC Cestodes and trematodes25
fer using the tibia for this procedure. The catheter SURGICAL AND ANESTHETIC
can be inserted on the tibial plateau. The gular ASSISTANCE
scutes are a good site for IO catheter placement in
Anesthesia and analgesia are relatively new con-
chelonians.
cepts in reptile and amphibian medicine. Only a
IM injections are routinely administered into
decade or so ago, individuals “anesthetized” rep-
the epaxial muscles along the spine or in the large
tiles by placing them in a refrigerator or freezer to
muscle groups in the front limbs. Reptiles and
severely restrict their metabolism. This technique
amphibians have a renal portal system that can
should never be used because it does not provide
be affected by drug administration in the tail or
the animal consistent anesthesia or analgesia and
rear limbs. To avoid these complications, always
can prove fatal. Prior to any anesthetic procedure,
administer medications in the cranial one-half of
the body. The muscle masses of reptile and amphib- the animal should be assessed and determined to
ian limbs are relatively small compared with those be stable. Basic health monitoring should include
of mammals; therefore, injections should be per- evaluating the hydration status, heart and respira-
formed sparingly and injection sites (e.g., right leg, tory rates, and baseline blood work.
left leg) should be alternated. Tricaine methane sulfonate (MS-222) and clove
Reptiles and amphibians are difficult to pill. oil are commonly used anesthetics for amphib-
Fortunately, there are a number of commercial ians. These compounds can be delievered through
compounding pharmacies that can compound an immersion/bath. The water used for the bath
a therapeutic into a liquid and simplify admin- should come from the animal’s enclosure to mini-
istration. Administering oral medications is a mize changes in water quality. The water depth for
straightforward process for reptiles. The glottis is the bath should be set to the level of the elbow of
located at the base of the tongue, and it is easily the patient. If kept in deep water, the amphibian
seen and therefore easy to avoid when dosing with could drown. These compounds are absorbed via
a syringe or passing a tube. the skin, primarily through the ventral abdominal

patch, or gills (e.g., axolotls). Both anesthestics pam to provide sedation and is an anticonvulsant.
have been found to provide general anesthesia; Tiletamine has been used in snakes and croco-
however, MS-222 is considered to be safer and dilians with some success, but recoveries are still
provides a longer duration of anesthesia. Doses prolonged. Tiletamine, like ketamine, should not
for MS-222 in amphibians can vary depending be used for surgical anesthesia in reptiles, but as
on whether the animal is terrestrial (0.5–2 g/L) or an induction agent in combination with an inhal-
aquatic (100–500 mg/L), and whether it has gills ant anesthetic. A dose of 3–5 mg/kg is routinely
(100–200 mg/L) or not. used with good results.
The anesthetics and analgesics used for domes- The alpha-2 agonists, such as medetomidine
tic species (e.g., dogs and cats) are routinely used and dexmedetomidine, are also routinely used for
in reptiles and amphibians, including the disso- reptiles and amphibians. These drugs can be used
ciatives, propofol, and inhalant anesthetics. The with the dissociative anesthetics to provide a more
most common dissociatives used in reptile and “complete” anesthesia. The alpha-2 agonists pro-
amphibian anesthesia are ketamine and tiletamine vide visceral analgesia and muscle relaxation, which
plus zolazepam. Ketamine has been used success- complement the dissociatives. These anesthetic
fully in reptiles and amphibians. Recommended agents can cause cardiopulmonary depression, so
doses vary with reptile and amphibian order, it is important to monitor animals closely during
health status, and size of the animal. A dose of their anesthetic procedure. Doses can vary by spe-
5–10 mg/kg ketamine can be given for short pain- cies and whether they are used in combination
less procedures or as a preanesthetic to facilitate with other anesthetics. Typically, medetomidine
intubation; a slightly higher dose might be needed doses are 0.025–0.1 mg/kg and dexmedetomidine
for chelonians: 10–20 mg/kg. In most species, the doses are 0.01–0.05 mg/kg.
animals will be induced within 10–20 minutes. Propofol has gained in popularity with veteri-
Ketamine provides little to no visceral analgesia; narians because it provides general anesthesia with
therefore a preoperative and postoperative analge- a rapid recovery. The primary disadvantage of pro-
sic should be considered for painful procedures. pofol is that it must be administered intravenously
A dose of 55–88 mg/kg has been recommended or intraosseously, which can be difficult in smaller
for surgical anesthesia, but ketamine alone should patients. An IV butterfly catheter can be used to
not be considered an adequate surgical anesthetic administer boluses to an animal as the procedure
in these species.11 There have been a number of warrants. A dose of 10–14 mg/kg IV in lizards
side effects reported with ketamine use, includ- and snakes provides reasonable general anesthesia
ing respiratory arrest, bradycardia, and prolonged for 15–30 minutes. A dose of 12–15 mg/kg IV is
recovery (1–4 days). Many of these side effects are recommended for chelonians.12 This anesthetic has
associated with the administration of high doses been used in amphibians with success, too. Intra-
(>100 mg/kg), but they can also occur at lower coelomic injections of propofol (35–45 mg/kg)
doses. Many anesthetic complications can be pre- have been found to provide sedation to surgical
vented by properly evaluating the animal prior to anesthesia in frogs and salamanders.
a procedure and monitoring the animal closely Inhalant anesthetics have reduced many of the
during the procedure. Tiletamine is a more potent risks associated with injectable anesthetics. Unlike
dissociative agent that is combined with zolaze- injectable anesthetics (e.g., ketamine), which can-
not be controlled once administered, delivery tored closely, can become apneic (stop breathing)
of an inhalant anesthetic through a precision and die. In the incremental approach, the inhal-
vaporizer can be controlled based on need. Ani- ant anesthetic is delivered in increments to ensure
mals under general inhalant anesthetics should a smooth procedure. The animal is started at
be intubated. Endotracheal tubes ensure that the 2%–3% (4%–5% sevoflurane) and the level
appropriate anesthetic and oxygen rates are being increased or decreased based on the animal’s sta-
administered. Endotracheal tube size will vary tus. The potential disadvantage of this technique
with the order and size of the animal. Cheloni- is that induction can take a long time when the
ans and crocodilians have closed tracheal rings, patient holds its breath and it is more likely to
like birds, and should not have their endotracheal struggle as it moves to stage 3 anesthesia. Main-
cuff inflated. The majority of reptile and amphib- tenance levels for isoflurane and sevoflurane are
ian cases presented in private practice are animals between 1.5% and 3.0% and 3.0% and 5.0%,
under 5 kg and can be maintained using a non- respectively, but will vary from patient to patient.
rebreathing system. When a procedure on a larger Anesthetic recovery for animals placed under gen-
animal (>5 kg) is required, a circle system, similar eral anesthesia (alone) is typically within 10–20
to that used in dogs, can be used. minutes after discontinuation of the gas.
The most common inhalants used in veterinary Monitoring of the reptile or amphibian dur-
practice are isoflurane and sevoflurane, and both ing an anesthetic or surgical procedure is often
of these anesthetics have been used successfully in performed by the veterinary technician. The respi-
reptiles and amphibians. Our knowledge about the ratory rate can usually be monitored by direct
metabolism of these gases in reptiles and amphib- visualization of the body wall in snakes and lizards,
ians is limited and often related to our knowledge whereas the gular area and “pumping” action of the
of it in mammals. The elimination of isoflurane legs are used to monitor respiration in chelonians.
and sevoflurane is exclusively through the respira- Auscultation of the heart is very difficult in
tory system. There are two trains of thought about reptiles. Placement of the stethoscope bell directly
anesthetizing an exotic animal: “full-throttle” and on the scales results in an irritating friction-
incremental anesthesia. generated sound. Esophageal stethoscopes can be
The “full-throttle” approach is based on the used; however, most reptile and amphibian patients
desire to deliver a high percentage of anesthetic are too small to accommodate these large tubes.
immediately. Many veterinarians will turn the Crystal ultrasonic Dopplers simplify monitoring
vaporizer directly to 5% (8% sevoflurane). This the heart rate by producing a sound that verifies
method is often used to induce fractious animals, cardiac function. Pulse oximeters have gained in
because they are anesthetized sooner, and it also popularity in veterinary hospitals and provide not
delivers high doses to animals that hold their only the heart rate but also arterial oxygen satura-
breath. This helps expedite the process of mov- tion. ECGs can also be used.
ing a patient from stage 1 anesthesia to stage 3 There are a number of different probes that can
anesthesia, skipping through stage 2 anesthesia, be purchased with these systems. For mammals,
where animals tend to struggle. The potential C-clip probes are often used, but for reptiles these
disadvantage of this technique is that the animal probes have limited usefulness because the signal
can become deeply anesthetized and, if not moni- cannot penetrate the colored scales. The cloacal

probes appear to work best for reptiles. Although maintaining a reptile or amphibian on inhalant
these devices can simplify the role of the veteri- anesthetics. Reptiles and amphibians normally
nary technician, placement and repositioning breathe by movement of their body wall (intercos-
might be required during the procedure. tal muscles), limbs, and viscera; amphibians can
The mucous membrane color and hydra- also respire through their skin. When reptiles or
tion status should also be monitored on a reptile amphibians are under general anesthesia, they
or an amphibian during a surgical procedure. might not be capable of breathing on their own
Amphibians should be kept moist throughout the and must be ventilated using positive pressure.
procedure to prevent desiccation. If there is con- Typically, 4–5 breaths a minute will be satisfac-
cern that an animal might experience significant tory. When a reptile or amphibian is ventilated,
blood loss during a procedure, it should be given it is important to use a pressure of less than 12
fluids (e.g., IV or IO) or a blood transfusion. cm of water to prevent their simple saclike lungs
Reptiles should be provided with heat during from rupturing.11 The veterinary technician plays a
a surgical procedure. Water-circulating heat pads vital role in the surgery and is often responsible for
provide good results and are unlikely to cause managing a number of tasks, including presurgi-
thermal burns. When working with these heat- cal preparation of surgical supplies, preparing an
ing elements, it is important to recognize that a aseptic surgical site, assistance during the surgical
reptile’s sharp claws could tear the heating pad, so procedure, and anesthetic monitoring.
protection (e.g., a towel) should be used. Reptiles Preparing the surgical suite for a reptile or
are dependent on the environmental tempera- amphibian patient should follow the basic tech-
ture to maintain their metabolism and ability to niques used for preparing the suite for mammalian
process anesthetics and recover from surgery. patients. The surgical packs should be sterilized by
Maintaining a reptile at an inappropriate temper- the same methods (e.g., autoclaved, gas) used to
ature will prolong the recovery, with full recovery prepare surgical equipment for domestic species.
times lasting 1–3 days in some cases. Selection of the appropriate suture material will
Amphibians do not tolerate excessive heat. reduce the possibility of incision dehiscence and
When performing a procedure on an amphibian, poor healing. The absorbable synthetic sutures
it should be done at an appropriate temperature for can be used for ligation and suture placement
that animal, typically 74o –78oF for tropical spe- internally, and nylon sutures can be used to close
cies and 68o –74oF for temperate species. Setting skin incisions. Chromic catgut and stainless steel
the ambient room temperature to an appropriate should not be used in reptiles or amphibians. In
level is preferred over using heat lamps or heating reptiles, the skin is considered the primary clos-
pads, which can overheat the animal and promote ing layer because it is unlikely to tear, whereas in
desiccation. mammals the linea alba is the primary closing
Reptiles and amphibians have very unusual layer. Skin sutures should remain in a reptile or
respiratory systems. The lungs of a reptile or amphibian patient for 4–6 weeks. This prolonged
amphibian are much simpler than those of mam- healing time is associated with the slower metabo-
mals or birds, and reptiles and amphibians lack lism common to ectotherms.
a true diaphragm. These anatomical features are The veterinary technician serves a primary role
important to consider when anesthetizing and in monitoring asepsis during the surgical proce-
dure. The surgical suite can become very busy, the anesthesia. Incisions should be irrigated liber-
and it is important that the technician ensure that ally to improve the veterinary surgeon’s view of
no individual compromises the sterility of the the surgical site. When performing a lavage in the
procedure. Preparation of the surgical site should coelomic cavity of the reptile or amphibian, it is
follow standard protocol, wiping from the cen- important to remember that it lacks a diaphragm
ter of the surgical site in a circular motion until and that excess irrigation fluid can place pres-
a desired area has been sterilized. Preparing the sure on the animal’s lung(s), making it difficult to
skin of reptiles can be difficult because of the breathe. To prevent this problem, lavage limited
scales, but attempts should be made to remove amounts of fluid at a time, removing any excess
heavy debris. The skin of an amphibian is very with sterile gauze or suction. Be careful when
thin, so minimal pressure should be applied when using suction because tissues can be damaged if
preparing the site. The surgical site should be pre- they are pulled into the suction tube.
pared with a nonirritating solution, such as dilute After the surgical procedure is completed, the
chlorhexidine or betadine, followed by isotonic animal should be moved to a clean, warm, quiet
sterile saline. Alcohol should never be used to area to recover. Remove the animal from the anes-
disinfect a surgical site on a reptile or amphib- thetic machine and allow it to recover on room
ian, because it creates an evaporative surface air. Reptiles are stimulated to breathe when their
that can lead to significant body heat loss. blood oxygen levels decrease to a threshold; main-
During a surgical procedure, the veterinary taining them on oxygen will only prolong the
technician is often expected to manage hemo- recovery.13 The animal should not be extubated
stasis. Hemostasis is essential in the reptile or until it has started to swallow. Animals that have
amphibian patient because any excess loss of blood had a coeliotomy or fracture repair should not be
could prove to be life-threatening. In most cases, provided with climbing branches until the veteri-
simply applying direct pressure using a sponge is nary surgeon feels that the animal is not in danger
sufficient. Do not wipe or smear the blood ves- of wound dehiscence.
sel, because this might cause an irritation or
further damage the blood vessel. If direct pres-
sure (30–120 seconds) is insufficient to stop the
hemorrhage, the veterinary surgeon will consider The majority of the diseases encountered in pet
other techniques such as suture or radiosurgery reptile and amphibian medicine are directly related
(Ellman International, Oceanside, NY). to inappropriate husbandry and are discussed
Incision irrigation and lavage are other impor- below. Animals maintained under inappropriate
tant functions that the veterinary technician temperatures, provided inadequate diets, or held
performs when assisting the veterinarian during under less than optimal housing conditions are at
the surgical procedure. The irrigating or lavage an increased risk of developing disease.
fluid should be isotonic (e.g., normal saline) and
prewarmed to the animal’s body temperature Husbandry-Related Problems
(37oC is sufficient) to prevent cold stress. Cold Thermal Burns
stress can rapidly result in a cascade of physiologic Reptiles will often seek heat to maintain their
changes that can alter the animal’s response to core body temperature. If an animal is placed in

Application of a wet-to-dry bandage can be

used to reduce wound contamination and encour-
age wound healing. The bandage should be
changed daily until the wound begins to “dry,”
and then as needed until the granulation tissue is
considered adequate. It is important to remember
that bandages that cover the body wall should not
be too restrictive in order not to impede respira-
tion. Animals with severe burns should be placed
on antimicrobials. Enrofloxacin (5–10 mg/kg by
mouth once daily) or trimethoprim-sulfa (15 mg/
Figure 2.19 Thermal burn in a green iguana. kg PO SID) provides excellent coverage and can
be initiated while an antimicrobial sensitivity is
pending.
an enclosure that has an exposed lightbulb, heat-
ing pad, or heat rock as its only source of heat, the Prey Bites
animal might remain on the device and develop Reptiles and amphibians hunt food only when
severe life-threatening burns (Figure 2.19). These they are hungry. Most owners offer their reptiles
cases should be considered emergencies and treated and amphibians live foods, assuming that the pet
appropriately. In severe burn cases, an animal can will eat, or at least kill, the food item. Unfortu-
lose significant amounts of fluids through the burn nately, this is not always the case. Many prey items,
sites and should be provided supplemental fluids. including rodents and insects, will “attack” the
The wound should be assessed for severity. Deep predator if left unattended. A number of reports
contaminated wounds have a guarded prognosis. have cited large snakes that died from wounds
Prior to initiating wound management, the vet- inflicted by a mouse or rat. Even common crickets
erinary technician should collect a bacteriological have been observed to “feed” on juvenile lizards.
sample and submit it for a culture and antimicro- A prey bite should always be managed as a con-
bial sensitivity to identify potential pathogenic taminated wound (see thermal burns). Owners
organisms and an appropriate antibiotic. should be educated about the dangers of feeding
Wound management should follow standard live prey and directed to observe their pet dur-
mammalian protocols. The wound should be ing feedings. All mammalian prey items (e.g., rats
irrigated with an isotonic saline solution and a and mice) should be humanely euthanized before
nonirritating cleansing solution, such as chlorhex- being fed to reptiles.
idine. Topical antimicrobials may be applied to
prevent wound contamination. Topical creams or Dysecdysis
ointments should be applied in a thin coat over the Reptiles shed the outer epidermal layer of their
wound, because excessive application can result in skin as they grow. In juvenile animals, shedding
anaerobic conditions. Silvadene cream is an excel- (ecdysis) occurs regularly and slows as the animal
lent antimicrobial cream that can be applied to matures. Shedding of the skin is a routine and
thermal injuries. necessary behavior that all reptiles experience;
however, patterns of shedding differ among spe- thorough history will often guide a veterinarian
cies. Chelonians and lizards routinely shed their in the diagnosis of this disease. Animals suffer-
skin in pieces, whereas snakes shed their skin in ing from SNHP are often young, fast-growing
one entire piece. Most of the problems associ- animals or reproductively active adult females
ated with shedding (dysecdysis) are reported in maintained at an inappropriate ETR (which
snakes, although dysecdysis can occur in all rep- reduces metabolism) and/or offered a calcium-
tiles. Causes of dysecdysis in reptiles have been deficient diet, excessive phosphorus diet, or not
associated with low environmental humidity and exposed to ultraviolet B wavelength light (which
temperature, ectoparasites, traumatic wounds, aids in synthesis of vitamin D).
systemic disease, mishandling, and the lack of an On physical examination, the animal often has
adequate surface to assist with shedding. muscle tremors and fasciculations, “swollen” man-
Treatment for dysecdysis should include cor- dibles and long bones (fibrous osteodystrophy),
recting any environmental and medical problems and might suffer from seizures. Clinical diagnosis
and soaking the animal in a shallow, warm (82°– is made from a thorough history, physical exami-
84°F) water bath. The depth of the water bath nation, and radiographs. These animals should be
should not exceed half the height of the animal. considered critical care cases, and therapy should
Never use a human water receptacle (e.g., bathtub be initiated immediately. Medical management
or sink) to soak a reptile because of the potential includes supplemental calcium and vitamin D
for introducing zoonotic pathogens (e.g., Sal- therapy, fluids to rehydrate animals, enteral sup-
monella spp.). After soaking, a soft cotton towel port to maintain energy demands, and treatment
can be used to gently wipe the animal down and of secondary problems, such as splinting patho-
remove any excess shed. Do not pull at skin that logic fractures.
is not ready to come off because you could dam-
age the underlying skin. Owners should be made Hypovitaminosis A
aware of the importance of checking the spectacles Chelonians offered inappropriate diets often
or eye caps to make sure that they are removed develop hypovitaminosis A. Animals presenting
after every shed. Retained spectacles can develop with hypovitaminosis A are often young, fast-grow-
into subspectacular abscesses, which can lead to ing animals or long-term wild caught specimens
the loss of the eye if not managed appropriately. maintained at inappropriate temperatures and
offered a restricted, vitamin A–deficient diet. On
Nutritional Diseases physical examination, the animals will often have
Secondary Nutritional Hyperparathyroidism unilateral or bilateral blepharoedema (swelling of
The most common nutritional disease reported the eyelids), a nasal and ocular discharge, diarrhea,
in reptiles is secondary nutritional hyperparathy- pneumonia, aural abscesses, and hyperkeratosis.
roidism (SNHP). SNHP may occur as a result of Vitamin A deficiency leads to changes in the epithe-
a calcium-deficient diet, phosphorus-rich diet, lial lining of the respiratory tract, oral cavity, skin,
or vitamin D deficiency. In this disease process, and urinary tract. The resulting squamous metapla-
the parathyroid glands are activated and release sia reduces the tight junctions formed by the cells
parathormone, which mobilizes calcium from the and allows for opportunistic pathogens to invade.14
skeleton for the animal to meet its daily needs. A Diagnosis is often made from the history, physical

examination, and response to treatment. Animals

with respiratory disease should have a culture and
sensitivity performed to evaluate appropriate antimi-
crobial therapy to manage opportunistic infections.
Animals considered to have hypovitaminosis A
should be administered vitamin A parenterally
(500–1,500 IU/kg every 10 days for 1–4 treat-
ments);15 however, oversupplementation of vitamin
A can lead to iatrogenic hypervitaminosis A. Hyper-
vitaminosis A leads to skin sloughing and can be
life-threatening.
Figure 2.20 Severe articular gout in a gecko.

Gout
Gout results from the deposition of monosodium
urate crystals into the viscera (visceral gout) or original dietary (e.g., reduce dietary purine-based
joints (articular gout) (Figure 2.20) as a result of proteins, offer correct diet) and environmental
the body synthesizing too much uric acid (e.g., (e.g., provide ad libitum access to water; do not
high-protein diets), dehydration, or renal impair- restrict water) problems, reduce uric acid pro-
ment. Animals presenting with gout are often duction in the body (allopurinol, 20 mg/kg by
adult and may be herbivores, omnivores, or car- mouth once daily), and increase urate excretion
nivores. Generally, these animals are reported to (probenecid, 250 mg/kg, by mouth once daily).16
be in good health, but become acutely depressed The prognosis for these cases is guarded.
and lethargic. A review of husbandry practices
will often reveal that these animals have been Infectious Diseases
offered an inappropriate diet or not provided Reptiles and amphibians are susceptible to a
sufficient access to a water source. On physical number of infectious agents, including viruses,
examination, these animals are clinically dehy- bacteria, and fungi. The majority of cases pre-
drated, have poor muscling condition, and are sented to veterinary hospitals are directly related
in overall poor condition. A thorough history, to inappropriate management. When a reptile or
physical examination, plasma chemistry profile, amphibian is maintained at low environmental
and radiographs will help establish a diagnosis. temperatures, its immune function is reduced and
Reptiles and amphibians with gout often have it is prone to opportunistic infections. Another
hyperuricemia; however, animals with gout can source of infectious diseases for reptile and
have normal plasma uric acid levels. If the kidneys amphibian collections is inadequate quarantine.
are impaired as a result of the monosodium urate Newly acquired animals should be segregated
crystallization, the calcium-to-phosphorus levels from other reptiles or amphibians to ensure that
will most likely be inverse (<1:1). Radiographs of a they are not shedding infectious agents that might
reptile with gout might reveal radiopaque lesions contaminate a collection. The quarantine period
in joints or viscera. The goal of treatment for a for a reptile or amphibian should be a minimum
reptile or amphibian with gout is to correct the of 60–90 days.17
should be performed prior to making the incision.

A microbiological sample should be collected for
culture and sensitivity once the incision is made.
Caseous abscesses can generally be scooped out
of the incision. The open wound should then be
irrigated with a nonirritating disinfectant, such as
diluted chlorhexidine. A single localized abscess
can often be managed by irrigating it and apply-
ing a topical antimicrobial ointment. Generalized
abscesses require systemic treatment and a sys-
temic antibiotic, based on the sensitivity findings.
Figure 2.21 A well-defined caseous abscess on the dor- The abscess should be managed as an open wound
sum of a snake. and allowed to heal by secondary intention.
Mycoplasmosis
Abscesses Mycoplasmosis is a bacterial infection that has
Abscesses are a common finding in animals that been associated with severe disease in cheloni-
are managed under inappropriate conditions. ans. Affected animals might present with nasal
Abscesses are often the result of an infectious and ocular discharge, conjunctivitis, palpebral
origin (e.g., bacterial infection), foreign body, or edema, and pneumonia. Mycoplasmosis has also
parasite. Abscesses in reptiles and amphibians can been identified in squamates and crocodilians.
be found anywhere on the body and are commonly There are several diagnostic tests available to con-
located on the toes and tail and in the oral cav- firm mycoplasmosis in reptiles, including culture,
ity. Abscesses are often firm, well-circumscribed an ELISA (enzyme-linked immunosorbent assay ),
lesions (Figure 2.21). Diagnosis of an abscess is and a PCR ( polymerase chain reaction) assay.
often made from the history, physical examina- Microbiologic culture can be used to confirm an
tion, and the results of an aspirate or biopsy of the infection, but it is difficult and time-consuming
mass. Reptile and amphibian abscesses are typi- to isolate this bacteria. Currently, parallel testing
cally caseous or “cheesy” in nature, rather than using both the ELISA and PCR assays provides
liquefactive as in mammals. This difference is the highest degree of sensitivity. Treatment may
related to the reduced enzymatic firepower that be attempted using tetracyclines and fluoroqui-
reptile cells possess in relation to higher verte- nolones. Mycoplasmosis has been associated with
brates. declines in native tortoise populations in the
Successful management of an abscess in a United States, and treatment of wild specimens is
reptile or amphibian requires incision and curet- not recommended.
tage. Simply initiating systemic antibiotic therapy
will be insufficient, because the inciting cause, or Viruses
nidus, if bacterial, is often located in the center of As diagnostic techniques to identify viruses
the abscess and will be unaffected by any drugs. A improve, more and more of these pathogens
local anesthetic line, or ring block using lidocaine, are being associated with disease in reptiles and

amphibians. The viruses that have received the tive treatment for this disease. Affected animals
most attention in pet reptile and amphibian med- should be euthanized to prevent the spread of the
icine are paramyxovirus, retrovirus, herpesvirus, disease to other snakes.
and ranavirus. Bearded dragon adenovirus was first reported
Paramyxoviruses are primarily associated with in Australia in the early 1980s. The virus was not
viperid snakes, although they have also been characterized in the United States until more than
identified in nonviperid snakes.18,19 This virus a decade later. Since that time, the virus has spread
is typically spread from contact with respira- through the bearded dragon population in the
tory secretions. Affected animals display clinical United States and should be considered endemic.
signs associated with respiratory disease, such as Transmission of the virus is primarily by the direct
nasal and oral discharge, open-mouth breathing, route (fecal-oral), although vertical transmission
increased lung sounds, and possible neurologic might also be possible. Affected animals might
signs, including tremors and seizures. Diagnosis present with anorexia, weight loss, limb paresis,
can be made antemortem from a blood test or diarrhea, and opisthotonus. Concurrent depen-
postmortem from a histologic diagnosis.20 Mixed dovirus and coccidial infections have also been
results have been found among different labo- observed in neonatal bearded dragons.22 Biopsies
ratories using the antemortem serologic test for of the liver, stomach, esophagus, and kidney may
paramyxovirus, so caution should be used when be collected to confirm diagnosis (antemortem).
interpreting the results.21 There is no effective On histopathology, basophilic intranuclear inclu-
treatment for this virus. sion bodies are strongly suggestive of adenoviral
Inclusion body disease primarily affects snakes infection. Antemortem diagnosis can also be made
in the family Boidae (e.g., boas and pythons). using PCR (fecal shedding). There is no effective
Historically, this virus was attributed to a ret- treatment for adenoviral infections, although
rovirus, although this has not been confirmed. supportive care (e.g., fluids, enteral nutrition, anti-
The method of transmission of this disease is biotics) can be useful in stemming the secondary
unknown, but it appears contagious and it is effects of the disease.
suspected that snake mites (Ophionyssus natricis) The incidence of herpesvirus infections in che-
play a role in its dissemination. Affected boa con- lonians has been on the rise since originally being
strictors present with chronic regurgitation, but isolated from sea turtles in 1975. Herpesvirus infec-
might develop neurologic signs, including loss tions have been identified in freshwater, marine,
of righting reflex, tremors, and disorientation, as and terrestrial species of chelonians. Transmis-
the disease progresses. Affected pythons develop sion of the herpesvirus is believed to be via the
severe neurologic signs, similar to those described horizontal route, although it has been suggested
for the boas, that progressively worsen. Animals that a vertical route of transmission is also pos-
typically succumb to this disease as a result of sible. Affected animals might present with rhinitis,
secondary infections and starvation. Diagnosis conjunctivitis, necrotizing stomatitis, glossitis,
can be made antemortem from surgical biopsies enteritis, pneumonia, and neurological disease.
and seeing inclusions in the cytoplasm of lym- Molecular diagnostics, electron microscopy, and
phocytes on a blood smear, and postmortem from viral isolation have been used to diagnose her-
histopathologic examination. There is no effec- pes infections in chelonians. Affected animals
should be given appropriate supportive care (e.g., to animals. Affected animals typically present
fluids, enteral nutrition, and antibiotics) to con- with yellow crusts that can be found anywhere on
trol clinical signs. Acyclovir has been used with their body. The crusts can progress into pyogranu-
some success by reducing viral replication. How- lomatous inflammation. Diagnosis can be made
ever, there is no effective treatment for this virus. from biopsy samples submitted for histopathology
Affected animals should not be released into the and culture. Treatment needs to be aggressive and
wild, to prevent translocation of the virus to naïve should include both topical (chlorhexidine and
chelonians. miconazole cream) and systemic (itraconazole, 5
Ranaviruses are members of the family Irido- mg/kg by mouth once daily) treatment.
viridae. These viruses have historically been an Chytrid fungi are a problem in both captive and
important pathogen in amphibians, more speci- wild populations of amphibians. This fungus has
ficially anurans. In recent years, they have been been attributed to worldwide population declines
found to cross over into other classes of animals, in amphibians. Affected animals lose their ability
including reptiles and fish. They have been found to regulate their fluid balance, because the patho-
in both wild and captive chelonians (e.g., box gen has a predilection for the keratinized tissues
turtles). Clinical signs in affected animals might associated with their ventral abdominal patch,
include anorexia, depression, upper and lower and become susceptible to other opportunistic
respiratory tract disease, cervical cellulitis, and infections. Diagnosis can be made from histopa-
death. This virus will likely become more prev- thology and culture. A PCR assay is also available.
alent in both wild and captive populations over Topical and systemic antifungals should be used
time as natural habitats of turtles are further to treat affected animals.
encroached upon by humans and animals, and as
turtles are brought into captivity without appro- Parasites
priate quarantine methods. Cryptosporidium serpentis is considered a “plague”
of captive snake collections. This apicomplexan
Fungi parasite has been associated with both high mor-
Fungi are being diagnosed more frequently in bidity and mortality in captive collections. Affected
captive reptile and amphibian cases. The appar- snakes commonly regurgitate their meals, have a
ent increased prevalence can be attributed to midbody swelling, and are dehydrated. A variety
better diagnostic testing and a greater aware- of methods can be used to diagnose cryptosporidi-
ness of these pathogens among veterinarians. osis in snakes. Acid-fast cytology of a regurgitated
Although most cases are associated with oppor- meal or fecal sample is often diagnostic; however,
tunistic infections, there has been a rise in cases multiple samples might be needed to confirm the
attributed to obligate fungal pathogens in both presence of the parasite, because they can be tran-
reptiles and amphibains. siently shed. Because there is currently no effective
The Chrysosporium anamorph of Nanniziopsis treatment, affected animals should be culled.
vriesii has been found to infect snakes, lizards, Cryptosporidium saurophilum is a more recently
and chelonians. Bearded dragons appear to be diagnosed species associated with lizards. Whereas
very susceptible. Often called “the yellow fungus” C. serpentis is associated with the stomach, C. sau-
in these lizards, this fungal pathogen can be fatal rophilum is associated with the intestine. Currently,

both merogenic and sporogenic phases. These

parasites are common in lower vertebrates (e.g.,
fish), but have also been implicated as a concern in
humans with acquired immunodeficiency virus.
Bearded dragons infected with these parasites
can present with a clinical picture similar to that
of as adenovirus or coccidiosis. Affected dragons
are anorexic, unthrifty, cachectic, and may die
acutely. Diagnosis is generally made postmortem.
Hepatic and renal necrosis is common, although
other organ systems (e.g., intestine and gonads)
Figure 2.22 Coccidiosis in a bearded dragon. This might also be affected. There is no effective treat-
particular organism is Isospora amphiboluri. ment. To limit the likelihood of introducing
this parasite into a collection, herpetocultur-
ists should acquire animals only from reputable
no consistent treatment is available for C. saurophi- breeders and quarantine any new arrivals for a
lum or C. serpentis. minimum of 60–90 days.
Coccidiosis is a major cause of morbidity and
mortality in reptiles. A species of special concern,
ZOONOTIC DISEASES
Isospora amphiboluri, is found in bearded dragons
(Figure 2.22). These endoparasites are especially The veterinarian and veterinary technician serve
problematic in neonatal dragons, often resulting vital roles in educating their support staff and
in stunting, diarrhea, and death. Whereas most clients about the potential diseases that their
coccidial infections in higher vertebrates are self- patients (reptiles and amphibians) might spread
limiting, these infections often persist in bearded to humans (zoonoses). Many zoonotic diseases
dragon colonies, because animals are held in high can be prevented by practicing strict hygiene and
densities and autoinfection is common in vivaria using common sense. Exotic pets should not be
that are not cleaned regularly. Historically, elimi- recommended for households with infants and
nating coccidia from bearded dragons was difficult young children, immunocompromised individu-
because most of the therapeutics used to eliminate als, or the elderly, because the immune systems in
the parasites were coccidiostatic (i.e., suppresses these groups of individuals are often naïve or inef-
but does not kill coccidia). Ponazuril (30 mg/kg ficient at protecting them against most pathogens.
by mouth once, with a second treatment 48 hours The most notorious reptile zoonosis is Salmo-
later) is coccidiocidal (i.e., kills coccidia) and has nella spp., a Gram-negative rod that is a facultative
excellent therapeutic value against I. amphiboluri. anaerobe (can live in the absence of oxygen). There
Quarantine and environmental disinfection/sani- are more than 2,435 serotypes of Salmonella spp.23
tation should also be done to eliminate coccidia All Salmonella spp. should be considered patho-
from dragon colonies. genic to humans.
Microsporidians are obligate intracellular In the early 1970s, there were more than
parasites. The life cycle of these parasites includes 280,000 human cases of salmonellosis in the
United States attributed to reptiles (turtles).24 dure. They should also not handle the animals near
Attempts to certify the animals (turtles) as Salmo- human food preparation sites or wash receptacles
nella-free in the United States failed because the (e.g., sinks and bathtubs) and should not allow the
animals were found to be latent shedders of the animal to roam free within a human domicile.
organism (i.e., they could test negative one week There are other species of bacteria (Gram-
and positive weeks or months later). In 1975, the positive and Gram-negative) that have been
United States Food and Drug Administration put isolated from both clinically healthy and dis-
an inter- and intrastate shipping ban on turtles eased reptiles that can cause disease in humans,
with a carapace under 4", effectively halting the including Aeromonas spp., Campylobacter spp.,
sale of turtles in the United States. The ban on tur- Citrobacter spp., Edwardsiella spp., Escherichia
tles proved to be successful as follow-up research coli, Klebsiella spp., Mycobacterium spp., Pasteu-
indicated a 77% decrease in turtle-associated sal- rella spp., Proteus spp., Staphylococcus spp., and
monellosis.25 Streptococcus spp. The population at risk is similar
In the late 1980s and through the 1990s, reptile- to that defined for Salmonella spp. and includes
associated salmonellosis again received national infants, immunocompromised individuals, and
attention. Many of the cases during this period the elderly—although clinically healthy adults
included infants, with one infant dying. These can also develop infections under certain cir-
cases differed from the turtle-associated salmonel- cumstances. Humans can be exposed to these
losis cases because the infants did not have direct pathogens through wound contamination (e.g.,
contact with the reptile in their household. Own- scratch or bite wounds), water exposure, or fecal-
ers should be warned of these potential hazards oral exposure. Adhering to strict hygiene practices,
and should practice strict hygiene, including hand such as hand washing, wearing protective gloves
washing after handling their pet or cleaning its when cleaning reptile/amphibian enclosures, and
environment, removing fecal wastes and cleaning not handling or allowing the animals near human
the reptile’s/amphibian’s habitat with an appropriate food preparation sites should prevent disease.
disinfectant, and wearing gloves during the proce-
1. Why is an environmental temperature range important for reptiles? Describe different methods for
providing a temperature gradient for reptiles.
2. Why is ultraviolet B radiation (UVB) important for reptiles? What recommendations would you
make to clients to ensure their pet reptile is provided with an appropriate source of UVB?
3. Describe the three different types of feeding strategies used by reptiles. Why is it a challenge to
meet the needs of these animals in captivity?
4. What are the recommended techniques to restrain a snake, chelonian, and lizard?
5. How is the hydration status of a reptile evaluated?

6. Describe the proper methods of performing a physical examination on a lizard, snake, and
chelonian.
7. How do you determine the sex of a snake, lizard, and chelonian?
8. How much blood can be safely collected from a reptilian patient?
9. Describe blood collection techniques used for reptilian patients.
10. How can you minimize the likelihood of “smudgeocytes” in a reptile blood smear?
11. How are erythrocytes and leukocytes different between reptiles and mammals?
12. What types of anesthetics can be used for reptiles and amphibians?
13. How do you assess depth of anesthesia in amphibians and reptiles?
14. Name three common nutritional diseases reported in captive reptiles.
15. What are the different routes for replenishing fluids in a reptile patient?
16. What are common infectious disease presentations in reptiles? Why are viral infections on the
rise?
17. Which zoonotic disease in reptiles has been associated with high morbidity in humans?
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Guzman D. Effects of ultraviolet radiation on plasma 25-hydroxyvitamin D concentrations in corn
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Veterinarians, 1990:151–56.
18. Ahne W, Neubert WJ, and Thomson I. Reptilian viruses: Isolation of myxovirus-like particles from
the snake Elaphe oxycephala. Journal of American Veterinary Medicine 1987;34:607.
19. Jacobsen ER, Gaskin JM, Simpson C, et al. Paramyxo-like virus infection in a rock rattlesnake.
Journal of American Veterinary Medicine 1980; 177(9):796.
20. Schumacher J. Viral diseases. In: Mader DR, ed. Reptile medicine and surgery. Philadelphia: WB
Saunders; 1996:224–34.
21. Allender MC, Mitchell MA, Dreslik MJ, et al. Measuring agreement and discord among hemagglu-
tination inhibition assays against different ophidian paramyxovirus strains in Eastern massasauga
(Sistrurus catenatus catenatus). Journal Zoo Wildlife Medicine 2008;29:358–61.
22. Kim DY, Mitchell MA, and Bauer R. An outbreak of adenoviral infection in inland bearded drag-
ons (Pogona vitticeps) coinfected with dependovirus and coccidial protozoa (Isospora sp.). Journal
Veterinary Diagnostic Investigation 2002;14:332–34.
23. Popoff MY, and Leminor L. Antigenic formulas of the Salmonella Serovars, 7th revision. World
Health Organization Collaborating Center for Reference Research on Salmonella, Pasteur Institute,
Paris, France, 1997.
24. Lamm SH, Taylor A, Gangarosa EJ, et al. Turtle-associated salmonellosis I: An estimation of the
magnitude of the problem in the United States, 1970–1971. American Journal of Epidemiology 1972;
95(6):511–17.

25. Cohen ML, Potter M, Pollard et al. Turtle-associated salmonellosis in the United States. Effect
of public health action, 1970–1976. Journal of the American Veterinary Medical Association 1980;
12(243):1247–49.
26. Jacobson ER. Use of chemotherapeutics in reptile medicine. In: Jacobson ER, and Kollias GV, eds.
Exotic animals. New York: Churchill Livingston; 1988:35–48.
27. Jacobson ER. Antimicrobial drug use in reptiles. In: Prescott JF, and Baggot JD, eds. Antimicrobial
therapy in veterinary medicine. Ames: Iowa State University Press; 1993:543–52.
28. A llen DG, Pringle JK, and Smith D. Handbook of veterinary drugs. Philadelphia: JB Lippincott;
1993:534–67.
29. K lingenberg RJ. Therapeutics. In: Mader DR, ed. Reptile medicine and surgery. Philadelphia: WB
Saunders; 1996:299–321.
30. Jacobson ER. Snakes Veterinary Clinics of North America Small Animal Practice 1993;23:1179–1212.
Ferrets
Chapter 3
INTRODUCTION
The ferret, Mustela putorius furo, belongs to the order Carnivora and the
family Mustelidae. These animals initially became popular as pets in the
United States during the 1970s. Over the next two decades their numbers
increased significantly, with estimates of more than 7 million ferrets being
kept as pets in 1990.1 More recent surveys conducted by the American Vet-
erinary Medical Association suggest that their popularity has continued to
rise into the new century, with a 6.5% increase in pet ferret numbers being
reported between 2001 and 2007 (http://www.avma.org/reference/market
stats/ownership.asp). The ferret has endeared itself to humans because of
its “spunky” disposition and small stature. The ferret has also become quite
popular in urban domiciles (e.g., apartments) that might be too small to
house dogs or cats.
Domestication of the ferret is not recent; it has been recorded that ferrets
were used for hunting more than 2,000 years ago.2 The ferret was originally
introduced into the United States more than 300 years ago.3 In other parts of
the world, such as England, the ferret serves in a working role as a hunter of
rabbits and rodents. Male ferrets are called hobs, females, jills, and their young,
kits. Sexing ferrets is straightforward; males have a prepuce on their ventral
abdomen, similar to dogs, and females have a vulva ventral to their anus. The
ferret is also used extensively in research.
Although the domestic ferret continues to gain in popularity in the United
States, it cannot legally be kept as a pet in all states. The ferret has developed
an unfortunate reputation in certain areas as dangerous around children or a
threat to native wildlife. In California, a 1933 law regulating the importation
of mustelids is responsible for the current prohibition on pet ferrets in Cali-
fornia. Local ordinances in certain “ferret-legal” states might also prohibit
ferrets as pets, so it is important to research the laws in your state and local

Table 3.1 Ferret Basic Information nonretractable claws, which it uses to dig and bur-
Body Weight
row, and ferret owners are often scratched by their
Adult Male (Hob)
pets while playing with them. Ferret owners might
Intact 1.0–2.0 kg3 request to have their pet declawed; however, the
Neutered 0.7–1.1 kg procedure would be very painful and should never
Adult Female (Jill) be performed.
Intact 0.5–1.0 kg3 The majority of ferrets offered for sale in pet
Neutered 0.5–0.7 kg shops are de-scented and neutered. These proce-
Birth Weight (Kit) 8–10 grams3
dures are commonly done to minimize the odor
Temperature, Pulse, and Respiration associated with these animals. Although the
Rectal Body Temperature 100°–103°F overwhelming majority of ferrets presented to vet-
Normal Heart Rate 170–230 beats/minute erinary hospitals will have had these procedures
Normal Respiratory Rate 25–40 breaths/minute done at the commercial breeders, there remain
Reproductive Cycle some private breeders who will sell their animals
Sexual Maturity 4–8 months of age3 intact. Removing the scent glands (anal glands)
Gestation 41–42 days3 and neutering/spaying a ferret are similar to the
Estrous Cycle Induced ovulator procedures described for dogs and cats, respec-
Weaning Age 6–8 weeks tively. Neutered animals might weigh significantly
Life Span 4–9 years average, up to less than their intact counterparts (Table 3.1). Fer-
11–12 years
rets can lose a significant amount of weight during
the summer months, only to gain the weight back
in the winter. Indoor domestic ferrets can expe-
municipality to protect yourself and your clients. rience a 10%–30% weight change, whereas an
In many states, the wildlife and fisheries depart- outdoor intact animal can fluctuate by as much as
ment regulates permits for domestic ferrets; it 40% of its body weight.3
should be contacted regarding official regulations. More than 30 hair coat color variations are rec-
Success in working with the ferret, as with all ognized in the domestic ferret. The most common
exotic species, requires veterinary technicians to colors, sable and albino, are naturally occurring
develop a basic knowledge of the anatomy and patterns, whereas many of the other variations are
physiology of the animal (Table 3.1), so that they the result of selective breeding (Figures 3.1 and
can perform a thorough physical examination, 3.2). Ferrets undergo routine spring and fall sea-
administer medical therapy, and answer an own- sonal molts, similar to domestic dogs. Ferrets have
er’s questions about his or her pet. very thick skin and a technician might find it dif-
ficult to inject vaccinations or subcutaneous fluids
Anatomy and Physiology between the shoulders. This thick skin over the
The technician should become familiar with those nape of the neck is a site where ferrets bite during
anatomical characteristics in the ferret that differ reproduction and territorial fighting.
from other domestic mammals. The ferret has a The ferret has a pair of anal glands that pro-
long, tubular body that enables it to maneuver duce a musky odor. Commercial breeding farms
through burrows when hunting prey. It has sharp, de-scent and neuter kits prior to shipping them
3 | Ferrets 81
shape of their os penis, calculi (mineral deposits)

can sometimes become obstructive. Male ferrets
also have a prostate. This accessory sexual organ
was originally not considered to be present in fer-
rets until cases of prostatomegaly became apparent
with adrenal gland disease.
Ferrets are true carnivores and have a relatively
short gastrointestinal tract, which makes them
capable of processing a meal within 3–4 hours.
This is important to consider when performing a
gastrointestinal radiographic contrast series.
Figure 3.1 A standard sable ferret. This is the most
common color produced in captivity.
HUSBANDRY
Ferrets may be maintained indoors or outdoors.
They are primarily maintained indoors in the
United States, whereas they are often maintained
outdoors in Europe. Ferrets kept outdoors should be
protected from extremes of heat and cold. During
the summer months, animals should be provided
shelter and fresh water and should be removed from
direct sun. Ferrets do not tolerate temperatures
over 88°–90°F. In the winter, animals should be
provided a shelter with straw or hay. When the tem-
perature drops below freezing (32°F), ferrets should
be brought into a warm shelter.
Ferrets should be given a well-ventilated, spa-
cious enclosure. Glass fish tanks are not suitable
for ferrets because they do not allow for ade-
Figure 3.2 An albino ferret. Note the general loss of quate ventilation. Animals maintained in glass
pigment throughout the hair coat and irises. enclosures often develop respiratory problems.
Galvanized metal cages or wood-frame cages are
to pet stores, whereas private breeders will often routinely used to house ferrets. Galvanized metal
leave that option to the new owner. is composed of zinc and could expose those ani-
Female ferrets are induced ovulators and mals that lick and chew the bars to heavy metal
must be bred by a male to stimulate ovulation. toxicity. Reports of heavy metal toxicity in ferrets
A female that is not bred or spayed could develop are rare, but should be considered in animals that
a life-threatening estrogen-induced anemia. Male display neurologic signs, vomiting, diarrhea, or
ferrets have a j-shaped os penis. Because of the hematochezia.

The enclosure should be large enough to pro- Commercial ferret harnesses can be used to walk
vide the animal an area to sleep, eat, exercise, an animal indoors or outdoors.
and have a latrine. Ferrets urinate and defecate
in corners and can be trained to use a litter box. Nutrition
Owners should be advised that they might need As mentioned, ferrets are true carnivores, as
to place a litter box in multiple corners to ensure evidenced by their relatively short gastrointes-
their pet will use it. Litter pans should have low tinal tract. The gastrointestinal transit time of
sides to allow an animal easy access. Fecal and the ferret is rapid (3–4 hours), so food quality
urine material should be removed from the litter is important to ensure maximal nutritional ben-
pan daily. Clients should be taught what to watch efit. The diet of a ferret should consist primarily
for when evaluating fecal and urine output in fer- of high-quality protein and fat. The exact nutri-
rets. Because several gastrointestinal diseases are tional requirements for the ferret have not been
associated with changes in fecal appearance and established, although it is generally accepted that
consistency (e.g., coronavirus infection: green, adult altered animals require 30%–40% protein
mucoid diarrhea; gastric ulcers: melena), the cli- and 18%–20% fat.5 Breeding animals and young,
ent’s ability to describe fecal changes can be fast-growing kits require significantly more pro-
important to the veterinary personnel working tein (minimum 35%) and fat (minimum 25%).
on a diagnosis. Also, because cystic calculi and Although readily accepted by ferrets, carbohy-
prostatomegaly are found in captive ferrets, his- drates (e.g., sweets) should be minimized in the
torical information regarding the production of animal’s diet. Carbohydrates, especially simple
urine and whether a ferret is straining to urinate sugars, can also prove problematic in ferrets with
are important pieces of information to guide vet- insulinoma. Feeding simple sugars can exacerbate
erinary personnel toward a diagnosis. the disease by increasing insulin levels and further
Ferrets naturally tend to burrow and hide when decreasing glucose levels. The provision of simple
they sleep, and it’s important to tell clients to pro- sugars (e.g., Karo syrup) to a ferret with an insuli-
vide their pet with a sleeping shelter. A number of noma should be reserved for emergency cases (e.g.,
commercial ferret hammocks or slings can be pur- animal is severely depressed, seizures). The short
chased, although most old towels or shirts work gastrointestinal tract of the ferret is not dependent
fine. Owners should be advised to observe their on dietary fiber, as is the case with herbivores.
pet closely to ensure that it does not attempt to Most commercial ferret diets contain minimal
ingest any of the material. Cardboard box shelter quantities of fiber.
can be provided to animals that are at risk with A number of commercial diets can provide a
the cloth material. ferret with adequate nutrition. In recent years,
Ferrets should remain in their cage and only be commercial ferret diets have been offered for
allowed to roam free in a home under close super- sale at retail pet stores. Ferret owners should be
vision. These animals are capable of fitting into encouraged to read the labels of commercial diets
small crevices between furniture and ventilation to ensure that the appropriate levels of protein
systems and are notorious for getting into trouble. and fat are offered, based on the animal’s age and
The ingestion of foreign material is the most com- reproductive status. Commercial feline growth
mon problem reported in unsupervised ferrets. diets are also routinely recommended for ferrets.
3 | Ferrets 83
Again, the ingredient list should be evaluated bathing; however, they may be bathed once a
and recommendations made based on the ani- month, if desired. The most appropriate shampoo
mal’s needs. The list of ingredients should start is one that is pH balanced, such as a commercial
with poultry products rather than vegetable (corn) ferret or kitten shampoo. Excessive bathing might
products. Canine diets should never be recom- lead to the development of dry, pruritic skin.
mended for ferrets, because they do not provide In the wild, ferrets use their sharp nails to dig;
adequate protein or fat and contain significant however, in captivity the need for this activity is
amounts of carbohydrates. A ferret can be offered reduced, so regular nail trimming is recommended
food ad lib. Ferret diets can be supplemented with to avoid painful scratches when interacting with
lean meats such as chicken or beef, or meat-based owners. Ferret nails can be trimmed in the same
(onion salt–free) baby foods. fashion as described for dogs and cats. If the nail
Ferrets should be offered fresh, clean water is cut short and the animal bleeds, an appropriate
daily. Water can be offered in heavy ceramic water styptic powder can be applied. On occasion, vet-
bowls or hanging sipper bottles. The bowl should erinary personnel are asked about the possibility of
be placed in a corner where it is unlikely the fer- declawing a ferret. Ferret nails are nonretractable,
ret will tip it over. Water sipper bottles should be like dog nails. Therefore, an onchiectomy should
placed in an area of the cage that is readily acces- never be performed on this species.
sible to the animal. Water-soluble vitamins are not Ferrets can develop significant dental tartar
necessary for ferrets that are fed a good-quality over time. To prevent potential dental problems,
commercial ferret or feline growth diet. the animal’s teeth should be brushed regularly.
Commercially available toothbrushes and tooth-
Transport paste available for use in dogs and cats can also
Owners should know that ferrets should be trans- be used to clean ferret teeth. Ferrets with dental
ported in a carrier when they visit the veterinarian. tartar should be scheduled for a scaling (tartar
If these animals are allowed free roam in a car removal) to minimize the risk of long-term gingi-
during transport, they could get into a particular val and dental disease. These types of procedures,
area that makes them difficult to retrieve, or they as with dogs and cats, require general anesthesia.
could ingest foreign material (e.g., coins) lying on
the floor of the automobile. Ferrets should also be
HISTORY
maintained in a transport carrier while they are
in the waiting room to prevent contact with other A thorough history is essential to making an
animals or a dog or cat attack. Tell owners that appropriate diagnosis for any exotic animal case,
they can reduce their ferret’s stress during trans- because many of the problems identified in exotic
port by placing a towel in the carrier to provide animals are directly related to inappropriate hus-
the animal a place to burrow and hide. bandry. A veterinary technician should first collect
the signalment, including age, sex, and color vari-
Grooming ety. Knowledge of the animal’s age and sex can
Ferrets naturally have a musky odor, which is be useful when developing a differential diagnosis
especially evident in intact animals during the list. For example, an adult intact female ferret with
breeding season. Ferrets do not require regular a history of weakness and lethargy might be suf-

fering from an estrogen-induced anemia, whereas including whether the animal is housed indoors or
an adult male or female kit would be very unlikely outdoors, if it has supervised or unsupervised run
to develop the same problem. Knowledge of the of the house, cage size and material, cage location
color variety is also important because differences in the house, whether ferrets are housed singly or
in physiologic parameters, such as hematology, together, substrate used in the cage, how often the
can vary (see Tables 3.2 and 3.3). cage is cleaned and the type of disinfectant used,
After the technician defines the signalment, whether a litter pan is used, the brand of cat litter,
he or she should focus on collecting background and the types of cage furniture (e.g., ferret ham-
information, including where the animal was mock) and toys. Questions about the animal’s
acquired, length of time owned, if the owner has nutrition are also important and should include
other pets, if he or she recently acquired another type of food (e.g., ferret or cat), brand, amount
ferret, the interaction between the owner and the fed, frequency, supplements, water source, and
pet, and the animal’s vaccination history (canine how often the food and water are changed.
distemper virus and rabies) and heartworm pre- Finally, questions should focus on the animal’s
vention status. This information should provide current health status and should include past
the technician with an initial understanding of the medical history, current presenting problem, and
client’s knowledge of the pet ferret. duration of the complaint. Although it is natural
The next set of questions should focus on how to want to focus on the problem at hand, a great
the animal is managed at home (husbandry), deal of information could be overlooked if the
Table 3.2 Ferret Hematological Reference Ranges4,6

Albino Fitch
Determination Male Female Male Female
PCV (%) 55 (44–61) 49 (42–55) 43 (36–50) 48 (47–51)
RBC (10 /µl)

6
10.2 (7.3–12.2) 8.1 (6.8–9.8) n/a n/a
Hemoglobin (g/dl) 17.8 (16.3–18.2) 16.2 (14.8–17.4) 14.3 (12.0–16.3) 15.9 (15.2–17.4)
Leukocytes (103/µl) 9.7 (4.4–19.1) 10.5 (4.0–18.2) 11.3 (7.7–15.4) 5.9 (2.5–8.6)
Neutrophils (%) 57 (11–82) 59.5 (43–84) 40.1 (24–78) 31.1 (12–41)
Bands (%) n/a n/a 0.9 (0–2.2) 1.7 (0–4.2)
Lymphocytes (%) 35.6 (12–54) 33.4 (12–50) 49.7 (28–69) 58 (25–95)
Eosinophils (%) 2.4 (0–7) 2.6 (0–5) 2.3 (0–7) 3.6 (1–9)
Monocytes (%) 4.4 (0–9) 4.4 (2–8) 6.6 (3.4–8.2) 4.5 (1.7–6.3)
Basophils (%) 0.1 (0–2) 0.2 (0–1) 0.7 (0–2.7) 0.8 (0–2.9)
Platelets (10 /µl)

3
453 (297–730) 545 (310–910) n/a n/a
Reticuloytes (%) 4.0 (1–12) 5.3 (2–14) n/a n/a
3 | Ferrets 85
Table 3.3 Ferret Serum Biochemistry Reference Ranges4,6,7

Determination Albino Fitch
Glucose (mg/dl) 136 (94–207) 101 (63–134)

Blood urea nitrogen (mg/dl) 22 (10–45) 28 (12–43)
Creatinine (mg/dl) 0.6 (0.4–0.9) 0.4 (0.2–0.6)
Total bilirubin (mg/dl) <1.0 n/a
Cholesterol (mg/dl) 165 (64–296) n/a
Calcium (mg/dl) 9.2 (8.0–11.8) 9.3 (8.6–10.5)
Phosphorus (mg/dl) 5.9 (4.0–9.1) 6.5 (5.6–8.7)
Alkaline phosphatase (IU/L) 23 (9–84) 53 (30–120)
Alanine aminotransferase (IU/L) n/a 170 (82–289)
Aspartate aminotransferase (IU/L) 65 (28–120) n/a
Sodium (mmol/L) 148 (137–162) 152 (146–160)
Chloride (mmol/L) 116 (106–125) 115 (102–121)
Potassium (mmol/L) 5.9 (4.5–7.7) 4.9 (4.3–5.3)
Total protein (g/dl) 6.0 (5.1–7.4) 5.9 (5.3–7.2)
Albumin (g/dl) 3.2 (2.6–3.8) 3.7 (3.3–4.1)
Globulin (g/dl) n/a 1.8 (1.3–2.1)
technician fails to collect the historical informa- on the table, because this often stimulates the ani-
tion in a thorough and systematic way. mal to struggle. Ferrets will often yawn while being
scruffed, which will facilitate examination of the
oral cavity.
RESTRAINT
Adult pet ferrets rarely bite, but might if they
Employing the appropriate technique when restrain- are in pain. A ferret will often make a hissing
ing a ferret is essential to the protection of the sound to warn of their dissatisfaction prior to
veterinarian, the technician, and the animal. Ferrets attempting to bite. Animals that are too diffi-
can be safely restrained by scruffing—a technique cult to handle can be sedated using anesthetics.
commonly used by the jill to move her kits. Scruff- Kits, on the other hand, are naturally very playful
ing is accomplished by grasping the skin over the (and teething) and are likely to bite. Fortunately,
dorsal cervical area (nape) with the index finger and their bite is similar to a puppy or kitten bite and
thumb (Figures 3.3A and 3.3B). Once the animal rarely breaks the skin of the handler. Moribund
is scruffed, it will often relax and offer little resis- and cooperative animals can simply be restrained
tance. The handler’s second hand should be placed on the examination table; however, any invasive
along the spine to protect it from injury. Do not procedure (e.g., vaccination, rectal temperature,
hold the rear legs or allow the animal to place them injection) will require scruffing.

Figure 3.3A Grasping the nape of a ferret is an excel- Figure 3.3B Most ferrets will yawn when scruffed,
lent way to gently restrain these animals. which allows veterinary personnel to examine the oral
cavity.
by restraint. The ferret should be mobile, aware
Ferrets are stoic animals and might not display of its surroundings, and its breathing pattern con-
overt clinical signs until late in the course of a sistent and not labored. Ferrets are naturally nasal
disease; therefore, the veterinarian will perform breathers, so open mouth breathing is an indica-
a thorough physical examination on every ani- tion of a problem. Coughing, sneezing, and nasal
mal presented to the veterinary hospital. Proper discharge also should be considered abnormal
restraint is essential for a veterinarian to perform a findings. A ferret presenting with dyspnea should
thorough physical examination, so it is important immediately be placed in an oxygen cage or pro-
for a veterinary technician to be on hand to assist vided oxygen via a face mask.
in the procedure. Physical examination of the fer- When removed from the carrier, the animal
ret follows the standard protocol recommended should be bright, alert, and responsive. If the fer-
for domestic species. ret is limp or nonresponsive, this behavior should
The ferret should be observed from a distance be considered abnormal and managed as an emer-
to assess those functions, such as locomotion, gency. A thorough physical examination can always
behavior, and respiration, that could be altered be delayed while stabilizing the patient.
3 | Ferrets 87
The animal’s eyes should be clear and free of

discharge. A fluorescein stain should be per-
formed on any animal in which a corneal ulcer is
suspected. In some cases the corneal ulcer will be
readily apparent because of gross changes to the
corneal surface, whereas in other cases it might be
more subtle and present in the form of increased
blinking or just holding an eye closed because it is
painful. Ferret pupils have a small oval shape and
horizontal position. It can be difficult to perform
a fundus examination in a ferret without using
mydriatics drugs (e.g., atropine). Figure 3.4 Ferrets tattooed with two ink dots in the
The nares should be clear and free of any crust- right ear were most likely raised at Marshall Farms.
ing or discharge. Ferret ears can have a dark, The two tattoos indicate that the ferret was spayed/
ceruminous wax buildup. If an excessive amount neutered and de-scented.
of wax is identified, a cotton-tipped applicator
should be dipped in mineral oil and a sample of delayed skin elasticity should be considered 5%
the wax collected and tested for ear mites (Oto- dehydrated. When an animal also presents with
dectes cynotis). The majority of ferrets presenting sunken eyes, resulting from the loss of fluid from
to veterinary hospitals in the United States will the retrobulbar fat, the animal should be consid-
have two small ink tattoos in their right ear (Fig- ered at least 8%–10% dehydrated.
ure 3.4), which were originally used to identify The length and condition of a ferret’s hair coat
ferrets raised by Marshall Farms (North Rose, can vary with the season, with the hair coat being
NY), the largest captive producer of ferrets in the much thinner in the summer than during the
United States. Other ferret producers have begun winter. Seasonal tail alopecia is also a common
using this method to mark their animals, too. The finding reported in ferrets during the late summer
tattoos indicate that the animal has been spayed/ and early fall. Animals that develop symmetrical
neutered and de-scented (anal glands removed). alopecia or thinning of the skin might have an
The oral cavity should be thoroughly evaluated. endocrinopathy (e.g., adrenal gland disease) (Fig-
The teeth should be free of obvious dental caries ure 3.5).
or fractures. The amount of dental tartar should The veterinarian will thoroughly evaluate the
be recorded, and animals with moderate to severe skin for defects such as tumors; mast cell tumors
dental tartar should be scheduled for a dental scal- are an especially common finding in ferrets. The
ing. The mucous membranes should be moist and ferret has peripheral lymph nodes similar to those
pink. The capillary refill time should be less than of the cat and dog, including the submandibular,
2 seconds. The veterinarian will assess hydration cervical, prescapular, axillary, abdominal, ingui-
status by evaluating the mucous membrane qual- nal, and popliteal lymph nodes. Examination of
ity and capillary refill time, packed cell volume, the lymph nodes is especially important in fer-
skin elasticity, and retrobulbar fat. A ferret with rets that can develop lymphoma. Normal lymph
a decreased capillary refill time (>2 seconds) and nodes are not typically palpated in a ferret. When

The stomach is located medial to the spleen and

typically palpates as a large empty tubular struc-
ture unless the ferret has eaten a recent meal or
has a gastric foreign body. The veterinarian will
slide his or her fingers more medially to find the
left kidney. It should have a uniform texture and
be approximately 2–2.5 cm. The right kidney can
be palpated by switching to the right side of the
abdomen. The right kidney is located cranial to
the left kidney and is often located under the last
ribs. It should have a texture and size similar to
the left kidney. Medial and slightly cranial to the
kidneys lie the adrenal glands. These structures
can be palpable in ferrets with adrenomegaly asso-
ciated with adrenal gland disease. The urinary
bladder should be palpable in the caudal abdomen
Figure 3.5 Generalized hair loss (alopecia) is one of
the most common clinical signs associated with adrenal if urine is present. A large firm prostate may be
gland disease. The skin in these animals also appears palpable caudal and dorsal to the urinary bladder
thin compared with that of unaffected animals. in male ferrets with prostate/adrenal gland disease.
Unless there is an intestinal foreign body, ileus, or
significant ingesta in the intestines, the intestines
a lymph node can be palpated, the veterinarian are not typically palpable. Likewise, unless there
will order a fine needle aspirate and cytologic is significant pathology to the liver (e.g., hepato-
evaluation of the sample. Obese animals might megaly), this organ is not typically palpated on a
appear to have a lymphadenopathy when, in real- routine physical examination.
ity, the nodes palpate larger than normal because A veterinarian will usually also perform a neu-
of excessive fat accumulation. rological examination during a routine physical
Abdominal palpation is much more rewarding examination, especially in animals with a history
in ferrets than in other mammals. The veterinar- of weakness, paresis, or paralysis. The limbs of the
ian will palpate the spleen by grasping the left side animal will be thoroughly palpated to rule out
of the abdomen with the index finger and thumb. fractures. The range of motion and reflexes associ-
Splenomegaly is a common finding in mature fer- ated with the shoulder, elbow, carpus, pelvis, stifle,
rets, so the organ is often easy to identify. There hock, and digits will be evaluated and any crepitus
are a number of different reasons that splenomeg- or problems recorded. Animals showing deficits
aly occurs in ferrets, including extramedullary associated with the cranial nerves (e.g., drooping
hematopoiesis, neoplasia, and trauma. Palpating eyelids, facial paralysis, hypersalivation) will also
the surface of the spleen can provide some insight be given a thorough evaluation.
into the underlying cause of disease, because neo- The veterinarian will evaluate the anus, ensur-
plastic conditions often affect the surface texture ing that the perianal region is free of fecal staining.
of the spleen (e.g., make it more “lumpy”). The vulva of the neutered jill should be small (<2
3 | Ferrets 89
mm) and free of discharge or staining. Jills that 100° and 103°F. Animals that struggle during the
are intact or have adrenal disease might develop examination could have a falsely elevated body
an enlarged and turgid vulva (Figure 3.6). Often temperature.
these animals will have a purulent vulvar dis- After the examination is completed, the tech-
charge. The penis of the hob might be difficult nician should record abnormal findings, and a
to extract from the prepuce in an animal that is problem list with differential diagnoses should
awake. If there is a history of stranguria, hema- be established. Based on the top differential
turia, or anuria, the animal should be sedated to diagnoses, diagnostic tests are prioritized to con-
thoroughly examine the penis. firm a diagnosis or to determine the severity of
Auscultation of the heart and lungs is an impor- the disease.
tant component of the physical examination. In
most mammals, the heart is located at the point of
DIAGNOSTIC SAMPLING
the elbow, whereas in the ferret the heart is located
in the mid-thoracic region between ribs 6 and 8. Blood Collection
Placement of the stethoscope bell housing in the Obtaining a blood sample from a ferret might
appropriate location is vital to evaluating the heart. prove challenging at first, but with experience the
The ferret heartbeat is much more rapid than that procedure will become routine. Ferrets that are
of domestic mammals, and a sinus arrhythmia is a not effectively immobilized using simple restraint
common finding. should be anesthetized. The advent of inhalant
Checking the rectal temperature of a ferret can anesthetics in veterinary medicine has simpli-
be a real challenge. A digital thermometer is pre- fied this procedure, allowing for rapid induction
ferred over a glass thermometer, because of the and recovery. The site chosen for venipuncture
risk of breakage and injury to the animal. The fer- will depend primarily on the volume of sample
ret’s normal body temperature should be between required and the technician’s skill level. Most
clinical laboratories can perform complete blood
counts and serum chemistry analysis on 1–2 ml
of blood, significantly reducing the volume of
blood required for testing. In certain cases, such
as a blood transfusion, the technician might need
to collect a larger volume of blood. The blood vol-
ume of a ferret has been estimated to be between
5% and 6% of the animal’s body weight, and up
to 10% of the animal’s blood volume (5–6 ml/kg
of body weight) can be safely collected at one
time.4
A number of different venipuncture sites have
been described to collect blood samples from
the ferret. The volume that can be collected and
Figure 3.6 Female ferrets with adrenal gland disease the quality of the sample might vary from site to
can develop significantly enlarged vulvas. site. In general, the cranial vena cava and jugular

vein are the preferred sites for sample collection, mately half its depth. Apply negative pressure to
because large volumes of blood can be collected the syringe once the needle has entered the tho-
from them relatively easily. Other sites include the rax until blood fills the syringe. In cases where
cephalic and saphenous veins and the tail artery. a large volume of blood is required, such as for
The cephalic vein should be reserved for intrave- a transfusion, a 25-gauge butterfly catheter can
nous catheterization and used for venipuncture be attached to a 12 or 20 ml syringe to facilitate
only as a last resort. Some have recommended collection.
clipping a nail to collect a blood sample, but this The jugular vein should also be considered when
should not be performed because it is painful and large volumes of blood are required. There are two
yields lymph-diluted samples. restraint techniques that can be used to prepare an
To collect a sample from the cranial vena cava, animal for jugular venipuncture. The first tech-
place the animal in dorsal recumbency. A total of nique is similar to that described for cats, where the
three people will be required to collect the sample animal’s front legs are held over the edge of the table
if the animal is not anesthetized: two handlers and the neck is stretched up. The second technique
and one sample collector. One handler should is performed on an animal in dorsal recumbency
grasp the head and stretch it forward with one and restrained using the same technique described
hand, while using his or her second hand to pull for the cranial vena cava technique.
the front legs back. The second handler should Animals that are difficult to manually restrain
restrain the animal’s rear legs. The technician should be anesthetized. The jugular vein of the
should anesthetize an animal that struggles dur- ferret courses in a more lateral direction than
ing restraint before performing the procedure. that in dogs and cats. Shaving the hair over the
The landmarks for the venipuncture site are the ventral cervical area can facilitate visualization of
manubrium and first right rib. The site should be the vein; however, the ferret jugular vein is often
aseptically prepared, using an appropriate anti- surrounded by fat and difficult to see. The site
septic to prevent the introduction of bacterial should be aseptically prepared using an appro-
contaminants into the thorax. A 25-gauge needle
fastened to a 3 ml syringe should be used to col-
lect the sample (Figure 3.7). The needle should be
inserted at a 45° angle to the body at the juncture
of the manubrium and first right rib and directed
toward the right rear leg. The cranial vena cava
can also be approached by inserting the needle
at the junction of the manubrium and left first
rib and directing it toward the right rear leg;
however, many veterinarians prefer the former
technique, because it doesn’t require passage of
the needle through mediastinal tissues. The level
of the cranial vena cava can vary from animal to
animal; however, most samples can be collected Figure 3.7 The cranial vena cava is a preferred site
by inserting the 5/8", 25-gauge needle to approxi- for collecting blood from a ferret.
3 | Ferrets 91
priate antiseptic. A 22-, 23-, or 25-gauge needle

fastened to a 3 ml syringe can be used to collect
the blood sample.
The trachea is located on the ventral midline
of the cervical region and can be used as a land-
mark. Apply gentle pressure with your thumb at
the thoracic inlet to increase visibility and resis-
tance in the vein. A slight bend (20° angle) in the
needle can be made to improve access to the vein.
The skin in the cervical region is more difficult
to penetrate than in other regions of the body;
therefore, be prepared to exert additional force. Figure 3.8 The lateral saphenous vein is an excellent
In those cases where the jugular vein is not vis- site for collecting small to moderate volumes of blood
from a ferret.
ible, a “blind-stick” will be necessary. Inserting
the needle just cranial to the thoracic inlet pro-
vides the greatest success for collecting a jugular Again, a slight bend (20° angle) in the needle
blood sample. By using this site, the technician might simplify the approach to the vessel.
can gain access to the vessel as it leaves the tho- Blood samples can also be collected from the
rax and before it makes a lateral deviation in the tail artery, although this technique is rarely used.
neck. Do not be overly aggressive when searching The tail artery is located 2–3 mm deep to the
for the jugular, because there are other vital tis- midline of the ventral tail. The animal should
sues in the cervical area that could be damaged. be restrained by scruffing and pulling the legs
The cephalic and saphenous veins can be used caudally. The site should be aseptically prepared
to collect small volumes of blood (<0.5 ml), but using an appropriate antiseptic. A 22-gauge nee-
should be reserved to use as intravenous catheter dle fastened to a 3 or 6 ml syringe can be used.
sites when an animal presents for any disease The needle should be inserted into the ventral
condition that might require fluid therapy. The midline of the tail and negative pressure applied
cephalic vein is located over the antebrachium, as until blood is observed filling the syringe. Because
in dogs, although the vein courses more laterally this is an artery, direct digital pressure should be
in the ferret. The lateral saphenous vein can be applied to the site for a minimum of 2 minutes
located at the level of the hock and courses diago- after withdrawing the needle.
nally in an anterior to posterior fashion (Figure Observed reference ranges for the ferret com-
3.8). Shaving the hair over the venipuncture sites plete blood count (CBC) and serum chemistry
will facilitate visibility. The site should be asep- panel are listed in Tables 3.2 and 3.3, respectively.
tically prepared using an appropriate antiseptic. These values represent observed reference ranges
The ferret should be restrained using the same and should not be considered complete.
techniques used to restrain a cat when collecting
a blood sample from the cephalic or saphenous Bone Marrow Aspiration
vein. A 25- or 26-gauge needle fastened to a 1 or Ferrets might develop several diseases that can
3 ml syringe can be used to collect the sample. lead to a suppression of the progenitor cells of the

bone marrow, including estrogen-induced ane- cally prepared. This procedure will introduce a
mia, neoplasia, and adrenal gland disease. Animals needle into the abdomen, so it is vital that sterile
with a nonregenerative anemia, thrombocytopenia, techniques be followed closely.
leukopenia, or pancytopenia are good candidates The spleen can be immobilized by grasping
for this diagnostic procedure. it through the skin and holding it between the
There are a number of sites that can be used to thumb and index finger. A 22- to 25-gauge needle
collect a bone marrow sample (humeral, femur, fastened to a 3 ml syringe can be used to collect
iliac crest); however, the proximal femur and proxi- the sample. The needle should be inserted into the
mal tibia are the most frequently used sites because spleen and negative pressure applied by rapidly
of accessibility. Ferrets undergoing a bone marrow pulling the plunger back several times. The nee-
aspiration should be given general anesthesia. For dle should be removed from the spleen and the
the proximal femur bone marrow aspirate, place sample prepared for cytology. Remember that
the ferret into lateral recumbency and shave the fur the sample is in the needle, and pulling back on
over the proximal femur. The site should be asepti- the plunger, once the needle is removed from the
cally prepared using an appropriate antiseptic, and spleen, can result in the sample being pulled into
the procedure should be performed using sterile the syringe and lost. Always remove the needle
techniques. The veterinarian will make an incision, from the syringe, then pull air into the syringe,
using a #15 scalpel blade, over the greater trochan- refasten the needle, and spray the sample onto
ter of the femur. A 20- or 22-gauge 1–1.5" spinal microscope slides. Different types of stains can be
needle can be inserted into the femur to collect the used to evaluate the slides (e.g., Diff Quik, Gram
sample. A 6 ml syringe can be fastened to the spi- stain), so it is important to ascertain which stains
nal needle to aspirate the sample. For the proximal the laboratory or pathologist reading the cytology
tibia, the same restraint, site preparation technique, prefers.
and equipment can be used. The landmark for the
tibia is the tibial plateau. The needle can be inserted Urine Collection and Interpretation
in a slight posterior direction so that it will slip into The collection of uncontaminated urine is essen-
the medullary cavity of the tibia. tial to evaluating the true status of a sample.
Free-catch urine samples are often contaminated
Splenic Aspirate with bacteria and can be misinterpreted by the
Splenomegaly is a common finding in adult fer- novice. Fortunately, cystocentesis can be per-
rets. A splenic aspirate is a relatively noninvasive formed relatively easily on an unanesthetized
technique compared with biopsy, and can be ferret. The animal should be placed in dorsal
used to collect a sample for cytology. It is impor- recumbency and the ventral abdomen aseptically
tant for clients to understand, however, that this prepared. The urinary bladder is located cranial
technique can lead to seeding the abdomen with to the pelvis and should be identified prior to
cancerous cells. Animals that are fractious should attempting this procedure. If the bladder cannot
be anesthetized to prevent splenic laceration. The be palpated, it is best to delay the procedure until
ferret should be restrained in right lateral recum- sufficient urine accumulates within the bladder.
bency, and the left side of the body wall in the Using your index finger and thumb, gently grasp
area of the spleen should be shaved and asepti- the abdomen in the area of the bladder and move
3 | Ferrets 93
your hand in a cranial to caudal motion. The sterile water or saline is infused through the tip of
urinary bladder should palpate like a water-filled the catheter while searching for the urethra to facili-
balloon. A 25-gauge needle fastened to a 3 or 6 ml tate the dilation of the urethral tip.
syringe can be used to collect the sample. Isolate Ferret urine should be yellow and have little
the bladder between your index finger and thumb turbidity (Table 3.4). These animals are true car-
and insert the needle perpendicular to the body nivores and should have a urine pH between 6.5
wall. Maintain a steady hand and prevent exces- and 7.5.9 Animals with alkaline urine might be
sive movement of the needle within the abdomen. predisposed to calculi formation. There should be
Urinary catheterization can also be used to col- no blood or bacteria from a sample collected via
lect a urine sample, but this procedure is difficult cystocentesis or catheterization.
in ferrets and requires anesthesia. In the female,
the urethral opening is located approximately 1 cm Radiology
cranial to the clitoral fossa.8 A vaginal speculum Radiographs serve as an important diagnostic tool
can be used to visualize the urethral opening and in ferret medicine. Standard safety protocols should
introduce an appropriate-sized catheter (e.g., 3.5 be employed when radiographing ferrets. Fer-
French). This procedure is best performed with the rets should be anesthetized to ensure that quality
ferret in sternal recumbency with the caudal half of radiographs are taken. Isoflurane is the anesthetic
the body elevated (e.g., place a rolled towel under of choice. A ferret radiographic technique chart
the abdomen). In the male, the penis must be gently should be established based on the capabilities of
exteriorized from the prepuce. An appropriate-sized a facility’s radiographic machine. A high-capacity
catheter (e.g., 3.5 French) can be introduced into radiographic unit capable of producing 300-mil-
the urethra and sutured to the skin to maintain ure- liampere exposures at times of at least 1/60th of
thral patency. This procedure is best performed with a second is recommended. The kilovoltage peak
the ferret in dorsal recumbency. Identifying the tip (kVp) settings should be adjustable by increments of
of the urethra can be difficult in hobs, especially 2 to provide finite detail. A thorough understand-
if there is pathology associated with this structure. ing of ferret anatomy is essential to radiographic
Some veterinarians have used a technique whereby interpretation.
Table 3.4 Urinalysis Results in the Ferret6

Determination Male Female
Color Yellow Yellow

Turbidity Minimal Minimal
Volume (ml/24 h) 26 (8–48) 28 (8–140)
Sodium (mmol/24 h) 1.9 (0.4–6.7) 1.5 (0.2–5.6)
Potassium (mmol/24 h) 2.9 (1.0–9.6) 2.1 (0.9–5.4)
pH 6.5–7.5 6.5–7.5
Protein (mg/dl) 7.0–33.0 0–32.0

Parasitology should be submitted for a saline direct smear and a

External Parasites fecal float for kits at the time of their initial exami-
Ear mites (Otodectes cynotis) are a common finding nation and for adult animals on an annual basis.
in ferrets, especially kits. Animals with ear mites Ferrets are susceptible to Dirofilaria immitis,
will often present with a thick, brown discharge in and animals in heartworm-endemic areas should
the ear. Owners often complain that the animal be tested and given a heartworm preventive.
shakes and scratches at its ears. A cotton-tipped Diagnosis of heartworm disease in ferrets can be
applicator dipped in mineral oil can be used to difficult. The two most commonly used diagnostic
collect a sample from the ear for diagnosis. The tests in veterinary clinical practice are the Knott’s
sample should be placed onto a glass slide and test and the enzyme-linked immunosorbent
evaluated under light microscopy. assays (ELISA). The Knott’s test is used to diag-
Fleas that parasitize dogs and cats can also nose circulating microfilaria, and the ELISA test
prey on ferrets. Ferrets with a flea infestation will is used to diagnose circulating antigens produced
often present with a history of pruritis and tail by gravid female worms. Sensitivity of these tests
base alopecia. On close examination of the ani- is often lower in ferrets than in canids, because
mal, the fleas or their feces (“flea-dirt”) will be adult worm burdens are low (e.g., 1 worm) or
obvious. Kits or severely compromised adult ani- occult (e.g., same sex) in ferrets. With the limita-
mals can become severely anemic if they have a tions of the currently available heartworm tests,
heavy flea burden. In these cases, a minute blood echocardiography might provide a more definitive
sample (<0.1 ml) can be collected and a packed and consistent approach to heartworm disease
cell volume determined. Animals with a packed diagnosis in the ferret.
cell volume less than 15% might require a blood
transfusion. Flea eradication is similar to that per-
VACCINATIONS
formed for cats, and the owner should be made
aware of the importance of treating both the ani- Canine distemper virus (CDV) is associated with
mal and the environment. high mortality in affected ferrets. Ferret own-
Ferrets maintained outdoors might be suscep- ers should be made aware of the risks of this
tible to fly-strike, especially if they have a skin disease and the likelihood of exposure, even to
laceration. Animals maintained outdoors should be indoor animals. Vaccination is the best protection
monitored closely for any injuries and the animal against infection. The preferred vaccine against
given shelter and protection against flies. Animals CDV in ferrets is the Purevax ferret distemper
that develop a maggot infestation should have the vaccine (Merial Inc., Athens, GA). This vaccine is
site shaved, maggots removed, and a topical antisep- a canarypox-derived vaccine and appears to have
tic cream applied to protect the injury site. fewer side effects than canine combination or
ferret-cell origin vaccines. The vaccine should be
Internal Parasites administered subcutaneously in the area between
Gastrointestinal parasitism is uncommon in fer- the shoulder blades or over one of the rear legs.
rets. Ferrets allowed to play outdoors are more The site of the injection should be recorded in case
likely to develop a patent parasite infection than a reaction is noted. The standard CDV vaccine
animals maintained indoors. A fecal sample protocol for a kit should include a vaccine at 6
3 | Ferrets 95
weeks, 10 weeks, and 14 weeks. A booster vaccine chloride at 0.5–2.0 mg/kg, IM or IV.4 When the
should be administered annually to adult ani- postvaccination reaction becomes life-threatening
mals. Ferrets >12 weeks of age with an unknown (e.g., severe dyspnea from inflammation in the
vaccine history should be given 2 vaccinations 3 airway), a potent steroid (e.g., prednisone or dexa-
weeks apart to stimulate an appropriate humoral methasone) and oxygen should be given. Animals
response. that have had a previous vaccine reaction should be
Ferrets are susceptible to rabies and should premedicated with oral diphenhydramine hydro-
be vaccinated against this devastating disease. chloride 15 minutes prior to the vaccination. As
There is one USDA-approved vaccine (Imrab 3, a matter of protocol in some veterinary practices,
Rhone-Merieux Inc., Athens, GA) for use in fer- all ferrets are premedicated with diphenhydramine
rets. The rabies vaccine should be administered to hydrochloride prior to being vaccinated. In addi-
a kit at ≥12 weeks of age and a booster adminis- tion, it has been recommended that only one vaccine
tered annually. The vaccine can be administered per visit be given to ferrets to limit the occurrence
subcutaneously or intramuscularly, and adminis- of vaccine reactions. In cases when the veterinarian
tration should align with local rabies ordinances. or client is concerned about the severity of a vaccine
Again, the vaccination site should be recorded in reaction in a ferret, alternatives to vaccination, such
case vaccine reactions are noted later. Vaccinated as monitoring antibody titers, can be done.
ferrets are currently protected under the same
statutes as dogs and cats, whereas an unvacci-
THERAPEUTICS
nated ferret should be managed as a wild animal
under circumstances of questionable rabies expo- There are no approved therapeutics for the ferret
sure. Ferret owners should be made aware that, in the United States. Current recommendations
by law, unvaccinated ferrets that bite a human are should follow those described for cats. The same
supposed to be treated like a wild animal, which routes of administration apply, including per os
could include euthanasia for rabies testing. (PO), subcutaneous (SC), intramuscular (IM),
Postvaccination hypersensitivity reactions are intraosseus (IO), and intravenous (IV). Animals
not an uncommon occurrence in ferrets. These that are critical require routes of administration
hypersensitivity reactions have been reported fol- that provide rapid drug delivery, such as IM, IO,
lowing single vaccinations, especially with some or IV, whereas less critical animals can be given
of the former ferret distemper vaccines (Fervac-D, therapeutics PO or SC. Intravenous injections
United Vaccine, Madison, WI), and vaccinations should be administered through an IV catheter
combining a distemper vaccine and rabies vaccine. to limit the likelihood of perivascular contamina-
Ferrets that experience a hypersensitivity reaction tion. The preferred site for IV catheterization is the
might develop gastrointestinal signs, includ- cephalic vein (Figure 3.9); however, if it is not pos-
ing vomiting and diarrhea, become dyspneic, or sible to catheterize this vein, the lateral saphenous
develop other systemic signs (e.g., depression, vein or jugular vein can also be used to provide
lethargy, and erythematous skin). IV access. Intraosseus injections can be given into
Treatment of a ferret experiencing a vaccine the femur or tibia. It should be noted that catheter
reaction should follow the standard protocol for placement into the tibia is more direct than into
mammals and include diphenhydramine hydro- the femur. Intramuscular injections are routinely

Figure 3.9 Ferret cephalic vein. Illustration by Michael L. Broussard.
administered into the epaxial muscles along the rate is especially important to consider in patients
spine or in the muscle bellies (e.g., quadriceps or that are not eating or drinking. Animals that are
hamstring: semimembranosus, semitendinosus, mildly dehydrated (<5%) can be administered flu-
biceps femoris) of the rear limbs. ids PO or SC, whereas an indwelling IV or IO
The muscle masses of the ferret limb are relatively catheter should be placed in any animal that is
small in comparison with those of other mam- greater than 5% dehydrated.
mals; therefore, the volume of the injection should Intraperitoneal delivery of fluids can also be con-
be limited. It is very difficult to orally administer sidered for more critical cases where IO or IV access
tablets or capsules to a ferret. Fortunately, there might not be possible. Fluids should not be admin-
are a number of commercial pharmacies that can istered orally to any animal with gastrointestinal
compound oral therapeutics into flavored liquids disease. Giving fluids to a patient with delayed gas-
to simplify delivery of the drug. trointestinal emptying or diarrhea could exacerbate
Fluid administration protocols for ferrets these disease conditions. Subcutaneous fluids can be
should follow those described for dogs and cats. administered in the SC space between the shoulder
The fluid maintenance rate for ferrets is 80–100 blades or along the lateral body wall. The cephalic
ml/kg/day. It is important to recognize that fluid and lateral saphenous veins are routine sites for cath-
replacement in a ferret, or in any vertebrate for eter placement.
that matter, should include both the daily main- The jugular vein can also be used if the other ves-
tenance needs of the patient and a correction for sels become unavailable. Ferrets that are alert and
its deficit (% dehydrated). The daily maintenance responsive will require sedation for this procedure,
3 | Ferrets 97
which can be accomplished by masking the animal Ferrets that are very active and chew at the catheter
with isoflurane anesthesia. A moribund animal will might require an Elizabethan collar, which is com-
not require sedation. The animal should be placed in mercially available or can be fashioned from exposed
sternal recumbency for cephalic catheter placement, radiographic film. The catheter should be flushed
although the animal may be placed into lateral regularly (e.g., q4h) with 0.9% heparinized saline.
recumbency for lateral saphenous catheterization. The animal should be observed regularly to ensure
One individual will need to “hold off” the vessel by the catheter remains patent and the animal does not
grasping the animal at the elbow for the cephalic become entangled in its fluid line.
vein and above the hock for the lateral saphenous Blood transfusions might be required in ani-
vein. IV catheters often become damaged when mals with severe anemias (PCV <15%). Because
they are inserted through tough skin. To avoid this ferrets lack distinct blood groups, they can be used
problem, make a puncture in the skin lateral to the as universal donors. Blood can be collected from an
vessel using a 22-gauge needle. A heparinized 22- to anesthetized blood donor from either the jugular
24-gauge catheter can be introduced into the skin vein or anterior cranial vena cava, using a 23-gauge
puncture and threaded into the vessel. An injec- butterfly catheter fastened to a 6 or 12 ml syringe.
tion port should be fastened to the catheter, and the The syringe should be preloaded with an anticoagu-
device can be secured to the animal’s leg using tissue lant (e.g., acid-citrate dextrose) at a ratio of 1 ml of
glue and appropriate bandage material. anticoagulant to 6 ml of blood.10 The blood should
Placement of a tongue depressor splint can reduce be administered to the recipient animal via a syringe
the likelihood of catheter failure. To do this, place pump or slow bolus through a cephalic or jugular
a tongue depressor on the posterior aspect of the catheter. The animal should be observed for any
forelimb. Measure the distance from the toes to reactions to the transfusion. The volume of blood
the elbow. Cut the tongue depressor to fit this dis- that can be collected from the donor and the volume
tance. Trim the cut end to minimize the potential required by the recipient can be determined using
for splinters. Secure the tongue depressor to the limb the formulae described in small animal medicine.
with tape, and then incorporate it into the bandage.
Table 3.5 Injectable Analgesic and Anesthetic Dosages for the Ferret11
Drug Dose Comments
Ketamine 10–20 mg/kg IM Tranquilization

30–60 mg/kg IM Anesthesia
Ketamine and Acepromazine 20–25 mg/kg (K) IM Anesthesia
0.2–0.35 mg/kg (A) SC, IM
Ketamine and Diazepam 10–20 mg/kg (K) IM Anesthesia

1–2 mg/kg (D) IM
Ketamine and Xylazine 10–25 mg/kg (K) IM Anesthesia

1–2 mg/kg (X) IM Avoid in sick animals
Butorphanol 0.1–0.5 mg/kg IM q12h Analgesia
Buprenorphine 0.01–0.03 mg/kg SC, IM q12h Analgesia

SURGICAL AND ANESTHETIC Surgical preparation of the ferret should follow

ASSISTANCE the same protocols described for dogs and cats.
The surgical site should be shaved, using a stan-
A variety of anesthetic agents can be used for ferrets
dard grooming clipper at a slow, cautious speed to
(see Table 3.5), although the inhalant anesthetics
prevent clipper burn and tearing of the skin. The
are by far the most commonly used. Injectable
shaved area should be uniform and provide the sur-
anesthetics can be used to preanesthetize the ani-
geon ample room to perform the surgery without
mal or in situations where an inhalant anesthetic
the risk of contamination (Figure 3.11). The surgical
is not available. For procedures that will induce
site should be aseptically prepared, using a surgical
pain, an appropriate analgesic protocol should be
established. Ferrets, like other mustelids, are very
responsive to opioids (e.g., butorphanol, 0.05–0.3
mg/kg intramuscular).
Ferrets should be fasted for a minimum of 4
hours prior to an anesthetic procedure, although
special precautions should be taken (e.g., IV dex-
trose) for an animal susceptible to a hypoglycemic
episode (e.g., ferret with insulinoma). A water
source can be left with the ferret up to the time
of the procedure. Ferrets should be maintained
on a water-recirculating heating pad during any
anesthetic procedure and recovered in a warmed
Figure 3.10. Ferrets can be “masked down” with iso-
environment to prevent hypothermia.
flurane or sevoflurane.
For short procedures, such as venipuncture or
radiography, inhalant anesthetics can be used to
facilitate sample collection. Ferrets can be “masked
down” using an appropriately sized mask, or placed
into an induction chamber and anesthetized (Fig-
ure 3.10). Inducing anesthesia via face mask at 5%
isoflurane or 8% sevoflurane expedites the process
of getting the animal through the sedation phase,
which is the time they struggle. Once the ferret
has lost its righting reflex, it can be maintained at
1%–2% isoflurane or 2%–3% sevoflurane. Anes-
thetized ferrets should be intubated to gain control
over their respiration. Ferrets can be intubated using
Figure 3.11 It is important to create an appropriately
a 2.0 to 4.0 mm OD endotracheal tube, depending
sized sterile field for a surgical procedure; the size of the
on their size. A laryngoscope can be used to visualize field will vary depending on the procedure. The surgi-
the airway. The animal should be monitored closely cal approach for a ferret with insulinoma and adrenal
during the procedure using appropriate equipment gland disease should include the area between the ma-
(e.g., Doppler, pulse oximeter, and EKG). nubrium of the sternum and cranial pelvis.
3 | Ferrets 99
scrub and warmed sterile saline. Avoid using alcohol procedure. The techniques used to remove a gas-
to prepare the surgical site because it can result in tric foreign body (e.g., endoscopy, gastrotomy) or
significant heat loss. The surgical site should be cov- small-intestine foreign body (enterotomy) should
ered with a sterile drape until the surgeon begins. follow protocols described for domestic species.12,13
The surgical instruments used to perform surgery
on dogs and cats can also be used for ferrets. Gastric Ulcers
Gastric ulcers are often reported in ferrets that
experience chronic stress. A number of different
etiologies have been associated with gastric ulcers
Gastrointestinal Diseases in the ferret, including primary gastritis, neopla-
See “Emerging Diseases,” below, for information sia, infection (e.g., Helicobacter mustelae), foreign
on other common gastrointestinal diseases. body ingestion, and inappropriate drug use (e.g.,
corticosteroids). Ferrets that present with gastric
Ingestion of Foreign Bodies ulcers are often inappetent, vomiting, and have
The curious nature of the ferret, in combination melena or diarrhea. Many of these animals also
with its voracious appetite, is likely the reason why grind their teeth and hypersalivate, symptoms
it ingests foreign material. Ferrets should always be that appear to be associated with upper gastro-
monitored closely when they are outside of a cage. intestinal pain. Diagnosis of gastric ulcers should
Kits are notorious for ingesting foreign material, follow standard protocol. A complete blood count
including metal, paper, and plastic, whereas adults and serum chemistry panel should be performed
are more likely to develop trichobezoars. Taking to evaluate the animal’s general health. Animals
time to ask the client about the different types of with chronic gastric ulcers could be anemic. Sur-
material a ferret might be exposed to in its envi- vey radiographs can be beneficial in identifying
ronment can be helpful when pursuing these potential causes of the gastric ulcer. Endoscopy
cases, especially if the material is not radiopaque can be used to visualize the ulcers and collect
(e.g., plastic). Affected ferrets might exhibit leth- biopsies for culture and histopathology. This
argy, inappetence, vomiting, or diarrhea. The technique is preferred when attempting to deter-
degree to which they express certain clinical signs mine if an animal has H. mustelae. Ferrets should
will vary based on the location and extent of the fast for at least 3 hours before the technician
obstruction (e.g., partial vs. complete). The veteri- performs radiographs or endoscopy to ensure no
narian will thoroughly evaluate ferrets suspected food remains in the stomach. Treatment for gas-
of ingesting a foreign body by performing a physi- tric ulcers depends on the etiology. In cases when
cal examination and surveying radiographs. In a biopsy is not possible, empirical therapy is initi-
some cases, the foreign material and secondary ated that includes antibiotics (metronidazole and
gas accumulation (e.g., ileus) will be palpable. A amoxicillin), an H2 antagonist, and a gut protec-
contrast series might be necessary if the suspected tant such as sucralfate.
foreign material is not evident on survey radio-
graphs. Surgical correction is necessary to remove Respiratory Diseases
the foreign material. The veterinary technician Ferrets are susceptible to many of the same respi-
should stabilize the surgical candidate prior to the ratory infections that are common to dogs and

cats. Animals that develop clinical signs associ- enza virus (H5N1) and swine (H1N1) influenza
ated with respiratory disease, such as coughing, virus. The human influenza virus primarily affects
sneezing, and dyspnea, should undergo diagnos- the upper respiratory system of ferrets, and clini-
tic testing in accordance with those described in cally ill animals might exhibit signs of sneezing,
other species. coughing, difficulty smelling (nasal discharge and
Ferrets are susceptible to canine distemper not using olfaction as they normally would), inap-
virus, with mortalities approaching 100%. This petence, and lethargy. Humans can infect their
virus replicates in the respiratory tract of the ferret, pets and vice versa. Diagnosing this viral infec-
and affected animals develop a chronic cough.14 tion in ferrets is not commonly done; instead,
Anorexia, lethargy, and pyrexia are also common affected animals are provided supportive care (e.g.,
findings, especially early in the development of fluid therapy, enteral support, antibiotics against
clinical signs. Ferrets with canine distemper can secondary bacterial infections), and a presumed
also develop symptoms associated with the skin diagnosis comes through a response to therapy.
(e.g., crusting under the chin and hyperkeratosis of Affected animals should also be kept away from
the footpads) (Figure 3.12), eyes (e.g., blindness), infants, the elderly, and those individuals with
and the central nervous system (e.g., incoordina- reduced immune function. The H5N1 (avian) and
tion). Diagnosis is typically achieved in animals H1N1 (swine) influenza viruses can also cause
with clinical disease by submitting fecal samples severe systemic disease in ferrets, ultimately lead-
for polymerase chain reaction testing. Treatment ing to their death.
is unrewarding, and affected animals should be
humanely euthanized. Prevention can be achieved Neoplasia
through routine vaccination (see “Vaccinations”). Neoplasia is a common finding in ferrets and can
Ferrets are susceptible to the human influenza affect any age group.15 The most common neoplas-
virus, as well as the highly pathogenic avian influ- tic diseases reported in ferrets are adrenal gland
neoplasia, insulinoma, and lymphoma. Adrenal
gland disease seems to be by far the most common
disease presentation for adult ferrets, with insuli-
noma being the second most common presentation
among adult animals. There are a number of poten-
tial etiologies for the high incidence of neoplasia
in ferrets, including genetics, early-age spay/neu-
tering, diet, photoperiod, and infectious agents; to
date, no specific cause has been identified.
Adrenal gland disease is most commonly diag-
nosed in adult ferrets (>3 years of age). Currently,
there is no documented sex predilection associated
with the disease. Ferrets affected with adrenal gland
disease often present with focal or generalized alo-
Figure 3.12 This ferret was diagnosed with CDV. pecia, pruritis, thinning of the skin, and weight
Note the severe hyperkeratosis of the footpads. loss. A majority of the animals remain active with
3 | Ferrets 101
Figure 3.13 The ferret prostate, when enlarged, can easily be palpated. Hobs with an enlarged pros-
tate often present for stranguria. Illustration by Michael L. Broussard.
the disease. Hobs that are affected with adrenal noted in them. In both genders a pancytopenia
gland disease can develop secondary prostatic might develop. To diagnose adrenal gland disease,
disease, which can affect their ability to urinate a series of diagnostic tests should be performed,
(Figure 3.13). In severe cases, hobs can present for including a complete blood count, chemistry
stranguria; clients might complain that the ferret panel, radiographs, ultrasound, and measure-
acts as if it wants to urinate, but can’t. These ani- ment of steroid hormone concentrations. Current
mals will often vocalize as they strain because of recommendations for treatment of adrenal gland
the pain associated with their inability to evacu- disease focus on surgical intervention as the best
ate their bladder. Because ferret adrenal gland chance for eliminating the cancer, although some
disease is associated with increased production successful medical therapies (e.g., leuprolide ace-
of sex hormones, hobs might also display sexual tate) have been reported. Adrenal gland neoplasia
aggression (e.g., aggression toward or attempts is most commonly identified in the left adrenal
to mount other ferrets). Jills with adrenal gland gland, but can occur in both glands. It is not
disease often develop a swollen vulva, and sexual uncommon to perform a unilateral adrenalectomy
behaviors (e.g., standing for coitus) might also be (Figure 3.14) only to have the contralateral gland

Figure 3.15 Insulinoma in a ferret. Note the nodular

appearance of these tumors.
Figure 3.14 An enlarged left adrenal gland at sur-
gery. This tumorous gland was removed and submitted unnecessary. Survey radiographs and ultrasounds
for histopathology. Final diagnosis: adenoma. rarely prove to be diagnostic, but can be useful
in identifying concurrent problems such as adre-
be affected later. Biopsy/histopathology of the nal gland disease. Current recommendations for
affected gland(s) should be performed. Adrenal treatment are focused on surgical intervention,
gland hyperplasia, adenoma, and adenocarcinoma although medical therapies have been reported
are the most common histopathologic diagnoses with some success. Performing a nodulectomy
associated with adrenal gland disease in ferrets. does not guarantee remission of the neoplasia. In
The medical management of adrenal gland disease cases where the neoplasia recurs, medical man-
with leuprolide acetate is not curative, but will agement using prednisone and diazoxide might
alleviate clinical signs. Clients opting to pursue be considered. Some ferrets have lived up to 3
medical management should be informed that the years postdiagnosis through medical manage-
treatment is lifelong and that it will not eliminate ment alone.
the cancer, thus a lapse in therapy will result in Lymphoma is the most common tumor in
the return of clinical signs. young ferrets.15 Affected animals can be clini-
Insulinomas are another common tumor cally normal or might present with weakness,
found in adult ferrets and are often identified lethargy, generalized lymphadenopathy, sple-
concurrently in ferrets with adrenal gland dis- nomegaly, or dyspnea. Diagnosis of lymphoma
ease. These beta-cell tumors can coalesce to form should include a complete blood count, chemis-
gross nodules within the pancreas (Figure 3.15). try panel, radiographs, ultrasound, and biopsy of
Affected animals often present with a glassy- affected tissues. Treatment can be difficult and
eyed appearance, hind leg or general weakness, remission is likely. Most ferrets diagnosed with
hypersalivation (accompanied by pawing at the lymphoma rarely live for more than a year even
mouth), or seizures. Blood work, including a with treatment. There are a number of different
fasting blood glucose, insulin level, complete chemotherapeutic protocols that can be used to
blood count, and chemistry panel, should be treat an affected animal. The treatment protocol
performed to confirm the diagnosis. If an ani- should be based on the animal’s condition and the
mal is suspected of being hypoglycemic, a fast is owner’s comfort level.
3 | Ferrets 103
Cardiovascular Diseases prevention is key. Ferrets can be placed on the

Dilated and hypertrophic cardiomyopathies have same preventives used for dogs and cats (adjusted
been reported in ferrets. Affected animals often for weight).
present with many of the same clinical signs
reported in dogs and cats, including weakness, Reproductive Diseases
lethargy, dyspnea, exercise intolerance, and hind Ferrets are induced ovulators and an intact jill that
leg weakness. A full cardiac diagnostic series is not bred can develop a life-threatening, estro-
should be performed to assess the animal’s condi- gen-induced anemia. Affected animals will have a
tion and should include a complete blood count, history of being intact and not bred, and will have
serum chemistry profile, radiograph(s), echocar- a swollen vulva, pale mucous membranes, and a
diograph, and EKG. Medical management of the history of weakness and lethargy. A blood sample
heart condition will vary depending upon the can be collected to assess the erythron and leu-
animal’s general physical condition upon presen- kon. In most cases, a pancytopenia will develop.
tation and the extent of the disease. Prevention is key, and any female ferret not being
Dirofilaria immitis, the parasite associated used for breeding should have an ovariohyster-
with heartworm disease in dogs and cats, can ectomy performed. Animals that are intended as
cause severe disease in ferrets. The majority of breeders and affected with the disease should be
the cases reported in ferrets are from the south- induced to ovulate and provided appropriate sup-
eastern United States, where mosquitoes can portive care, including fluid therapy and a blood
be active year-round; however, this disease can transfusion, if necessary.
occur in ferrets anywhere it is found in dogs and
cats. Being housed indoors is protective, but does Urogenital Diseases
not ensure an animal will not become infected. Ferrets can develop urolithiasis if they are main-
Heartworm infestations in ferrets are typically at tained on a low-quality cat or dog food. Magnesium
a lower worm burden (1–4 worms) than those in ammonium phosphate is the most common uro-
dogs, but the pathology is more severe because lith identified in the ferret.16 Cystitis might also be
of the small size of the ferret heart. Affected identified in animals with urolithiasis and should
animals often present with lethargy, depression, be managed accordingly. A thorough diagnostic
weakness, rear leg paresis, and exercise intoler- screening should be performed on affected ani-
ance. Unfortunately, by the time most affected mals and should include a complete blood count,
animals present, the disease is severe. Confirma- chemistry panel, radiograph(s), urinalysis, and
tion of heartworm disease can be made in ferrets urine culture. Affected animals often have alkaline
using a Knott’s test (although a rare occurrence, urine as a result of a predominance of plant-based
ferrets can have patent infections with micro- proteins in their diet, whereas an animal offered a
filaria), ELISA heartworm tests, radiographs, high-quality, meat-based diet will have an acidic
and ultrasound. Ultrasound is often the test of urine (normal). In males a blockage of the urethra
choice, because it allows the veterinarian to see should be considered an emergency, and immediate
the parasites within the heart. Treatment is diffi- steps should be taken to remove the offending cal-
cult because of the potential for thromboembolic culi. In severe cases, surgical removal of the uroliths
disease. Because of the severity of this disease, might be required.

Renal cysts are an incidental finding often Emerging Diseases

reported at necropsy.17 A specific etiology for renal There are several recent diseases that appear to be
cysts has not been determined. On occasion, renal emerging in captive ferrets. Unfortunately, there
cysts will be identified on routine examination, is much we do not know about these diseases, so
survey radiographs, or ultrasound. A thorough it is important to record and share these findings
diagnostic workup, including an analysis of blood with others. By disseminating new knowledge we
and urine, should be performed to determine if will be able to further elucidate the epidemiology
the animal has any renal compromise as a result of these diseases and establish preventive methods
of the renal cysts. to minimize their dissemination into captive pop-
ulations and design effective treatments.
Bacterial Diseases Ferret enteric coronavirus has been associated
Ferrets are susceptible to opportunistic Gram- with epizootic catarrhal enteritis, a severe disease in
positive and Gram-negative pathogens. Kits and ferrets characterized by severe dehydration, a green-
geriatric animals are typically more susceptible to mucoid diarrhea, and death. The disease tends to
bacterial pathogens than a healthy adult animal. be introduced into established ferret households by
Animals being maintained on immunosuppressive newly introduced kits that are carriers. A variant of
doses of corticosteroids (e.g., high doses of pred- this virus appears to be associated with a feline infec-
nisone for insulinoma treatment) are also more tious peritonitis (FIP)–like disease in ferrets (ferret
susceptible to opportunistic infections. Sample col- infectious peritonitis).18 The systemic disease in fer-
lection should follow standard sterile techniques. A rets is characterized by widespread dissemination of
commercial sterile culturette and transport media the virus; two of the more interesting findings are
can be used to collect samples and protect them generalized nodules throughout the abdomen and
from desiccation during transport to a diagnostic abdominal masses (palpable on examination). Cur-
laboratory. Standard microbial techniques can be rently there is no effective treatment for this disease;
employed to isolate a potential pathogen. Most however, some veterinarians are using some of the
opportunistic infections are associated with aerobic treatments used for cats with FIP.
infections; however, in certain abscesses facultative Disseminated immunopathic myositis is a
or obligate anaerobic organisms should be consid- disease that tends to affect young ferrets (kits to
ered. Helicobacter mustelae are Gram-negative rods young adults).18 This disease is characterized by a
that are routinely cultured from gastric ulcers. Most fatal, inflammatory condition of the muscles. The
bacterial infections are associated with pneumonia, most common findings in affected ferrets are a
urinary cystitis, dermatitis, and diarrhea. A num- high fever (105°–108°F; 40.5°–42.2°C), anorexia,
ber of pathogens have been isolated from these and an inability to move. The etiology of this syn-
different organ systems, including Streptococcus drome is not known, and currently there is no
zooepidemicus and S. pneumoniae, E. coli, Klebsiella effective treatment.
spp., Pseudomonas spp., and Bordetella spp. Fungal Mycoplasmosis is a disease that is well-known
infections in ferrets are rare. In cases where a fungal in chelonians, birds, and rats. Recently, this dis-
infection is suspected, the techniques used to collect ease has also been reported in ferrets.18 Affected
and process samples employed in other domestic animals display typical signs for this pathogen,
species may be followed. including conjunctivitis, sneezing, wheezing,
3 | Ferrets 105
and coughing.18 In more severe cases the pathogen Other diseases that appear to be emerging in
can move from the upper to the lower respiratory ferrets remain classified based on clinical presen-
tract. A novel Mycoplasma spp. has been identified tation or diagnostic testing and require additional
in affected animals.18 Treatment for this disease research, including oral ulceration syndrome,
should include antimicrobials with good specific- acute hemorrhagic syndrome, and aplastic ane-
ity against Mycoplasma spp. and supportive care. mia/bone marrow hypoplasia syndrome.18
1. What are the terms used to define a male, female, and juvenile ferret?
2. What type of enclosure is appropriate for ferrets?
3. What type of diet should a ferret be provided?
4. What are some common grooming concerns for captive ferrets?
5. Describe how to properly restrain a ferret.
6. Describe how to examine a ferret.
7. What are some common venipuncture sites in a ferret? How much blood can you collect from a ferret?
8. What are some common ectoparasites found on ferrets?
9. Which vaccinations are considered essential in ferrets?
10. What are the different routes for replenishing fluids in a ferret patient?
11. What preanesthetic recommendations would you make to a client to minimize complications with
an anesthetic event?
12. What are two common gastrointestinal diseases of captive ferrets?
13. What are the common presenting signs of a ferret with adrenal gland disease?
14. What are the common presenting signs of a ferret with insulinoma?
15. Which parasite of dogs is also found in ferrets? How can you diagnose it?
16. Name three emerging diseases in ferrets.
REFERENCES
1. Rupprecht CE, Gilbert J, Pitts R, et al. Evaluation of an inactivated rabies virus vaccine in domestic
ferrets. Journal of the American Veterinary Medical Association 1990;193:1614–16.
2. Fox JG. Taxonomy, history and use. In: Fox JG, ed. Biology and diseases of the ferret. Philadelphia:
Lea and Febiger; 1988:3–13.

3. Brown SA. Basic anatomy, physiology and husbandry. In: Hillyer EV, and Quesenberry KE, eds.
Ferrets, rabbits and rodents: Clinical medicine and surgery. Philadelphia: WB Saunders; 1997:3–13.
4. Fox JG. Normal clinical and biological parameters. In: Fox JG, ed. Biology and diseases of the ferret.
Philadelphia: Lea and Febiger; 1988:159–73.
5. Bell J. Ferret nutrition and diseases associated with inadequate nutrition. Proceedings of the North
American Veterinary Conference, Orlando, FL, 1993:719–20.
6. Thorton PC, Wright PA, Sacra PJ, et al. The ferret, Mustela putorius furo, as a new species in toxicol-
ogy. Lab Animals 1979;13:119–24.
7. Kawasaki TA. Laboratory parameters in disease states in ferrets. Proceedings of the North American
Veterinary Conference, 1992:663–67.
8. Quesenberry KE. Basic approach to veterinary care. In: Hillyer EV, and Quesenberry KE, eds. Fer-
rets, rabbits and rodents: Clinical medicine and surgery. Philadelphia: WB Saunders; 1997:14–25.
9. Williams CSF. Practice guide to laboratory animals. St. Louis, MO: CV Mosby; 1976:66.
10. Hoefer, HL. Transfusions in exotic species. In: Hohenhaus AE, ed. Transfusion medicine. Philadel-
phia: JB Lippincott; 1992:625–35.
11. Brown SA. Ferret drug dosages. In: Bauck L, Boyer TH, Brown SA, et al., eds. Exotic animal for-
mulary. Lakewood, CO: American Animal Hospital Association; 1995:5–11.
12. Orsher RJ, and Rosin E. Small intestine. In: Slatter D, ed. Textbook of small animal surgery. Phila-
delphia: WB Saunders; 1997:593–612.
13. Van Sluys FJ. Gastric foreign bodies. In: Slatter D, ed. Textbook of small animal surgery. Philadel-
phia: WB Saunders; 1997:568–71.
14. Pearson RC, and Gorham JR. Viral disease models. In: Fox JG, ed. Biology and diseases of the ferret.
Philadelphia: Lea and Febiger; 1988:305–14.
15. Brown SA. Neoplasia. In: Hillyer EV, and Quesenberry KE, eds. Ferrets, rabbits and rodents: Clini-
cal medicine and surgery. Philadelphia: WB Saunders; 1997:99–114.
16. Hillyer EV. Urogenital diseases. In: Hillyer EV, and Quesenberry KE, eds. Ferrets, rabbits and
rodents: Clinical medicine and surgery. Philadelphia: WB Saunders; 1997:44–52.
17. Fox JG. Systemic diseases. In: Fox JG, ed. Biology and diseases of the ferret. Philadelphia: Lea and
Febiger; 1988:255–73.
18. Johnson-Delaney K. Emerging ferret diseases. Journal of Exotic Pet Medicine 2010;20:1–4.
Further Reading
Fox JG. Anesthesia and surgery. In: Fox JG, ed. Biology and diseases of the ferret. Philadelphia: Lea and
Febiger; 1988:289–30.
Heard DJ. Principles and techniques of anesthesia and analgesia for exotic practice. Vet Clinic of North
Am/Small Animal Practice 1993;23:1301–27.
Hillyer EV, and Brown SA. Ferrets. In: Birchard SJ, and Sherding RG, eds. Saunders manual of small
animal practice. Philadelphia: WB Saunders; 1994:1317–44.
Rabbits
Chapter 4
INTRODUCTION
One of the most common misconceptions regarding rabbits is that they

belong to the order Rodentia, which includes mice, rats, and guinea pigs.
Rabbits belong to the order of animals called Lagomorpha, which also
includes hares and pikas. Rabbits differ from mice, rats, and guinea pigs
because they have a second pair of underdeveloped smaller peg teeth directly
behind the primary incisors, which rodents do not have. This classifica-
tion difference is important to point out in the beginning of this chapter,
because rabbit husbandry and health concerns are very different from those
of rodents. Many rabbits are obtained through impulse purchases during the
spring and Easter season. Often these impulse purchases do not include edu-
cation on proper husbandry, nutrition, or health maintenance. It is hoped
that new rabbit owners will schedule an appointment with a veterinarian
for a routine health examination and, most importantly, receive an educa-
tion during the visit on the requirements for maintaining a healthy, happy
pet. Frequently, an owner will ask questions regarding the basic physiologic
values of their new pet rabbit. It is important for the technician to know the
normal physiologic values not only to answer owners’ questions, but also
to assess the patients’ health status upon presentation to the clinic and to
administer medical therapy (Table 4.1).
Anatomy and Physiology

The technician needs to become familiar with a few areas of rabbit-specific
anatomy. It might seem that rabbits are very docile animals. Although rab-
bits can be very gentle, they are territorial and will mark and viciously defend
their territory. The chin glands, anal glands, and inguinal glands are used to
mark territory and young. Males mark most often, followed by dominants
of both sexes over subordinates.1 The scrotal sacs are cranial and lateral to

Table 4.1 Rabbit Basic Information1

General Category Classification Physiologic Parameters
Body Weight Adult Male (Buck) 2–5 kg

Adult Female (Doe) 2–6 kg
Birth Weight (Bunny) 30–80 g
Temperature, Pulse, Rectal Body Temperature 101.3°–104°F
and Respiration
Normal Heart Rate 180–250 beats/minute
Normal Respiratory Rate 30–60 breaths/minute
Amounts of Food and Water Daily Food Consumption 50 g/kg
Daily Water Consumption 50–150 ml/kg
Daily Urine Excretion 10–35 ml/kg
Age at Onset of Puberty Sexual Maturity, Male 22–52 weeks

and Breeding Life
Sexual Maturity, Female 22–52 weeks
Breeding Life, Male 60–72 months
Breeding Life, Female 24–36 months
Female Reproductive Cycle Estrous Cycle Induced ovulation

Estrus Duration Prolonged
Ovulation Rate 6–10 eggs

Pseudopregnancy 16–17 days
Gestation Length 30–33 days
Litter Size 4–12 bunnies
the urethral opening, which in many cases is near that provides protection to the plantar surface of
or over the anus. The penis can be pushed out of the foot. In the “Rex” breed this fur is absent,
the urethral opening by applying gentle pressure which predisposes these animals to sore hocks.
to the base of the prepuce. This fur has developed to protect the feet in the
The female might have a large “dewlap” or rabbit’s natural habitat, not in wire-bottomed
fold of skin under her chin. During nesting, the cages. Large, obese rabbits can develop sores on
female sometimes removes hair from the dewlap the ventral surface of their hocks, because that
as a source of soft nest material. The external part of the leg is in contact with the cage surface
genitalia are cranial to the anus, and the urogeni- when they are resting.
tal orifice is located between the folds of skin at Owners and rabbit handlers must be cautious
this site. The ears make up a large percentage of of the sharp claws, especially the claws on the rear
the rabbit’s body. At no time should the animal legs. When struggling, a rabbit will kick forward
be picked up by the ears. Regarding other parts with the rear legs and scratch, sometimes severely,
of the rabbit’s body, they have footpads like cats, an unprepared holder. Declawing rabbits is not
dogs, and rodents. Their feet are covered with fur recommended. The underlying tissue support and
4 | Rabbits 109
footpads are not present to aid and protect the foot

when healing. Sharp claws should be trimmed to
blunt the sharp points, or the plastic rubberized
Soft-Paws can be used (Figure 4.1).
HUSBANDRY
Pet rabbits are very sensitive to heat. When edu-
cating a rabbit owner, emphasis must be placed on
their pet’s intolerance to heat. It would be most
appropriate to give owners this information in the
spring, when many of these pets are purchased.
They have a well-developed hair coat that pro-
tects them against cold weather, but they quickly
overheat when environmental temperatures are
high. When a rabbit is housed outside in a nonair-
conditioned house or apartment or in a car (when
traveling), the owner must implement precautions
to prevent hyperthermia. The rabbit should not be
Figure 4.1 Soft-Paws can be placed on a rabbit’s
maintained in outdoor temperatures over 90°F or claws to diminish its ability to scratch its owner.
humidity over 90%. Common housing precautions
against heat stress include providing a shaded enclo-
sure (roof or natural setting), placing 2-liter soda nature of a natural hunter when a prey animal (the
bottles filled with frozen water in the cage, keeping rabbit) is observed. If rabbits are allowed to roam
the rabbit in an air-conditioned room during the the house, plants and electrical cords need to be
summer months, and providing a fan for an animal removed or made inaccessible. These animals
housed outside. During the winter months, when can maneuver behind furniture and “dig” under
humans need extra clothing, pet owners might erro- rugs; hiding cords under rugs does not prevent
neously assume that extra measures are needed to the rabbit from gnawing on them. The recom-
keep their pet rabbits warm. If a plywood “house” mendation for allowing pet rabbits to roam free
is placed in the animal’s enclosure and lined with within a given area includes making it impossible
hay, this should protect the animal in temperatures for the rabbit to escape, and observing the animal
down to 32°F (Figures 4.2A, 4.2B, and 4.2C). while it is out of the cage. A special wire enclo-
Rabbit owners will house their pets either pri- sure or grazing ark can be made with wire sides
marily inside or primarily outside. Animals that and top for use outside. The open bottom of the
are housed inside can be allowed to roam out- special enclosure allows the animal to graze pro-
side in the grass within a fenced enclosure. No tected and unattended. Because the grazing ark is
exposure to other animals such as dogs or cats mobile, the owner can move the enclosure to fresh
is recommended because of the unpredictable grass as needed.

110
Figure 4.2A Typical outdoor housing for pet rabbits. The cage protects the rabbit from predators and inclement
weather. Illustration by Michael L. Broussard.
Figure 4.2B Morant pen. This outdoor hutch allows the rabbit access to the sun and
grass while providing shelter in the event of a storm. Illustration by Michael L. Broussard.
4 | Rabbits 111
Figure 4.2C Indoor rabbit housing. This pop-up style rabbit hutch has a place for food and water. Illustration by
A rabbit can be house-trained to use a litter tray the house. It is preferable to have a rabbit cage to
as soon as it is brought into a house. If the rabbit put the rabbit in at night and establish the latrine
will be housed in a cage and allowed to free-roam, location within that enclosure. The tray should
it is best for the animal to use a litter box that has have low sides and be filled with a preferable sub-
been placed in its cage. Close the cage and allow strate (recycled paper substrate, hay, straw), and,
the rabbit to develop a sense of location for its when first acquired, the new pet should be placed
latrine. Once the latrine area has been established, in the tray every few minutes.1 Litter training is
place a litter box in that location again, allowing possible with most rabbits, but owners should be
the rabbit to use the litter box a number of times informed that these animals are very territorial,
before opening the cage door. When the cage door and adult bucks might mark different areas of the
is finally opened, the rabbit should go back to the house with strong-smelling feces to identify their
cage to defecate and urinate in the litter box. If the territory.
rabbit is free-roaming within the house, the owner These animals are prey species in their natural
will have to determine where the rabbit’s latrine setting and propagate readily. Pet rabbits should
is and place the litter box in that location. The not be housed together after they reach sexual
rabbit will dictate where the litter box is placed in maturity, because of their strong territorial nature.

It is not uncommon for two males housed together mon sequel for rabbits in outdoor environments
to viciously fight when they reach sexual maturity. that develop open wounds. There have been rare
Fighting can even occur when a male and a female reports of rabbits that are housed outside being
are housed together, with the female fighting the exposed to and becoming infected with rabies.2
male rabbit in her territory. If a breeder asks about
breeding without causing fighting, tell the client Nutrition
to always bring the female rabbit into the male’s Rabbits normally feed in the early morning and
enclosure for the act of breeding, and then return in the evening. Pet owners should be made aware
the doe to her cage. that rabbits also eat their feces to reinoculate their
Commercial cages are available to house rabbits digestive system with good bacteria. The process
indoors. These relatively small cages are excellent of eating feces is called coprophagy, and this
for the dwarf and mini breeds, but lack the exercise usually occurs 3–8 hours after eating.3 These soft
space needed for the larger breeds. If owners prefer and sweet-smelling feces, or cecotropes, are often
to build the rabbit cage, inform them that two func- produced in the early hours of the morning. The
tional spaces are needed: one space for resting and cecotropes contain high levels of vitamins B and
sleeping, and the other for exercise. As mentioned K and have twice the protein and half the fiber of
earlier, rabbits are susceptible to foot/leg problems regular hard feces.4
(sore hocks) if they are large and are housed in a Rabbits should be fed free-choice timothy or
wire-bottom cage. The cage bottom must have a grass hay and a regulated grass-based pelleted
solid surface in part of the area, and the other sec- diet (Figures 4.3 and 4.4). These pellets can be
tion (which is usually wire) should be covered with purchased with protein contents that range from
a layer of substrate—either hay or large pine shav- 10%–12% to 22%–24%. Pellets containing 16%
ings. The sides of the cage must be made of wire to protein are the most commonly fed. Recommend
allow for ventilation. The top can be made of wire, that your clients offer pellets with a fiber content
but if the cage is to be kept outdoors, the area in of more than 16% to guard against anorexia and
which the rabbit sleeps needs to be covered with diarrhea. A higher fiber content helps reduce the
plywood or corrugated fiberglass roofing material onset of obesity, which is common in pet rabbits.
to protect against precipitation. Owners should be Free-choice feeding of pellets also encourages obe-
encouraged to clean the cage every one to two days. sity; therefore, sedentary pet rabbits should be fed
Because rabbits are natural prey species, own- 1/8 to 1/2 cup per day, depending on their size.4
ers should be informed that living with dogs and The exceptions to this rule are lactating does and
cats is a potential danger. At no time should rab- growing young, which need as much food as they
bits be allowed to commingle with dogs or cats, will eat. Tell the pet owner to wait 5 days after
and they should be allowed out of their cage only birth and then start increasing the amount of pel-
under supervision. Rabbits and birds can live in lets by 150 grams, or 5 ounces, per day.4 If there
the same house without any problem, but rabbits are no pellets left in the food container over the
should not be housed with guinea pigs. Without next 5-day period, they should add 150 grams
any ill effects to themselves, rabbits can carry more food. They should reduce the amount of
and transmit Bordetella bronchiseptica, a disease pellets in the diet only when some of the pellets
that is deadly to guinea pigs.1 Fly-strike is a com- remain the next morning.
4 | Rabbits 113
Figure 4.3 A timothy grass–based pelleted diet is rec- Figure 4.4 Grass hay is recommended to maintain the
ommended for pet rabbits. overall health of a rabbit.
At weaning, it is recommended that the doe be eaten when placed in the litter box (remove soiled
removed from the cage to reduce the stress of a hay), when pelleted food is hidden in the hay, or
new environment on the young. There has been an when the hay is lightly misted with water.5
emphasis on the importance of fiber in a rabbit’s Water is extremely important, and access to
diet to prevent obesity, diarrhea, and hairballs. clean tap water needs to be provided. Rabbits easily
Timothy hay is recommended as the best source learn to drink from inverted water bottles that have
of rabbit fiber and is universally available along a stainless steel tube extending down into the cage
with other grass hays (e.g., orchard grass, prairie (Figure 4.5). These water containers are commonly
grass). Overall, the best daily diet for pet rabbits sold as Lix-it bottles. Rabbits, like most animals,
is a measured timothy grass–based pellet with drink from water bowls, but their low profile often
free-choice grass hay and a treat of dark green contaminates the water bowl with food and feces.
leafy vegetables.4 To increase or improve hay Drinking from the water bowl will also moisten the
consumption, tell clients to introduce a variety of dewlap on large females, predisposing them to bac-
grass hays to young rabbits and offer at least half terial and fungal dermatitis. The water bottle must
a body size in volume per day. Often more hay is be kept clean and full of fresh water at all times.

rabbits to reduce owner injury. Traditional dog

nail trimmers can be used on rabbit claws. In
many rabbit patients the vascular “quick” can be
observed through the clear claw. With the rabbit
well restrained the claw is clipped below the level
of the blood line. If the claw is cut too close and
bleeding occurs, a silver nitrate hemostatic stick
can be used to apply the chemical cautery agent.
Plastic nail caps that are applied with tissue glue
can also be used to prevent owner injury caused
by sharp claws. Rabbits should never be declawed
because they have a different foot anatomy than a
cat. If a rabbit is declawed, permanent foot injury
will result from which most will not recover.
HISTORY
Veterinary technicians must obtain a thorough

history of the patient before an educational rec-
Figure 4.5 Water bottles should be cleaned and re-
ommendation can be given or a proper physical
filled on a regular basis.
exam performed. The name, breed, sex, and age
of the animal to be examined are the first ques-
Transport tions to ask when taking a patient’s history. As
A plastic pet carrier filled with a recycled paper noted in Table 4.1, there is quite a difference in
product substrate is recommended to transport the physiologic parameters when comparing sex
rabbits to a veterinary clinic. In many cases a rab- and rabbit breed. As with most species, smaller
bit patient should be removed from and placed breeds of rabbits will mature faster than larger
back in the carrier by removing the top of the car- breeds. Common breeds of large pet rabbits are
rier. When lifting the patient out of the carrier the Angora, Lop-Eared, and New Zealand White;
rear leg must always be supported. Never place a common small breeds are Mini Lop-Eared and
rabbit headfirst into a cage or pet carrier; always Netherlands Dwarf (Figures 4.6A and 4.6B).
put the animal in tail first. Rabbits will kick out The next group of questions centers on gen-
with their rear legs and cause serious spinal dam- eral background information, such as length of
age; therefore, proper handling and supporting time owned, where the animal was acquired, how
the rear legs at all times will reduce unintended often the animal is handled, and character of
injuries. the fecal material. After getting answers to these
preliminary questions, the veterinary technician
Grooming should start to have a basic understanding of the
Rabbits have powerful rear legs and sharp claws. owner’s knowledge of rabbits and care provided.
Claw trimming is an important procedure in pet Husbandry questions should follow, including
4 | Rabbits 115
its life expectancy. One area of questioning that

must not be overlooked is the status of other pets
or animals in the house. Housing other pets with
rabbits exposes them all to disease and injury.
Finally, the technician should obtain information
about past health problems and the reason the
patient is presenting.
Many larger-breed rabbits can weigh up to 6
kilograms. The smaller breeds seem to be the most
popular companion animals. Many unwanted
older rabbits are large-breed animals that were
Figure 4.6A Many different rabbit breeds are main- sold as bunnies, either unknowingly or unscrupu-
tained as companion animals. This is a lion-headed lously, as a dwarf breed. The owner who brings
rabbit. in a rabbit that he or she believes is a dwarf breed
when it is not should be informed of this.
RESTRAINT
It is very difficult to restrain most rabbit patients.

These small mammals have very strong muscles
in their rear legs and jump quickly, with force.
If not maintained in a proper position, a patient
can jump out of the technician’s arms onto the
floor. An unexpected fall of this magnitude
often creates an injury that was not present at
the beginning of the appointment. To prevent
Figure 4.6B This is an example of a dwarf rabbit. this tragic scenario, there are certain guidelines
to follow when holding a rabbit for examination,
transport, and placement in or removal from a
indoor/outdoor roaming habits, cage location, cage.
type and size of caging, cage substrate, frequency Ears are not handles. Although rabbit ears are
of cage cleaning, and type of disinfectant (if any) usually large and appear to be an excellent piece of
used when cleaning the cage. Some of the most anatomy to grasp, do not succumb to this illusion.
important questions a technician should ask a The ears are delicate, and when they are pulled,
rabbit owner are the type of food and water that a rabbit will use its powerful rear legs to escape.
are offered and how much and how often the When a rabbit kicks its rear legs and its body is
bowls are cleaned and refilled. The rabbit’s gas- unsupported, spinal trauma or fracture can occur,
trointestinal system is very sensitive, and rabbits which can cause temporary or even permanent
are susceptible to obesity; therefore, educating paralysis. Always support the body by placing a
clients in husbandry will help a pet rabbit reach hand on the rear of the animal during transport

or examination (Figure 4.7). When removing the

patient from a cage or pet carrier, grab the scruff
with one hand, placing the other hand under its
tail, supporting the rear legs. Place the animal
on an examination table that is covered with a
towel, which provides a nonslip surface. This
towel can then be wrapped around the animal’s
body, forming a “bunny burrito” and preventing
leg movement (Figure 4.8). While it is in a bunny
burrito, the animal’s head and tail can be exam-
ined and oral medications can be administered.
The towel must be removed to perform a full-body Figure 4.7 A rabbit’s rear should be supported to pre-
examination and auscultation. If the animal is to vent the patient from kicking and injuring its back.
be transported, place its head in the crook of one
elbow, with the arm supporting the body of the
rabbit and the hand of that arm over the rump.
The opposite hand should grab the scruff (Figure
4.9). When placing a patient into a cage or carrier,
always back the animal into the enclosure. If rab-
bits are placed headfirst into an enclosure, they
might jump out of a handler’s grasp into the cage,
possibly injuring themselves or the handler.
Figure 4.8 A “bunny burrito” can be used to restrain
The rabbit physical examination should always
rabbit patients.
take place on a properly restrained animal.
This is easier said than done on many rabbit
patients, but veterinary technicians should heed
this advice to prevent tragedies from occurring.
Observation of the animal in the carrier initiates
a physical examination (Figure 4.10). Observe
and note the animal’s attitude, posture, and
physical activity (if any) in the record. Closely
examine the hair coat and skin next, looking
for hair loss, skin lesions, and ectoparasites.
Rabbits are susceptible to respiratory disease,
ear mites, and ocular trauma. You must con-
sider these disease problems during an external Figure 4.9 When carrying a rabbit, support the rear
physical examination of the eyes, nose, and ears. legs and apply a firm grip to the dorsal cervical area.
4 | Rabbits 117
After you complete the examination, record

any abnormal findings and establish a list of dif-
ferential diagnoses. Finally, prioritize diagnostic
tests to confirm a diagnosis or to determine the
severity of the disease.
DIAGNOSTIC SAMPLING
Blood Collection
Rabbits can be difficult patients from which to
obtain blood for diagnostic testing. Covering a
Figure 4.10 Rabbits should be transported to and rabbit’s eyes might help reduce movement of the
from the veterinary clinic in a plastic pet carrier. Al- patient and the stress associated with restraint.
ways back a rabbit into a cage or carrier. In many older textbooks, the larger rabbit spe-
cies were used to show how to collect blood from
the marginal ear vein or central ear artery (Figure
One major problem rabbits often present with is 4.11A and 4.11B). In larger rabbit species, these
malocclusion of the incisors or molars. Rabbit sites are effective for obtaining blood at volumes
patients generally do not like people looking in necessary for diagnostic tests, but this is not the
their mouths, especially if they have dental prob- case with smaller, popular companion rabbit spe-
lems. Proper restraint is emphasized for the oral cies. Although the marginal ear vein and central
examination. You can manipulate the lips with a ear artery might be considered as sites of blood
tongue depressor, which will allow you to observe collection in small rabbit breeds, they are often
the front teeth. Rabbit patients have been known too small to collect any significant amount of
to bite an unsuspecting veterinarian or techni- blood. The ear vein and artery have a tendency
cian during this procedure, so use caution. An to develop thrombi, leading to vascular ischemia,
easy way to examine the molars in the back of a which ultimately causes necrosis of the affected
rabbit’s small mouth is to use an otoscope with area on the dorsal surface of the ear. For this
an appropriate-sized head. This is about the only reason, only experienced phlebotomists should
way to simplify a difficult operation. collect blood from these areas.
Hydration status of the animal can be checked Other recommended venipuncture sites are
during the oral examination through mucous the jugular vein (site of choice for smaller rabbit
membrane capillary refill time or packed cell vol- breeds) (Figures 4.12A and 4.12B), the cephalic
ume percentage, or corneal moisture. Palpation of vein (Figure 4.12C), and the lateral saphenous vein
the body and extremities is necessary to look for (Figure 4.12D). The jugular and lateral saphenous
possible fractures and lymph node or organ enlarge- veins are the blood collection sites of choice for
ment. The examination should be completed with a most rabbit patients. Because rabbit fur is dense
neurologic assessment, auscultation of the heart and and difficult to shave and the skin is easily ripped
respiratory system, and examination of the external by the blade of a clipper, it is preferable to pluck
reproductive structures and anus. the hair over the vein rather than shave it, after

118
Figure 4.11A A rabbit’s ear, showing the central ar- Figure 4.11B Collecting blood from the marginal
tery and marginal ear vein. ear vein.
Figure 4.12A Blood collection from a rabbit’s jugular vein, with patient in dorsal recumbency.
Illustration by Michael L. Broussard.
4 | Rabbits 119
Figure 4.12C Collecting blood from the cephalic vein

of a rabbit.
Figure 4.12B Blood collection from a rabbit’s jugular Figure 4.12D Collecting blood from the saphenous
vein, with patient in ventral recumbency. vein of a rabbit.
which an alcohol wipe can be used to help identify attached into the vessel and allow the blood to
the collection site. The vein should be clamped drip from the needle into an open blood tube.6
with two fingers proximal to the venipuncture The cephalic vein is accessible, more so in larger
area to increase vascular pressure and dilate the breeds than in smaller breeds, because of the short
vessel. A small-gauge (25-, 26-, or 27-gauge) antebrachial length and small vein size in the
needle is used to penetrate the vein from which diminutive rabbits. This is also true of the saphe-
blood is being collected. If blood collection is slow nous vein, which courses across the lateral aspect
owing to vessel size, using a heparinized needle of the tibia. Again, always pluck the hair over the
will help prevent blood clotting in the syringe. collection site instead of shaving to prevent clipper
To avoid collapse of the vein or artery caused by trauma to the skin.
excess pressure during collection with a syringe or As stated, the site of choice for blood collection
vacutainer tube, insert a needle without a syringe in most rabbit species of varying sizes is the jugular

vein, but ear veins can also be used, and they can Table 4.2 Rabbit Complete Blood Count
be used for intravenous catheter placement. Reference Ranges6,7,8
Although some rabbit patients do not need to Cell Types Normal Range
be sedated for blood samples to be obtained, it Erythrocytes 5.1–7.9 x 106/μl
might be easier to give the patient a small amount Hematocrit 36–48%
of sedation to reduce stress and possible injury Hemoglobin 10.0–15.5 mg/dl
to the patient or veterinary personnel. Isoflurane Leukocytes 5.2–12.5 x 103/μl
inhalation anesthesia (induction 5%, then main- Neutrophils 20–74%
tain at 1.5%–2% with a 1.5 L flow rate of oxygen) Lymphocytes 30–85%

Eosinophils 0–4%
administered through a face mask is probably the
Monocytes 1–4%
easiest, quickest, and safest method to sedate a
Basophils 2–7%
rabbit for venipuncture and other diagnostic col- Platelets 122–795 x 103/μl
lection techniques (Figure 4.13). When collecting Serum Protein 5.4–7.5 g/dl
any diagnostic sample from a rabbit patient that Albumin 2.7–4.6 g/dl
is fractious, always consider sedation to prevent Globulin 1.5–2.8 g/dl
injury to the patient. The neck should be care-
fully shaved from the mid-cervical to the caudal
cervical area on the ventral, ventrolateral aspect enough blood volume to safely collect enough to
of the body. obtain diagnostic results. Rabbit blood volume
To collect the blood, the rabbit should be has been recorded to be between 57 and 78 ml/
placed in dorsal recumbency with its head over kg.7 Reference ranges for complete blood counts
the edge of the table and its feet held in a caudal and serum chemistry panels are listed in Tables
position. Take care not to overextend the neck in 4.2 and 4.3, respectively.6,8,9
this position, or respiratory compromise might
occur. Even the smallest rabbit breeds have a large Bone Marrow Aspiration
Recommended sites for collecting bone marrow
in rabbits include the femur, humerus, pelvis, and
proximal tibia. The technician should follow the
same precollection protocol when obtaining a
bone marrow aspirate in a rabbit as with any other
small animal. The patient must be anesthetized
for this procedure.
Collection of Cerebrospinal Fluid

This is not a very common diagnostic procedure
performed on pet rabbits, but it could be helpful
in diagnosing listeriosis if the cerebrospinal fluid
(CSF) is cultured.7 CSF samples should be either
Figure 4.13 Rabbits can be induced and maintained submitted quickly or refrigerated to prevent cel-
for short procedures using a face mask. lular degradation, which occurs rapidly at room
4 | Rabbits 121
Table 4.3 Rabbit Serum Biochemistry occurs; therefore, the sample should be monitored
Reference Ranges6,7,8 for quality during collection.
Analytes Normal Range
Serum Glucose 75–150 mg/dl Urine Collection Using Cystocentesis

Blood Urea Nitrogen 17.0–23.5 mg/dl A cystocentesis can be successfully accomplished
Creatinine 0.8–1.8 mg/dl on most rabbit patients without sedation or anes-
Total Bilirubin 0.25–0.74 mg/dl thesia. Rabbits can be hypnotized while in dorsal
Serum Lipids 280–350 mg/dl recumbency, which is the position of choice for
Phospholipids 75–113 mg/dl cystocentesis collection. The patient’s scruff and
Triglycerides 124–156 mg/dl
rear limbs need to be restrained to prevent any
Cholesterol 35–53 mg/dl
sudden movements while the needle is in the blad-
Serum Calcium 5.6–12.5 mg/dl
Serum Phosphate 4.0–6.2 mg/dl
der collecting urine. A 22-gauge needle attached
Alkaline Phosphatase 4–16 U/L to a 10 ml syringe is the recommended collection
Alanine Aminotransferase (ALT) 48–80 U/L combination for cystocentesis. The bladder should
Aspartate Aminotransferase (AST) 14–113 U/L be palpated cranial to the pelvis along the ventral
Lactate Dehydrogenase 34–129 U/L midline of the body prior to placing the needle
in the abdomen.7 Cystocentesis preparation for
rabbits is similar to that for dogs and cats. It is
temperature. The correct position for this proce- imperative that all precautions be considered to
dure is to place the rabbit in lateral recumbency prevent an iatrogenic bladder infection.
with its head flexed to the ventral chest wall. The Midazolam, 0.5–2 mg/kg intramuscularly,
area from the occipital protuberance to the level will provide excellent sedation for catheterization
of the third cervical vertebra and laterally past the of the urethra in male and female rabbits.10 The
margin of the atlas needs to be prepped for the col- male is collected with a well-lubricated 9 French
lection procedure.6 This external skin preparation catheter.7 The patient is best positioned in a sitting
is similar to the methods used for CSF in canine posture to extend the penis and access the ure-
patients. A 22-gauge, 1.5–3.5" spinal needle is rec- thra. The female’s urethral orifice is located on the
ommended for this procedure in rabbits. A stylet floor of the vagina and is best catheterized with
is always recommended to prevent blockage of the the patient in sternal recumbency.7
needle in this very critical procedure. The spinal Normal rabbit urine ranges in color from
needle should enter the skin halfway between the orange to brown. The urine color corresponds to
cranial margins of the wings of the atlas and the diet, concentration of crystals, and urinary tract
occipital protuberance, slowly advancing toward health. Normal rabbit urine is cloudy, containing
the nose until penetration is felt through the dura many ammonium magnesium phosphate, calcium
and subarachnoid membranes.7 The CSF should carbonate monohydrate, and anhydrous calcium
be allowed to drip into a plastic collection device, carbonate crystals. The veterinary technician
because leukocytes adhere to glass.7 As with other should understand that this finding is different
companion animal species, the area being tested from that in any other companion animal, but
is surrounded by very vascular tissue, and blood it is a normal finding. Table 4.4 lists the normal
contamination of the CSF sample commonly parameters of a rabbit urinalysis.10

Table 4.4 Rabbit Normal Urinalysis Values nal abscesses, and reproductive, gastrointestinal,
Urinary Parameters Normal Results
and respiratory diseases. It is recommended that
rabbits be sedated or maintained under general
Urine Volume
Large 20–350 ml/kg/day anesthesia for the radiographic procedure. This
Average 130 ml/kg/day prevents injury and stress to the patient and usu-
Specific Gravity 1.003–1.036 ally prevents poor radiographic images owing to
Average pH 8.2
patient movement. Most importantly, it reduces
Crystals Present Ammonium Magnesium
Phosphate, Calcium Carbonate
the chance of human skeletons (hands and fin-
Monohydrate, Calcium gers) showing up in the film. Isoflurane is the
Anhydrous Carbonate general anesthesia of choice for rapid induction
Casts, Epithelial Cells, Absent to rare
and recovery.
or Bacteria
Leukocytes or Occasional
Erythrocytes Present Other Diagnostic Imaging Modalities
Albumin Present Occasional in young rabbits Rabbits can be imaged using ultrasound (US),
computed tomography (CT), and magnetic reso-
nance imaging (MRI). These advanced imaging
modalities allow greater interpretation of dis-
Microbiology ease conditions within the skull and body cavity.
Rabbits are predisposed to Pasteurella multocida Ultrasound imaging is useful for determining and
infections that usually present as respiratory dis- evaluating reproductive tract disorders (e.g., uter-
ease. P. multocida infections are so common in ine adenocarcinoma). Preparation of the patient
rabbits that they are often called “snuffles,” because for US, CT, and MRI is similar to that described
of the nasal and ocular discharge associated with for obtaining traditional radiographic images. In
the disease. To culture the organism for isolation, some cases in which the patient is compliant, US
introduce a mini-tipped culturette into the deep examinations can take place using light sedation
nasal sinuses to the level of the medial canthus and proper restraint.
of the eye.7 If the rabbit is too fractious, sedation
is recommended. Abscesses that may or may not Parasitology
be caused by P. multocida, Staphylococcus aureus, External Parasites
Pseudomonas aeruginosa, Proteus spp., or Bacteroi- The advent of new ectoparasitic medications allows
des spp. have to be cultured on the interior wall the use of one product to effectively treat or pre-
of the lesion, because most rabbit abscesses are vent many different parasites that infest rabbits.
sterile in the center. All other culture procedures One example of these new products is imidaclo-
used to collect fungal and bacterial organisms in prid and moxidectin topical solution (Advantage
rabbit patients are similar to those employed on Multi for cats 9 weeks of age and older, 5.1–9 lbs;
dogs and cats. Bayer HealthCare LLC, Animal Health Division,
Shawnee Mission, KS) used at a dose of one 0.4 ml
Radiology tube, placing the contents on the skin between
Many rabbit case presentations require radiographic the scapulas, once a month. This solution will treat
evaluation, including fractures, malocclusion, inter- or prevent fleas, Psoroptes cuniculi, Cheyletiella
4 | Rabbits 123
parasitivorax, Listrophorus gibbus, and Trichostron- tin (Ivomec, Merck AgVet Division, Rahway, NJ)
gylus spp. at 0.4 mg/kg SC once every two weeks for three
Psoroptes cuniculi, or the rabbit ear mite, is a very treatments, or once and repeated in 18 days.11 The
common finding in pet rabbits (Figures 4.14A and crusts should not be cleaned, because the under-
4.14B). The animal usually presents with thick lying tissue is very irritated. After the mites have
crust originating from the base of the external ear been killed and healing takes place, the crust
canal extending up to, and sometimes out of, the usually sloughs in one piece. Topical treatment
ventral aspect of the pinna. Identification of the of the infestation is not necessary if ivermectin is
mite can be made through a direct examination of being used, but it might help as adjunct therapy to
the ear crust or observation of the mites within the expedite the healing process. The use of fipronil is
ear canal, using an otoscope. Treat with ivermec- contraindicated in rabbits. Do not use it, because
it has been associated with neurologic disease and
death in these animals.
Cheyletiella parasitivorax is commonly called
walking dandruff, or the rabbit fur mite. This
ectoparasite can also infect humans and other
companion animals. C. parasitivorax is rather
large, and the dandruff and debris that are col-
lected from a suspect case can be examined under
a microscope by picking up the material on a
piece of scotch tape. This is commonly called
the “Scotch Tape” test in dermatology. The life
cycle of the rabbit fur mite is about 5 weeks, and
avermectin is the treatment of choice. The pet’s
environment should also be treated with flea-
Figure 4.14A Typical ear presentation of a rabbit control products to prevent reexposure. Other mites
with Psoroptes cuniculi.
have been diagnosed in rabbits, including Sarcoptes
scabiei, Notoedres cati, and Demodex cuniculi, but
these are relatively uncommon findings.11
Fleas also feed on rabbits. As with other com-
panion animals, signs of infestation include dried
bloody flea feces (“flea dirt”), itching, and the
appearance of fleas themselves. Treatment is similar
to that for cats, and the owner must be reminded to
treat the environment as well as the patient.11
Large maggot larvae and smaller fly larvae
affect rabbits. The large maggot larvae from flies
(Cuterebra spp.; Figure 4.15) are usually noted
as a swelling in the ventral cervical, axillary, or
Figure 4.14B A Psoroptes cuniculi mite. inguinal area or the dorsal rear.11 Maggots must

THERAPEUTICS
Often rabbit patients do not present in a condition

that would initially seem critical. After a thorough
history and physical examination, the veterinar-
ian might decide that the patient is in distress
and the technician must be prepared to provide
the necessary critical care. If injections need to be
administered, subcutaneous sites of choice include
the dorsal cervical region and lateral flank area;
the intramuscular sites are the epaxial muscles that
Figure 4.15 This Cuterebra spp. larvae was removed course along the caudal vertebral column or the
from a rabbit patient. cranial aspect of the quadriceps muscle group in
the rear leg.6
Oral suspensions that have been flavored by a
compounding pharmacy are the recommended
be surgically removed and surrounding tissues method for administering oral medications. Other
treated to prevent any secondary complications. oral medication flavoring options are strawberry
Smaller fly larvae are attracted to moist, matted jam, a small piece of banana, and piña colada
fur around the anogenital area. The patient that mix. Crushed tablets or pills can be mixed in a
is suffering from maggot infestation needs to have gel substance, for example Nutracal, and placed on
its fur trimmed and skin treated. Cleaning and the fur around the mouth. Rabbits, being fastidi-
removal of maggots are best accomplished on a ous groomers, will readily lick their fur clean and
sedated patient. ingest the medication.
Internal Parasites Lacrimal Duct Cannulation

The most common intestinal parasite class that It is not uncommon to have a rabbit patient
affects rabbits is coccidia of the genus Eimeria. present with epiphora and concurrent facial der-
E. stiedae, which affects the liver, is very com- matitis associated with the moisture around the
mon in mismanaged rabbit breeding operations. eye. The epiphora is often caused by an occluded
All other rabbit coccidia affect the intestinal tract, nasolacrimal duct caused by collected debris or
with diarrhea being the most common clinical inflammation associated with an upper respiratory
presentation. Coccidia (sulfamerazine; 100 mg/ bacterial infection. The nasolacrimal duct should
kg orally), protozoan parasites (metronidazole; 20 be flushed using a lacrimal cannula (straight or
mg/kg, orally), nematode (fenbendazole; 10 mg/ curved) or a small-gauge IV catheter with the
kg, orally, repeat in 14 days), and cestode (pra- needle removed. The ocular opening to the naso-
ziquantel; 5.10 mg/kg, subcutaneous, repeat in 10 lacrimal duct is located behind the ventral lid
days) parasites can be diagnosed through direct margin near the medial canthus. The lid margin
fecal examinations and fecal flotations. Once the is retracted along with excess conjunctival tissue
parasite has been correctly identified, the appro- revealing the punctum. The cannula/catheter is
priate medication should be prescribed. gently inserted into the punctum, while sterile
4 | Rabbits 125
saline is gently flushed into the duct (Figure 4.16).

Antibiotic solutions can be used to treat infections
involving the nasolacrimal duct, and radiopaque
dyes are used to determine if the duct is patent in
cases where this is not evident.
Fluid Therapy
For rabbit patients the cephalic or lateral saphe-
nous veins are recommended for indwelling
catheter placement when providing fluid ther-
apy. In dwarf breeds, 24- or 27-gauge catheters
can be used, whereas in larger breeds (e.g., New Figure 4.16 Flushing a rabbit patient’s nasal lacrimal
Zealand white) a 22-gauge catheter is optimum. duct.
If an intravenous catheter cannot be placed
because of a dehydrated or hypotensive condi-
tion, an intraosseous (IO) catheter is the best patients. It is recommend to feed 50 cc of mixed
option.12 The IO catheter of choice for rabbits Critical Care for Herbivores (Oxbow Pet Prod-
is a 20-gauge, 1" spinal needle, which should be ucts, Murdock, NE, and Lafeber Company,
inserted into the greater trochanter of the femur, Cornell, IL) per kilogram of body weight divided
passed parallel to the long axis of the femur or between 4 and 6 feedings per day (Table 4.5).13 To
into the tibial plateau and passed parallel to the feed supportive liquid diets a “catheter tipped”
long axis of the tibia.12 The IO catheter should 50 ml syringe is recommended. Once it is filled,
be maintained in place similar to the way an IV a small amount (5–10 ml) is injected into the oral
catheter would be maintained, but placement cavity through the side of the mouth. The patient
can be validated through radiographic imag- should be allowed to swallow the liquid before it
ing. Maintenance fluid requirements of 75–100 is given more. Usually a maximum of 20 ml of
ml/kg/day have been published and should be supportive diet is provided to the patient at each
provided in critically ill patients as a continu- feeding.
ous infusion.12 Colloidal fluids (e.g., hetastarch) If the rabbit patient cannot or will not accept
should be provided for hypoproteinemic patients the supportive diet through syringe feeding, a
or when crystalloid (e.g., lactated Ringer’s solu- nasogastric tube can be put in place. The naso-
tion) is unable to increase blood pressure.12 gastric tube can be used once (e.g., to remove air
Subcutaneous fluid administration, 1–2 times from the stomach or administer food or medica-
daily at 50–100 ml/kg, can be provided if the tion), or it can be maintained in place for a period
rabbit is stable, and preferably, if the rabbit is of time (e.g., long-term food supplementation).
drinking, oral fluids should be accessible.12 Four to eight French tubes (it is recommended to
use nasogastric tubes manufactured for rabbits)
Critical Care Diet can be placed in both conscious and anesthetized
Commercially produced, supportive liquid diets animals. The tube should be premeasured to the
can provide nutrition to critically ill anorexic level of the seventh rib and marked at the level of

Table 4.5 Recommended Amount to Feed 50 ml of Mixed Critical Care™ for Herbivores (Oxbow Pet
Products, Murdock, NE) per Kilogram of Body Weight Divided Between 4 and 6 Feedings per Day13
Number of Feedings per Day
Weight of Rabbit (Kg) 3 4 5 6
0.5 8 ml 6 ml 5 ml 4 ml
0.9 15 ml 11 ml 9 ml 8 ml
1.4 23 ml 17 ml 14 ml 11 ml
2.3 38 ml 28 ml 23 ml 19 ml
3.2 53 ml 40 ml 32 ml 27 ml
the nose. The tube should not be placed any fur- procedure. Presurgical antibiotic therapy is depen-
ther than the nasal marking on the tube. A local dent on the procedure being performed and the
anesthetic agent is applied to the tube and inside patient’s medical history. Intravenous or intraos-
the nasal opening into which the tube is being seous catheters can be placed prior to surgery, and
inserted. The latex catheter is then placed in the also in emergency situations, if fluid replacement
nares and pushed through the upper respiratory or therapeutic agents need to be quickly assimi-
sinus into the esophagus and finally into the lated. All veins that were mentioned as sites for
stomach. The place marked prior to tube inser- venipuncture can be used for intravenous catheter
tion should be immediately outside the nasal placement, but the larger veins (e.g., cephalic and
opening when the procedure is finished. The tube saphenous) are recommended.6 Complications,
can then be sutured to the top of the head, and such as venous thrombi and eventual skin slough-
an Elizabethan collar placed on the patient if it ing of the affected area, make the ear vessels a
tries to disturb the sutured area (Figure 4.17). poor choice for indwelling catheter placement. If

ASSISTANCE
Once the decision has been made to perform a sur-
gical procedure, certain equipment requirements
must be met for proper surgical preparation. To
aid in the intubation process, a short narrow laryn-
goscope and a rigid plastic catheter are needed. All
other surgical equipment is similar to that used for
small kittens and dogs. Medical skin staples allow
for rapid closure in the thin elastic skin, and most
rabbit patients are unable to remove them.
Preparation of the patient prior to surgery Figure 4.17 Nasogastric tube in place to provide
starts with food removal 2–4 hours before the supplemental nutrition.
4 | Rabbits 127
an intravenous catheter cannot be placed because Table 4.6 Rabbit Surgery Preparation
of vascular complications, an intraosseous cath- 1. Warm the immediate environment with the use of
eter should be placed in the greater trochanter circulating water blankets or heat lamps.
of the femur. Rabbit daily fluid requirements 2. Clip the minimum amount of hair from the body surface
range between 50 and 100 ml/kg/day and can at and around the surgical site.
be replaced daily, divided into 2 equal amounts, 3. Use warmed surgical scrub solution for surgical site
or continuously provided through an infusion preparation.
pump.6 If the patient does not accept the catheter, 4. Avoid alcohol rinses for surgical preparation,
substituting warmed saline.
a collar should be applied.
5. Cover the exposed surface of the animal with a drape.
Preparation of the surgical area is important
and difficult when clipping thick, fine rabbit fur. 6. Minimize the duration of surgery and anesthesia.
In addition, the skin is thin, elastic, and easily

traumatized. The clipper blade should be held flat,
close to the skin, and the fur clipped at a slow, cau-
tious speed. Regular cleaning of the clipper blade
during the preparation will improve the ability of
the blade to cut the fine fur.
The surgical site should be prepped after clip-
ping to reduce the heat loss in these small animals.
General recommendations to reduce heat loss are
listed in Table 4.6.14
When anesthetizing a rabbit, the biggest dif-
ficulty facing the technician is the intubation
process. The mouth does not open widely, the
distal portion of the tongue is muscular, the lar-
ynx is in the caudal oropharynx, and rabbits are
predisposed to having laryngospasms.14 Various
methods of intubation can be used, other than
the oral route, including nasotracheal and a blind
technique, using an endotracheal tube attached Figure 4.18 Rabbit glottis observed through an endo-
to a standard stethescope.15 The most successful scope prior to intubation.
and least traumatic method for intubating a rab-
bit is using a rigid endoscope and visualizing the
tracheal opening (Figure 4.18). Most rabbit sur-
gical procedures that require a short time period Gastric Stasis or “Wool Block”
to complete might be accomplished by inducing As discussed earlier in this chapter, rabbits are pre-
the patient using indicated anesthetic agents and disposed to hairballs when fed an improper diet.
maintaining it via face mask on isoflurane inhala- Because rabbits are unable to vomit or regurgitate
tion anesthesia. Tables 4.7 and 4.8 list sedation stomach contents, hairballs have to be digested or
and anesthetic agents. passed through the intestinal tract. When hairballs

Table 4.7 Rabbit Premedication, Sedation, and Chemical Restraint Agents10

Drug Dose Comments
Acepromazine 0.25–1.0 mg/kg IM or SC* Good for preanesthetic use and for mild
tranquilization
Diazepam 1–5 mg/kg IM or IV Preanesthetic/tranquilizer
Fentanyl-Droperidol 0.13–0.22 ml/kg IM or SC Excellent restraint, good analgesic qualities
Medetomidine 0.25 mg/kg IM Sedatic
Reversal agent:
Atipamezole (0.001 mg/kg SC, IV, IP)
Midazolam 1–2 mg/kg IM, IV Preanesthetic/tranquilizer
Xylazine 1–5 mg/kg IM or SC Good sedation/analgesia
Might produce respiratory depression and slow
heart rate
Reversal agent:
Yohimbine (0.2 mg/kg IV)
*SC = subcutaneously, IM = intramuscularly, IV = intravenously
Table 4.8 Rabbit Injectable Anesthetic Agents10

Drug Dose Comments
Diazepam/Ketamine Diazepam (0.5 mg/kg) and Good for sedation and adjunct to supplemental
Ketamine (10–20 mg/kg) IV inhalation anesthesia
Medetomidine/Ketamine 0.35 mg/kg IM and 5 mg/kg IV Anesthesia: Surgical depth approximately
19 minutes
Tiletamine-Zolazepam 5–25 mg/kg IM Light sedation and general anesthesia
High dose could cause severe depression, slow
recovery, and possible nephrotoxicity
Xylazine/Ketamine 1. Xylazine (3–5 mg/kg) and Good for some surgical procedures
Ketamine (20–40 mg/kg) IM
2. Xylazine (3mg/kg) and Xylazine can cause respiratory depression and
Ketamine (10 mg/kg) intranasal hypotension
Intranasal administration good for short-term
anesthesia
become too large, gastric motility is affected, not fed and subsequently develop a negative
and the animal becomes anorexic. Treatment energy balance, hepatic lipidosis will occur.
includes antibiotics, cisapride (0.5 mg/kg SC Prevention of hairballs in rabbits is initiated
q8.12h) to stimulate gastric motility, and syringe through owner education on proper dietary
feeding the patient. A recommended recipe for requirements. Since the recommendation of grass
syringe feeding is one cup rabbit pellets, one 8 oz. diets, there appears to be a significant reduction
can Ensure, and one 8 oz. container fruit yogurt; in the number of rabbit patients presenting with
blend and feed via syringe. If obese rabbits are trichobezoars.
4 | Rabbits 129
Gastroenteritis disease signs associated with the infection. The

Antibiotics can cause a fatal gastrointestinal bacte- bacterial organism is transmitted through direct
rial overgrowth if administered to rabbits. Never contact, fomites, and sexual intercourse, but usu-
use the following unless they are the absolute ally gains entry into the host through the nares
last resort for treatment: clindamycin, amoxi- or wounds. Culture of the respiratory system,
cillin and derivatives, ampicillin, penicillin, through the nares, is usually the best way to con-
cephalosporins, and erythromycin. Always make firm a diagnosis, but response to treatment of this
sure that the drug being given is appropriate to use pervasive disease precludes diagnostic testing. The
in rabbits. Treatment of gastroenteritis is similar best prevention of this disease is client education
to that for other pets; that is, maintaining hydra- and the purchase of rabbits from reputable breed-
tion status, identification of the causative agent, ers who have a P. multocida–free herd.
and proper treatment. E. coli, Clostridium piliforme,
Salmonella spp., and Pseudomonas spp. are common Malocclusion
bacterial organisms that cause gastroenteritis. Overgrowth of the incisors or the cheek teeth is a
problem often affecting pet rabbits (Figures 4.19A
Pasteurella Multocida “Snuffles” and 4.19B). Malocclusion of the teeth might pres-
This is the most common disease affecting pet ent as the rabbit not being able to chew and hold
rabbits. Pasteurella multocida can infect all major food in its mouth or excessive drooling around the
body systems (especially the respiratory system) edges of the mouth. A complete oral examination
and major organs, and it can cause subcutaneous is required for each patient. The incisors can be
abscesses. Another common presentation is a head examined by using a tongue depressor and moving
tilt, which is often the result of an internal ear the lips to observe the teeth. In most cases of rab-
infection associated with P. multocida. This bac- bit malocclusion, the upper incisors grow behind
terium can survive within a rabbit host for years the bottom incisors. Genetics and traumatic injury
without causing any overt disease signs. During appear to be the main sources of this disease.
this period, shedding can take place, which can The cheek teeth are best examined using an
then infect any rabbit that comes into contact otoscope (Figure 4.20) or a small rigid endosope
with the infected animal. Treatment has improved (Figures 4.21A, 4.21B, and 4.21C). The teeth can
with Baytril enrofloxicin 5–20 mg/kg PO, once be trimmed using small clippers and the cheek
a day for up to 21 days. As with any antibiotic teeth floated, using a dental unit, small rabbit
treatment administered to rabbits, during the floats, or a Dremel tool with special rabbit tooth-
treatment period owners should be advised to trimming bits and specula for exposure in the
closely observe their pet’s eating habits, stool, and small oral cavity (Figure 4.22). In the majority of
general disposition. If there is any decrease in food cases, affected patients never “grow out” of this
consumed, change in fecal consistency, or depres- problem and have to be treated on a regular basis,
sion, the antibiotic treatment should be stopped about every 6 weeks. Removal of the overgrown
and the case reassessed. There is no guarantee that teeth is not recommended, unless there is a com-
the treatment will cure the patient of the infection, plicating abscess at the base of the tooth. This
but treatment is usually successful in reducing the is a very common problem in pet rabbits, and

Figure 4.19A Maloccluded incisors of a rabbit.
Figure 4.20 Examination of a rabbit’s teeth using an

otoscope.
owner. Once the hock area ulcerates because of

improper flooring, secondary bacterial infections
infiltrate the wound. This is a very difficult disease
to treat, and owner understanding and compli-
ance are essential for a successful outcome. The
Figure 4.19B Maloccluded molars of a rabbit, show-
importance of proper husbandry practices should
ing enamel projections and irritated lingual surface.
be stressed to clients. The environment needs to
be cleaned, and the wounds must be cleaned and
further reading is recommended in more detailed bandaged.
texts.16,17
ZOONOTIC DISEASES
“Sore Hocks” or Ulcerative Pododermatitis
Ulcerative pododermatitis is an infection of the There are not many cases of diseases being trans-
plantar surface of the hock. This condition is usu- mitted from rabbits to their human caretakers.
ally the result of poor husbandry practices by the Although uncommon, such disease transmission
131
Figure 4.21A Examining a rabbit’s teeth using an Figure 4.21B Trimming a rabbit’s teeth using a
endoscope. Dremel tool.
Figure 4.21C Rabbit’s teeth after trimming. Figure 4.22 Dental instruments for use with rabbits.

can and does occur. Common bacterial patho- that exhibit hair loss. The most common der-
gens that can be transferred include Salmonella matophyte isolated in pet rabbits is Trichophyton
spp., Pasteurella multocida, and bacteria through mentagrophytes, which is extremely zoonotic to
scratches or bites. Dermatophyte (ringworm) children and older adults.
infections can cause dry, crusty lesions on rabbits
1. How would you determine the sex of a rabbit?
2. What would you recommend to owners if they complain their rabbit is scratching them with its
sharp claws?
3. Describe the proper husbandry and nutritional recommendations for rabbits.
4. How do you house-train a rabbit?
5. Describe how one properly restrains a rabbit for a physical examination. What are the possible
consequences if the rabbit is not properly restrained?
6. Describe how to examine a rabbit.
7. What is the procedure for collecting blood from a rabbit? Bone marrow? Cerebrospinal fluid?
Urine?
8. How should you sedate a rabbit for diagnostic sample collection?
9. What is “snuffles,” and how is it treated?
10. Describe diagnostic imaging modalities used to examine rabbits. What are the advantages and
disadvantages of each?
11. What are the common rabbit parasites and treatment options for each of them?
12. Describe the procedure for cannulating the lacrimal ducts of rabbits.
13. Describe fluid therapy administration in rabbits.
14. Describe dietary supplementation recommendations for critically ill rabbit patients.
15. Describe proper intubation of a rabbit.
16. Describe common disease presentations of rabbits and treatment options.
4 | Rabbits 133
REFERENCES
1. Donnelly TM. Basic anatomy, physiology and husbandry. In: Quesenberry KE, and Carpenter JW,
eds. Ferrets, rabbits and rodents: Clinical medicine and surgery, 2nd ed. St. Louis, MO: Saunders/
Elsevier; 2004:136–46.
2. Willsey AL, Cherry B, Rudd RJ, and Trimarchi CV. Rabies virus infection in a pet guinea pig and
seven pet rabbits. Journal of the American Veterinary Medical Association 2005:227, 932–5.
3. Cheeke PR. Rabbit feeding and nutrition. Orlando, FL: Academic Press; 1987:15–33.
4. Brooks D. Nutrition and gastrointestinal physiology. In: Quesenberry KE, and Carpenter JW, eds.
Ferrets, rabbits and rodents: Clinical medicine and surgery, 2nd ed. St. Louis, MO: Saunders/Elsevier;
2004:155–60.
5. Hromanik D. Application of Hay Science. Exotic DVM 2003;5.4:40–41.
6. Mader DR. Basic approach to veterinary care. In: Quesenberry KE, and Carpenter JW, eds. Fer-
rets, rabbits and rodents: Clinical medicine and surgery, 2nd ed. St. Louis, MO: Saunders/Elsevier;
2004:147–54.
7. Benson KG, and Paul-Murphy J. Clinical pathology of the domestic rabbit. In: Rupley AE, and
Reavill DR, eds. The vet clinics of North America, exotic animal practice, clinical pathology and sample
collection. Philadelphia: WB Saunders; 1999:539–51.
8. Johnson-Delaney CA, and Harrison LR. Rabbits. Exotic companion medicine handbook for vet-
erinarians. Lake Worth, FL: Wingers Publishing; 1996:9–10.
9. Harkness JE, and Wagner JE. The biology and medicine of rabbits and rodents, 3rd ed. Philadelphia,
PA: Lea & Febiger; 1989.
10. Harkness JE, and Wagner JE. The biology and medicine of rabbits and rodents, 4th ed. Philadelphia,
PA: Lea & Febiger; 1995.
11. Quesenberry KE. Rabbits. In: Birchard SJ, and Sherding RG, eds. Saunders manual of small animal
practice. Philadelphia: WB Saunders; 1994:1345–47.
12. Ramer JC, Paul-Murphy J, and Benson KG. Evaluating and stabilizing critically ill rabbits—Part II.
Compendium for Continuing Education 1999;21:116–25.
13. Oxbow Pet Products, Critical Care™ for Herbivores Educational Brochure; 2003.
14. Hess L. Dermatologic diseases. In: Quesenberry KE, and Carpenter JW, eds. Ferrets, rabbits and
rodents: Clinical medicine and surgery, 2nd ed. St. Louis, MO: Saunders/Elsevier; 2004:194–202.
15. Heard DJ. Anesthesia, analgesia and sedation for small mammals. In: Quesenberry, KE, and Car-
penter, JW, eds. Ferrets, rabbits and rodents: Clinical medicine and surgery, 2nd ed. St. Louis, MO:
Saunders/Elsevier; 2004:356–69.
16. Harcourt-Brown FM, ed. Rabbits. Journal of Exotic Pet Medicine 2007;16(3).
17. Capello V, and Lennox AM. Dentistry of exotic companion mammals. Journal of Exotic Pet Medi-
cine 2008;17(2).

Rodents
Chapter 5
Guinea Pigs,
Hamsters, Gerbils,
Rats, and Mice
Information on the guinea pig and small pet rodent (hamsters, gerbils, rats,
and mice) has been compiled into one chapter. Because there are many
similarities in care, husbandry, diagnostic testing, and treatment for these
animals, some information is true for all rodents, in which case it is described
in just one area of the text, and readers are referred to that specific section.
When information is unique to a specific species, that information is covered
separately.
INTRODUCTION
GUINEA PIGS
Guinea pigs (Cavia porcellus) are native to the Andean highlands of north-
central and northwestern South America.1 Three main breeds are maintained
as companion animals: (1) the English, or common, which is characterized
by short, straight, fine hair; (2) the Abyssinian, with rough, wiry hair in
rosettes or whorls; and (3) the Peruvian, with long, straight, silky hair (Fig-
ures 5.1A and 5.1B). Of all rodent species, guinea pigs might be the best
choice for pets. They are usually nonaggressive, rarely bite, enjoy being held,
and are long-lived in comparison with many other rodents.

Figure 5.1A Many different breeds of guinea pig can Figure 5.1B This is a Red Dutch guinea pig.
be purchased as pets. This photo shows a Tort and White.
With the advent of commercial guinea pig diets owners, because the irritation promotes saliva-
and supplies from a large number of companies, tion and anorexia.
it has never been easier to properly care for these
rodents. Cavies (a common name for guinea pigs) HAMSTERS
belong to a group of animals that requires an exter- The golden or Syrian hamster (Mesocricetus aura-
nal source of vitamin C. Often, the vitamin C is tus) is a very popular pet because of its small size
incorporated into the diet, but if the diet is deficient and cute appearance, especially the teddy bear.
in the daily requirement of this essential vitamin, The golden hamster is the most popular pet
supplementation must be provided in the water species of hamsters, but there are also Chinese,
or on the food. Vitamin C deficiency is one of the European, Hungarian, and Siberian dwarf ham-
most common health problems treated by veteri- sters. Although cute and small, these rodents can
narians. This information, along with basic dietary be territorial and aggressive, and they can bite
suggestions and husbandry techniques, should be their owners. Reduction of the animal’s natural
provided to the owner during the cavy’s first veteri- aggressive personality is usually achieved through
nary examination. To determine the health status routine handling. To reduce fighting between
of the patient and to answer basic questions, a tech- pet hamsters, animals should be housed in sepa-
nician should be familiar with baseline guinea pig rate cages. All gender combinations will fight or
physiologic information (Table 5.1). succumb to immunosuppression initiated by psy-
As with other animals in the order Rodentia, chological stress as a result of a dominant animal
guinea pigs have open-rooted teeth, which grow within the environment. Females that have given
continuously; thus, they need a normal occlusive birth will often cannibalize their young if dis-
surface to wear properly and prevent overgrowth. turbed.
It is common in cavies to have malocclusion of Hamsters are nocturnal animals and like to
the cheek teeth, which causes enamel projections exercise during the night. If the exercise wheel is
to rub against the tongue surface. This condi- not oiled, the squeaking apparatus may disturb
tion is commonly called “slobbers” by guinea pig the owner. These animals are notorious for escap-
5 | rodents 137
Table 5.1 Guinea Pig Basic Information1

General Category Classification Physiologic Parameters/Quantity
Body Weight Adult Male 900–1,200 g

Adult Female 750–900 g
Birth Weight 60–110 g
Temperature, Pulse, and Respiration Rectal Body Temperature 101.5°–103°F
Amounts of Food and Water Daily Food Consumption 6 g/100 g body weight/day
Daily Water Consumption 10 ml/100 g body weight/day
Age at Onset of Puberty Puberty, Male 9–10 weeks

and Breeding Life
Puberty, Female 6 weeks
Breeding Initiation, Male 3–4 months
Breeding Initiation, Female 2–3 months
Female Reproductive Cycle Estrous Cycle 15–17 days

Estrus Duration 1–16 hours (avg. 8 hours)
Litter Size 3–4 average
ing their enclosure. The owner must be made To properly sex hamsters, rats, mice, and gerbils,
aware of the importance of purchasing an escape- the distance from the anus to the genital opening
proof cage with an appropriate screen top that can is measured. This distance in males is twice that of
be fastened securely. female animals.2 Females have three openings in this
Veterinary technicians need to be aware of a area (urinary, genital, and anal), whereas males have
few anatomical differences found in hamsters. (See two openings (urogenital and anal).2 Male guinea
the baseline hamster physical information listed in pigs have a urethral opening between two large
Table 5.2.1) The most prominent are the large cheek scrotal sacs cranial to the anus that when observed
pouches that can store large pellets, seed, or bedding appear as an i from the anus. The dot on the i is
material. It is very common for hamsters to have full the prepucal opening. The female guinea pig has a
cheek pouches, which deform the face, but this is Y-shaped depression in the tissue cranial to the anus.
a normal behavior pattern for these animals. Male
hamsters have two small, symmetrical black spots GERBILS
on the lateral flank region of the body. These are One of the friendliest small rodent pets is the
lateral flank sebaceous glands. The glands are testos- Mongolian gerbil (Meriones unguiculatus) (Figures
terone dependent and are better developed in males 5.2A and 5.2B). The most common color of pet
than in females.2 The only open-rooted teeth in gerbils is tannish brown (agouti), but other hair
small rodents, including hamsters, are the incisors. coat colors are available. If multiple animals are

Table 5.2 Hamster Basic Information1

Body Weight Adult Male 85–130 g

Birth Weight 2g
Temperature, Pulse, and Respiration Rectal Body Temperature 99°–101°F
Age at Onset of Puberty Puberty, Male 45–75 days

and Breeding Life
Breeding Initiation, Male 10–14 weeks
Breeding Initiation, Female 6–10 weeks
Female Reproductive Cycle Estrous Cycle 4 days (polyestrous)

in the same enclosure with different hair coat col- environment. Owners should be encouraged to
ors, like-colored individuals will usually associate regularly clean the enclosure to maintain healthy
with each other.1 animals in an artificial setting. Food, water, and
These animals are native to a very dry environ- husbandry management for gerbils is similar to
ment; therefore, they do not drink much water that for other small rodents. (See the baseline ger-
and produce little waste that would soil their bil physical information listed in Table 5.3.2)
Figure 5.2A Gerbils make excellent companion Figure 5.2B Gerbil in a typical cage.
animals.
5 | rodents 139
Table 5.3 Gerbil Basic Information1


Birth Weight 2.5–3.5 g
Normal Heart Rate 360 beats/minute
Normal Respiratory Rate 90 breaths/minute
Amounts of Food and Water Daily Food Consumption 5–8 g
Daily Water Consumption 4 mL
Age at Breeding Initiation Breeding Initiation, Male 70–85 days
Breeding Initiation, Female 65–85 deays
Female Reproductive Cycle Estrous Cycle 4 days (polyestrous)

Gestation Length (nonlactating) 24–26 days
Gestation Length (concurrent 27–48 days
lactation)
There is an androgen-dependent midventral scent (Refer to the baseline rat physical information
gland on a gerbil’s body. This scent gland should not listed in Table 5.4.1,2 )
be mistaken for an abnormal dermatologic lesion. Rats are continuous, polyestrous rodents that
should be bred in polygamous or monogamous
RATS setups because of the males’ aggressive territorial-
Rats, like mice, are common laboratory animals ity behavior.1 When breeding rats in a polygamous
and are also propagated for reptile food. Unlike ratio, there might be 1 male with 2–6 females.
mice, rats have excellent pet characteristics that Females are removed from a polygamous cage
include a personable disposition and a charming prior to parturition. A monogamous pair is main-
intelligence. The common rat species maintained tained together with the young until weaning.
as a companion animal is Rattus norvegicus, with
the white rat and hooded rat being the most com- MICE
mon variations. Although rats have an excellent Although not a common companion animal, mice
temperament for companionship, they can inflict (Mus musculus) are maintained in captive condi-
a serious bite if provoked. Also, as with other ani- tions as pets and for use as reptile food. The African
mal species, humans can be allergic to their hair, pygmy mouse is a genus of mouse that is commonly
skin dander, urine, and salivary proteins.2 Rats maintained as a pet.2 A number of behavioral and
are not as territorial as other rodent species and physical characteristics make mice undesirable pets,
are very social. Food, water, and husbandry man- including aggressive, protective behavior, often
agement is similar to that for other small rodents. resulting in painful bites to the owner; territorial

Table 5.4 Rat Basic Information1


Birth Weight 5–6 g
Daily Water Consumption 10–12 ml/100 g body weight/day
Age at Onset of Puberty Sexual Maturity, Male 65–110 days

and Breeding Life
Sexual Maturity, Female 65–110 days

behavior that often results in severe injury to cage

HUSBANDRY
mates; potential human allergies to the hair and
skin dander; and a strong, undesirable smell to the Environmental Concerns
urine. Even with these undesirable characteristics, Guinea Pigs
mice can be good pets for owners who are willing Guinea pigs are commonly maintained in indoor
to work with the animals and accept their nega- cages. The general environment of the house will
tive aspects. (See mouse basic information in Table usually provide an adequate temperature range to
5.5.) maintain proper health and comfort. These ani-
Mice are maintained in environments that are mals are native to the Andean mountain range and
similar to those for other small rodents, but a thor- are more sensitive to warmer temperatures than to
ough cage cleaning is required more often because cooler ones. Temperatures above 80°–85°F might
of their smelly urine (Figure 5.3). Food, water, and cause heat-related death.1
husbandry management is similar to that for other A guinea pig enclosure should have 1 cubic foot
small rodents listed in this chapter. of space per adult and be made out of wire mesh
Mice, like rats, are continuous polyestrous (0.5–1.5" spacing). Breeders should have twice
rodents that should be bred in polygamous the recommended adult floor space.2 The cage
or monogamous setups, because of the males’ should have an open top with sides at least 10"
aggressive, territorial behavior.1 When breed- high and should also have a hiding box to provide
ing mice in a polygamous ratio, there might be security when needed.1 Cavies are very susceptible
1 male with 2–6 females. Females are removed to infectious pododermatitis, or “bumblefoot.” A
from a polygamous cage prior to parturition. A solid floor is preferred over a wire mesh floor to
monogamous pair is maintained together with prevent bumblefoot and protect against limb and
the young until weaning. nail trauma. Other pets that might harm guinea
5 | rodents 141
Table 5.5 Mouse Basic Information1


Birth Weight 0.8–2.0 g
Age at Onset of Puberty Sexual Maturity, Male 50 days

and Breeding Life
Sexual Maturity, Female 50–60 days

pigs, such as dogs and cats, should be kept in an animal could escape into the house. If a hamster
area that will prevent an attack and exposure to does escape, the best way to capture it is to place
Bordetella spp. bacteria. food in the center of the room. Once it has been
As with all rodents and pocket pets, guinea determined in which room the animal is hiding,
pigs’ bedding must be changed on a regular basis, the room should be sealed. Because hamsters are
because feces, urine, food, and water soil the envi- nocturnal animals, capturing them at night—in
ronment. Hardwood shavings, composite recycled a dark room, with a flashlight—might work best.
paper materials, pellets, and shredded paper may This technique will work for the capture of other
be used as bedding material. Guinea pigs are also small rodents and pocket pets as well.
susceptible to submandibular abscesses, commonly
called “lumps.” These abscesses are caused by hay,
straw, or woodchips that are eaten and puncture the
gingival surface, seeding bacteria within the oral
cavity. The bacterial infection migrates into the sub-
mandibular/cervical area, forming large abscesses.
If a patient presents with these abscesses, the diet
should be reviewed in order to help identify and
eliminate the initiating cause of the problem.
Small Rodents
As discussed previously, hamsters commonly
chew their way out of enclosures. It is impor- Figure 5.3 Typical mouse cage, with recycled paper as
tant that the housing be “hamster-proof,” or the a substrate.

The recommended cage size for hamsters, mice, week. If the plastic tube housing systems are used,
and gerbils is 20" × 20" × 6–10" high.1 Owners routine cleaning of the sections, using hot water
should be informed that the cage should pro- and a mild detergent, is called for. Ventilation is
vide enough room for the animal to exercise and essential in all small-rodent housing to prevent
should contain an exercise wheel and a hiding box irritation of the respiratory tract from the ammo-
(Figures 5.4A and 5.4B). For proper ventilation, a nia vapors generated by urine.
screen top is recommended. Hardwood shavings,
commercial recycled paper pellets (CareFresh; Nutrition
Absorption Corp., Ferndale, WA), and shredded Guinea Pigs
papers are the primary substrate choices for rodent A commercial guinea pig feed (20% crude protein
cages, with cleaning occurring one to two times a and 16% fiber) is the best basic diet, along with free
choice of timothy hay.2 Many companies manufac-
ture timothy hay guinea pig pellets, and this should
be the base diet. Discourage owners from using any
rodent diet that contains seed. The dietary source
should be fresh and supplemented with ascorbic
acid (vitamin C). If the diet is not fresh (within 30
days of milling date), there is a possibility that the
vitamin content has degraded and is not adequate
for the pet’s daily requirements. Supplemental
vitamin C will aid in the cavy’s general health; it
requires 7–10 mg/kg/day and, if pregnant, 20–30
mg/kg/day. Kale, cabbage, and oranges are very
good dietary sources of vitamin C. Vitamin C tab-
Figure 5.4A A typical cage that can be purchased lets manufactured specifically for guinea pigs are
from a pet store. available commercially through Oxbow Pet Prod-
ucts (Murdock, NE). Commercial vitamin C drops
can be mixed into the sipper bottle water to provide
additional vitamin C (Figure 5.5). Any vitamin C
supplement that is added to the water must be refor-
mulated and changed daily, because the half-life of
vitamin C is only 24 hours in glass bottles of clean
water.1 Timothy hay, alfalfa cubes, small amounts
of green vegetables, and apples are all treats that
these animals eat on a regular basis.2 Treats should
be limited to 1–2 tablespoons over a 24-hour
period, with the bulk of the dietary requirements
coming from guinea pig chow.2 Feeders and sipper
Figure 5.4B An exercise wheel. tubes should be suspended on the side of the cage
5 | rodents 143
to prevent fecal contamination and dumping of the nance. Treats may be offered in the form of nuts,
contents onto the cage floor. raisins, apples, and greens, at no more than ½ tea-
spoon per 24 hours.1
Small Rodents Sipper bottles and small food containers that
The nutritional requirements for most small fit on the side of the enclosure reduce spillage and
rodents are the same. A number of commercial urinary/fecal contamination. Water and feed con-
hamster/rodent pellets are available (Figure 5.6). tainers should be cleaned daily and replenished
The formulas that contain at least 16% protein with fresh contents.
and 8% fiber provide for optimum health.1,2 The
owner should be informed that any seed-based Transport: All Rodents
rodent diet is unacceptable for health mainte- There are a number of options for transporting
small rodents. If the cage is small, it may be used,
or there are a variety of small plastic and wire car-
riers suitable for these animals.
Grooming: All Rodents

The only small rodent that requires nail trimming
on a regular basis is the guinea pig. Human toe-
nail clippers can be used to trim the claws below
the sensitive vascular “quick.” On many guinea
pig patients it is difficult to see exactly where the
Figure 5.5 Vitamin C supple-
quick is; therefore, one should be conservative in
ment can be added to a guinea
the amount of nail removed. The rear nails are
pig’s drinking water.
routinely longer than those on the front legs. The
guinea pig should be properly restrained and if
bleeding does occur, a silver nitrate–tipped cau-
tery stick can be used to provide hemostasis.
Rats may have sharp claws that the owner asks
to have cut. A very short trim, using human nail
clippers, will adequately blunt the claws to reduce
injury due to scratching in these animals.
HISTORY
GUINEA PIGS
The same basic background information is
Figure 5.6 Hamster food can be purchased as a pel- required for guinea pigs as for other animals that
leted diet or with a seed base. The recommended diet are examined at the veterinary clinic. How long
for hamsters is a pelleted diet. the animal has been owned, where it was acquired,

how often it is handled, and the character of the is recommended that this section be referred to
feces and urine are a few of the questions that when examining these animals.
should be asked for background information.
Husbandry questions include where the animal is
RESTRAINT
housed; whether it is allowed to roam unobserved
in the house; cage location, type, size, material, GUINEA PIGS
substrate, furniture, and toys; how often the Guinea pigs should be restrained by grabbing the
cage is cleaned; and the disinfectant used. When animal around the shoulders with one hand, lift-
investigating the diet, it is important to ask owning the animal up, and supporting the rear with
ers if pellets are fed, how much, and also what the the other hand (Figures 5.7A and 5.7B). The han-
animal is actually eating. Supplemental offerings dler must be careful not to squeeze too hard with
and frequency of feeding are very important data the hand around the neck and chest, because
for the case workup. To round out the nutrition
section, the technician should find out about the
water supply, how often the water is changed,
and how much the animal drinks on a daily
basis. Because vitamin C is a required nutrient
for guinea pigs, it is very important to ask about
vitamin C supplementation and the age of the
animal’s food. Vitamin C will degrade over time
and when exposed to extreme heat. Recently pur-
chased food that has been stored properly is likely
to have maintained the nutritious value of that
vitamin.
Because animals can transmit diseases among Figure 5.7A When restraining a guinea pig, the ani-
mal must be supported in the rear.
one another, the technician’s final questions
should center on other pets in the household—
if new animals have been added to the family
or if the animals are housed together. Finally, a
description of any previous problems and a com-
plete chronological description of the presenting
problem are needed to complete the history form.
SMALL RODENTS
The same questions used to obtain a history for
guinea pig patients can be used for other small
rodents and pocket pets. The history and physical
examination information in the following rodent Figure 5.7B Proper restraint of a guinea pig also re-
and pocket pet sections will not be repeated. It quires a firm grasp around the shoulder and neck area.
5 | rodents 145
respiratory compromise could occur. To prevent

respiratory distress, the handler should place the
hand around the neck from the ventral aspect of
the animal, while supporting the rear legs with
the other hand.
HAMSTERS
Hamsters and other small rodents can be restrained
by pinching the skin on the scruff. It is important
to get a tight hold of the skin to prevent escape or
injury. Hamsters’ eyes can prolapse with a tight
grip, but gentle pressure on the globe, pushing into
the orbit, usually resolves the problem.
Figure 5.8 Proper method for restraining a gerbil.
GERBILS
A gerbil should be restrained by cupping a hand
over the animal’s back and immobilizing its head
between the forefinger and middle finger, with
the thumb supporting the rear of the animal
(Figure 5.8). Never attempt to restrain a gerbil
by its tail, because the skin is easily removed
(Figure 5.9).
RATS
To restrain a rat, the animal should be picked up
with one hand placed over its back and rib cage, Figure 5.9 A gerbil’s tail should never be pulled, be-
while restraining its head with the thumb and cause as a defensive response, the skin will deglove.
forefinger directly behind its jaws (Figure 5.10).
The other hand grasps the tail, stabilizing the ani-
mal (Figure 5.11). As with other rodents, the skin
on the dorsal cervical region can also be used to
pick up rats.
MICE
To restrain a mouse, the tail should be grabbed
with the thumb and forefinger, allowing the
mouse to hold on to an object with its front feet.
When the mouse securely attaches itself to an
object, the other hand then grabs the dorsal skin Figure 5.10 The proper method for restraining a rat.

Figure 5.11 A rat’s body should be supported when it Figure 5.12A Proper method for capturing and re-
is being examined off a table. straining a mouse. A mouse can be grabbed by the tail.
in the cervical region, while keeping the tail in a

firm grasp (Figures 5.12A, 5.12B, and 5.12C).
PHYSICAL EXAMINATION: ALL RODENTS
Prior to restraint, the veterinarian will observe

the animal’s attitude, activity, and posture. The
next step is to weigh the animal in a basket on
a digital gram scale. If possible, temperature, res-
piration, and pulse should be measured and any
abnormalities in rate or character noted. The vet-
Figure 5.12B Proper method for capturing and re-
erinarian will begin the physical examination at straining a mouse.
the head, looking for any abnormalities. Eyes,
ears, and nares are observed, looking for discharge
or inflammation. The oral cavity in guinea pigs is
difficult to examine because of the small opening
and tendency for the buccal mucosa to encroach
toward the middle of the mouth. A small rabbit
speculum or an otoscope can be used to examine
the oral cavity and teeth (Figure 5.13). Mucous
membranes help determine hydration status using
capillary refill time and moisture. Body condition
and abdominal palpation findings are important
information to be obtained. Lymph nodes and
limbs are palpated prior to examining the claws Figure 5.12C Proper method for capturing and re-
and plantar surface of each foot. It is not uncom- straining a mouse.
5 | rodents 147
mon for guinea pigs to present with long claws

(Figure 5.14). The patient should have a normal
posture, be aware of its surroundings, and move
properly. Any problems should be noted in the
record. Finally, a dermatological exam considers
hair coat quality, alopecia, external parasites, or
any skin abnormalities (Figure 5.15). All abnormal
findings are written in the record for case review,
differential diagnosis determination, diagnostic
testing, and treatment considerations.
Figure 5.13 An otoscope with a designated reusable

plastic cone can be used to obtain a quick examination DIAGNOSTIC SAMPLING
of the teeth of both guinea pigs and rabbits.
Blood Collection
Guinea Pigs
In guinea pigs and other pocket pets, blood col-
lection can be quite difficult. Approximately
0.5–0.7 ml/100 grams of body weight can be
safely removed from a non-anemic, healthy guinea
pig.3 For many small exotic mammal patients,
including the guinea pig, the location of choice
for blood collection is the cranial vena cava (see
Figure 5.16). Owing to the location of the cranial
vena cava and the size of other blood vessels, seda-
Figure 5.14 Guinea pigs’ claws should be trimmed on
tion or anesthetization of the guinea pig patient
a regular basis.
is recommended prior to performing the phlebot-
omy. To collect blood from the cranial vena cava,
one should do the following:4
• Isolate the center of the cranial sternum and

manubrium.
• Insert a 25- to 27-gauge needle to the right of
the manubrium at a slight angle directed toward
the opposite lateral body wall.
• Advance the needle only as negative pressure is
applied. If there is not a “flash” of blood in the
needle hub once the needle has been inserted,
Figure 5.15 Guinea pigs often present with alopecia, pull the needle almost out of the body cavity
which might be associated with vitamin C deficiency and redirect dorsally first, then if unsuccessful,
and/or ectoparasite infestation. ventrally until blood is observed in the syringe.

• Be sure not to advance the needle too far. In Small Rodents

most patients the vessel is usually very close to Although hamsters, gerbils, mice, and rats are
the ventral surface under the cranial sternum. very small animals, their blood must be collected
• Maintain a consistent flow of blood once the and tested for diagnostic purposes. As described
cranial vena cava has been located. for the guinea pig, the cranial vena cava is the site
• Finish collecting and then twist the needle of choice for collecting adequate volumes of blood
when pulling it out of the body cavity. for diagnostic testing on hamster patients. A safe
amount of blood to draw from a noncritical ham-
The easiest veins to see are the lateral saphenous
and cephalic, but they are very small and easily
collapse when too much suction is used to col- Table 5.6 Guinea Pig Complete Blood Count
lect blood. The fur should be clipped over the Reference Ranges3
vein from which the blood will be taken and the Cell Type Normal Range
surface prepared with alcohol. A small 25- or Erythrocytes 3.2–8.0 x 106/µl
26-gauge needle, usually placed on a 3 cc syringe, Hematocrit 32%–50%
is recommended to collect the blood. The short Hemoglobin 10–17 g/dl
jugular vein can be used, but it is difficult to Leukocytes 5.5–17.5 x 103/µl
find, and if the cranial vena cava is used in cavies Neutrophils 22%–48%
Lymphocytes 39%–72%
for blood collection, it might lead to bleeding
Eosinophils 0%–7%
complications. The position to collect from the
Monocytes 1%–10%
jugular vein is similar to the technique used for
Basophils 0%–2.7%
cats. Reference ranges for complete blood counts Platelets 260–740 x 103/µl
and serum chemistry panels are listed in Tables Serum Protein 4.2–6.8 g/dl
5.6 and 5.7, respectively.3 Albumin 2.1–3.9 g/dl
Globulin 1.7–2.6 g/dl
Table 5.7 Guinea Pig Serum Biochemistry

Reference Ranges3
Analyte Normal Range
Serum Glucose 60–125 mg/dl

Blood Urea Nitrogen 9.0–31.5 mg/dl
Creatinine 0.6–2.2 mg/dl
Total Bilirubin 0–0.9 mg/dl
Serum Phosphate 3.0–7.6 mg/dl
Alkaline Phosphatase 55–108 U/L
Alanine Aminotransferase (ALT) 25–59 U/L
Figure 5.16 Blood can be collected from the cranial
Aspartate Aminotransferase (AST) 26–68 U/L
vena cava of many small exotic mammals.
5 | rodents 149
ster patient would be approximately 0.7 ml/100 using the thumb and forefinger. The taut skin on
grams of body weight. Clipping the hair and disin- the lateral aspect of the thigh allows exposure of
fecting the topical skin surface will properly prepare the saphenous vein. A 23-gauge needle is used to
the blood collection sites. General anesthesia is a puncture the vein, and blood is collected in a micro-
consideration whenever blood is being collected hematocrit tube as it flows from the vessel.3
for diagnostic testing in these small animals. Usu- The jugular vein and ear vessel can be used in
ally, inducing the animal in a closed chamber larger rodents and pocket pets for blood collec-
and maintaining the patient in a mask will allow tion. To collect blood from the jugular vein, a 3 cc
the technician plenty of time to collect the blood syringe and 25-gauge needle are needed, whereas
sample. Table 5.8 describes the technique used for a microhematocrit tube is used to collect blood
retro-orbital blood collection in small rodents. from the ear vessel. Blood samples obtained from
On smaller rodents, the saphenous vein or lat- nail and ear clips are not considered appropriate
eral vein of the tarsus can be used for multiple diagnostic samples. Cardiac puncture is recom-
blood collections without the use of anesthesia. The mended only for terminal cases, when the animal
patient must be properly immobilized in a restraint is maintained under general anesthesia, because
tube (35 cc syringe) with the leg extended and the of possible complications involving the lungs and
skin held tight on the medial aspect of the thigh heart vessels. Reference ranges for complete blood
counts and serum chemistry panels for hamsters
are listed in Tables 5.9 and 5.10, respectively.1
Table 5.8 Retro-Orbital Blood Collection3 The collection of samples for diagnostic testing
1. Stabilize head at base of skull and point of jaw. in gerbils is similar to the techniques used in other
2. Occlusion of the jugular vein may distend the venous rodents. The reference ranges for complete blood
plexus. counts and serum chemistry panels for gerbils are
3. Retract the dorsal lid of the eye with the index finger. listed in Tables 5.11 and 5.12, respectively.2,3
4. Collection: The collection of samples for diagnostic test-
 H
amsters—a microcapillary tube or small-bore
ing in rats is similar to the techniques used with
Pasteur pipette is inserted midway along the
superior border of the eye and advanced to the other rodents. The reference ranges for complete
plexus located posterior to the globe.4 blood counts and serum chemistry panels for rats
 M
ice and Gerbils—a microcapillary tube or small-
are listed in Tables 5.13 and 5.14, respectively.2,3
bore Pasteur pipette is inserted at the medial
canthus. The collection of samples for diagnostic test-
 R
ats—the middorsal approach, similar to that used ing in mice is similar to techniques used for other
with hamsters, is considered the most direct access
to the dorsal anastomotic vein.
rodents. The reference ranges for complete blood
5. Once the tube is placed in the correct position, the
counts and serum chemistry ranges for mice are
tube can be gently rotated until the conjunctiva is listed in Tables 5.151,2 and 5.16, respectively.
punctured and the orbital venous plexus is penetrated.
6. The tube is filled by capillary action. Bone Marrow Aspiration: All Rodents
7. Slight pressure may be placed over the eye to aid in Marrow samples can be obtained from the ilium,
hemostasis after the bleeding.
tibia, sternum, femur, or the bones of the proxi-
8. 0.5 ml may be collected from an adult mouse or gerbil.
mal one-third of the tail.4 Preparation of the

Table 5.9 Hamster Complete Blood Count Table 5.11 Gerbil Complete Blood Count
Reference Ranges1 Reference Ranges2,3
Cell Type Normal Range Cell Type reference Range
Erythrocytes 5.0–10 x 106/µl Erythrocytes 7.0–10 x 106/µl

Hematocrit 36%–55% Hematocrit 41%–52%
Hemoglobin 10–16 g/dl Hemoglobin 12.1–16.9 g/dl
Leukocytes 6.3–8.9 x 103/µl Leukocytes 4.3–21.6 x 103/µl
Neutrophils 10%–42% Neutrophils 5%–34%
Lymphocytes 50%–95% Lymphocytes 60%–95%
Eosinophils 0%–4.5% Eosinophils 0%–4.0%
Monocytes 0%–3.0% Monocytes 0%–3.0%
Basophils 0%–1.0% Basophils 0%–1.0%
Platelets 200–500 x 10 /µl 3
Platelets 400–600 x 106/µl
Serum Protein 5.9–6.5 g/dl Serum Protein 4.3–12.5 g/dl
Albumin 2.63–4.10 g/dl Albumin 1.8–5.5 g/dl
Globulin 2.7–4.2 g/dl Globulin 1.6–6.0 g/dl
Table 5.10 Hamster Serum Biochemistry Table 5.12 Gerbil Serum Biochemistry
Reference Ranges1 Reference Ranges2,3
Analyte Normal Range Analyte reference Range
Serum Glucose 60–150 mg/dl Serum Glucose 50–135 mg/dl

Blood Urea Nitrogen 10.0–25.0 mg/dl Blood Urea Nitrogen 17.0–27.0 mg/dl
Creatinine 0.92–0.99 mg/dl Creatinine 0.5–1.47 mg/dl
Total Bilirubin 0.25–0.60 mg/dl Total Bilirubin 0.2–0.6 mg/dl
Cholesterol 25–135 mg/dl Cholesterol 90–150 mg/dl
Serum Calcium 5.0–12.0 mg/dl Serum Calcium 3.7–6.2 mg/dl
Serum Phosphate 3.4–8.2 mg/dl Serum Phosphate 3.7–7.0 mg/dl
Alkaline Phosphatase 3.2–30.5 U/L
Alanine Aminotransferase (ALT) 11.6–35.9 U/L
Aspartate Aminotransferase (AST) 37.6–168.0 U/L
unsealed ziplock bag, which often will cause it to

urinate. For guinea pigs and larger pocket pets, a
samples is consistent with that of other mamma- standard cystocentesis procedure can be used to
lian patients. (See “Bone Marrow Aspiration” in collect urine directly from the bladder.
Chapter 4 on rabbits.)
Microbiology: All Rodents
Urine Collection: All Rodents Guinea pigs are susceptible to Bordetella bronchi-
When the patient is hospitalized, a standard septica and Streptococcus pneumonia respiratory
rodent cage (without substrate) can be used to col- bacterial infections. It is best to prevent these respi-
lect urine and feces. For small rodents, the sample ratory infections by separating other pets (e.g.,
can also be collected by placing the animal in an dogs, cats, rabbits) from guinea pigs. Staphylococcus
5 | rodents 151
Table 5.13 Rat Complete Blood Count Table 5.15 Mouse Complete Blood Count
Reference Ranges2,3 Reference Ranges1,2,3
Cell Type Normal Range Cell Type reference Range
Erythrocytes 5.4–8.5 x 106/µl Erythrocytes 7.0–12.5 x 106/µl

Hematocrit 37%–49% Hematocrit 36%–49%
Hemoglobin 11.5–16 g/dl Hemoglobin 10.2–18 mg/dl
Leukocytes 6.6–12.6 x 103/µl Leukocytes 6.0–15.0 x 103/µl
Neutrophils 6–17% Neutrophils 10%–40%
Lymphocytes 9–34% Lymphocytes 55%–95%
Eosinophils 0–6% Eosinophils 0%–4.0%
Monocytes 0–5% Monocytes 0.1%–3.5%
Basophils 0–1.5% Basophils 0.0%–0.3%
Platelets 450–885 x 10 /µl
3
Platelets 60–1,200 x 106/µl
Serum Protein 5.6–7.6 g/dl Serum Protein 3.5–7.2 g/dl
Albumin 3.8–4.8 g/dl Albumin 2.5–4.8 g/dl
Globulin 1.8–3.0 g/dl Globulin 1.8–3.0 g/dl
Table 5.14 Rat Serum Biochemistry Reference Table 5.16 Mouse Serum Biochemistry
Ranges2,3 Reference Ranges1,2,3
Analyte reference Range Analyte reference Range
Serum Glucose 50–135 mg/dl Serum Glucose 62–175 gm/dl

Blood Urea Nitrogen 15.0–21.0 mg/dl Blood Urea Nitrogen 12–28 mg/dl
Creatinine 0.2–0.8 mg/dl Creatinine 0.3–1.0 mg/dl
Total Bilirubin 0.20–0.55 mg/dl Total Bilirubin 0.1–0.9 mg/dl
Cholesterol 40–130 mg/dl Cholesterol 26–82 mg/dl
Serum Calcium 7.2–13.9 mg/dl Serum Calcium 3.12–8.5 mg/dl
Serum Phosphate 3.11–11.0 mg/dl Serum Phosphate 2.3–9.2 mg/dl
Alkaline Phosphatase 56.8–128 U/L
Alanine Aminotransferase (ALT) 17.5–30.2 U/L
Aspartate Aminotransferase (AST) 45.7–80.8 U/L
rial diseases that are of great concern, including
mycoplasma in rats and mice and Lawsonia intra-
aureus is the major causative agent found in cellularis in hamsters, are discussed in greater
infectious pododermatitis lesions. Streptococcus detail in the “Health Maintenance and Disease”
zooepidemicus and Streptobacillus moniliformis section later in this chapter.
are common isolates of infections affecting the
cervical lymph nodes, commonly called “lumps.” Radiology: All Rodents
Routine culture techniques should be used to iso- Radiology techniques for guinea pigs and other
late and identify the bacterial organism causing pocket pets are similar to those used on rabbits.
a disease. Bacterial infections also cause disease Please refer to Chapter 4 for radiology techniques
in other pet rodent species. The specific bacte- needed for guinea pigs and pocket pets.

Fecal Examination and Anal Tape Test: during the recovery period. Once the guinea pig
Small Rodents has been treated and no mites remain, new toys
Routine fecal parasite evaluations should be per- should be purchased.
formed on small rodents when presented for a Lice and mites, including T. caviae, can
health examination or an abnormal stool. Com- be treated with imidacloprid and moxidec-
mon protozoal organisms that can be detected tin (Advantage Multi for cats [orange], Bayer
using a direct fecal examination include Giardia HealthCare, Shawnee Mission, KS, 0.1 ml/kg
spp., cryptosporidiosis, and Spironucleus muris.3 topically, every 30 days for 3 treatments) or iver-
Hymenolepis diminuta is a tapeworm that can mectin (Ivomec, Merck & Co., Inc, West Point,
cause constipation in hamsters.3 This tapeworm PA, 0.5 mg/kg SC, and repeat in 10 days. Unfor-
can be detected during a fecal examination, at tunately, T. caviae and other guinea pig parasites
which time the owner must be informed that it is are becoming resistant to ivermectin treatment
a zoonotic parasite. alone, so 4–5 treatments of ivermectin (10 days
Rodent pinworms, specifically Syphacia muris apart) are needed, with the owner cleaning the
and Syphacia obvelata, are commonly diagnosed environment twice a week. To aid in treatment
using the sticky side of clear cellophane tape to of difficult mite and lice infestations, lime sul-
make an impression of the anus. The sticky sur- fur dip (2.5% solution, apply once per week for
face will pick up the banana-shaped pinworm 4–6 weeks) is also prescribed as an adjunct ther-
eggs, which can then be observed under a micro- apy. The combined treatment protocol is usually
scope. effective.
Guinea pigs are exposed to ectoparasites
Parasitology through direct contact. Most of the animals
External Parasites that are affected are recent purchases from a pet
Guinea Pigs store. If fleas are a problem, a pyrethrin-based
Guinea pigs can be infested by mites, lice, and fleas. cat flea powder is effective, especially after the
The most significant ectoparasite is the sarcoptic environment is treated and the patient has been
mite, Trixacarus caviae.3 Guinea pigs infested with bathed. As with rabbits, newer antiparasitic
T. caviae have intense itching episodes that result medications appear effective in treating guinea
in hair loss and skin lesions, primarily involving pigs that present with ectoparasites. Imidaclo-
the thighs and back.3 Treatment of guinea pigs prid and moxidectin (Advantage Multi for cats
diagnosed with T. caviae is difficult, because the 9 weeks of age and 5.1–9.0 lbs, topical solution,
environment and the animal must be treated at Bayer HealthCare LLC, Animal Health Divi-
the same time. Pet owners should be advised to sion, Shawnee Mission, KS) can be used to treat
clean the enclosure at least twice a week during guinea pigs diagnosed with fleas, mites, or lice
the treatment period, and all toys and bedding at a dose of 0.1 ml/kg once every 30 days for 3
material should be removed. It is also impor- treatments. As with other treatments, it is very
tant to discuss the zoonotic potential of T. caviae important that the owner maintain a clean envi-
with the owner. During the treatment phase, the ronment for the patient with regular cleaning of
owner should wear latex gloves, and exposure to the cage, at least 2 times a week, while it is on the
other family members and pets should be limited medication protocol.
5 | rodents 153
Small Rodents mite), Demodex nanus, Polyplax spinulosa (spined

Three species of mites are found in hamsters: rat louse), and fleas. Diagnosis and treatment are
Demodex criceti, Demodex aurati, and Notoedres similar to those recommended for mice, although
spp.6 Imidacloprid and moxidectin (Advantage the dosages and duration will differ. The dose of
Multi for cats 9 weeks of age and 5.1–9 lbs, topical imidacloprid and moxidectin topical solution for
solution, Bayer HealthCare LLC, Animal Health rats is 1 drop topically once a month to treat exter-
Division, Shawnee Mission, KS) can be used to nal parasites.
treat the Demodex spp. hamster mites at a dose of A number of parasites have been identified in
1 drop topically once a week. Notoedres spp. are mice. Hymenolepis nana (dwarf tapeworm) and
found around the hairless areas of the body: nose, Cysticercus fasciolaris (larval stage of the cat tape-
ears, feet, and genitals.6 Spleorodens clethrionomys, worm) can be isolated from these small rodents.
the nasal mite, and Ornithonyssus bacoti, the tropi- The dwarf tapeworm is often found in young mice
cal rat mite, can also infest hamsters.6 Diagnosis that are dead or in mice that present with severe
of ectoparasites in small rodents is similar to that gastroenteritis (resulting in diarrhea). Diagnosis
in other species listed in this text. A skin scraping of the dwarf tapeworm can be made with a fecal
of the affected area will usually yield the parasite flotation exam or by finding the tapeworms in the
that needs to be treated. small intestine at necropsy. Dwarf tapeworm can
Ivermectin is the drug of choice for ectoparasites be treated with praziquantal.
in small mammals and pocket pets. Topical spot Syphacia oblevata are commensal oxyurid
applications of amitraz, using a cotton-tipped nematodes that feed on bacteria that inhabit the
applicator, work the best on very small mammals intestinal tract of mice.6 Although nonpathogenic
diagnosed with Demodex spp. in most cases, an overwhelming number can cause
Gerbils are generally healthy animals; conse- severe irritation of the terminal gastrointestinal
quently, they are not very susceptible to parasite tract. These nematode parasites can be diagnosed
infestations. If parasites are suspected, follow the using transparent tape and applying it to the rec-
instructions for diagnostic testing used in other tal area. After removing the tape from the affected
small rodents. Demodex spp., causing clinical der- rectal area, it can be placed on a slide and the ova
matological lesions, including alopecia, have been viewed under a microscope. Ivermectin and fen-
reported.4 Parasites are not a problem in healthy bendazole have been used effectively in treating
animals, and underlying causes of immunosuppres- this parasite in mice.6
sion must be investigated if they are diagnosed. The Giardia muris is a common protozoal parasite
same dose of imidacloprid and moxidectin topical that affects mice. This organism can be seen using
solution described for hamsters can be used for ger- a direct fecal examination. Metronidazole is the
bils diagnosed with Demodex spp. treatment of choice for Giardia infections in small
Specific parasites identified in rats include rodents.
the dwarf tapeworm (Hymenolepis nana), pin- Ectoparasitism in mice is a presentation that
worms (Syphacia muris), nematodes (specifically clinicians often see and diagnose. Myobia musculi,
Trichosomoides crassicauda), Giardia muris, and Myocoptes musculinis, Radfordia affinis, and Psore-
the following ectoparasites: Ornithonyssus bacotic gates simplex are all mice fur mites that can cause
(tropical rat mite), Radfordia ensifera (rat fur severe self-mutilation and hair loss (Figure 5.17).

be made by finding individual eggs with polar

bodies during fecal examination, or by finding
the whole worm within the lumen of the small
intestine during necropsy.6
As mentioned earlier, this is a zoonotic parasite
and proper precautions should be taken regard-
ing hygiene to prevent exposure after handling
the animal. Recommended treatment for H. nana
is praziquantel (Droncit, Bayer HealthCare LLC,
Animal Health Division, Shawnee Mission, KS,
Figure 5.17 Mice are susceptible to ectoparasites and 5–10 mg/kg IM or SC).
often present with alopecia.
THERAPEUTICS: ALL RODENTS

Polyplax serrata, the house mouse louse, can cause
anemia, pruritus, dermatitis, and death.6 Diag- This section will include the therapeutic issues
nosis of ectoparasites in mice is similar to that in for all small mammals and pocket pets. The size
other companion animal species. Treatment of of these patients contributes to the difficulty in
ectoparasites can be accomplished with ivermectin properly administering therapeutic medication.
and topical mitacide. As with those of other rodent The scruff of the neck and caudal flank are the
species, there appears to be an increasing resistance subcutaneous sites that can be used to admin-
to ivermectin by ectoparasites that affect mice. The ister medication or fluids.7 The semitendinosus,
dose to treat mice ectoparasites with imidacloprid triceps, or epaxial muscles are commonly used
and moxidectin topical solution) is 1 drop once for intramuscular injections, whereas intra-
every 30 days. peritoneal injections are used in extremely
small species.7 On larger rodents and pocket
Internal Parasites pets, intravenous injections can be given in the
Guinea Pigs cephalic, saphenous, or jugular vein.7 Intraosse-
Not many internal parasites of consequence are ous catheters are much easier to administer in
commonly diagnosed in pet guinea pigs. Cryp- these small animals than intravenous catheters.
tosporidium wrairi is a protozoal diarrhea that The tibial plateau and the greater trochanter are
infects the small intestine and can cause death.5 the sites of choice for intraosseous catheter place-
Clinical signs are consistent with other gastro- ment in pocket pets.7
intestinal illnesses, including diarrhea, anorexia, Although many methods can be used to
and weight loss. This infection is rare, but pos- administer medication in small mammals, oral
sibly zoonotic. There is no effective treatment for treatment (using a dropper or tuberculin syringe)
guinea pigs with this disease. is the easiest and least stressful to the patient.
Medication can be added to the food or water, but
Small Rodents often the patient is anorexic, which means that
Hymenolepis nana, the dwarf tapeworm, can the medicated food/water is not palatable. Hence,
cause constipation in hamsters. Diagnosis can the patient will not self-treat.
5 | rodents 155

ASSISTANCE: ALL RODENTS
Inducing and maintaining guinea pigs, other
small rodents, and pocket pets under anesthesia
can be very challenging. There are still concerns
and differences in anesthetic protocol because of
these animals’ small size, but in general, isoflurane
anesthesia is a safe agent when used on a relatively
healthy surgical candidate.
An induction chamber is used to induce the Figure 5.18 Hamsters as well as other exotic small
patients and then they are maintained under mammals are often maintained on gas anesthesia by
using a face mask.
gas anesthesia using a face mask (Figures 5.18,
5.19, and 5.20). Although it might be possible to
intubate a larger rodent or pocket pet, it is very
difficult under most conditions.8 Guinea pigs will
have elevated fluid accumulation around the glot-
tis if it is irritated during intubation. The elevated
fluid will increase the difficulty of intubating the
animal and could result in aspiration or apnea. In
most cases a guinea pig can be maintained for a
procedure in which general anesthesia is required
by using a face mask.
Guinea pigs have a tendency to regurgitate
gastric contents when under general anesthesia;
therefore, it is recommended to fast these ani- Figure 5.19 An induction chamber is often used to
mals at least 2–4 hours prior to surgery.8 To guard induce exotic small mammals for general gas anesthesia.
against aspiration of stomach contents in a patient
that is not intubated, place the head and neck in a
position slightly higher than the body.
Table 5.17 provides guidelines for surgical
preparation and assistance in surgical procedures
on small exotic animals.9
Premedication and sedation doses for rodents
are listed in Table 5.18. If the surgeon wants to
perform the procedure under injectable general
anesthesia, the doses are listed in Table 5.19.
Analgesia is important for patient recovery and
should be administered prior to, during, and after Figure 5.20 Mouse under general anesthesia, in
surgery, depending on the case presentation and preparation for surgery.

Table 5.17 Basic Surgery Guidelines for procedure being performed. In Table 5.20, anal-
Rodents and Pocket Pets9 gesic drug doses are listed for small animals.
1. Obtain accurate body weight.
2. Know the appropriate preoperative fasting interval.

Rat Intubation
Although rats are often maintained on general
3. Properly dose and administer medication.
anesthesia with a face mask, if needed they can
4. Minimize stress through premedication or minimal
be intubated. A speculum (Hallowell Engineer-
handling.
ing and Manufacturing Corp., Pittsfield, MA)
5. Administer oxygen when using only injection
anesthesia.
has been developed specifically to intubate rats
and a smaller one for mice. The rat patient is pre-
6. Prevent hypothermia by using external heat sources.
medicated with midazolam (1–2 mg/kg IM) and
7. Provide fluid therapy and maintain hemostasis during
buprenorphine (0.02–0.05 mg/kg SC) prior to the
surgery.
intubation procedure. Once sedated, the patient
Table 5.18 Premedication and Sedation Drug Doses for Rodents9

Drug Guinea Pig Rat Mouse Hamster Gerbil
Acepromazine 0.5–1.5 0.5–2.5 0.5–2.5 0.5–5.0 0

Diazepam 1.0–5.0 3.0–5.0 3.0–5.0 3.0–5.0 3.0–5.0
Midazolam 1.0–2.0 1.0–2.0 1.0–2.0 1.0–2.0 1.0–2.0
Xylazine* 5.0–10.0 10.0–15.0 10.0–15.0 8.0–10.0 5.0–10.0
Atropine 0.05 0.05 0.05 0.05 0.05
*Xylazine has a reversal agent, Yohimine (0.2 mg/kg IV).
All doses are mg/kg and should be given IM or SC.
Table 5.19 Injectable Anesthesia in Rodents9

Acepromazine/ 0.5–1.0 2.5–5.0 2.5–5.0 2.5–5.0 0

Ketamine 20–50 50–150 50–150 50–150 0
Xylazine/ 3.0–5.0 5 5.0–10.0 5.0–10.0 2.0–3.0
Ketamine 20–40 90 50–200 50–150 50–70
Diazepam/ 3.0–5.0 3.0–5.0 3.0–5.0 5 3.0–5.0
Ketamine 20–40 40–100 40–150 40–150 40–150
Tiletamine/
20–40 50–80 50–80 50–80 50–80
Zolazepam
All doses are mg/kg and should be given IM.
5 | rodents 157
Table 5.20 Analgesic Doses for Rodents

2 2 1.0–5.0 1.0–5.0 1.0–5.0

Butorphanol
(q2h–4h) (q2h–4h) (q2h–4h) (q2h–4h) (q2h–4h)
0.005 0.05–0.1 0.05–0.1 0.05–0.1 0.05–0.1
Buprenorphine
(q8h–12h) (q8h–12h) (q8h–12h) (q8h–12h) (q8h–12h)
All doses are mg/kg and should be given SC or IM.
is placed in ventral recumbency with the head orrhage in the joints and gingiva, malocclusion,
elevated. With a pair of hemostats, the tongue is rough hair coat, alopecia, anorexia, lameness, and
retracted, allowing for visualization of the glottis bruxism. The appropriate vitamin C supplemen-
with the aid of the rat speculum. A drop of lido- tation for guinea pigs is 15–25 mg/day, and for
caine is then placed on the glottis using a catheter pregnant animals 30 mg/day.6 Vitamin C can be
sheath, after which one should wait approximately ingested in the food and water or on the food as a
60 seconds prior to the intubation attempt. For supplement. Fresh cabbage, kale, and oranges are
most adult rats a soft 16- to 20-gauge catheter sources of supplemental vitamin C.6
sheath can be used, through which a stiff piece of
fishing line is passed to act as a guide. The tongue “Bumblefoot”
should be retracted again and the glottis visualized “Bumblefoot,” or infectious pododermatitis, is
using the speculum attached to an otoscope head. usually the result of footpad trauma progressing
Insert the fishing line into the trachea, remove into a chronic Staphylococcus aureus infection.6
the speculum, and feed the endotracheal tube The initiating cause of many bumblefoot infec-
through the fishing line into the trachea. Be care- tions is inadequate caging substrate, particularly
ful not to bend the very flexible catheter sheath wire-bottom cages and abrasive bedding mate-
that is now serving as an endotracheal tube. The rial. Owners must be informed of the guarded
endotracheal tube can then be tied in place and prognosis in resolving these foot infections. Surgi-
verified through the use of positive pressure venti- cal debridement, topical and systemic antibiotic
lation. Similar placement of an endotracheal tube treatment, and bandaging of the affected feet are
can be performed on a mouse. required to improve the chances of recovery. To
prevent recurrence, the owner should be advised
to change the substrate and floor of the cage into
a solid floor with nonabrasive bedding.
GUINEA PIGS
Scurvy “Lumps”
Guinea pigs lack the ability to endogenously Lumps is a common term given to a disease of the
synthesize ascorbic acid. Therefore, to maintain cervical lymph nodes that results in abscessation
proper health, it is essential that a dietary supple- owing to a Streptococcus zooepidemicus infection
ment of vitamin C be provided. Common signs (Figures 5.21A and 5.21B). S. zooepidemicus is
associated with vitamin C deficiency include hem- part of the normal flora of guinea pig conjunctival

affected teeth. All of the teeth previously mentioned

can become overgrown, resulting in anorexia and
hypersalivation. The teeth should be trimmed on
a regular basis to prevent the inability to eat and
trauma to the tongue and buccal surface. Gen-
eral anesthesia is recommended for trimming the
molars and premolars, although the incisors can be
trimmed using regular restraint. Vitamin C defi-
ciency has been implicated as a possible contributor
to the disease process owing to the breakdown of
collagen formation in the tooth socket, causing
instability that leads to malocclusion.
Figure 5.21A A common disease presentation of
guinea pigs is submandibular abscessation. Antibiotic-Associated Enterotoxemia
When treating guinea pigs with antibiotics, it must
be remembered that their normal gastrointestinal
flora are predominantly Gram-positive organisms.6
Classes of drugs that include penicillin and ami-
noglycosides will kill the normal gastrointestinal
flora, causing an overgrowth of Clostridium diffi-
cile.6 Never prescribe antibiotics for a guinea pig
patient unless there is a reference for its use in this
species. Other antibiotics that are recommended
for use in guinea pigs should be monitored during
Figure 5.21B Aspirated purulent material collected
from a submandibular abscess. the treatment period. If there is any evidence of the
patient becoming anorexic or having diarrhea, the
and nasal mucosa.6 Once the oral mucosa has been medication should be discontinued and the patient
compromised, usually by poor-quality hay, the rechecked for drug-induced gastroenteritis. Placing
bacteria travel through the bloodstream into the cer- the patient on a probiotic or yogurt supplement while
vical lymph nodes. Complete surgical excision of the it is being treated with antibiotics might be helpful.
affected lymph nodes is recommended for treating
the disease. The owner should be informed of the HAMSTERS
disease process and measures taken to prevent recur- This section will review the common hamster dis-
rence, including stress reduction and a quality diet. eases seen in veterinary practice. An overview of
etiology, treatment, and prevention will follow a
Malocclusion brief description of the disease presentation.
Guinea pigs have open-rooted incisors, premolars,
and molars. Open-rooted teeth grow continuously “Wet-Tail”
and, if the teeth are not properly aligned, maloc- Diarrhea and gastrointestinal disorders in ham-
clusion will occur—resulting in overgrowth of the sters have been given a common name by the
5 | rodents 159
medical community and general public: “wet-tail.” should be considered as a differential diagnosis,
A number of conditions and bacterial organisms especially if an asymmetrical mass is present. Treat-
can contribute to this condition, but the primary ment is removal of the affected tissue, if possible, to
organisms implicated in this disorder are different increase the quality of life for the small rodent.
for young and adult animals.
In young hamsters (3–10 weeks old) proliferative Ocular System
ileitis is commonly caused by Lawsonia intracellu- Hamsters might present with one or both eyes pro-
laris.7 This disease must be treated aggressively with truding from the socket(s). If the animal is grabbed
fluid therapy, antibiotics, and force-feeding. One of too tightly on the back of the neck, the eyes will
the recommended antibiotic regimes is enrofloxacin start to bulge out of the sockets. If the eyes do
(10 mg/kg PO q12h for 5–7 days).7 Fluid therapy prolapse from the socket, the eye and ocular area
is very important to combat electrolyte imbalances should be moistened with ophthalmic wash and
caused by diarrhea, dehydration, and anorexia. An lubricant (the lid margins retracted) and the globe
electrolyte and glucose injection, at a dose of 40–60 gently returned to its normal anatomical location.
ml/kg SC q24h, should help maintain fluid and The animal should then be maintained on antibi-
electrolyte levels within the body.7 Force-feeding a otic ophthalmic treatment for a week to 10 days.7
finely ground mixture of one-half fruits and veg- If the problem recurs, a tarsorrhaphy or enucleation
etables and one-half hamster pellets, at a dose of may be indicated.
20–30 ml/kg q24h PO, will increase the caloric
intake and energy level of the patient.7 Trauma
When an improper antibiotic is selected to treat If two or more hamsters are housed together in the
adult hamsters that present with diarrhea, nor- same cage, it is not uncommon for bite wounds to
mal flora can be killed, resulting in overgrowth of occur (Figure 5.22). These wounds often become
Clostridium difficile. Penicillin, lincomycin, and baci- infected and should be treated by shaving the hair
tracin are all antibiotic choices that will contribute to around the wound, culture of the affected area,
the death of normal gut flora in hamsters, leading to flushing with a dilute antimicrobial solution, then
enterotoxemia.7 treating with a topical antibiotic along with sys-
Tyzzer’s disease, caused by the bacterium Clostrid- temic antibiotic therapy.
ium piliforme, brings about significant gastrointestinal
illness in hamsters and gerbils, but not in rats and GERBILS
mice.7 Tyzzer’s disease is commonly transmitted “Sore Nose”
between animals in displays and holding areas. This “Sore nose” in gerbils is a disease condition thought
gastrointestinal bacterial infection primarily affects to be caused by an increased secretion of porphy-
immunosuppressed, stressed animals. rins.5 The harderian gland secretes porphyrins,
which act as a primary skin irritant around the nasal
Neoplasia opening. The irritated skin area is susceptible to sec-
The average life span of a hamster is 2 years. The ondary bacterial infections caused by Staphylococcus
short life span and aging process increase the preva- spp. Treating the resulting infectious dermatitis and
lence of tumors in these small rodents. If an animal reducing stress to the animal will usually resolve the
is more than 18 months of age, neoplastic disease problem (Figure 5.23).

Figure 5.22 Hamsters that are housed together often Figure 5.23 “Sore nose” is a common clinical disease
fight and may develop bite wound abscesses. presentation of gerbils.
Epileptiform Seizures of approximately 3 years and their physiologic

At around 2 months of age, 20%–40% of gerbils predisposition. The most common subcutaneous
develop epileptiform seizures.5 There is no treatment tumor in rats is the fibroadenoma of the mam-
for the seizures, which usually last for a few min- mary tissue (Figure 5.24).7 Mammary tumors
utes but do not appear to leave any permanent can reach very large sizes and affect both males
physical damage. As the animal ages, the seizure and females. To reduce the incidence of fibroad-
activity declines in severity and occurrence. enomas, ovariohysterectomies are advocated at
an early age in female rats. Whereas mammary
Rats tumors in mice are almost always malignant,
Bacterial and Viral Infections rat mammary tumors are usually localized and
Staphylococcus aureus is the most common cause respond to surgical resection (Figure 5.25).
of ulcerative dermatitis in rats.7 Mycoplasma pul-
monis, Streptococcus pneumoniae, Corynebacterium Sialodacryoadenitis Virus
kutscheri, Sendai virus, and cilia-associated respi- This virus is a cornavirus that affects the cervical
ratory bacillus have been isolated and identified as salivary glands and sometimes the lacrimal glands
infectious agents causing rat respiratory disease. of the eye. The cervical lymph nodes can become
With respiratory pathogens, clinical signs can vary enlarged, and the eyes might protrude if the lacri-
from mild dyspnea to severe pneumonia and death. mal gland(s) are affected. There is no treatment for
The treatment of mycoplasmosis in rats is similar to this highly contagious disease.
that described for infected mice in the next section.
MICE
Tumors Barbering
Rats are very susceptible to tumors, most likely Barbering is a condition in which a cagemate bites
because of the animals’ average life expectancy fur from the affected area to the skin without caus-
5 | rodents 161
ing any dermatological damage. This condition is

usually caused by stress induced by overcrowd-
ing or because of the establishment of a hierarchy
within the group.
Tumors
As with many small rodents, mammary tumors
are a common presentation in older female mice.
The most common mammary tumor found in
mice is the adenocarcinoma.7
Bacterial and Viral Infections

Bacterial infections associated with dermatitis
lesions and subcutaneous abscesses in mice are
commonly caused by Staphylococcus aureus, Pas-
teurella pneumontropica, and Streptococcus pyogens.7
Acute and chronic respiratory infections can be
caused by Sendai virus or Mycoplasma pulmonis,
Figure 5.24 Mammary tumors are commonly diag- but are most commonly associated with Sendai
nosed in older female rats. virus, from which adults survive but neonates often
die. Chronic respiratory infections—with clini-
cal signs of pneumonia, suppurative rhinitis, and
occasionally otitis media—might be the result of
a M. pulmonis infection. Both infections should be
treated using supportive care, although mycoplas-
mosis can be treated specifically with enrofloxacin
in combination with doxycycline hyclate for 7 days.7
ZOONOTIC DISEASES: GUINEA PIGS
There are not many zoonotic diseases associated

with guinea pigs. The zoonotic diseases that could
cause problems are rarely transmitted to human
caretakers. Trixacarus caviae, or the guinea pig sar-
coptic mite, may be the most problematic. When
guinea pigs are being treated for a mite infestation,
owners should take precautions against exposure.
Figure 5.25 A rat with a body bandage to prevent Guinea pig dermatophyte, or “ringworm”
self-trauma to a surgical site that involved the removal infections, can be transmitted to humans. Der-
of a mammary tumor. matophyte infections, particularly Trichophyton

mentagrophytes, do not commonly affect guinea the disease condition. Again, owners should be
pigs; but if diagnosed, environmental cleaning instructed to use caution to prevent exposure and
and patient treatment are required to resolve possible contamination.
1. Which rodent requires vitamin C supplementation, and how is this vitamin provided to prevent a
deficiency?
2. How are rodents sexed?
3. What are the dietary recommendations for rodents?

4. What are the husbandry requirements for pet rodents?
5. Describe nutritional recommendations for each rodent species commonly kept as a companion
animal.
6. How would you properly restrain a rodent patient for a physical examination?
7. Describe how to perform a physical examination on rodent patients.
8. How and where is blood collected from each rodent species for diagnostic sampling?
9. What are the proper procedures for collecting bone marrow and urine from rodent patients?
10. What are the common pathogenic organisms cultured from rodents?
11. What is the anal tape test? Why is it used?
12. Describe common external parasites diagnosed in pet rodents and recommended treatment
options.
13. How are rodents sedated, induced, and maintained on general anesthesia?

Describe how rats are intubated.
14. Describe common rodent disease presentations and treatment options.
5 | rodents 163
REFERENCES
Guinea Pig
1. Harkness JE. Pet rodents: A guide for practitioners. Lakewood, CO: AAHA Press; 1997.
2. Johnson-Delaney CA, and Harrison LR. Guinea pigs. Exotic companion medicine handbook for vet-
3. Quesenberry KE, Donnelly TM, and Hillyer EV. Biology, husbandry and clinical techniques of
guinea pigs and chinchillas. In: Quesenberry, KE, and Carpenter, JW, eds. Ferrets, rabbits and
4. Cualiffe-Beamer T, and Les E. The laboratory mouse. In: Poole TB, ed. The UFAW handbook on the
care and management of laboratory animals. Essex: Longman Scientific & Technical;1994:290–91.
5. Chrisp CE, Suckow MA, Fayer R, et al. Comparison of the host ranges and antigenicity of Crypto-
sporidium parvum and Cryptosporidium wrairi from guinea pigs. J Protozool 1992;39:406–49.
6. O’Rourke DP. Disease problems of guinea pigs. In: Quesenberry KE, and Carpenter JW, eds. Fer-
2004:245–54.
7. Adamcak A, and Otten B. Rodent therapeutics. Vet Clinics of North America. Exotic Animal Practice.
January 2000;3:221–35.
8. Bennett RA. Soft tissue surgery. In: Quesenberry KE, and Carpenter JW, eds. Ferrets, rabbits and
9. Heard DJ. Anesthesia, analgesia and sedation for small mammals. In: Quesenberry KE, and Car-
penter JW, eds. Ferrets, rabbits and rodents: Clinical medicine and surgery, 2nd ed. St. Louis, MO:
Saunders/Elsevier; 2004:356–69.
Hamster, Rat, and Mouse

1. Johnson-Delaney CA, and Harrison LR. Small rodent: Exotic companion medicine handbook for vet-
erinarians. Lake Worth, FL: Wingers Publishing 1996:48–61.
2. Harkness JE. Pet rodents: A guide for practitioners. Lakewood, CO: AAHA Press; 1997:27–30.
3. McClure DE. Clinical pathology and sample collection in the laboratory rodent. Vet Clinics of North
America. Exotic Animal Practice (September 1999);2:565–90.
4. Silverman J. Biomethodology. In: Vantloosier GL Jr., and McPherson EW, eds. Laboratory hamsters.
Orlando, FL: Academic Press; 1987:70–94.
5. Bihun C, and Bauck L. Small rodents, basic anatomy, physiology, and clinical techniques. In: Que-
senberry KE, and Carpenter JW, eds. Ferrets, rabbits and rodents: Clinical medicine and surgery, 2nd
ed. St. Louis, MO: Saunders/Elsevier; 2004:286–98.
6. Morrisey JK. Parasites of ferrets, rabbits and rodents. Seminar on Avian Exotic Pet Medicine
1996;5:106–14.
7. Donelly TM. Disease problems of small rodents. In: Quesenberry KE, and Carpenter JW, eds. Fer-
2004:299–315.

Gerbil
1. Wong R, Gray-Allan P, Chifa C, and Alfred B. Social preference of female gerbils (Meriones unguicu-
latus) as influenced by coat color of males. Behavioral Neural Biology 1990;54: 184–90.
2. Johnson-Delaney CA, and Harrison LR. Small rodents: Exotic companion medicine handbook for vet-
3. Bihun C, and Bauck L. Small rodents, basic anatomy, physiology, and clinical techniques. In: Que-
senberry KE, and Carpenter JW, eds. Ferrets, rabbits and rodents: Clinical medicine and surgery, 2nd
ed. St. Louis, MO: Saunders/Elsevier; 2004:286–98.
4. Morrisey JK. Parasites of ferrets, rabbits and rodents. Seminar on Avian Exotic Pet Medicine
1996;5(2):106–14.
5. Donelly TM. Disease problems of small rodents. In: Quesenberry KE, and Carpenter JW, eds. Fer-
2004:299–315.
Hedgehogs
Chapter 6
INTRODUCTION
Hedgehogs are shy, nocturnal mammals from the order Insectivora.

Although these animals are known primarily for their sharp quills, there are
many other fascinating characteristics about them. In the United States, the
most common hedgehog pet species is the white-bellied, four-toed African
or African pygmy hedgehog (Atelerix albiventris).1 These animals were origi-
nally imported two to three decades ago, but are now captive bred in large
numbers. Although they have not yet garnered the popularity of other small
exotic mammals (e.g., rabbits and guinea pigs), they have certainly found a
niche among pet owners.
Anatomy and Physiology

The most obvious anatomic peculiarity associated with hedgehogs is their
quills (Figure 6.1). Although these quills are a useful antipredator tool in
the wild, they make the job of veterinary personnel charged with examining
them challenging. When aggravated, the classic response of a hedgehog is to
“ball up.” Because of their unique anatomy, they are capable of completely
tucking in their short limbs and forming an impenetrable “ball of quills.”
Fortunately, as these animals age and are handled, they become more agree-
able to examination. In cases when they don’t, general anesthesia can be
used to limit the effect of the quills.
The quills of hedgehogs are not barbed, but do come to a sharp point (Fig-
ure 6.2). There is also a misconception that they can inject venom. Although
hedgehog quills are not venomous, it is not uncommon for hedgehogs to
“anoint” their quills with saliva, which can introduce bacterial pathogens
into puncture wounds of would-be predators or unprotected handlers. When
hedgehogs are not on alert, they lay their quills down, and touching them
is analogous to petting rigid hair; however, any time hedgehogs become

defensive, they can erect their quills, using a

combination of muscles to create a protective bar-
rier. The primary muscle groups associated with
control over the quills are the front dorsalis, cau-
dodorsal, and panniculus carnosus orbicularis.
Because most hedgehogs consider a visit to the
veterinary hospital a negative experience, veteri-
nary personnel working with hedgehogs should
wear leather gloves (e.g., welder’s or gardening
gloves) to reduce the likelihood of being injured.
Hypersensitivity reactions to hedgehog quills have
been documented.
Hedgehogs are well suited for a terrestrial exis-
tence. They have long snouts that they use, similar
Figure 6.1 Although it might appear that the quills of
an African hedgehog cover their entire body, in actual- to pigs, for rooting out grubs and vegetation (Fig-
ity they cover only their dorsum. ure 6.3). The eyes of hedgehogs are small, dark
(or pink in leucistic or albino animals), and set
back. They appear to rely more on their sense of
smell than on their vision. Hedgehogs have short
hair–covered ears. It is not uncommon for them
to have crusts or splints in the edges of their ears.
Although at times this finding is associated with
a mite infestation, at other times it appears to be
related to low environmental humidity. These
animals should be maintained in 30%–50%
humidity to limit the potential for dry skin. The
teeth of hedgehogs have closed roots, so dental
conditions should be managed like those of a dog
or cat. Their dental pattern is: incisors 3/2, canine
1/1, premolars 3/2, and molars 3/3. Their incisors
Figure 6.2 This close-up of the quills reinforces are normally slightly procumbent and have a wide
how sharp they are at their point. Veterinary
gap.
personnel working with these animals should
wear appropriate leather gloves to minimize the
Sexing hedgehogs is straightforward. Males
likelihood of injuring themselves or the animal have an obvious prepuce, but no scrotum. They
(e.g., by dropping the animal). also have open inguinal rings, which allow them
to move their testicles between the inguinal region
and abdomen. Females have an obvious vulva that
is cranial but close to the anus. The gestation of
hedgehogs is approximately 35 days. Although
these animals can become sexually mature before
6 | hedgehogs 167
presented with a new object, might perform

a ritual called self-anointing. The animal first
licks the object, then begins to hypersalivate.
This frothy saliva is then rubbed on its skin and
spines; the purpose of this ritual is unknown.3
Some people have confused this with rabies, but
this is a normal behavior elicited under certain
conditions.
Hedgehogs are territorial, as are most small
mammals; therefore, close monitoring for fight-
ing is required when a new animal is introduced
to a group within an enclosure. Males are typi-
cally solitary, but do maintain harems. As with
Figure 6.3 Hedgehogs are well suited for a terrestrial other animals, it is important for the technician
existence. Note the long snout for rooting, the short legs, to know the normal physiologic values in order to
and the deep-set eyes. assess the patient’s health status. In Table 6.1,2 a
list of common physiologic data used to interpret
a physical examination can be found.
6 months, it is recommended to delay breeding
until after 6 months to minimize problems with
HUSBANDRY
dystocia.
The average longevity for hedgehogs is 3–5 years. Environmental Concerns
Although these animals should be capable of living Pet hedgehogs can be maintained in the environ-
6–10 years, many succumb to cancer much earlier. mental temperatures favored by human inhabitants
Captive hedgehogs appear to have a high prevalence of the house (70°–78°F). Cold environmental tem-
of neoplasia compared with other species.2,3 peratures (<65°F) can induce brumation (a type of
Hedgehogs have some interesting behaviors hibernation) in hedgehogs. This can lead to reduced
that can be confusing to those with limited expe- metabolism and increased likelihood of opportu-
rience with these animals. A hedgehog, when nistic infections. Sustained warm temperatures
Table 6.1 Hedgehog Basic Information2

Average Life Span 3–5 years

Birth Weight Average 10 g
Temperature Rectal Body Temperature 97°–100°F
Female Reproductive Cycle Gestation Length 34–37 days
Litter Size 3 average

(>88°F) can lead to heat stress, which can be fatal. commercial hedgehog diets. These products are
Owners should be informed that if they live in envi- not regulated, and there can be extreme differ-
ronments where the ambient temperature is higher ences in the quality of the foods. For example,
or lower than that considered acceptable for a one commercial product has 15% protein and
hedgehog, they might need to provide supplemen- another has 35% protein. This is a >100% differ-
tal heat or cooling for their pet. ence in protein. Hedgehogs fed one of these diets
The preferred housing for these small, spiny might be provided too much protein, depend-
animals is a glass-sided enclosure with a coming on what else is in their diet, and the animal
mercial screen top that can be secured with tabs fed the lower-protein diet may not receive suffi-
or screws. The “hedgehog house” should have cient protein. Because hedgehogs are omnivores,
enough floor surface area to include a small hid- like humans, diversity in their diet is best. A
ing box, a specific hedgehog exercise wheel (wire recommended diet for adult hedgehogs is pro-
wheels are dangerous), and a pan or shallow dish vided in Table 6.2, and should be followed if a
for swimming. Plastic-sided cages with appropri- commercial diet is not available. Hedgehogs are
ately sized wire bars (not too large, or they will capable of digesting chitin and have a relatively
allow escape or injury) can also be used. The low metabolism. Advise owners to avoid high-fat,
cage substrate of choice is shredded newspaper soft, or high-sugar foods to avoid obesity, a com-
or a pelleted paper product. Woodchips, ground mon problem in hedgehogs.
corncob, ground walnut shell, and cloth towels
are not recommended for hedgehog cage flooring, Transport
because these materials might be inappropriately Hedgehogs can be transported in their enclo-
ingested or cause string strangulation of the sure, if small enough, or carriers suitable for small
limbs. Instruct the client to clean the enclosure mammals (e.g., guinea pigs, rats).
and substrate regularly, because glass tanks have
poor ventilation, and a buildup of urine and fecal Grooming
material can lead to respiratory problems. Hedgehogs may develop long claws that require
routine trimming. If the claws need to be trimmed,
Nutrition the same technique as described for a rat (Chapter
Hedgehogs need fresh water daily. Although they 5) can be used. In most cases the hedgehog will
can learn to drink from sipper tubes, a small need to be sedated. An alternative method for an
shallow dish might be preferred as a water con- alert hedgehog is to place the animal on a screen
tainer. These animals are naturally insectivores/ and trim the claws as they extend through the mesh.
omnivores, and their diet should reflect their
dietary wants and nutritional needs. Commer-
HISTORY
cial pelleted hedgehog diets can be used, but they
should be used in combination with vegetables, A thorough history is essential to making an
fruits, and insects. When insects are offered, they appropriate diagnosis for any exotic animal case,
should be “gut loaded” to maximize their nutri- because many of the problems identified in exotic
tional value. It is important to read the labels of animals are directly related to inappropriate hus-
6 | hedgehogs 169
Table 6.2 Hedgehog Daily Diet2 and should include types of food (e.g., commer-
1. 3 heaping teaspoons high-quality cat/kitten chow
cial, live foods), brand, amount fed, frequency,
2. 1 heaping teaspoon fruit/vegetable mix
supplements, water source, and how often the
Finely chop all ingredients and mix together: food and water are changed.
 ½ teaspoon leafy dark greens (spinach, kale, leaf Finally, questions should focus on the animal’s
lettuce)
 ¼ teaspoon diced carrot, ¼ teaspoon diced apple, current health status and include past medical
 ¼ teaspoon diced banana, ¼ teaspoon diced grape history, current presenting problem, and dura-
or raisin
tion of complaint. Although it is natural to want
 ¼ teaspoon vitamin/mineral powder (e.g., Vionate)
to focus on the problem at hand, a great deal of
3. 6 small mealworms or 1–2 crickets
information could be overlooked if the techni-
cian doesn’t collect the history using a thorough
and systematic approach.
bandry. A veterinary technician should first collect
the signalment, including age and sex of the hedge-
RESTRAINT
hog. Knowledge of the animal’s age and sex can
be useful when developing a differential diagnosis The spines on these small mammals make restraint
list. For example, an adult intact female hedgehog difficult. The animal handler should wear light-
may be more likely to suffer from a reproductive weight leather gloves (gardening or work gloves)
neoplasia than a young, immature animal. to prevent injury to the technician or veterinarian
After defining the signalment, the history examining the patient. Some hedgehogs are docile
should focus on collecting background informa- enough to be examined without “balling up,” but
tion, including where the animal was acquired, there is always a possibility that they will become
length of time owned, if the owner has other frightened and curl, causing pain to the handler.
pets or hedgehogs, if he or she recently acquired Most hedgehog patients need to be anesthetized
another hedgehog, and the interaction between with isoflurane or sevoflurane to facilitate the physi-
the owner and the pet. This information should cal examination process. General anesthesia is quick
provide the technician with an initial understand- and, in most cases, reduces stress to the animal
ing of the client’s knowledge of the pet hedgehog. and handler. The patient is induced in an induc-
The next set of questions should focus on how tion chamber or large mask and maintained using
the animal is managed at home (husbandry), an appropriately sized mask to fit over its snout.
including whether the animal is housed indoors If the hedgehog will be kept under anesthesia for
or outdoors, if it has supervised or unsuper- an extended time, it should be intubated. In some
vised run of the house, cage size and material, cases, it is preferable to give injectable preanesthetics
cage location in the house, whether animals are to induce or extend anesthesia. A list of appropriate
housed singly or together, substrate used in the preanesthetics can be found in Table 6.3.
cage, how often the cage is cleaned and type of Other methods have been used to uncurl and
disinfectant, whether a litter pan is used, and examine these animals without using general anes-
types of cage furniture (e.g., shelter). Questions thesia: (1) Rocking back and forth while holding
about the animal’s nutrition are also important the animal in ventral recumbancy a few inches over

Table 6.3 Injectable Anesthetic Agents Used in Hedgehogs4

Drug Route Dosage
Ketamine IM 5–20 mg/kg

Ketamine and Diazepam IM 5–20 mg/kg (Ketamine)
0.5–2.0 mg/kg (Diazepam)
Ketamine and Xylazine IM 10–20 mg/kg (Ketamine)
2 mg/kg (Xylazine)
the table; as the head extends from the curl, put one globes and pupils, which make fundic exams dif-
thumb on the back of the neck and the other on the ficult, even with mydriatics. The ears might have
back to encourage uncurling. (2) Stroke the rump cerumen (earwax), which should be removed and
spines in a circular pattern or backward motion. (3) examined for the presence of ear mites.
Hold the animal facedown over the examination The oral cavity should be moist and pink.
area. The hedgehog can be “scruffed” by holding Examine the teeth for excess tartar. Because
the spined skin for restraint. These physical han- neoplasia is so common in hedgehogs (e.g., squa-
dling techniques are not recommended unless the mous cell carcinoma), it is important to look for
animal is very ill or docile. masses in the oral cavity or any crusting around
this area. The integument and spines should be
examined closely. Any masses should be examined
further, using fine needle aspirates and cytology
The animal must be properly restrained. It is or biopsy. Crusts and quill loss are common with
important that the technician or veterinarian be dermatologic diseases such as mite infestations or
able to examine the entire animal without concern ringworm. Again, if these types of lesions are seen
about being stuck by quills. A complete physical on the examination, they should be noted and
examination will be performed on each hedgehog further evaluated using appropriate diagnostic
patient that enters the clinic. The questions used to tests (e.g., skin scrape and cytology and dermato-
obtain the clinical history and physical examina- phyte culture, respectively).
tion procedures for hedgehogs are similar to those The areas where the submandibular, prescapu-
used for other small mammals. It is recommended lar, axillary, lumbar, and popliteal lymph nodes
that the examination begin with the nose, eyes, and are located should be palpated. In healthy hedge-
ears. There should be no nasal discharge and the hogs, the lymph nodes will be small and not
nose should be moist. The eyes should be clear and palpable. Abdominal palpation should include
free of discharge. Positioning of the eyes should all four abdominal quadrants. Internal anatomy
be noted, because severely dehydrated hedgehogs of hedgehogs is similar to that of other domestic
(>8%) will have sunken eyes. The corneas should pets, so veterinary technicians can rely on their
be transparent. If there are any concerns about experience with those species to determine what
corneal ulcers, a fluorescein stain should be per- is normal or abnormal. The limbs should be pal-
formed. The anterior chamber can be examined by pated for any abnormal structures or crepitus.
using a direct light source. Hedgehogs have small Examine the nails closely. Because hedgehogs
6 | hedgehogs 171
are held on soft substrates in captivity, their nails superficial veins, including the lateral saphenous
tend to grow and curl under or around the foot- and cephalic veins. However, it is best to reserve
pads. Check the body temperature of a hedgehog the cephalic vein for intravenous catheter place-
using a plastic (not glass) thermometer. Hedge- ment. For larger volumes of blood, the jugular vein,
hog body temperatures are typically 97°–100°F. cranial vena cava, and femoral veins can be used.
Finally, auscult the hedgehog. Heart and respi- The cranial vena cava is the preferred venipunc-
ratory rates are typically 160–220 and 30–40, ture site for hedgehogs, because most of their other
respectively. Of course, the stress associated with vessels are small and surrounded by subcutaneous
travel to the clinic and the examination itself can fat. The cranial vena cava can be approached from
alter these numbers. either the right or left side of the thoracic inlet. A
3 cc syringe with a 5⁄8", 26- or 25-gauge needle can
be used to collect the sample. The venipuncture
DIAGNOSTIC SAMPLING
site should be aseptically prepared using standard
Blood Collection techniques. The needle should be inserted at the
Using a 1 or 3 cc syringe with a ¼" 26-gauge level of the first rib and manubrium (sternum)
needle, blood samples can be collected from the (Figures 6.4 and 6.5). The vessel is not typically
Figure 6.4 Hedgehog vena cava. Illustration by Michael L. Broussard.

very deep, and it is unlikely you will need to insert

the needle more than 0.25 cm into the chest. Blood
for diagnostic sampling is best obtained from an
anesthetized hedgehog rather than from one that
is being manually restrained. Reference ranges for
complete blood counts and serum chemistry panels
are listed in Tables 6.4 and 6.5, respectively.5
Bone Marrow Aspiration

This is not a common procedure for hedgehog
Figure 6.5 The cranial vena cava is an excellent site
patients. Methods that have been described for
for collecting blood samples from hedgehogs.
other small animals (e.g., dogs, cats) should be used
for hedgehogs while taking into account the relative
Table 6.4 Hedgehog Complete Blood Count size of their anatomical structures. A spinal nee-
Reference Ranges dle should be used to access the marrow cavity of
Cell Type Normal Range hedgehog bones (fibia or femur). The spinal needle
Erythrocytes 4.4–6.0 x 106/µl has a stylet inside the cannula of the needle that will
Hematocrit 28%–38% prevent plugging with bone and/or cartilage.
Hemoglobin 9.9–13.1 g/dl
Leukocytes 5.8–21.0 x 103/µl Microbiology
Neutrophils 49%–70% Microbiological samples can be obtained from
Lymphocytes 22%–38%
hedgehog patients as with other small animals.
Eosinophils 2%–11%
Since the normal flora of hedgehog anatomical
Monocytes 0%
areas/body systems (e.g., reproductive, gastroin-
Basophils 0%–5%
testinal, integument) have not been determined,
Serum Protein 5.3–6.3 g/dl critical assessment of the microbial isolates relative
Albumin 3.4–3.6 g/dl to the disease condition of the patient is highly
recommended. Microbiological assessments of
hedgehog disease conditions are as important as
Table 6.5 Hedgehog Serum Biochemistry with other small-animal patients.
Reference Ranges
Analyte reference Range Urinalysis
Serum Glucose 81.5–116.1 mg/dl Urinalysis can provide important insight into
Blood Urea Nitrogen 21.3–32.9 mg/dl the general well-being of a hedgehog. Urine can
Creatinine 0.2–0.4 mg/dl be collected by cystocentesis, catheterization, or
Total Bilirubin 0–0.1 mg/dl free catch.4 Abnormal findings in hedgehog urine
Serum Calcium 9.5–10.9 mg/dl include white blood cells, neoplastic cells, and crys-
Serum Phosphorus 4.7–6.5 mg/dl
talluria.4 Because these animals are omnivores, their
Alanine Aminotransferase (ALT) 39.7–68.9 IU/L
urine should be screened using references for dogs.
6 | hedgehogs 173
Radiology each animal. Radiographic interpretation is simi-

Other diagnostic procedures that need to be per- lar to that for domestic pets, although the quills
formed on hedgehogs are done in a manner similar to can become superimposed over important soft
those used for other small mammals. Radiographs, tissues if the animal is not positioned correctly
for example, should be done under anesthesia. This (Figures 6.6A and 6.6B).
will ensure that the animals are motionless and
positioned in a manner so that desired organ sys- Parasitology
tems/structures can be evaluated. A minimum of External Parasites
two survey radiographs should be collected from A common clinical presentation is quill loss owing
to Caparinia tripilis, the common mange mite of
hedgehogs.6 Pruritus, quill loss, and hyperkera-
tosis are commonly associated with a quill mite
infestation. Diagnosis can be made through skin
scrapings of the affected area. Treatment can be
achieved using ivermectin (0.2–0.4 mg/kg orally
or subcutaneously every 10–14 days for 2 or 3
treatments); however, resistance can occur and
higher doses may be necessary. Selamectin can
also be used to treat hedgehogs with mite infesta-
tions. For an effective treatment, owners should be
made aware that they must clean the environment
at least every two days to prevent reinfestation.
Figure 6.6A Lateral radiograph of a hedgehog. Note Other mite species, including Chorioptes spp.,
the ileus in the small intestine. This animal had gastro- fleas, and ticks, are also external parasites that
intestinal disease associated with a neoplastic condition might be found on hedgehogs.5 Treatment and
and an opportunistic bacterial infection. prevention of mites are similar to those used with
other small mammals.
Internal Parasites
Routine fecal flotation and direct fecal para-
site examinations are used to diagnose internal
parasites. Isospora eriniacei and Eimeria rastegaiv
are the common coccidian parasites identified
in hedgehogs.4 To treat coccidia, sulfadimethox-
ine is recommended (2 to 20 mg/kg, orally, daily
for 2–5 days, skip 5 days and repeat).4 Ponazuril
(20 to 30 mg/kg, orally, every other day for 3
treatments), a coccidiocide, can also be used to
Figure 6.6B Dorsoventral radiograph of a hedgehog. eliminate coccidians.

Commonly identified nematode species include fore, premedication with atropine, 0.01–0.04 mg
the lungworm (Crenosoma striatum), intesti- /kg intramuscularly, should be administered,
nal nematodes (Capillaria erinacei), tapeworms especially if a face mask is used for the procedure.
(Hymenolepis erinacei), and flukes (Brachylaemus Although there a variety of anesthetic agents
erinacei). The treatment of choice for nematodes is (e.g., ketamine, dexmedetomidine, propofol,
fenbendazole (10–25 mg/kg orally) or ivermectin buprenorphine, butorphanol) that can be used
(0.2 mg/kg subcutaneously or orally).4 Cestodes for hedgehogs, inhalant anesthetics are by far the
should be treated with praziquantel (7 mg/kg most commonly used. Injectable anesthetics can
subcutaneously or orally) and might require addi- be used to preanesthetize the animal or in situa-
tional treatments to fully resolve.4 These parasites tions when an inhalant anesthetic is not available.
are less commonly seen now that the majority of For procedures that will induce pain, an appro-
hedgehogs are bred in captivity. priate analgesic protocol should be established.
Hedgehogs should be fasted for a minimum
of 12 hours prior to an anesthetic procedure,
THERAPEUTICS
although special precautions should be taken
Because hedgehogs are covered with spines and (e.g., IV dextrose) for an animal susceptible to
go into a defensive posture when upset, treatment a hypoglycemic episode (e.g., chronic disease,
can be difficult. Oral medications that are flavored starvation). A water source can be left with
to be palatable are the recommended treatment of the hedgehog up to the time of the procedure.
choice. The patient readily accepts this type of Hedgehogs should be maintained on a water-
treatment without stress and trauma. If subcuta- recirculating heating pad during any anesthetic
neous injections are used, tissue absorption can procedure and recovered in a warmed environ-
be affected by the thick fat layer under the skin. ment to prevent hypothermia, which can lead to
For this reason, subcutaneous injections should be torpor in these animals.
given ventrally, where the fat layer is less dense. For short procedures, such as venipuncture or
Because hedgehog veins are short and small, an radiography, inhalant anesthetics can be used to
intraosseous catheter placed in the proximal femur facilitate sample collection. Hedgehogs can be
or proximal tibia is recommended for critical placed in an induction chamber and anesthe-
patients. The approach is through the trochanteric tized. Inducing anesthesia via face mask at 5%
fossa in the femur or off the tibial tuberosity with isoflurane or 8% sevoflurane expedites the pro-
the tibia. A 1.5", 20- or 22-gauge spinal needle can cess of getting the animal through the sedation
be used to insert the catheter.7 phase, which is the time when they struggle.
Once the hedgehog has lost its righting reflex,
it can be maintained at 1%–2% isoflurane or
2%–3% sevoflurane. Anesthetized hedgehogs
ASSISTANCE
should be intubated to gain control over their
Hedgehogs require general anesthesia for a respiration. Hedgehogs can be intubated using
thorough physical examination or for a surgical pro- a 1.0–3.5 mm OD endotracheal tube, depend-
cedure. These animals have a tendency to salivate ing on their size. A laryngoscope can be used to
excessively while under general anesthesia; there- increase visualization of the airway. The animal
6 | hedgehogs 175
should be monitored closely during the proce- Dermatomycoses

dure using appropriate equipment (e.g., Doppler, Fungal organisms that are often identified as
pulse oximeter, and EKG). infecting hedgehogs are Trichophyton mentagro-
Surgical preparation of the hedgehog should phytes, T. erinacei, and Microsporum spp.5 These
follow the same protocols described for dogs and organisms can be diagnosed as a single infection
cats. The surgical site should be shaved using a stan- or a concurrent infection with a mite infesta-
dard grooming clipper at a slow, cautious speed to tion. Diagnosis is established by culturing spines
prevent clipper burn and tearing of the skin. The from the affected areas in DTM media. Systemic
shaved area should be uniform and provide the sur- treatment of oral griseofulvin is recommended at
geon ample room to perform the surgery without 30–40 mg/kg once daily for 30 days.5 Lime sulfur
the risk of contamination. If an approach over the dip and enilconazole are nonteratogenic alterna-
dorsum is required, the quills can be individually tives that have a better therapeutic window.
plucked. The surgical site should be aseptically pre-
pared, using a surgical scrub and warmed sterile Respiratory Disease
Bordetella bronchiseptica, Pasteurella multocida,
saline. Avoid using alcohol to prepare the surgical
and Corynebacterium pneumonia have been identi-
site because it can result in significant heat loss. The
fied as respiratory pathogens affecting hedgehogs.
surgical site should be covered with a sterile drape
Routine diagnostics to identify the causative
until the surgeon begins. The surgical instruments
agent of the respiratory disease are required for
used to perform surgery on dogs and cats can be
proper treatment. Treatment for severe respiratory
used for hedgehogs as well.
disease includes antibiotics (based on culture and
sensitivity of the causative agent), supportive fluid
HEALTH MAINTENANCE AND DISEASE therapy, oxygen therapy, and nebulization.4
Neoplasia
Neurologic Disease
Neoplasia is by far the most common disease
Hedgehogs are susceptible to a demyelinat-
presentation in hedgehogs. These animals are sus- ing paralysis. The etiology of this disease is not
ceptible to many of the same types of neoplasias known; however, it typically occurs in young adult
reported in domestic pets, including osteosar- animals (18–24 months of age). Affected animals
coma, squamous cell carcinoma, lymphosarcoma, have a progressive ascending ataxia. Over time
neurofibromas, adenocarcinomas, and leukemia. the hedgehogs lose weight and become unable to
Because there are many neoplastic diseases that move. This disease appears always to be fatal. Ani-
affect hedgehogs, any abnormal mass should be mals presenting with these clinical signs should be
biopsied for disease determination. Some internal given a thorough workup. It is likely at some point
neoplasias can present as nonspecific diseases, so in the near future that an etiology will be identi-
all sick hedgehogs should have a complete diag- fied if enough cases are thoroughly evaluated.
nostic workup. As with other animal species, the
older the animal, the more predisposed it is to Cardiac Disease
neoplastic disease. Hedgehogs are considered geri- Hedgehogs are susceptible to developing cardio-
atric when they reach 3 years of age. myopathy. Affected animals often present with a

history of lethargy, general weakness (especially in ZOONOTIC DISEASES

the hind limbs), coughing, and exercise intolerance.
There are few reports of zoonotic diseases associated
A thorough examination, including radiographs
with African hedgehogs. One of special concern
and echocardiography, is necessary to make a
is Salmonella spp. It is not known whether hedge-
diagnosis. These diagnostic tests are important to
hogs normally harbor Salmonella spp. as an
characterize the type of cardiomyopathy (hypertro-
indigenous component of their microflora, as
phic vs. dilatative). A final diagnosis is necessary
reptiles do, but based on the previous reports of Sal-
to select treatment. Treatment should follow stan-
monella Tilene being isolated from hedgehogs and
dards used for domestic pets.
human caretakers, it is likely that these animals can
naturally harbor this pathogen.9,10 Since that time,
Gastrointestinal Disease
salmonellosis associated with different serotypes
Being omnivores, hedgehogs typically harbor the
has been reported.11 Clients should be made aware
same types of microflora seen in dogs. In general,
of the potential zoonotic risk associated with these
it is expected that their microflora is a combina-
animals, and given recommendations for practicing
tion of Gram-positive and Gram-negative aerobes
routine disinfection. Recommend that they clean
and facultative anaerobes. Hedgehogs with gastro-
hedgehog cages and equipment with 10% bleach,
intestinal disease typically present with a history
allowing for at least 10 minutes of contact between
of anorexia and diarrhea. A thorough workup
the bleach and the equipment. It is important to
similar to that done for domestic pets should be
remove all organic material before applying the
performed in these cases. A number of potential
bleach, to limit the potential for deactivation.
opportunistic bacteria can cause disease, includ-
The finding of cryptosporidiosis in a juvenile
ing Pseudomonas spp., E. coli, and Salmonella spp.
hedgehog is important. Animals harboring Cryp-
There has also been at least one report of crypto-
tosporidium parvum can pose a special health risk
sporidiosis in an African hedgehog.8 This parasite
to humans, especially young, geriatric, or immu-
can infect the lower small intestine and large intes-
nocompromised individuals.8
tine, causing severe pathology. Cryptosporidium
Dermatomycosis is a potential zoonotic dis-
spp. are difficult to diagnose because of their small
ease that has been associated with hedgehogs.11
size, so if they are being considered in a differential
This disease is common to many exotic small
list, it is important to submit fecal samples for acid
mammals, so it should come as no surprise that
fast staining and immunofluorescent antibody
hedgehogs can serve as a source of infection to
testing. This disease is difficult to eradicate; most
humans. Affected animals develop typical dry,
cases either self-clear or the animals succumb to
scaly skin. Because these animals can be asymp-
the disease.
tomatic, it is important to consider their potential
role when a human case occurs in a household.
6 | hedgehogs 177
SElf-Study Questions
1. How do you determine the sex of a hedgehog?
2. How long do hedgehogs live? What is the primary disease process affecting their longevity?
3. What is an appropriate environmental temperature for hedgehogs?
4. What type of enclosure is best for a hedgehog?
5. What type of diet is best for a hedgehog?
6. Describe the techniques used to perform restraint and a physical examination on a hedgehog
patient.
7. What are some common venipuncture sites in hedgehogs?
8. Name two common ectoparasites of hedgehogs.
9. Why is it difficult to deliver medications to hedgehogs?
10. Name three potential zoonotic agents associated with hedgehogs.
REFERENCES
1. Smith AJ. Husbandry and nutrition of hedgehogs. Vet Clinics of North America (Exotic Animal Prac-
tice) 1999;2(1):127–41.
2. Johnson-Delaney C, Harrison LR. Hedgehogs: Exotic companion medicine handbook for veterinarians.
Lake Worth, FL: Wingers Publishing; 1996:1–14.
3. Hoefer HL. Hedgehogs. Vet Clinics of North America (Small Animal Practice) 1994;24(1): 113–20.
4. Larsen RS, Carpenter JW. Husbandry and medical management of African hedgehogs. Veterinary
Medicine (October 1999): 877–88.
5. Ness RD. Clinical pathology and sample collection of exotic small mammals. Vet Clinics of North
America (Exotic Animal Practice) 1999; 2(3):591–620.
6. Gerson L, Boever WJ. Acariasis (Caparinia spp.) in hedgehogs (Erinaceus spp.): Diagnosis and treat-
ment. Journal of Zoo Animal Medicine 1983;14:17–19.
7. Brown SA, and Rosenthal KL. Self-assessment color review of small mammals. Ames: Iowa State Uni-
versity Press; 1997:14–15.
8. Graczyk TK, Cranfield MR, Dunning C, Strandberg JD. Fatal cryptosporidiosis in a juvenile cap-
tive African hedgehog (Atelerix albiventris). Journal of Parasitology 1998;84: 178–80.
9. Centers for Disease Control and Prevention. African pygmy hedgehog–associated salmonellosis—
Washington, 1994. Morbidity and Mortality Weekly 1995;44:462–3.
10. Craig C, Styliadis S, Woodward D, Werker D. African pygmy hedgehog–associated Salmonella
Tilene in Canada. Canada Communicable Disease Report 1997;23:129–31.
11. Riley PY, and Chomel BB. Hedgehog zoonoses. Emerging Infectious Diseases 2005;11:1–5.

Sugar
Chapter 7
Gliders
INTRODUCTION
The sugar or honey glider (Petaurus breviceps) is a marsupial that is native

to New Guinea and Australia (Figure 7.1). It is about the size of a North
American flying squirrel, generally gray with a black stripe running along
the dorsal surface from the nose to the base of the tail. These animals have
some control of the tail, which can be used as a rudder during gliding or for
carrying nest material up a tree. The second and third digits of each hind
foot are partially fused, forming a “hair comb,” which is used for grooming
their soft fur (Figure 7.2).
Male sugar gliders have three scent glands: one on top of the head (which
forms a bald spot upon maturation), another on the chest (causing an orange
or rusty discoloration of fur in that area), and one in the anal area. When
stressed or frightened, both sexes can secrete a white oily substance from
three paracloacal glands.1 The testicles are located in a furry pouch in the
midventral, and a bifurcated penis is ventral to the base of the tail (Figure
7.3). Male sugar gliders reach sexual maturity about 12–15 months after
they leave the pouch.1 The penis has a distal bifurcation and extends from
the prepuce located near the base of the tail. The urethra terminates at the
proximal aspect of the penis, not the distal bifurcation.1
The female has a pouch, or marsupium, located on the ventral aspect of
the body where the young are raised as well as being the location of their
largest scent gland. Female sugar gliders do not have the bald scent gland
(on top of the head) that is found on males of this species (Figure 7.4).

Figure 7.1 Sugar gliders are maintained as companion Figure 7.2 Modified sugar glider claw, which is used as
animals. Photograph courtesy of Javier Nevarez, DVM. a grooming tool. Photograph courtesy of Javier Nevarez,
DVM.
Figure 7.3 The pendulous testicles of a male sugar Figure 7.4 Scent glands of a sugar glider are also
glider. found on the cranial ventral body wall.
Sexual maturity of female sugar gliders is reached ing into their paws to brush their hair coat.1 This
at approximately 8–12 months after they leave the sneezing should not be confused with a disease
pouch.1 Once sexually mature, they cycle every 29 condition.1 Sugar glider sounds have been classi-
days.1 fied as crabbing, barking, chirping, and hissing.1
Sugar gliders groom themselves on a regular The noises are similar to their identifying terms
basis and will use saliva generated from sneez- but are emitted based on different conditions.
7 | sugar gliders 181
Table 7.1 Sugar Glider Basic Information1

General Category Classification Physiologic Parameter/Quantity

Birth Weight 0.19 g
Temperature Rectal Body Temperature 97.2°F
Female Reproductive Cycle Sexual Maturity 8–12 months
Litter size 1–2 average
Pouch Emergence 60–70 days
Weaning Age 110–120 days
Averge Life Span (captive) 12–15 years
Heart Rate 200–300 beats/minute
Respiratory Rate 16–40 breaths/minute
Food Consumption 15%–20% body weight
Male Sexual Maturity 12–15 months
Crabbing, a loud irritating noise, is produced and strict supervision must be maintained when
when the animal is frightened or believes it is in sugar gliders are handled by small children or
danger. Barking is an apparent form of commu- released from their enclosure.
nication, whereas chirping is a low purring sound
made when the animal is content.1 As mentioned
HUSBANDRY
earlier, the hissing or sneezing sound is made
when the sugar glider is generating saliva for Cage dimensions for adult sugar gliders should be
grooming and should not be considered a disease at least 18" × 18" × 24" with the size of the wire
condition. Sugar gliders are nocturnal animals, as openings not more than 0.5–1.0". The cage size
evidenced by their extremely large eyes. Because recommended for 1–2 young sugar gliders (joeys)
these animals are awake at night, they have a ten- that are less than 5 months out of the pouch is
dency to bark—especially the males during a full 20" × 30".1 The smaller cage size encourages exer-
moon. Leaving a light on in an adjacent room cise, reduces stress, and promotes bonding for
will help reduce this bothersome behavior early young animals.1 Any cage material that meets
in the morning. As it is with other animals, it is the specified dimensions will work, but polyvinyl
important for the technician to know the normal chloride–coated stainless steel wire mesh is recom-
physiologic values in order to assess the patient’s mended. To prevent trauma, the owner must be
health status (See Table 7.1). advised to be sure no protruding wires or openings
These animals are extremely sensitive to pesti- are found within the enclosure, with the rectangu-
cides, cedar shavings, branches from toxic trees, lar cage openings being no larger than 0.5" × 1".1
and bright direct light (either artificial or sun- Young joeys require a nesting cloth that cannot
light). Dogs and cats should be kept at a distance, be pulled apart and is easily washable for sleeping,

warmth, and security. The nesting cloth, along Coral, FL) as 75% of overall diet (i.e., 30–60
with a suspended heat lamp, will help reduce the g/day/animal), a calcium-based multivitamin,
incidence of hypothermia in young sugar gliders. and fresh fruits and vegatables.1 Calcium-based
A pine box approximately 6" × 8" × 6" is needed multivitamin supplements (Glide-A-Mins, Pock-
for adult animals to sleep in during the day. This etPets, Cape Coral, FL) should be applied as
box can be a premanufactured bird nesting box. indicated on the container instructions or sprin-
Shredded paper makes an excellent nontoxic box kled lightly on fruits and vegetables every other
substrate. Old towels or cloth can unravel, leaving day.1 No more than 25% of the diet should be
loose strings to choke the animal or strangulate fresh fruits and vegetables.
a foot or tail. Tree branches need to be included As mentioned previously, a separate “din-
in the enclosure for the animal to climb on during” area established in a container will keep the
ing its play and exercise time. The branches can enclosure free of food debris that results from the
be obtained from nontoxic species of hardwood messy feeding habits of these animals. Any fruits
trees (e.g., maple, hickory, manzanita). The ambi- and vegetables left at the end of the day should be
ent temperature range that should be provided for removed and the dining container cleaned prior
sugar gliders is 75°–80°F.1 to the next day’s meal. To help young sugar glid-
Toys manufactured for rodents will provide ers adapt to a pellet diet, a fruit sauce (e.g., apple)
entertainment and exercise for sugar gliders and can be placed on top of the offering. Treats can be
are recommended. Although sugar gliders are given periodically, but only those manufactured
relatively clean and odor-free, owners should be for sugar gliders are recommended.
aware that the cage will develop an unpleasant
smell if not cleaned about twice a week because of Grooming
accumulation of food and excreta. Sugar glider nails can be trimmed using human
nail clippers in a similar manner to that described
Nutrition for rats (Chapter 5). Owners must be aware that
Sugar gliders are messy eaters; therefore, plac- the trimming of nails may reduce their pet’s abil-
ing their food in a separate container within the ity to climb.
enclosure that they can crawl into to eat will keep
the food and surrounding substrate clean. Two
HISTORY
food dishes and a sipper bottle should be used to
feed and provide water for sugar gliders. Because The same basic background information is
sugar gliders appear sensitive to chlorinated required for sugar gliders as for other animals
water, owners should provide bottled or filtered that are examined at the veterinary clinic. How
water in the sipper bottle and change it daily.1 long the animal has been owned, where it was
One food dish is used for dry food, and the other acquired, how often it is handled, and the charac-
is for moist food. The recommended daily diet ter of the feces and urine are a few of the questions
for a sugar glider should be 15%–20% of the that should be asked for background information.
animal’s body weight.1 The diet should include a Husbandry questions include where the animal is
sugar glider pellet (NutriMax, VetsPride, Nash- housed; whether it is allowed to roam unobserved
ville, TN; Glider-R-Chow, PocketPets, Cape in the house; cage location, type, size, material,
substrate, furniture, and toys; and how often the ine the entire animal without stress to the patient
cage is cleaned and the disinfectant used. When or veterinarian. A complete physical examination
investigating the diet, it is important for the techni- will be performed on each sugar glider patient
cian to ask if commercial products/table foods are that enters the clinic. The physical examination
fed, how much, and also what the animal is actually procedures for sugar gliders are similar to those
eating. The same needs to be asked regarding live used for other small mammals.
(prey) foods (e.g., mealworms). Supplemental offer-
ings and frequency of feeding are very important
DIAGNOSTIC SAMPLING
data for the case workup. To round out the nutrition
information, the technician should find out about Blood Collection
the water supply, how often the water is changed, Recommended sites for blood collection, which is
and how much the animal drinks on a daily basis. best accomplished under general anesthesia, are
Because diseases are transmissible between ani- the jugular vein, cranial vena cava, and medial
mals, the final questions should center on other tibial artery.1 Blood volumes of up to 1% of the
pets in the household: if new animals have been animal’s body weight can be safely collected
added to the family or if the animals are housed using a 1 cc syringe and a 26-gauge needle. Ref-
together. Finally, a description of any previous erence ranges for complete blood counts and
problems and a complete chronological descrip- serum chemistry panels are listed in Tables 7.2
tion of the presenting problem are needed to and 7.3, respectively.1 The technique used to col-
complete the history form. lect blood from the cranial vena cava is described
in Chapter 5 in the “Guinea Pig” section. When
collecting blood from a sugar glider patient, only
RESTRAINT
0.9% of an animal’s body weight in grams can be
Sugar gliders are restrained by holding the head safely removed.1 The amount of blood collected
between the thumb and middle finger and rest- will depend on the condition of the patient.
ing the index finger on top of the head.1 The
body will then lie in the palm of the restrainer’s Bone Marrow Aspiration
hand. Isoflurane anesthesia is the agent of choice This is not a common procedure performed on
for general anesthesia of these small marsupials. sugar glider patients. Methods that have been
Placing the patient in an induction chamber using described for other small animals (e.g., dogs, cats)
5% isoflurane with 1.5 L flow of oxygen will allow should be used for sugar gliders while taking into
the animal to become anesthetized with minimal account the relative size of their anatomical struc-
stress. The animal can then be maintained on tures. A spinal needle should be used to access the
approximately 2%–3% isoflurane, using a face marrow cavity of sugar glider bones. The spinal
mask and 1.5 L flow of oxygen. needle will have a stylet inside the cannula that
will prevent plugging with bone and/or cartilage.
Microbiology
The animal must be properly restrained. It is Microbiological samples can be obtained from
important that the veterinarian be able to exam- sugar glider patients as with other small animals.

Table 7.2 Sugar Glider Complete Blood Count Since the normal flora of sugar glider anatomical
Reference Ranges1 areas/body systems (e.g., reproductive, gastroin-
Cell Type Reference Range
testinal, integument) have not been determined,
critical assessment of the microbial isolates relative
Erythrocytes 7.0–8.8 x 106/µl
to the disease condition of the patient is highly
Hematocrit 39.7–47.7%
recommended. Microbiological assessment of
Hemoglobin 13.9–17.1 g/dl
sugar glider disease conditions is as important as
Leukocytes 2.1–8.5 x 103/µl
with other small animal patients.
Neutrophils 0.2–2.4 x 103/µl
Lymphocytes 1.6–6.0 x 103/µl
Urinalysis
Eosinophils 0.04–0.16 x 103/µl
The analysis of urine can provide important
Monocytes 0–3.0 x 103/µl
insight into disease presentations such as cystitis,
hematuria, and stranguria. Urine can be collected
by cystocentesis (ventral percutaneous approach)
or free catch on a smooth metal or plastic tray.
Table 7.3 Sugar Glider Serum Biochemistry
Reference Ranges1,2,3 Radiology
Analyte Reference Range Radiographic images are obtained in a manner
Serum Glucose 152–171 mg/dl similar to that used with other small mammals.
Blood Urea Nitrogen 15–18 mg/dl
With most sugar glider cases, quality radiographic
Creatinine 0.6–0.8 mg/dl
images require the patient to be placed under gen-
Total Bilirubin 0.1–0.7 mg/dl
eral anesthesia. This will ensure that the animal is
motionless and positioned in a manner whereby
desired organ systems/structures can be evaluated.
Serum Phosphorous 5.0–6.0 mg/dl
A minimum of two survey radiographs should be
Alanine Aminotransferase (ALT) 96–136 IU/L
obtained from each patient. Radiographic inter-
Aspartate Aminotransferase (AST) 54–99 IU/L
pretation is similar to that for domestic pets.
Alkaline Phosphatase 89–115 IU/L
Creatinine Phosphokinase 1,080–1,636 IU/L
Injection Sites
Sodium 138–143 mEq/L
Intravenous injection sites on sugar gliders include
Potassium 4–5 mEQ/L
the cephalic and lateral saphenous veins. Quadriceps,
Chloride 105–108 mEq/L
biceps, and cervical epaxial muscles are commonly
used as intramuscular injection sites. Administra-
Magnesium 1–2 mEq/L
tion of subcutaneous therapeutic agents is performed
Amylase 2,117–3,350 IU/L along the dorsal midline between the scapulas.
Total Protein 6.74–7 g/dl Subcutaneous fluids can be administered at approxi-
Albumin 3.12–4.64 g/dl mately 2% of the body weight every 8–12 hours.1
Globulin 2.9–3.1 g/dl Other diagnostic procedures performed on
sugar gliders are done in a manner similar to those
used on other small mammals.
Parasitology sugar gliders. Once the patient is induced, a face

Internal Parasites mask or 1 mm endotracheal tube is used to admin-
Although common in wild sugar gliders, para- ister the flow during the procedure. Sugar gliders
sites are not commonly diagnosed in captive-bred can develop apnea during induction, but careful
animals. Coccidia and Giardia spp. have been monitoring of the heart rate will help determine
identified in animals raised in captivity.2 the overall condition of the patient until it is fully
Sulfadimethoxine is recommended for treat- induced and begins breathing on its own. If the
ment of coccidia, and metronidazole is the drug heart rate begins to decrease significantly, stop the
of choice for Giardia spp. infections. procedure and wake up the animal. Surgical prep-
aration of sugar gliders is similar to that for other
small mammals.
THERAPEUTICS
The most effective route to administer up to 10%

of the patient’s body weight in replacement flu-
ids is via an intraosseous catheter. The proximal Nutritional Osteodystrophy
tibia is the recommended location for placing the The most common disease seen in captive-bred
24-gauge introsseous catheter in a sugar glider. sugar gliders is nutritional osteodystrophy.1 Ani-
Fluid administration should follow the same mals that present with severe depression and
parameters as those for a similarly sized mammal. hind limb paralysis will radiographically reveal
This includes estimating dehydration deficit, daily osteoporosis and pathologic fractures.1 Treat-
fluid maintenance requirements, and interosseous ment consists of cage rest, supplemental calcium
fluid administration in the proximal femur. The (initial treatment: calcium gluconate 100 mg/kg
selection of fluid product to use is dependent on subcutaneous administration every 12 hours for
the patient’s physiologic status and disease diag- 3–5 days, followed by calcium glubionate 150
nosis. Subcutaneous fluid administration is best mg/kg orally every 24 hours as needed), vitamin
achieved along the dorsum. Sugar gliders are D3, and diet modification.1 A preventive diet
small animals, and all precautions used for other should contain approximately 1% calcium, 0.5%
animals of their size should be taken into consid- phosphorus, and 1,500 IU/kg vitamin D3 on a
eration prior to, during, and after surgery. The dry-weight basis.1 Poor nutrition can also lead
surgical candidate should be fasted for 4 hours to obesity, emaciation, and constipation in sugar
prior to the initiation of the procedure.1 Care in gliders.
providing external heat, hemostasis, and fluid
therapy during surgery is essential for a successful Pasteurella Multocida
completion and an uneventful recovery. Pasteurella multocida has been identified in sugar
glider deaths that resulted from generalized
organ and subcutaneous abscessation.1 Preven-
tion starts with keeping sugar gliders away from
ASSISTANCE
rabbits that might be subclinical carriers of this
An induction chamber using isoflurane or sevoflu- bacterial organism. The treatment of choice is
rane as the anesthetic agent is recommended for enrofloxicin.

186
Table 7.4 Dosages of Common Therapeutic Agents Used for Sugar Gliders1,2,3
Drug Dosage Comments
Antimicrobials*
Amoxicillin 30 mg/kg PO, IM q24h x 14 days
Amoxicillin/Clavulanic acid 12.5 mg/kg PO divided q24h
Ciprofloxacin 10 mg/kg PO q12h x 7–10 days
Clindamycin 5–11 mg/kg PO Higher dose for osteomyelitis
Enrofloxacin 5 mg/kg PO q12h
Itraconazole 5–10 mg/kg PO q12h
Trimethoprim/Sulfamethoxazole 15 mg/kg PO q12h x 7–10 days
Antiparasitic Medication
Fenbendazole 20–50 mg/kg PO q24h x 3 days Repeat in 14 days
Ivermectin 0.2 mg/kg PO, SC Repeat in 10–14 days
Metronidazole 25 mg/kg PO q12h x 7–10 days
Selamectin 6–18 mg/kg topically Repeat every 30 days
Analgesics
Buprenorphine 0.01–0.03 mg/kg IM
Butorphanol 0.1–0.5 mg/kg IM q6–8h
Diazepam 0.5–1.0 mg/kg IM Treat seizure activity
1.0–2.0 mg/kg PO
Meloxicam 0.1–0.2 mg/kg PO q12h
Other Therapeutic Agents
Atropine 0.01–0.02 mg/kg SC, IM
Bismuth subsalicylate 1 ml/kg PO q8–12h x 5–7 days
Calcium glubionate 150 mg/kg PO q24h
Calcium gluconate 100 mg/kg SC q12h x 3–5 days Diluted in saline to 10 mg/ml
Cisapride 0.25 mg/kg q8–24h PO, IM Use with stool softener
Dexamethasone Anti-inflammatory: 0.1–0.6 mg/kg SC, IM, IV
Shock: 0.5–2.0 mg/kg SC, IM, IV
Diphenhydramine 0.5–2.0 mg/kg PO, SC q8–12h
Enalapril 0.5 mg/kg
Furosemide 2–4 mg/kg
Metoclopramide 0.05 mg/kg PO, SC q8h
Sulfadimethoxine 10 mg/kg PO q12h x 7–10 days
Vitamin A 500–5,000 IU/kg IM
Vitamin B complex 0.02–0.2 ml/kg SC, IM
Vitamin E 10 IU/kg SQ
*For compounding oral formulations tutti frutti and other fruit flavors recommended.
IM: intramuscular; IV: intravenous; PO: per os (oral); SC: subcutaneous.
Other Diseases fluoxetin (1–5 mg/kg orally every 8 hours) has

Sugar gliders can present with many disease con- been used with some success, with the dose being
ditions, like other small exotic mammals. These increased depending on treatment response. A
include gastrointestinal, urinary tract, respira- listing of common sugar glider therapeutic agents
tory, ocular, traumatic, toxicosis, reproductive, and dosages is found in Table 7.4.
and dental disease.1 For self-mutilating animals,
1. What are the second and third digits on each hind foot used for?
2. What are scent glands, and where are they located?
3. Describe the external anatomy of both male and female sugar gliders.
4. What are the husbandry and dietary recommendations for sugar gliders?
5. What is the proper procedure for restraining a sugar glider?
6. Describe the techniques used to perform a physical examination on a sugar glider.
7. How is blood collected from a sugar glider?
8. Where are the injection sites located?
9. Describe the therapeutic options for sugar gliders.
10. How are sugar gliders anesthetized?
REFERENCES
1. Brust DM. Sugar gliders: A complete veterinary care guide. Association of Sugar Glider Veterinar-
ians. http://www.sugarglidervetinfo.com/default.html. Veterinary Interactive Publications;(2009).
2. Pye G, and Carpenter JW. A guide to medicine and surgery in sugar gliders. Vet Medicine (Octo-
ber 1999):891–904.
3. Ness RD. Clinical pathology and sample collection of exotic small mammals. Vet Clinics of North
America (Exotic Animal Practice) 1999; 2(3):591–620.

Fish
Chapter 8
INTRODUCTION
The popularity of ornamental fish dates back more than 2,000 years in
China. In the United States, interest in ornamental fish rose during the
1940s with the advent of aviation and the importation of fish from around
the world. The advancement of aquarium technologies, such as filtration
and nutrition, has enabled this hobby to continue to flourish today. In 2001,
at the time of the first edition of this text, the American Veterinary Medi-
cal Association market research statistics for pet ownership in the United
States estimated there were more than 6,000 fish per 1,000 households. In
its most recent survey (2007), the number of fish per 1,000 households has
increased by 50%, with more than 9,000 fish per household. As numbers
of the animals continue to rise, there will be increased demand for veteri-
narians and veterinary technicians to provide medical and surgical care for
these animals.
Most ornamental fish are maintained in aquariums within the home,
although the popularity of outdoor ponds continues to rise. Historically,
ornamental fish were considered replaceable pets; however, as the value of
these animals has risen, pet owners have sought the advice of veterinary
professionals to manage their valuable collections. Another contributing
factor to the change in the human-animal bond as it relates to fish is
associated with the longevity of these animals. Improved husbandry (e.g.,
filtration, water treatment methods) and nutrition have helped maximize
longevity in fish. Fish that historically were short-lived (1–2 years) in the past
are now being kept alive for significantly longer periods (4–6 years). Goldfish
and koi are known to live well into their 20s and 40s, respectively. As these
animals live longer and owners become attached to their pets, veterinarians
and their technicians will be expected to give the same high-quality care that
they provide for other domestic species.

Changes in the availability of medica- ing an understanding of the taxonomy of these

tions (e.g., antibiotics) for treating fish are also animals, along with basic anatomic and physio-
expected to increase the reliance of aquarists on logic differences among these species, is essential
veterinarians. In the United States, “prescription to our success with managing them in captivity.
only” antibiotics (e.g., tetracyclines, ampicillin,
erythromycin, metronidazole) and antiparasitics Anatomy and Physiology
(e.g., praziquantel, fenbendazole) for treating fish Technicians should develop a basic understand-
have been sold for decades over the counter at ing of anatomy prior to working with an animal
local pet retail stores. Because the federal govern- species. A background knowledge of anatomy will
ment was concerned that humans were buying prove beneficial when collecting diagnostic sam-
their prescription medications at their local ples or administering therapeutics. The focus of
pet retailer because of cost, they made manu- this chapter will be on teleosts or bony fishes.
facturers of these drugs change their products Fish are covered with a mucous coat that is pro-
from tablet to powder form. Although one can duced by cells in their integument. This mucous
appreciate the government’s attempts to prevent coat serves as the first line of defense against
citizens from purchasing lesser-quality antibiot- pathogenic organisms, such as bacteria, fungi, and
ics, it is unlikely that altering the product’s form viruses. This is an important component of their
will be sufficient, if price is more important to innate immune system, which fish heavily rely on
the consumer. This fact, in combination with because the other components of their immune
increased concerns about appropriate disposal of system (cell-mediated and humoral components)
antibiotics and antibiotic resistance in bacteria, are more primitive than those of other vertebrates.
may lead to further restrictions that will result in The mucous barrier contains various-sized proteins
veterinarians being the primary source for these (e.g., immunoglobulins) that bind these pathogens
drugs for aquarists. and prevent invasion. If this protective barrier is
penetrated, fish must rely on their humoral and
Taxonomy cell-mediated defenses; however, whereas mam-
Fish represent the largest group of vertebrates, mals have at least five different types of antibodies,
with over 25,000 different species, 50 orders, and fish have only one (IgM). It is for this reason that
445 families. While the majority of fish found in veterinarians and veterinary technicians need to
the world are from marine environments (61%), use caution when handling fish, to minimize any
freshwater fish tend to be presented more com- damage to the protective mucous barrier and skin.
monly to the veterinary hospital, especially koi Fish that present to a veterinary hospital with an
(Cyprinus carpio) and goldfish (Carassius auratus). increased white-gray slime covering need to be
Within this class of animals there is a high degree evaluated to determine the underlying cause of
of anatomic and physiologic variation. For vet- the increased mucus appearance (see “Diagnostic
erinary personnel, this presents a real challenge Sampling” later in the chapter). Fish should be
when working with these animals. Fortunately, handled only when necessary to prevent damaging
there are closer to 250 species commonly found this protective barrier; it is preferable to anesthetize
in the pet trade, which still represents the largest fish for examination and diagnostic tests to mini-
group of vertebrates found in captivity. Develop- mize any damage to the integument and mucous
8 | fish 191
barrier that might occur in alert fish when they to certain niches. For example, the anal fin of
struggle. the knifefish is a large single fin located on the
The scales of a fish are located in the dermis ventrum of the animal and serves as the primary
and provide protection over the musculature. Sev- source of locomotion. Spines might be associated
eral types of scales are found on teleosts, including with some fins and serve as a defense mechanism.
ganoid, cycloid, and ctenoid. The ganoid and The lionfish (Pterois volitans) produces venom that
cycloid scales are found on the more primitive can be injected into a potential predator, causing
species of teleosts, whereas the ctenoid scales are significant pain and discomfort. Knowledge of
found on the more evolutionary advanced fish. the species that produce venom is essential to pre-
The scales serve as a protective armor, and damage vent injury to the handler. Fish can damage their
to or loss of the scales might result in introduction spines when captured in a net. To prevent this,
of opportunistic infections. Handling should be fish can be scooped into a plastic cup or bucket to
minimized to avoid traumatizing the scales. facilitate removal from an aquarium.
Teleosts typically have two sets of paired fins, Gills are the primary respiratory organs of
the pectoral and pelvic fins, and three unpaired most fish, although certain species use accessory
fins: the dorsal, anal, and caudal fins (Figure 8.1). organs to aid in the absorption of oxygen. Gills
Some fish can have two dorsal fins. There are serve to absorb oxygen, excrete waste products
also some groups (e.g., salmonids, characins, and (e.g., ammonia and carbon dioxide), and regu-
catfishes) of fish that have an additional small adi- late ion and water balance. It is important to note
pose fin between their dorsal fin and caudal fin. that, unlike other vertebrates that excrete end
Fins are used for steering, balancing, and brak- products of protein catabolism (e.g., uric acid or
ing. Certain species have modified fins to adapt urea nitrogen) through the kidneys, fish excrete
these products through the gills. Therefore, dam-
age to the gills from infectious diseases or poor
water quality can exacerbate problems for fish
because of their inability to release systemic tox-
ins. Teleosts have four pairs of gills, and the gills
are located under the operculi (gill plates) in the
branchial chambers. The gills are attached to a
bony gill arch, and each gill comprises primary
and secondary lamellae. The secondary lamella is
the site of gas exchange. Exposure to parasites and
toxic compounds, such as ammonia, results in the
excessive production of mucus, which can impede
gas exchange (see “Diagnostic Sampling”). Fish
Figure 8.1 Fish have both paired (pectoral [Pt] and
possess a two-chambered heart: a single atrium
pelvic [Pv]) unpaired fins (dorsal [D], caudal [C], and
anal [A]). These structures function in locomotion and
and a ventricle. The heart is located ventral to the
steering. Injuries to the fins can lead to opportunistic pharynx and cranial to the liver. Unoxygenated
infection, difficulty in acquiring food, and increased blood is pumped from the heart to the gills, where
stress from bullying by other fish. it is oxygenated and distributed to the rest of the

body. Fish possess two portal systems, a renal

portal system that drains the caudal musculature
and a hepatic portal system that drains venous
blood from the digestive tract.
The lateral line is a mechanosensory structure
that is used by fish to monitor changes in sound
waves and water pressure. The lateral line origi-
nates on the head, around the eyes and nares,
and extends along the lateral body wall. Certain
groups of marine fish, including tangs, angelfish,
and freshwater fish (e.g., cichlids) maintained
in captivity, can develop head and lateral line Figure 8.2A A marine Koran angelfish (Pomacan-
erosions (Figure 8.2A and 8.2B). The specific thus semiciculatus) with severe head and lateral line
erosions.
etiologies for this syndrome have not been eluci-
dated, but dietary deficiency, water quality, and
infectious diseases are all suspected.
The digestive tracts of fish vary depending
on their feeding strategy. Herbivorous fish have
a much longer digestive tract than omnivorous
and carnivorous fish. This relates primarily to
an increased demand for time to maximize the
extraction of nutrients from cellulose-based prod-
ucts. In many cases, segments of the bowel are
tightly coiled to conserve space within the coelo-
mic cavity. The stomach is absent in some species,
such as the goldfish and carp. Pyloric cecae are
found in some species of fish, which secrete
digestive enzymes and increase the absorptive
surface area of the digestive tract. The number
of pyloric cecae can be used in fish identifica-
tion to differentiate certain species. Fish possess a
large liver that is located in the cranial area of the
body cavity. The normal color of the liver should
be red-brown; however, yellow, fatty livers are a
common finding at necropsy. This is often the
result of diets rich in fats and protein.
The swim bladder is a unique structure found
in fish. In some species, such as the lungfish, Figure 8.2B A freshwater cichlid (oscar; Astronotus
the swim bladder serves as a respiratory organ; ocellatus) with severe head and lateral line erosions.
however, in most fish, the swim bladder serves to Note the full thickness erosions into the dermis.
8 | fish 193
maintain the buoyancy of the fish. There are two can lead to less effective results with freshwater
different types of swim bladders: physostomous fish.
and physoclistous. Physostomous swim bladders Determining the sex of a fish depends on
have a duct that connects the swim bladder to the whether the animal is sexually dimorphic or not.
esophagus. Air in the swim bladder is controlled For example, in some livebearers, males have a
via gas flow through this duct. Physoclistous gonopodium, which serves as an intromittent
swim bladders do not have a connecting duct, organ (e.g., penis). The gonopodium is located
but instead have airflow regulation through the on the anal fin and lies parallel to the body. In
blood supply (rete mirabile). The swim bladder other fish, males develop specific colors or struc-
is located in the dorsal coelomic cavity; the only tures (e.g., growths on their head or fins) during
structure more dorsal is the kidney. Fish that the breeding season that help separate the sexes.
have problems with their swim bladder frequently During this period, females often develop a
present with buoyancy issues (e.g., floating on the round abdomen because of the increased size of
surface or sunk to the bottom). their ovaries. Because there are more than 25,000
Fish possess a single kidney that is divided different species of fish, it is not possible to learn/
into an anterior and a posterior segment. The know all of the intricacies of determining sex in
kidney is located retrocoelomically in the dor- fish, so it is best to research the methods for the
sal body wall. The kidney functions primarily species presenting at your hospital. In cases when
as an osmoregulatory and hematopoietic organ. sex of the fish needs to be determined, endoscopic
The anterior kidney and the interstitium of the sexing can be done.
posterior segment serve as the primary sites for Fish possess a defense mechanism—composed
blood cell and immunoglobulin production; of free and fixed phagocytic macrophages located
fish do not possess bone marrow. The posterior in the spleen, heart, and kidney—that filters for-
kidney primarily regulates electrolyte and urine eign material from the blood. The erythrocytes
output. Fish that are found in a saltwater or of fish are oval-shaped with a centrally located
hypertonic environment tend to lose water and nucleus. When using a Wright-Giemsa or Diff-
absorb salts. To prevent dehydration, these fish Quik stain, the cytoplasm has a pale pink/orange
must drink water and excrete excess electrolytes, color and the nucleus a deep purple color.
such as sodium and chloride, through the kid- Thrombocytes have a small nucleus and a
ney and gills. Fish that live in a freshwater or spindle-shaped cell. Typically, the cytoplasm of
hypotonic environment constantly absorb water a thrombocyte is clear. These cells are analogous
by osmosis. To prevent overhydration, freshwa- to platelets in mammals and are responsible for
ter fish excrete large volumes of dilute urine. blood clotting. In some fish, these cells can be
This physiology is important to consider when difficult to discern from small lymphocytes.
developing treatment plans for fish. Fish from a Because of their “sticky” nature, the cytoplasmic
saltwater environment are more likely to ingest membranes of thrombocytes tend to get stuck on
medications (e.g., antibiotics) that are placed in a slide and deform when a blood smear is made.
the water, whereas freshwater fish are less likely to This is generally a sufficient finding to sepa-
do the same because they don’t “drink the water.” rate a thrombocyte from a well-formed, round
Not considering this during the treatment plan lymphocyte.

Fish leukocytes can be divided into the same

two basic groups seen in higher vertebrates:
agranular and granular. Agranular leukocytes
include the lymphocyte and monocyte, whereas
granular leukocytes include the neutrophil/het-
erophil and eosinophil. Neutrophil and heterophil
are often used interchangeably in fish based on the
staining characteristics of the cells. In either case,
these cells lack some of the enzymatic capacity of
higher vertebrates.
Lymphocytes are the most common cell type
in fish and are morphologically similar to those Figure 8.3A Fish blood cells. Heterophil (H),
in mammals, with an acentric nucleus, high thrombocyte (T).
nuclear to cytoplasmic ratio, and blue cytoplasm.
Fish produce both T and B lymphocytes, and the
cell size can vary from small to large. Lympho-
cytes are important in producing antibodies and
modulating the cell-mediated immune response.
Monocytes are the largest leukocyte and have
a pale blue-gray cytoplasm and a higher cytoplas-
mic to nuclear ratio than lymphocytes. These cells
play an important role in phagocytizing foreign
material and presenting antigen to lymphocytes
for antibody production. They are also commonly
associated with chronic inflammatory responses.
Large lymphocytes can be difficult to discern Figure 8.3B Fish blood cells. Neutrophil (N),
from monocytes; however, if you compare nuclear erythrocyte (Er).
to cytoplasmic ratios between the cells, it should
be possible to separate them. HUSBANDRY
Neutrophils/heterophils possess rod-shaped
granules and are weakly phagocytic. These cells Environmental Concerns
are associated with the acute inflammatory Aquarium
response and stress leukograms. Eosinophils Fish are housed primarily in glass or acrylic tanks.
exist in some species of fish, but their function The primary differences between these tanks are
is unclear. It is likely that they play some role in that glass weighs more than acrylic, acrylic scratches
controlling/managing parasites in fish. The exis- more easily, and acrylic tanks are available in a
tence of basophils is controversial. An example of wider range of sizes and shapes. When dealing with
common fish white blood cells can be found in larger glass tanks, the weight of the structure should
Figures 8.3A–D. be included with the water weight when deciding
8 | fish 195
Water weighs approximately 8 pounds per gal-

lon. The weight of a large aquarium can place
significant stress on a floor. A pet owner should be
advised to assess the structural integrity of a floor
prior to placing a large aquarium in the home.
An aquarium should be placed on a secure, level
stand.
Fish are primarily considered ectotherms, or
“cold-blooded,” and are dependent on their envi-
ronmental temperature to regulate their core
body temperature. To maintain the overall health
Figure 8.3C Fish blood cells. Eosinophil (Eo), of these animals, they should be housed at a con-
lymphocyte (L), erythrocyte (Er). stant environmental temperature. A commercially
available aquarium heater can be used to establish
an appropriate temperature. Freshwater tropical
species should have a water temperature of 76° to
78°F. Certain species (e.g., Discus: Symphysodon
aequifasciatus) might require higher temperatures
(82°–86°F) to stimulate their reproductive cycle.
Freshwater coldwater species (e.g., goldfish and
koi) should be maintained at 65° to 68°F. Marine
tropical species tolerate temperatures of 74° to 78°F.
Fish that are maintained at low temperatures will
develop hypothermia; this can lead to a reduction in
the overall metabolism and immune function of the
Figure 8.3D Fish monocyte (M). fish, making them less active and more susceptible
to chronic infections. Fish maintained at excessive
temperatures often become hyperthermic and die.
whether a stand or floor joist has sufficient strength Outdoor pond fish can develop hyperthermia in
to support the system. Acrylic tanks are typically certain climates, and owners should be advised to
more popular with marine fish enthusiasts. When provide them with appropriate shade.
making recommendations to clients regarding The selection of a substrate for an aquarium
the most appropriate size and shape of a tank, it should be based on the types of fish being placed
is important to take into consideration the types in the system, whether live or plastic plants will
of fish an individual expects to maintain and the be used, and the aesthetics of the system. Gravel
aesthetic appeal of the aquarium as a piece of fur- size is important when working with fish that
niture. For example, freshwater angelfish should be are aggressive feeders or “gravel sifters.” Problems
maintained in an aquarium with vertical height to are commonly seen with large, predatory fish that
prevent cramping of their tall dorsal and anal fins. are aggressive feeders and consume gravel when

hunting prey. In some cases, they consume suffi- fluorescent light. The primary benefits to the fish
cient gravel to cause a foreign body obstruction in come from the provision of well-defined visible
the stomach or small intestine/stomach interface. light. This is especially important for fish bred
Affected animals typically present with anorexia, in captivity, because it maximizes their color and
and a diagnosis can be made using survey radio- allows for standard breeding rituals to occur. The
graphs. If there is a complete obstruction, surgery infrared or heat component of artificial light is
to remove the foreign material is required. Fish not required if a heating element is provided. It
that are “gravel sifters” occasionally ingest gravel is preferred to use a heating element to stabilize
that can lead to an obstruction, but this is rare. temperature rather than light, because tempera-
Gravel size and depth are an important consider- ture can fluctuate when the light is turned on
ation for live plants. Some plants will die if they and off. Ultraviolet B radiation is not considered
do not have sufficient substrate depth to establish important for fish because it does not penetrate
roots, whereas others will perish if their roots are water very deeply, although there have been no
buried too deeply. The aesthetic component is studies evaluating its effect on fish.
really a decision to be made based on preference;
however, to minimize the potential for problems, Filtration
gravel should be of a sufficient depth to maintain In nature, waste products produced by fish,
live plants, if desired, and plants should be large plants, and other sources are carried away by flow-
enough that they can’t be ingested. ing water, reducing the potential dangers to fish.
Live plants have their own following among In the home aquarium or pond, wastes and toxins
aquarists. Although live plants can add oxygen to can accumulate, leading to a dangerous situa-
the water, remove carbon dioxide and nitrates, and tion for fish. Filtration is the key to maintaining
add beauty, they can also introduce disease. Many healthy water for fish in an aquarium or pond.
live plants are infested with snails (gastropods). There are three primary types of filtration, includ-
These unwanted visitors can harbor a variety of ing mechanical, biologic, and chemical (Figures
bacterial and parasitic disease agents. Clients 8.4A, 8.4B, and 8.4C). The different types of fil-
should be made aware of this and educated about tration work independently of one another, but
the importance of inspecting their plants before should be used in combination to maximize water
adding them to an aquarium or pretreating the quality.
plants with a commercial anti-gastropod product. Mechanical Filtration. Mechanical filtration
Lighting is an important consideration for removes organic debris from the water by passing
aquariums. Fish are built to be exposed to light it through a filter material, such as floss, fiber, or
cycles common to their origin. For example, fish a paper cartridge. The amount of work that this
at the equator are used to a more standard light type of filter can perform depends on the type
cycle than those found near the poles, where and (pore) size of the filter material and the motor
light duration increases or decreases between sea- or pump that is moving the water past the filter
sons. In captivity, it is easiest to manage fish on a material. A densely packed fiber or small pore size
12-hour light and 12-hour dark cycle. A variety in the paper cartridge will restrict the size of waste
of lights are available for aquariums. In general, that can pass. Maintenance of these filters involves
the most recommended variety is a high-quality cleaning or replacement of the floss or cartridge.
8 | fish 197
The air pressure exerted by the pump will also

affect a mechanical filter. The faster the pump
pushes water past the filter material, the faster it
will clog. Mechanical filtration is very useful in
both the home aquarium and outdoor pond. This
type of filtration is best used with other types
of filtration (chemical and biologic) to improve
the overall quality of water in the system. How-
ever, for a combination filter to be most effective,
Figure 8.4A Three types of filtration are used in most the mechanical filter needs to be placed in line
filtrations systems: mechanical, chemical, and biologi- before the chemical or biologic filter; this will pre-
cal. In this filter, the synthetic pads serve as the me- vent obstructions from forming in the chemical
chanical filter. and biologic filters. Mechanical filtration should
always be used with a sand filter or bead filter.
The mechanical filter will protect the sand or bead
filter by removing large particulate matter, which
might otherwise clog the biologic filter. Mechani-
cal filtration does have limitations and is not
effective for trapping finite particles or chemicals.
Biologic Filtration. Biologic filtration relies
on bacteria to take toxic compounds and make
them less toxic (e.g., Nitrosomonas spp. oxidizes
ammonia to nitrite and Nitrobacter spp. oxidizes
nitrite to nitrate; Nitrospira spp. also plays a role
in this process). This type of filtration is the most
common form used in the home aquarium and
Figure 8.4B Ultraviolet radiation serves as a chemical
outdoor pond. While the water and surfaces of the
filter.
tank serve as sites for bacteria to grow and func-
tion, several different types of commercial biologic
filters are available that enable the bacteria to
become colonized, including undergravel filters,
bio-wheels, sand or bead filters, and wet-dry fil-
ters. A biologic filter should be selected based on
the size of the aquarium (gallons of water), num-
ber of fish (density), and frequency of feeding.
Nitrogen is a component of protein. When
fish are fed, they take protein from the diet and
convert it to energy and waste product. The waste
product is converted into ammonia and excreted
Figure 8.4C Plastic balls serve as a biologic filter. from the gills. Leftover food in an aquarium also

degrades into ammonia. In an aquarium, ammo- oxygen depletion, owners should aerate the water
nia levels can build to dangerous levels for fish, with a fountain or airstone during the times when
leading to illness or death. Ammonia is an irritant a problem might occur.
to the gills and skin of fish. Fish suffering from Antibiotics can have negative effects on biologic
ammonia toxicity might become tachypneic, gasp filters. These types of compounds are routinely
at the surface, try to jump out of the aquarium, or used to empirically treat aquariums and ponds;
rub against rocks and plants. however, they are not specific and kill beneficial
Total ammonia-nitrogen (TAN) is divided into bacteria and pathogens alike. If there is concern
two forms, ionized (NH4+) and un-ionized (NH3). about the biologic filter, it is recommended to shut
The un-ionized form is more toxic than the ion- off the biologic filter to protect the bacteria essen-
ized form.1 The quantity and form of ammonia tial to its function.
found in water are dependent on biologic, chemi- A biologic filter requires time to become
cal, and physical factors.2 Biologic factors include established. The amount of time depends on the
the number of fish, the amount of food offered, temperature of the water and the organic load on
live plants, and so on. Chemical factors include the system. For example, a system maintained at
pH and alkalinity. When the pH is low, or acidic, 23°C takes 4–6 weeks to become established.
the majority of ammonia in the water is ionized, Commercial microbial products are available that
whereas when the pH is high, or basic, the un- claim to expedite the establishment of the micro-
ionized or more toxic form is common. Tempera- flora. Unfortunately, there is no hard evidence to
ture affects the amount of each form of ammonia support using these products. Water samples, filter
in the water; as water temperature increases, the pads, or aquarium substrates from established sys-
amount of un-ionized ammonia also increases. tems have also been used to seed a tank. However,
Several factors can affect the function of a bio- the addition of these products might also lead to
logic filter, including water temperature, water the introduction of pathogens.
oxygen content, and drugs/therapeutics. In out- Chemical Filtration. A number of different
door ponds when the water temperature drops types of chemical filters are available in the pet
below 65°F, nitrite is not converted into nitrate as trade. Chemical filtration refers to those filters
rapidly because Nitrobacter bacteria do not toler- that remove toxic compounds by binding them
ate the cold. Owners should be advised to closely or converting them into nontoxic substances. The
monitor nitrite and nitrate levels during those original form of chemical filtration was activated
times when the water temperature might drop. To carbon. Carbon can bind a number of different
prevent excess work for the biologic filter, owners substances (nonspecific). When the binding sites
should stop or reduce the amount of food being are full, they no longer act as filters and will need
offered to the fish. All of the bacteria essential to be replaced or cleaned. Placing the carbon
to the biologic filter need oxygen (aerobic condi- in vinegar (acetic acid) will acidify it and break
tions). In the home aquarium, oxygen levels are the bonds with any chemicals that have formed,
often adequate; however, in outdoor ponds, oxy- allowing it to be reused in the tank after being
gen levels can become depleted, depending on rinsed thoroughly. Other forms of chemical fil-
the time of day or season. (See “Oxygen” under tration are more specific, such as the resins that
“Water Quality.”) To prevent a problem with bind only ammonia. Other forms of chemical fil-
8 | fish 199
tration, such as ultraviolet sterilizers and protein Ammonia, Nitrite, and Nitrate. Ammonia is
skimmers, alter or trap compounds. Ultraviolet produced in fish as an end product of protein
sterilizers expose compounds to short-wavelength catabolism and is excreted directly across the
light, altering their form and rendering them gills into the aquatic medium. Ammonia is also
harmless. Protein skimmers trap protein in bub- derived from feces, uneaten food, and decaying
bles so that they can be separated from the water organic matter. Ammonia nitrogen can occur in
and removed. Chemical filtration, in combina- two forms: ammonium (NH4+) and ammonia
tion with mechanical and biologic filtration, can (NH3). Ammonia is the more toxic form to fish.1
improve water quality dramatically, creating a The relative concentration of each form varies
healthy environment for fish. with water pH and temperature.2
Ultraviolet (UV) sterilizers can be used to con- Ammonia is soluble in water, and minimal
trol certain pathogens and algae. A UV sterilizer amounts are lost through evaporation. In a closed
has a UV bulb encased in a waterproof sheath system, such as an aquarium or backyard pond,
within a cylinder. As water passes through the ammonia levels can build up to toxic quantities
cylinder, the water is exposed to ultraviolet light, (>1 ppm). Even low levels of ammonia can be toxic
which can alter the DNA or RNA of a micro- to the gills and skin, resulting in increased suscep-
organism. The amount of time that it takes for tibility to infection. (See “Diagnostic Sampling.”)
the water to pass the bulb and the bulb wattage Owners should be advised to closely monitor
determine the effectiveness of the UV sterilizer. ammonia levels in new systems or systems that
A low-wattage bulb in a short cylinder will have contain a large number of fish. Ammonia should
little effect on pathogens. These systems have also be tested weekly using a standardized commercial
been used with great success at controlling patho- test kit, which is available at local pet retailers. In
gens and algae in outdoor ponds. an established system, the ammonia level should
be zero. If the ammonia level begins to rise, then
Water Quality the system should be reevaluated. Overfeeding
Water quality is very important to the health of a fish, and overstocking an aquarium can overburden
and poor water quality can prove fatal. Two types of the biologic filter. Severe temperature fluctua-
systems can be used: open and closed. In open water tions and insufficient oxygen levels can also result
systems, the water in the aquarium is continually in a significant loss of the biological filter. This
replenished using a freshwater source. A person who is especially common in ponds that have signifi-
lives by the ocean might collect seawater for a home cant summer algal blooms. New systems require
marine aquarium, although this is not recommended time to become established, and new fish should
because of the potential contaminants in the water. be added gradually to prevent an overload of the
Open water systems are rarely used because they are biologic filter.
labor-intensive and require regular exchange of the Because ammonia is a common waste product
entire system. The majority of home aquariums use produced by fish and excessive decaying food,
closed recirculating systems, which recirculate the most problems can be prevented by limiting the
same water over and over again using a filter. In the stocking numbers in an aquarium and by offer-
closed system, freshwater is added only after evapora- ing only the quantity of food that the fish will
tion or at the time of a water change. consume within a 2- to 5-minute period. In cases

when ammonia levels are creating problems, the less than 0.5 ppm are generally regarded as safe;
first recommendation technicians should give levels less than 3.0 ppm are associated with stress
their clients is to remove 25%–50% of the water and can predispose fish to opportunistic infection;
from the system and replace it with fresh, dechlo- levels greater than 5 ppm are considered toxic.
rinated water. There are commercial products When fish show clinical signs associated with
available that can chelate the ammonia source, nitrite toxicity, they should be removed from the
but they are only a temporary solution. The pri- toxic water and placed into a fresh, dechlorinated,
mary cause of the elevated ammonia level must be well-oxygenated system. Fish with methemoglo-
diagnosed and corrected. binemia have reduced oxygen carrying capacity and
Ammonia is a colorless, odorless substance that require well-oxygenated water. This can be accom-
can cause significant mortality in a home aquar- plished by placing into the hospital tank a fine-mist
ium. Most inexperienced aquarists tend to single airstone that creates a break in water surface ten-
out infectious diseases when they experience fish sion, increasing water oxygen levels. A significant
losses; however, poor water quality (e.g., excessive water change (25%–50%) should be made in the
ammonia or nitrite) is often a primary or second- original aquarium or pond and the biologic filter
ary cause of mortality in these animals, and water reestablished.
should be tested on a regular basis. In the nitrogen cycle, nitrite is further oxidized
The nitrogen cycle eliminates ammonia by con- to nitrate (NO3) by Nitrobacter spp. and Nitro-
verting it into less toxic compounds. Ammonia spira spp. Reports of nitrate toxicity are rare in
is initially oxidized to nitrite (NO2) by bacteria fresh- and saltwater fish, but elevated levels can
(Nitrosomonas spp. and Nitrospira spp.) within be stressful and predispose the animals to oppor-
the aquatic system. Nitrite is also toxic to fish and tunistic pathogens. Nitrate is used by plants and
can be rapidly absorbed across the gills. Affected algae as a food source. Nitrate can be removed
animals develop a methemoglobinemia and have from an aquatic system by performing regular
characteristic “brown-blood,” gasp for air at the water changes.
water surface, and die suddenly. Nitrite levels in “New Tank” Syndrome. “New tank” syndrome
an aquatic system might rise soon after treatment is a common problem reported by beginner/novice
of the water with antibacterial compounds or a aquarists who overload a newly established biologic
reduction in water temperature. Antibiotics added filter. “New tank” syndrome occurs primarily when
to the water are nonselective and will kill both fish are overstocked in a new aquarium. The high
pathogenic and commensal organisms. These density of fish creates a high ammonia load on the
compounds can kill enough bacteria associated new system. This is often coupled with overfeeding,
with the biologic filter to prevent the oxidation of which leads to additional organic load on the sys-
ammonia and nitrite. Nitrosomonas spp. will recol- tem and a rise in ammonia levels. In most cases, the
onize before Nitrobacter spp., so ammonia levels owners report acute death of the fish and the clini-
should be expected to decrease before nitrites. cal signs are consistent with ammonia and nitrite
Nitrobacter spp. are more sensitive to temperature toxicity. These problems can be prevented if the
fluctuations than Nitrosomonas spp.; therefore, new owner is patient and realizes the importance
elevated nitrite levels are often detected soon after of providing a break-in period for the filter (4–6
a reduction in water temperature. Nitrite levels weeks). Owners should be made aware that fish
8 | fish 201
should be stocked gradually, usually 1–2 fish per tral, and values above 8.0 are basic. The pH in
week. A standard rule of thumb for freshwater most aquariums and ponds should fall between
stocking density is 1–1.5" of fish per gallon of 6.5 and 8.5. In the extreme ranges (<4 or >10),
water, whereas in saltwater systems the stock- water would be so acidic or basic that it would
ing density should be 2–2.5" of fish per gallon of burn the fish. This means that the difference
water. With the advent of new filtration systems, between 7.0 and 8.0 is much more significant
stocking densities will continue to increase; how- than you might expect, because the pH values are
ever, if the filter becomes compromised or fails, based on a logarithmic scale. Therefore, if the pH
the results would be disastrous. is allowed to fluctuate, fish will become stressed
Oxygen. Fish acquire free oxygen directly and more susceptible to disease.
from the water. Oxygen diffuses into water at the The pH of natural bodies of water varies based
surface when the surface tension of the water is on the substrate, watershed, and other environ-
broken. The amount of available or dissolved oxy- mental factors. Fish from Central and South
gen (DO) within the system can be measured America thrive in water that is neutral or slightly
using special equipment. In most cases, a DO >5 acidic, whereas fish from Africa and Asia thrive
ppm is sufficient to maintain fish. In most home better in neutral to alkaline water.
aquariums, there is sufficient DO. Water should always be tested prior to replace-
Oxygen depletion is a major concern in out- ment in an aquarium. A number of factors can
door ponds during the summer months. During affect the pH in an aquarium or pond, includ-
the day, plants produce their own food (pho- ing the biologic filter, fish density, vegetation,
tosynthesis) by taking carbon dioxide from the and algae. Biologic filtration actually produces
water and using energy produced by the sun. As acid when ammonia is converted into nitrite. If
plants make their food, they release oxygen into the water has a low buffering capacity and the
the water. During the night when plants or algae aquarium or pond biologic filter is converting a
cannot undergo photosynthesis, they actually large amount of ammonia, the pH could become
consume oxygen. In ponds with a large number very acidic. Fish produce carbon dioxide (CO2 ) as
of plants or phytoplankton, oxygen levels in the a waste product. When an aquarium or pond is
water can fall to dangerously low levels for the heavily stocked with fish, the amount of CO2 can
fish. Another factor that can affect oxygen lev- build up in the water. Carbon dioxide promotes
els in water is temperature. Oxygen is lost to the acid production and can actually decrease the pH
atmosphere more rapidly in warm water than in (acidic). Plants and phytoplankton (algae), which
cold water. The use of aerators or fountains, espe- use photosynthesis during the day to make energy,
cially at night, will help maintain adequate levels use CO2 as their primary substrate. However, at
of oxygen in a pond. night, plants and algae use oxygen (like fish) and
Water pH. The pH of water is calculated as the expel CO2 as a waste product. In a system with a
negative logarithm of hydrogen ions. In simplest large amount of plants and phytoplankton, the pH
terms, pH can be divided into three categories: can drop to a dangerously low level. Fish die-off
acid, neutral, and basic. The range of pH values in ponds is often associated with high CO2, low
fits on a scale of 1–14. Values below 7.0 represent pH, and low oxygen levels. When plants or fish
acidic water, values between 7.0 and 7.9 are neu- die, they also release compounds that can lower

the pH. To prevent this from becoming a problem, conditions. Calcium appears to protect fish that
owners should be advised always to remove dead are exposed to a low pH or elevated ammonia by
fish or plants immediately. altering osmoregulatory functions.3 Calcium and
Chlorine. Chlorine is a gas that is added to magnesium are essential to growth and develop-
our municipal water supplies to protect us from ment of young fish.4 Calcium and magnesium can
bacteria and other harmful organisms. Unfortu- also protect fish from heavy metal exposure by
nately, chlorine is toxic to fish. When a fish is competing for gill absorption sites. Copper is rou-
placed in chlorinated water, the chlorine crosses tinely used to treat ectoparasites on fish. Calcium
the gills and blocks the fish’s ability to absorb and magnesium will compete with the copper for
oxygen, which causes suffocation. This whole absorption sites, reducing the effectiveness of the
process can take minutes to hours, depending copper. Distilled water should never be used to
on the amount of chlorine in the water. Sodium replenish water in an aquarium, because it is defi-
thiosulfate can be added to tap water to neu- cient in these essential cations.
tralize chlorine, immediately making the water Alkalinity. In natural water systems such as
safe for fish. Municipal water supplies add vari- lakes, fish are exposed to a relatively stable pH
able amounts of chlorine at different times of the because of buffers. The most common buffers
year, depending on the source of water. If owners in aquatic systems are bicarbonate (HCO3) and
have questions about the timing or amounts of carbonate (CO32−). Other buffers that can occur
chlorine that are added, they should be advised in water in lesser amounts are hydroxide (OH−),
to call their local water company. They should silicates, phosphates, and borates. The quantity
always test the water before replacing it in the of buffers within a system depends on location.
aquarium or pond to ensure that the chlorine has Some municipal water supplies contain minuscule
been removed. amounts of buffers, whereas others might have
Chloramine. Chloramines are also routinely large quantities of buffers. Commercial buffers
added to municipal water supplies for sterilization can be added to an aquarium or pond to increase
purposes. Chloramines are formed by combining the total alkalinity in the system, creating a more
chlorine with ammonia. Commercial dechlorina- stable pH.
tors can be added to tap water to neutralize chlorine; Total alkalinity also plays an important role in
however, the ammonia will remain in the water. the chemistry of potential toxins such as lead, zinc,
Ammonia is toxic to fish and can prove fatal to fish and copper. Heavy metals are absorbed from the
at levels higher than 1 ppm. A functional biologic water by the gills and are fatal to fish. Bicarbonate
filter will convert the ammonia to nitrate. and carbonate can actually bind the heavy met-
Hardness. Hardness is a measure of the amount als, rendering them harmless. This is important
of divalent cations, primarily calcium and magne- to remember when treating fish with nonchelated
sium, in the water. In natural waters, the divalent copper. If the alkalinity is high, the unchelated
ions are derived from limestone, salts, and soils. The copper can be bound and rendered useless.
normal range for hardness in freshwater systems is Monitoring Water Quality. For new tanks, own-
0–250 mg/L, whereas in saltwater systems the total ers should test water weekly for ammonia, nitrite,
hardness can exceed 10,000 mg/L.3 Calcium and nitrate, pH, alkalinity, and hardness. If problems
magnesium play an intricate role in water quality occur, they should test the water more frequently,
8 | fish 203
and allow 4–6 weeks for the biologic filter to

become established. Owners should be advised to
add only 1 or 2 fish at a time so that the biologic
filter is not overloaded. They should always test
new water for the previously mentioned param-
eters and for chlorine and chloramine before
replacing it in the aquarium or pond.
For established tanks, 10%–20% of the water
should be replaced every 1–3 weeks. Frequency of
water change will depend on the load on the sys-
tem (i.e., size of aquarium, number of fish, amount
of food offered). A small aquarium will need more Figure 8.5 A wide variety of commercial fish food is
frequent changes than a large aquarium. By closely available at local pet retailers. It is important to read
labels carefully to ensure that a particular group of fish
monitoring the water (ammonia, nitrite, nitrate,
is provided the most appropriate diet.
pH, alkalinity, and hardness), owners will be able
to determine when it needs to be changed. Before
replacing the water, owners should be sure to test cooked, squashed peas has also been found to
it for the same parameters, as well as for chlorine have positive benefits for fish with swim bladder
and chloramine. disease. It is not known why this dietary supple-
ment works, but it is suspected to be associated
Nutrition with changes in gas-producing bacteria. Obesity
A variety of commercially available fish foods are is a common problem identified in captive orna-
available in the pet retail trade (Figure 8.5). Many mental fish because of a combination of high-fat,
of these diets are specifically formulated to meet high-protein commercial diets and restricted
the needs of particular fish, including herbivores, exercise (aquarium size). Restricted feeding and
omnivores, and carnivores. It is important for vet- providing the largest swimming area possible will
erinarians and veterinary technicians to learn to reduce the potentially life-threatening problems
read the labels of foods offered to their patients, associated with obesity. Live foods are routinely
so that they can give owners sound advice offered to carnivorous fish to balance commercial
regarding what should and should not be recom- food preparations and to increase exercise levels.
mended. In general, carnivorous fish should be Live foods can transmit disease and should be
offered diets with the highest protein (>50%), fol- purchased only from a reputable dealer. Another
lowed by omnivores (40%–50%) and herbivores benefit of live foods is that they provide enrich-
(30%–40%). The inverse is true as it relates to ment for fish and force them to practice normal
fiber. Commercial fish foods are sold in flake and hunting behaviors.
pelleted rations. In certain fish, especially orna-
mental goldfish, the ingestion of floating pellets Transport
has been associated with buoyancy problems (Fig- Fish should be transported in a plastic sealed con-
ure 8.6). Fish that develop such problems should tainer, which should be used exclusively to transport
be offered sinking pellets. In addition, feeding fish and never reused to carry human food items.

be addressed in the history: the owner’s general

knowledge, the aquarium environment, the water,
and the fish. Questions regarding the owner’s gen-
eral knowledge of aquarium management should
include length of aquarium ownership/experience,
number of aquariums they own, where the fish
were obtained, time spent viewing the fish, and
weekly maintenance program.
The history of the aquarium environment
should include questions about tank volume, tank
placement, tank top, lighting, heating, filtration,
substrate, and aquarium decorations (e.g., plants,
rocks, logs, and toys). It is important for the
technician to ask about tank volume, because it
Figure 8.6 This goldfish has a swim bladder problem. allows him or her to determine the relative stock-
Feeding floating pellets to some fish can lead to in- ing density of the aquarium. The placement of the
creased ingestion of air, which can affect buoyancy.
tank within the home might provide insight into
problems associated with algal overgrowth (e.g.,
The container should be cleaned with warm, soapy direct sunlight exposure) or toxins (e.g., clean-
water and rinsed thoroughly after each use. Bleach ing sprays). Some fish owners do not cover their
should never be used to clean the container. The aquariums with a top. Tanks without tops experi-
water used to transport the animal should come ence faster evaporation and are more prone to fish
from the home aquarium. A separate container of loss because of jumping.
aquarium water should also be brought to the veter- A number of different lighting systems are avail-
inary hospital—in case of spillage, for water quality able for the home aquarium. Owners should be
testing, and as a source for recovery from anesthe- asked whether they have fluorescent or incandescent
sia. The fish should be transported immediately to lighting, the bulb wattage, and the amount of time
the veterinary hospital. Special precautions should the lighting remains on during the day. Incandescent
be made during the winter and summer to prevent lights produce radiant heat and are associated with
water temperature fluctuations, such as preheating increased water temperatures. Fluorescent lighting,
and -cooling the transport automobile in the winter especially full-spectrum lighting, is preferred for
and summer, respectively. Signs of transport stress live aquatic plant systems.
may not be apparent for several days after the move, Most aquariums are heated with thermostati-
so owners should be advised to monitor the animals cally controlled heaters. Questions regarding
closely for 3–5 days post-transport.5 heater usage (yes or no), type, and wattage size
should be asked. Owners should also be asked if
they use a thermometer and, if so, the tempera-
HISTORY
ture in the aquarium. Fish are poikilotherms and
A thorough history is key to developing a diag- must be provided an appropriate environmental
nostic and therapeutic plan. Four key areas must temperature.
8 | fish 205
Because there are a number of different types Because fish are typically anesthetized for the
of filters, questions should be asked to determine hands-on component of the examination, abnor-
type of filter, length of usage, and owner’s general malities in breathing, locomotion, and mentation
knowledge of filtration. Information should be might not be seen. Any abnormal findings should
ascertained regarding aquarium decorations, such be recorded prior to a hands-on examination.
as plants, rocks, logs, and toys. The addition of A fish can be captured with a net or a gloved
new live plants might introduce disease. hand, or it can be scooped into a plastic cup or
Most fish-owning clients have a limited knowl- bucket. Animals in a large aquarium must be
edge of water chemistry; therefore, veterinary caught with a net. Netting a fish can be a very
technicians must be patient with their clients when traumatic experience. It is best to reduce the light-
taking a history of water quality. Questions must ing in the room when capturing a fish to prevent it
be asked regarding the source of the water, how from swimming into the tank walls and injuring
often the water is changed, and water quality tests itself. Once the fish is captured, it should be trans-
that have been performed. Veterinary hospitals that ferred into a bucket with water collected from the
work with ornamental fish should have water qual- primary aquarium.
ity test kits and should perform the appropriate A hands-on physical examination of a fish
water tests during the visit. should be performed in a thorough and rapid
The final history questions should focus on the manner (Figure 8.7). The veterinarian will wear
fish. Questions regarding types of fish, number of examination gloves to minimize the potential
fish, and length of ownership are all important. spread of zoonotic pathogens through open cuts
Many infectious disease cases are the direct result on his or her hands and to protect the fish skin
of adding new, unquarantined fish. Types of other from the oils found on human hands. Generally,
aquatic organisms, such as snails, must also be a fish is anesthetized for a physical examination
addressed because these animals can also intro- and diagnostic tests are collected at the same time.
duce disease. Owners should be asked whether Tricaine methane sulfonate is the anesthetic of
the fish are eating and if any abnormal behaviors choice (see “Diagnostic Handling”). If the fish is
have been noted, such as whirling, inverted swim- already moribund, anesthesia can be skipped. The
ming, jumping, tachypnea, or lethargy. The final physical examination should be performed out of
questions should address the number of affected water to improve visualization of the animal. The
fish, specific lesions, and duration of the present- fish should be replaced into the water bucket every
ing disease. 30–45 seconds during the procedure to allow it
to respire and to rewet the gills and body. The
fish should be cupped in the hand with minimal
restraint, because the protective mucous layer and
A fish physical examination will be performed in scales can be damaged from minor manipulation.
two stages: a hands-off examination and a hands- Handlers should have a basic knowledge of the
on examination. The hands-off examination fish they are working with to prevent injury to them-
should be done while the fish is in its transport selves and other hospital staff. Many ornamental
container. Observe the fish for abnormalities in fish have spines associated with their fins, which can
behavior, breathing, locomotion, and attitude. cause pain upon puncture and become a source of

• Opercula and gills: The opercula should move

freely during normal respiration. When the
opercla are lifted, the gills should be bright
red. Excessive mucus and free hemorrhage are
abnormalities that require additional examina-
tion/testing.
• Body condition: The muscling over the head,
neck, and spine should be evaluated. Any prom-
inence of the skull or spine is an indication of
poor body condition.
Figure 8.7 A hands-on examination of a fish should • Skin: The integument should be inspected for
be done using the same thorough protocol used for do- lost scales, hemorrhage, abscesses/granulomas,
mestic pets. Never go directly to an abnormality, but
and excessive mucus.
instead start at the head and work through the fish,
• Fins: The pectoral, pelvic, anal, caudal, dorsal,
being sure to examine all systems. Anesthetizing the
patient for the examination reduces the stress on the and adipose (if present) fins should be inspected
fish and gives the examiner additional time to for excessive mucus, hemorrhage, and tears. Any
examine the fish. erosions noted on the fins should be documented.
• Abdominal cavity: The abdominal cavity (loca-
infection to the handler. There are also a number of tion of the viscera) should be palpated to
ornamental fish, such as the lionfish, that can inject determine if there are any firm masses or free
venom; they should be handled only by profession- fluid (ascites).
als. In most cases, anesthetizing fish is preferred to • Anus/Urogenital openings: Most teleosts have a
ensure safety of the animals and the handler. separate anus as the terminus of the gastroin-
When performing the hands-on physical exami- testinal tract and a urogenital opening as the
nation, the following structures should be evaluated: terminus of the excretory and reproductive
tracts. Examine these openings for any dis-
• Nares: They should be clear and not eroded. charge or prolapse of tissues.
These are blind pockets in most fish.
• Eyes: The corneal surfaces should be clear. A
DIAGNOSTIC SAMPLING
fluoroscein stain can be done to check for cor-
neal ulcers. The anterior chamber should be Fish have evolved to mask their illness. Although
clear of red and white blood cells. Lenticular this protects against predation under natural con-
dislocation is common with trauma and should ditions, it can make the job of the veterinarian
be evaluated. Fundic examinations are difficult and veterinary technician more difficult. Because
in fish. of this defense mechanism, it is important for
• Mouth: The mouth should be clear of discharge. veterinary professionals to pursue appropriate
The maxillae and mandibles should be freely diagnostic tests to determine underlying causes of
movable. Dislocation is common in some spe- disease. The purpose of this section is to review
cies. Water should move freely through the oral common diagnostics used to characterize the dis-
cavity and out the opercula. ease status of fish.
8 | fish 207
Fish that present with a history of tachypnea (Figure 8.8). The gill filaments should be placed
or gulping air at the water surface should have onto a microscope slide with a drop of 0.9% saline
their gills examined. Common differentials for or water from the fish’s aquarium/recovery bucket,
such cases include poor water quality, bacterial covered with a coverslip, and reviewed under a light
infections, and parasite infestations. Fish suffering microscope. Samples can also be stained to review
from ammonia toxicity appear irritated, gasp at the tissues for the presence of bacteria. Once the
the water surface, and may rub against rocks in the procedure has been completed, the animal should
enclosure as a result of the irritation caused by the be recovered in dechlorinated, fresh water.
toxin. Affected animals can die suddenly. Anytime Fish that present with a history of scraping
a fish presents with breathing at the water surface, against materials in the aquarium, increased
a thorough evaluation of the gills should be done. mucus production, hemorrhage on the skin, or loss
A gill biopsy is a simple diagnostic test that of scales should have a skin scrape done to deter-
can provide significant information regarding the mine the underlying cause of disease. Common
patient’s status. Fish should be anesthetized for a gill differentials for these types of cases include poor
biopsy to provide appropriate sedation and analge- water quality, bacterial infections, and parasite
sia, and MS-222 is the anesthetic of choice for this infestations. A skin scrape is a simple diagnostic
procedure. Once a fish is anesthetized, it should be test that can be used to identify specific pathogens
removed from the anesthetic solution using gloved on the surface of a fish integument. Once again,
hands and placed onto a dechlorinated, moist paper the animal should be anesthetized to reduce stress.
towel. A pair of fine iris scissors should be inserted The animal can be restrained by hand or placed
under the operculum and gently lifted, enabling on a moistened paper towel. A microscope slide
the veterinarian to insert his or her thumb under should be placed at a 45° angle on the skin at the
the operculum to provide direct visualization of the site of the lesion(s) and gently dragged in a caudal
gills. Iris scissors should be reinserted under the oper- direction (Figure 8.9). The material collected from
culum, and 4–6 gill filaments should be collected the skin scrape should be placed on an additional
Figure 8.8 A gill biopsy in a cichlid. To perform the Figure 8.9 A skin scrape in a cichlid. Place the mi-
procedure, insert your free thumb under the operculum croscope slide at a 45° angle to the skin at the site of the
and lift. Insert a pair of iris scissors under the opercu- lesion and draw the slide caudally. Dragging the slide
lum and clip 4 to 6 primary lamellae to examine. cranially will damage scales.

microscope slide, a drop of 0.9% saline or water

from the fish’s aquarium/recovery bucket added to
the mix, and the material covered with a coverslip.
Additional slides can be made with Diff-Quik or
Gram stains to look specifically at cell types and
bacteria. A light microscope with the capacity
of 1,000× magnification (10× eye pieces, plus a
100× immersion oil objective) will be required to
screen the samples. The fish should be recovered
in dechlorinated water.
Fish that present with a history of abnormal Figure 8.10 A fin biopsy in a cichlid. Using a pair of
growths, discolorations, or ulcerations in their iris scissors, remove a section of affected fin. Place the
fins should receive a fin biopsy. Common differ- fin on a slide with a drop of 0.9% saline or water from
entials for these types of cases include poor water the fish’s aquarium and cover it with a coverslip. Re-
view the slide under a light microscope.
quality, trauma, water mold infections, bacterial
infections, and parasite infestations. A fin biopsy
can be especially useful in cases with ectoparasites, the heart. The caudal tail vein is located ventral
bacteria, or water molds, because these organisms to the vertebral column and runs parallel to the
can be seen on the cytologic review of the fin spine. A 3 ml syringe with a 25- to 30-gauge
biopsy. A fish undergoing this procedure should needle is recommended for sample collection.
be anesthetized. A pair of iris scissors should be There are 2 approaches to the ventral tail vein:
used to cut a sample from an affected fin (Fig- a lateral approach and a ventral approach. For
ure 8.10). Do not worry about cutting around fin the lateral approach, the needle should be gen-
rays, as the fins will heal rapidly once the incit- tly inserted at a 45° angle (between scales) into
ing cause is treated. The sample should be placed the caudal peduncle at the level of the lateral line
on a microscope slide, mixed with a drop of 0.9% and walked off the ventral edge of the vertebral
saline or water from the aquarium/recovery water, column until a flash of blood can be seen in the
covered with a coverslip, and evaluated under a needle (Figure 8.11). For the ventral approach,
light microscope. The fish should be recovered in the animal should be held in dorsal recumbency
dechlorinated water. and the needle inserted into the ventral midline
The examination of blood samples (hematol- of the caudal peduncle at a 90° angle. The needle
ogy and biochemistries) can provide insight into should be inserted to the level of the vertebral
the general health of an animal that might not column and gently walked along the spine until
otherwise be obvious on physical examination. a flash of blood is observed. The heart is located
The volume of blood that can be collected from ventral and caudal to the gills/operculum. For
a fish has been estimated to be similar to that of cardiac blood samples, the operculum should be
mammals, approximately 0.8%–1.0% of the body elevated (similar to the technique used for a gill
weight.6 Always preload the needle with heparin biopsy) and a needle inserted caudally and ven-
to prevent blood clotting. The primary sites of trally at the level of the caudal isthmus (Figure
venipuncture in fish are the caudal tail vein and 8.12). Once collected, samples should be placed
8 | fish 209
immediately into their appropriate transport

tubes. When working with tropical fish, many
prefer using Microtainers (Becton Dickinson
Corp., Franklin Lakes, NJ), because the sam-
ple volumes collected are typically small. These
transport tubes have a dry anticoagulant, so there
is no concern about sample dilution.
Red blood cell estimates are not typically
done for fish unless there is a problem, because
it is necessary to do manual counts and standard
hematologic machines cannot count nucleated
erythrocytes. Fortunately, most veterinarians are Figure 8.11 Ventral tail vein venipuncture in an oscar.
comfortable reviewing packed cell volumes (PCV)
to get an appreciation of erythrocyte numbers;
PCV values for fish are typically between 20%
and 40%. When veterinary technicians read man-
ual differentials for white blood cell counts, they
should note what they see with the erythrocytes.
Immature erythrocytes in fish, as in amphibians,
reptiles, and birds, are smaller in size, have a higher
nuclear to cytoplasmic ratio, and have a basophilic
cytoplasm, compared with mature erythrocytes.
When large differences (3–4+) are noted in color
(polychromasia) or size (anisocytosis) of erythro-
cytes, it is important to document and consider Figure 8.12 Cardiac venipuncture in a goldfish.
when interpreting the overall erythrocyte status
of a patient. Biologics, Houston, TX) can stabilize the cells
Complete blood counts in fish require special and minimize “smudgeocytes.” To do this, add
care. Because all of the blood cells are nucleated 1 drop of bovine albumin and 5 drops of whole
in fish, standard hematologic equipment cannot blood to a test tube. Mix the solution by gen-
be used. Instead, manual counts must be done. tly rotating/rocking it. Once it is mixed, use a
To perform a manual count in a fish, start by hematocrit tube to collect some blood from the
making a high-quality blood smear. Make the tube and make your smears using standard glass
blood smear using either standard microscope microscope slides. Blood smears can also be
slides or coverslips. Blood cells in fish are more made using coverslips (without bovine albumin).
fragile than those found in mammals; there- In reptiles, no significant difference in the num-
fore, it is important to use caution when making ber of “smudgeocytes” has been noted between
blood smears to minimize the likelihood of cell samples premixed with albumin and made with
rupture (“smudgeocytes”). Premixing a blood slides and those made with coverslips, although
sample with 22% bovine albumin (Gamma both of these techniques resulted in significantly

fewer “smudgeocytes” than smears made only be performed in a consistent manner. Seventy
using glass slides (not pretreated with albumin). percent ethyl alcohol should be applied to the
Once the slides are made, estimating white ventral surface of the fish and the area flamed.
blood cells and differential count is easiest if you Once the alcohol has burned off, the fish should
do the following: be opened using sterile scissors and forceps. After
the coelomic cavity is exposed, samples can be
1. Count the number of white blood cells on 10 collected using either a sterile swab or sterile
fields at 400× (10× eyepiece and 40× objective). biopsy techniques.
The fields should represent a section of the There are many opinions about the most
blood smear where the cells fill (but don’t appropriate culture media and incubation tem-
overfill) the slide and are evenly distributed. peratures for isolating bacterial pathogens from
2. Divide the total number of white blood cells fish. A standard blood agar plate can be used
counted by 10 to get the average number of as the initial plate, or other specialized plates
cells per field. can be used if a specific pathogen is suspected.
Salt should be supplemented to the plate when
3. Multiply the average number of cells per field
attempting to isolate pathogens from marine fish.
by 2,000 to get the estimated white blood Plates should be incubated at 25°C and 37°C.
cell count. Although it is often argued that the 25°C incuba-
4. Perform a 100- or 200-cell differential to tion temperature is preferred because it mimics
determine the proportions of white blood the temperature of the ectothermic host, bacteria
cells. The more cells counted (200 vs. can grow at a range of temperatures and most
100), the tighter the results will be. These grow faster and more proficiently at higher tem-
proportions can then be multiplied by the peratures (37°C). Exceptions to this are water
estimated white blood cell count (see step 3) molds and fungi. These organisms can be out-
to estimate absolute values of the different competed at 37°C and tend to grow better at
cell types. 20°–25°C. Culture plates should be evaluated for
growth at 24- and 48-hour time periods. A Gram
Microbiology stain should be performed on any isolate. Bio-
Microbiologic samples can be collected from a chemical identification of the organism should
fish during an antemortem or postmortem exam. follow standard microbiologic protocol.
Antemortem samples are routinely collected from
specific lesions on the skin, fins, or eyes. Contami- Radiology
nation is a significant concern in these cases, and Several case presentations require radiographic
results should be interpreted accordingly. A sterile evaluation, including foreign body ingestion, neo-
swab can be rubbed over the affected area to col- plasia (Figure 8.13), internal abscesses, and swim
lect the sample. The sample should be refrigerated bladder disease (Figure 8.14). Fish should be anes-
until it is plated, which should occur within 24 thetized during the procedure to prevent thrashing
hours. and damage to the mucous barrier and integu-
Postmortem cultures routinely involve internal ment. Tricaine methane sulfonate is the anesthetic
organs. To ensure sterility, the necropsy should of choice. The fish should be recovered as soon as
8 | fish 211
the procedure is completed. The techniques used to tions can also be administered via a stomach tube.
perform the radiographs will vary from machine to A red rubber feeding tube can be used for this pro-
machine. High-detail films should be used to procedure. The distance from the mouth to just distal
vide the best radiographic image. to the opercula should be measured and marked,
thereby denoting the approximate location of the
Parasitology stomach. The tube should be inserted to the level
Parasites are a common finding in fish. Although the of the mark, and the medication delivered. If the
majority of the parasites encountered with captive tube is not passed through the esophagus, it will
fish are found externally (e.g., skin and gills), there be seen passing out one of the opercula.
are certainly endoparasites (e.g., gastrointestinal, Intramuscular injections are administered
liver) reported in these species, too. As mentioned into the epaxial muscle surrounding the spine.
previously, screening for parasites should be done The needle is inserted between scales. Irritating
as a component of the general examination of a fish
(see “Diagnostic Sampling”). Skin scrapes, fin biop-
sies, and gill biopsies are invaluable for evaluating
fish for external parasites. Fecal examinations, both
direct saline fecal smears and fecal flotations, can
be used to screen fish for gastrointestinal parasites.
Because fish serve as intermediate hosts for a vari-
ety of parasites (e.g., trematodes, nematodes), some
parasites can be identified/confirmed only using
histopathology at postmortem.
Figure 8.13 A lateral survey radiograph of an oscar
with a renal tumor.
THERAPEUTICS
Therapeutics can be administered to fish in a water

bath, orally, via intramuscular injection, via intra-
coelomic injection, or by intravenous route. Water
bath treatment with certain drugs is of little value
to freshwater fish, but have been used with success
to treat marine fish. Marine fish actually drink
water, so any medication placed in the water will
be ingested. Freshwater fish do not drink water
and are not likely to receive the same benefit.
Carbon filters should be removed when a bath or
immersion treatment is used.
Oral medications can also be placed in food
Figure 8.14 A lateral survey radiograph of an oranda
and delivered to the fish during routine feedings. goldfish with a swim bladder problem. In this case, the
Unfortunately, many sick fish are anorexic and do fish had excess gas in the caudal chamber that displaced
not benefit from medicated food. Per os medica- it ventrally.

compounds should not be administered intramus-

cularly because they can lead to muscle necrosis.
Intracoelomic injections are routinely used to
administer antibiotics to fish. The fish is held in dor-
sal recumbency, allowing gravity to drop the viscera,
and the injection administered between the scales of
the ventrum into the coelomic cavity (Figure 8.15).
Again, irritating compounds should not be used.
Intravenous injections are not routinely used,
but might be useful during emergency situations.
Inappropriate use of antibiotics and antiparasitics
can lead to development of resistant strains of bac-
teria and parasites. Figure 8.15 Intracoelomic injections are an excellent
way to provide essential medications to fish. Note how
the fish is placed in dorsal recumbency to allow gravity to
SURGICAL AND ANESTHETIC ASSISTANCE pull the viscera away from the injection site. Also, note
how the needle and syringe are held parallel to the body
Surgical procedures are becoming routine with to limit the potential for deep injection into the viscera.
fish. The basic tenets of surgery in domestic species
apply to fish surgery as well. Fish surgery can be
performed in or out of water. The preferred method Historically, veterinarians working with lower
is out of water because it increases visualization of vertebrates (e.g., fish, amphibians, and reptiles)
the surgical field. Tricaine methane sulfonate is have relied on “bruticaine” to restrain animals
the anesthetic of choice for surgical procedures. for physical examination and short surgical pro-
Surgical procedures should be performed using a cedures. This technique is unacceptable, because
recirculating anesthetic machine. Preparation of there are a number of safe, reliable anesthetic
the surgical area should be done with a noninsult- agents that can be used to appropriately restrain
ing disinfectant or saline. Avoid alcohol rinses for or anesthetize a fish for different procedures.
surgical preparation, because they increase heat A fish should be thoroughly evaluated prior
loss. Many disinfectants cause chemical burns to performing an anesthetic procedure. Fish
or are toxic and should be avoided. Microsurgi- that are stressed, maintained under inappropri-
cal equipment should be used to perform surgeries ate water temperatures, or have ingested a recent
in fish. Synthetic absorbable sutures are typically meal are not considered good anesthetic candi-
used for fish to ligate internal structures and for dates. Prospective anesthetic candidates should
body wall closure. Although it is possible to use be maintained in clean, dechlorinated, well-
nylon to close the skin, most surgeons prefer not oxygenated water (5–10 ppm) under reduced
to use this suture material because they would lighting. Food should be withheld for a minimum
need to renet the fish to remove the sutures. Clear of 6–8 hours to ensure that they do not regurgi-
drapes should be used to limit contamination of tate and contaminate the anesthetic solution.
the surgical site, while retaining good overall visu- Always wear a pair of examination gloves when
alization of the patient. handling fish to administer an anesthetic (e.g.,
8 | fish 213
intramuscular injection) or to perform a proce- although for longer procedures animals should
dure. Fish that are mishandled might develop be maintained on a recirculating anesthetic sys-
an injury to their integument, damaging their tem. A simple system consisting of a submersible
dermis (scale loss) and increasing their suscepti- electric pump, flexible tubing, and two reservoirs
bility to opportunistic pathogens. Gloves are also (one for anesthetic and one for recovery) can be
beneficial to handlers and will protect them from used to maintain a fish during a surgical proce-
potentially zoonotic diseases such as Mycobacte- dure (Figure 8.17). The tubing should be placed
rium spp. directly into the animal’s mouth to irrigate the
Monitoring fish during an anesthetic procedure gills. The recirculating pump can be moved from
can be difficult. In most cases, opercular move- the anesthetic solution to nonanesthetic solution
ment, loss of equilibrium, sensitivity to painful as the depth of anesthesia varies.
stimuli, fin color, and gill color are used to assess Clove oil has been used for centuries by
the patient. In larger specimens, a pulse oximeter, humans for a variety of ailments, including as
EKG, or crystal Doppler can be used to moni- a topical anesthesia for dental pain. Because
tor heart rate, although the heart of a fish can MS-222 is regulated for food fish and there is a
continue to pump for a period of time after the withdrawal period associated with it, aquacultur-
animal is dead. In the case of waterborne anesthet- ists have shown increased interest in clove oil as
ics, dechlorinated water can be used to irrigate the an unregulated anesthetic. The active component
gills and “lighten” the plane of anesthesia. of clove oil is eugenol, which can provide surgical
The most widely used anesthetic agent for fish levels of anesthesia for fish; however, the duration
is tricaine methane sulfonate (MS-222). It is a and quality of anesthesia are not as good as those
benzocaine derivative with a sulfonate radical. provided with MS-222. The safety index of this
Tricaine methane sulfonate is absorbed across drug is also considered to be lower than that of
the gill epithelium and biotransformed in the MS-222.
liver and possibly the kidney.7 The drug and its Quinaldine sulfate is another water-based
metabolites are excreted primarily through the drug that can be used to anesthetize fish. Quin-
gills. The stock solutions are very acidic and aldine sulfate, like MS-222, is strongly acidic
should be buffered prior to being used. Sodium in solution and should be buffered before use.
bicarbonate (baking soda) can be used to buffer The dose used for quinaldine sulfate is simi-
the anesthesia water, and it should be added at lar to that used for MS-222, although some
an equal weight to the MS-222. Induction with consider quinaldine to have a lower margin of
MS-222 is generally accomplished with 100–150 safety. Quinaldine is not metabolized by the fish
ppm. For some larger fish, a higher dose (200 and is excreted unchanged. Quinaldine can be
ppm) may be needed. Maintenance of anesthesia used for many basic procedures, but is not rec-
during a procedure can typically be done using ommended for surgical procedures that require
50–100 ppm MS-222. total loss of movement.
For short anesthetic procedures, such as physi- Inhalant anesthetics have been used with vari-
cal examination and basic diagnostics, anesthesia able success. An inhalant anesthetic, such as
can be infused over the gills (through the mouth isoflurane, can be poured directly into the aquatic
or under the opercula) via a syringe (Figure 8.16), medium in the concentrated form or “aerated” in

Figure 8.16 This fish was anesthetized for its exami-

nation and diagnostic testing (venipuncture and radio-
graphs). Because these are short procedures, anesthesia
was maintained by flushing the gills with 50 ppm
MS-222. Moistening the body during the procedure to
prevent drying out is also recommended. Figure 8.17 A recirculating anesthesia machine for
fish. Notice how the equipment was placed on the cart
to make it portable. This system has a reservoir in the
the form of a gas. Regulating the concentration bottom to hold the anesthesia water. A power head
of anesthetic in the water can be difficult. Incom- within the reservoir drives the anesthesia water up to
plete distribution of the inhalant anesthetic in the the fish. The tubing from the reservoir is placed in the
fish’s oral cavity. Anesthetic water that passes out of the
water column can result in “pockets” of gas and
opercula and mouth flows through a drain back to the
variable anesthetic effects. The use of inhalants reservoir. Note the valve to connect an air pump for
places additional risk on individuals performing oxygenating the anesthesia water.
the surgery; therefore, attempts should be made
to scavenge the waste gas.
Reports in lay literature have suggested that be used to effectively immobilize elasmobranchs.9
carbon dioxide can be used as a fish anesthetic.8 Propofol has also been found to have value as an
There are many different commercially available anesthetic in larger teleosts, in which it is possible
sources of CO2 , including Alka-Seltzer, carbon to gain access to a blood vessel to deliver the anes-
dioxide gas (used for aquatic plant aquariums), thetic intravenously.
and sodium bicarbonate. Unfortunately, CO2
is difficult to regulate, and if not monitored
closely, will result in a rapid decrease in pH and
death of the fish. With the availability of safe, Bacterial Diseases
effective anesthetics such as MS-222, there is no Bacterial diseases are commonly reported in orna-
reason for veterinarians to use CO2 . mental fish, and the majority of infections are
Injectable anesthetics are rarely used to anes- caused by Gram-negative rods. Many of the oppor-
thetize ornamental fish, because high doses of tunistic pathogens isolated from sick fish, such as
drug are required and incomplete anesthesia Aeromonas spp. and Pseudomonas spp., are rou-
is achieved. Injectable anesthetics have proven tinely isolated from the water column; therefore,
effective in elasmobranchs, and recent research it is important to minimize/restrict antibiotics in
indicates that medetomidine and propofol can the water where resistance can develop. Many of
8 | fish 215
these infections develop when there is damage to

the animal’s protective integument or immune
system. Septicemia is a common finding and
must be treated aggressively. In a number of these
cases, the organisms isolated from the lesions are
multidrug-resistant, similar to the “flesh-eating”
bacteria isolated from humans (Figure 8.18). Bac-
terial infections should be diagnosed by culture
and sensitivity. A therapeutic plan should follow
the sensitivity results.
Viral Diseases
Viral diseases in ornamental fish are rare. The Figure 8.18 Severe ulcerative dermatitis in a koi. The
pathogenicity of viruses can vary with tem- Aeromonas salmonicida isolated from this lesion was
resistant to the majority of antibiotics it was screened
perature. Most viral infections in fish are
against.
host-specific. In many cases, young, naive fishes
become sick, and older animals become carriers.
The most commonly reported virus in ornamen- rus spp.) flukes will become hypoxic, gulping air at
tal fish is lymphocystis, an iridovirus that infects the surface and coughing (Figure 8.19). Fish infested
fibroblasts.10 Affected animals develop large with skin parasites, such as ich (Ichthyopthirius mul-
coalescing nodules that can occur anywhere on tifiliis), rub against hard surfaces, lose scales, and
the body. The virus is self-limiting. In most cases, hemorrhage in the area of parasite attachment. Fish
the fish resolve spontaneously; however, in cases with endoparasites are often anorexic, in poor condi-
where the lesions affect the eyes or mouth (i.e., tion, and fail to thrive. The diagnostic tests routinely
the vision or ability to eat), the animal may die. used to identify ectoparasites include a skin scrape,
Lymphocystis can be diagnosed on gross exami- fin biopsy, and gill clip. A fecal float and direct saline
nation or histopathology. There is no effective smear should be performed to evaluate a fish’s endo-
treatment, although the mass can be surgically parasite status.
debulked if the tumor affects the animal’s ability
to eat, see, or swim. Water Molds
Saprolegnia spp. is a common water mold isolated
Parasites from tropical ornamental fish and cold-water
Parasites are routinely identified on imported aquaculture species. Water molds are primar-
ornamental fish. When parasitized animals are ily opportunists; they often infect open wounds,
added to an established aquarium, the parasites although primary infections are also possible.
will soon spread to the other tank inhabitants. Affected fish generally present with white, cot-
Both ectoparasites and endoparasites are reported ton-like lesions on fins and skin. A skin scrape or
in fish. The clinical signs associated with a para- biopsy of an affected area can be used to confirm
site infestation will vary, depending upon the a diagnosis of water molds, which are classified
location of the parasite. Fish with gill (Dactylogy- based on their branching nonseptate hyphae.

aspirating the swim bladder once or twice with a

needle and syringe and correcting the diet (chang-
ing from floating to sinking foods and adding
squashed cooked peas to the diet once weekly) are
sufficient to treat this condition. In other cases,
especially when there is infection, systemic antibi-
otics might be necessary. In some cases, surgery is
needed to correct the swim bladder disease (Fig-
Figure 8.19 Dactylogyrus spp. isolated from the gills ure 8.20).
of a goldfish. Note the characteristic eyespots of this As fish live longer because of improved hus-
parasite. bandry, the incidence of neoplasia is expected
to increase. Anytime a mass is seen on a fish,
neoplasia should be included in the differential.
Noninfectious Diseases Neoplasia can show up in many different loca-
Elevated ammonia, nitrite, and chlorine, and tions on fish, although integumentary (Figure
highly variable water temperatures, dissolved oxy- 8.21) and visceral (Figure 8.22) tumors are the
gen, and pH, can cause clinical disease in fish. most common. In most cases, a surgical approach
In most cases the fish respond similarly by being is taken for these cases. Chemotherapeutics and
tachypneic, gulping for air at the surface of the radiation therapy are not well studied in fish.
water, producing excess mucus, and swimming in
an agitated pattern. Routine water testing can pre-
ZOONOTIC DISEASES
vent these problems because they can be identified
early and corrected. Humans can be exposed to fishborne diseases
Swim bladder disease is being seen more fre- through ingestion of contaminated fish or water
quently in goldfish, and most cases are associated or through direct contact with fish or water. Zoo-
with the “round belly”/fancy types (e.g., orandas, notic diseases attributed to ornamental fish are
ryukins, black moors). In most cases, the fish float
abnormally (e.g., like a fish bobber); however, in
some cases the swim bladder disease causes the
fish to be unable to get lift in the water (i.e., they
present with always lying on the bottom of the
aquarium). The former cases are typically associ-
ated with excess gas in the swim bladder, and the
latter are associated with fluid in the swim blad-
der. Radiographs can be used to assess the swim
bladder and give insight into the fish’s status.
Fine needle aspiration with cytology can be used
to remove excess gas from the swim bladder and Figure 8.20 This oranda goldfish was not responsive
evaluate cell types within the bladder (e.g., epithe- to several aspirations of the swim bladder, so the caudal
lial, blood cells, bacteria). In some cases, deflating/ chamber was amputated at surgery.
8 | fish 217
routinely associated with contamination of open

wounds or puncture wounds that occur during
handling. Humans with a compromised immune
system might be predisposed to opportunistic
infection. Most cases of fishborne zoonotic dis-
eases result in mild episodes of the disease.11 A
number of bacteria have been associated with
human illness, including Clostridium spp., Ery-
sipelothrix rhusiopathiae, Mycobacterium spp.,
Staphylococcus spp., and Streptococcus iniae. Sev-
eral of these pathogens, including Erysipelothrix
rhusiopathiae, Mycobacterium fortuitum, and M.
marinum, have been associated with “fish han-
dler’s disease,” which is characterized by lesions
Figure 8.21 An osteoma in a royal plecostamus associ-
on the hands and arms (the areas we place our
ated with the pectoral fin.
hands). Members of the family Enterobacteria-
ceae, including Edwardsiella tarda, Klebsiella spp.,
Salmonella spp., and Yersinia spp., are routinely
isolated from aquatic environments and have also
been associated with human illness. Increased
numbers of multidrug-resistant Aeromonas spp.
and Pseudomonas spp. are also being seen associ-
ated with tropical fish, especially koi, and special
care should be taken in these cases because these
organisms are opportunists in humans. Fish
parasites and toxins have been found to cause
human illness, but are generally associated with
ingestion of the fish. To prevent the transmission Figure 8.22 An ovarian adenocarcinoma in a koi.
of potentially zoonotic diseases, veterinary pro-
fessionals should follow standard safety protocols
and wear protective clothing.

self-study questions
1. What does mucus on the skin of a fish represent?
2. What are the primary functions of the gills of a fish?
3. What are the different types of filters that are available?
4. How does a biologic filter work?
5. What water chemistry parameters should be tested during a fish exam?
6. Why is untreated tap water fatal to fish?
7. What are common questions that should be included in an anamnesis for fish?
8. How do you anesthetize fish?
9. Describe a physical examination of a fish.
10. Where can you collect blood from a fish?
11. What diagnostic tests would you perform to evaluate a fish presenting for dyspnea and rubbing
against materials in its aquarium?
12. How can you deliver medications to a fish patient?
13. What are some common infectious diseases of fish?
14. If a goldfish presents for “bobbing” at the water’s surface, which anatomic structure is most likely
affected?
15. Which group of pathogens is most commonly associated with zoonotic disease from tropical fish?
REFERENCES
1. Russo RC. Ammonia, nitrite, and nitrate. In: Rand GM, and Pertocelli SR, eds. Fundamentals of
aquatic toxicology. New York: Hemisphere, 1985:455–71.
2. Emerson K, Russo RC, Lund RE, and Thurston RV. Aqueous ammonia equilibrium calculations:
Effect of pH and temperature. Journal of Fish Research Board of Canada 1975;32: 2379–83.
3. Tucker CS. Water analysis. In: Stoskopf MK, ed. Fish medicine. Philadelphia: WB Saunders;
1993:166–97.
4. Piper RG, McElwain JB, Orne LE, McCraren JP, Fowler LG, and Leonard JR. Fish hatchery man-
agement. United States Department of Interior, Fish and Wildlife Service, Washington, DC; 1982.
5. Tomasso JR, Davis KB, Parker NC. Plasma corticosteroid and electrolyte dynamics of hybrid striped
bass (white bass x striped bass) during netting and hauling stress. Proceedings of the World Maricul-
ture Society, 1980; 11:303–10.
8 | fish 219
6. Stoskopf MK. Clinical pathology. In: Stoskopf MK, ed. Fish medicine. Philadelphia; WB Saunders;
1993:113–31.
7. Stoskopf MK: Anesthesia of pet fishes. In: Bonagura JD, ed. Kirk’s current veterinary therapy XII.
Philadelphia: WB Saunders; 1995:1365–69.
8. Gratzek JB. Aquariology: The science of fish health management. Morris Plains, NJ: Tetra Press;
1992:232.
9. Miller S, Mitchell MA, Heatley JJ, Wolf T, Lapuz F, Lafortune M, and Smith JA. Clinical and car-
diorespiratory effects of propofol in the spotted bamboo shark (Chylloscyllium plagiosum). J Zoo Wild
Med 2005; 36(4):673–76.
10. Dunbar CE, and Wolf K. The cytological course of experimental lymphocystis in the bluegill. Jour-
nal of Infectious Disease 1996; 116:466–72.
11. Nemetz TG, and Shotts EB. Zoonotic diseases. In: Stoskopf MK, ed. Fish medicine. Philadelphia:

Index
A Alpha-2 agonist, 64 Anorexia, 6, 24, 72, 73, 100, 104, 125,

Alter compound, 199 128, 176, 196, 211, 215. See also
Abdominal cavity, 17, 87–88, 170, 206, Aminoglycoside, 158 specific types of exotic animals
208 Amitraz, 153 Antemortem
Abscess, 16. See also specific types of Ammonia, 142, 191, 197–199, 199–200, diagnosis, 72
exotic animals 202, 207 sample, 210
aural, 69 Ammonium, 199 serologic test, 72
caseous, 71 Ammonium magnesium phosphate Anterior chamber, 15, 170
generalized, 71 crystal, 121 Antibiotics, 30, 99, 125, 128, 129, 175,
internal, 122, 210 Amoxicillin, 99, 129 198, 200, 212. See also specific
oral cavity, 49 Amphibian. See also Reptile and types of exotic animals
single localized, 71 amphibian enterotoxemia, 158
subcutaneous, 129, 141, 161, 185 Ampicillin, 129, 190 “prescription only,” 190
subspectacular, 69 Anaerobe, 24, 176 systemic, 71, 159
tooth, 129 Analgesia, 63 Anticoagulant, 21, 52–53
Acclimatization, 2 Anal gland, 80, 87, 107 Antidepressant drug, 31
Acid, 142, 201 Anal tape test, 152 Antifungus, 73
acetic, 198 Anatomy. See specific exotic animals Anti-gastropod product, 196
amino, 44–45 Androgen-dependent midventral scent Antihistamine drug, 31
ascorbic, 142, 157 gland, 139 Antimicrobial drug, 68, 71
ethylenediaminetetraacetic, 52 Anemia, 61, 99, 154 Anti-mite device, 4
uric, 70, 191 aplastic, 105 Antiparasitics, 190
Acquired immunodeficiency virus, 74 estrogen-induced, 81, 84, 92, 103 Antivenom, 47
Acyclovir, 73 nonregenerative, 92 Anus, 88, 108, 117, 137, 166, 206
Adenocarcinoma, 102, 122, 161, 175 Anesthesia. See also specific types of Anxiety, 13
Adenoma, 102 exotic animals Apnea, 155, 185
Adenovirus, 72, 74 “complete,” 64 Apple, 44, 142–143
Adrenalectomy, 101 “full-throttle,” 65 Aquarium. See Fish tank
Adrenal gland, 81, 87–89, 92, 100–102 gas, 28, 29 Arthropod, 25–26
Adrenomegaly, 88 general, 20, 24–25, 29, 32, 66, 83, Ascarid, 27
Aerobic condition, 198 92, 122, 149, 155, 158, 165, 174, Asepsis, 66–67
Age, 12, 46, 83, 114, 159–160, 167, 169 183–184 Aspiration, 155
Aggression, 101, 136, 139, 195–196 incremental, 65 Ataxia, 175
Air conditioner, 2 surgical, 64 Atrium, 191
Air sac, 17, 25–26, 28–29 water, 213 Atropine, 87, 174
Airstone, 198 Anesthetics. See Surgical procedure and Auscult, 171
Alcohol, 28, 99, 119, 210, 212 anesthetics Avian influenza virus (H5N1), 100
Alfalfa, 142 Anhydrous calcium carbonate crystal, Avian species (Aves), 112. See also specific
Alkalinity, 93, 202 121 topics on
Alopecia, 87, 94, 147, 153, 157 Anisocytosis, 53, 209 anesthetics, 27–29

222 index
diagnostic sampling, 19–27 Biochemistry, 56, 208 196

disease, 29–34 Biopsy, 102, 207, 211, 215–216 Broccoli, 44, 45
health maintenance, 29–34 Bird. See Avian species (Aves) “Brown-blood,” 200
history, 12–13 Bird band, 10–11 Brumation, 167
husbandry, 1–12 Birdcage, 2–4, 12 Bruxism, 157
identification, 12 Biting, 75, 80, 85, 117, 132. See also Budgerigar, 3, 7, 14, 26, 29
physical examination, 15–19 specific types of exotic animals Buffer, 202
restraint, 13–15 Bladder infection, 121 Bullfrog, 45
surgical procedure, 27–29 Bleach, 176, 204 “Bumblefoot,” 140, 157
zoonotic disease, 34 Blepharoedema, 69 “Bunny burrito,” 116
Aviary, 27 Blindness, 100 Buoyancy, 193, 203
Axillary region, 50 “Blind-stick,” 56, 91 Buprenorphine, 156, 174
Azure staining cell, 53 Blood, 52–55, 147, 149. See also specific Burn, 16, 40, 67–68, 68, 212
Azurophil, 53–54 types of Burrowing, 82, 83
Azygous vein, 56–57 agar plate, 210 Burying, 40
clotting, 193 Butorphanol, 98, 174
culture, 14
B distributed, 191
Bacillus, 160 “flash” of, 147
C
Bacitracin, 159 loss, 52 Cabbage, 142, 157
Background information, 46, 84, 114, transfusion, 89, 94, 97 Caecilian, 59
143–144, 169, 182–183 unoxygenated, 191 Cage. See specific types of
Bacteria, 60, 70, 112, 159, 190, 196, 210. venous, 192 Calcium, 6–7, 33, 42, 44–45, 69, 182,
See also specific types of withdrawal, 20 202
disease, 104, 214–215 Blood cells, 193 carbonate monohydrate crystal, 121
“flesh-eating,” 215 Blood collection. See also specific types of diet, 44, 69
gas-producing, 203 exotic animals disodium
gastrointestinal (GI) tract, 29–31, diagnostic sampling, 19–21, 52–60, 89– ethylenediaminetetraacetate, 33
129 91, 117–120, 147–149, 171–172, supplementation, 6–7, 185
good, 112 183 Calculi, 49, 81, 82, 92
infection, 29–31, 61, 104, 124, 130, retro-orbital, 149 Canarypox-derived vaccine, 94
136, 141, 150, 159 Blood glucose, 102 Cancer, 167
intracellular, 34 Blood sample, 52, 54–56, 58–59, 171, Canine distemper virus (CDV), 84,
isolation, 24 208–209 94–95, 100
opportunistic, 176 Blood smear, 53, 72, 209 Cannibalization, 136
Bacteriological sample, 68 Blood supply, 193 Cannulation, 24, 28, 124–125, 183
Baking soda, 213–214 Blood vessel, 55 Capillary refill time, 87, 117, 146
Balancing, 191 Blood volume, 20, 89, 97, 120, 183 Capturing, 13–15, 141, 205
“Balling up,” 165, 169 Body Carapace, 40, 49
Banana, 124 cavity, 17, 25 Carbaryl powder, 26
Bandage, wet-to-dry, 68 condition, 206 Carbohydrate, 44, 82, 83
Barking, 180–181 harness, 10 Carbon, 198
Basilic vein, 20 support, 115–116 Carbonate, 202
Basking, 40 temperature, 27–29, 89, 171, 195 Carbon dioxide, 29, 191, 196, 201, 214
Basophil, 53, 54, 72, 194 weight, 5, 7, 15, 147, 149, 183–185 Cardiac disease, 175–176
Bathing, 83 Bonding, 181 Cardiac puncture, 149
Beak, 8–9, 13–15, 26, 33 Bone marrow aspiration, 92, 105. See also Cardiocentesis, 58
Bearded dragon, 51, 72–74 specific types of exotic animals Cardiomyopathy, 103, 175–176
Bedding, 141, 157 Booster vaccine, 95 Cardiopulmonary depression, 64
Beef, 83 Borate, 202 Cardiovascular disease, 103
Behavior, 41–42, 60, 86, 101, 139–140, Bornavirus, 33 Caries, 87
167, 205. See also specific types of Bovine albumin, 53, 209 Carnivore, 43–44, 81, 82
Bell, 49 Brachial vein, 56–58 Cat, 112, 141, 181
Benzocaine, 213 Braking, 191 Cat flea powder, pyrethrin-based, 152
Beta-cell tumor, 102 Branchial chamber, 191 Catgut, 66
Betadine, 67 Breathing, 12, 18, 47, 66–67, 72, 205 Catheterization, 58, 121, 154, 171–172,
Bicarbonate, 202 Breed, 108, 112, 114–115, 125 174, 185
Bicep, 184 Breeding, 12, 46, 80, 83, 139, 140, 193, butterfly, 97
index 223
indwelling, 125 Clinical disease, 216 Crust, 170

intraosseous, 125, 127 Clitoral fossa, 93 Crusting under chin, 100
intravenous, 90, 95, 97, 120, 125, Cloaca, 14, 16–17, 24, 28 Cryptosporidiosis, 152, 176
127 Clog, 197 Crystalline secretion, 49
latex, 126 Closed recirculating system, 199 Crystalluria, 172
saphenous, 97 Cloth, 82 Ctenoid scale, 191
urinary, 93 Clove oil, 213 Culture, 14, 21, 24, 210. See also specific
Caudodorsal muscle, 166 Coagulation, 21 types of
Causative agent, 129, 175 Coccidian, 173 Cuttlebone, 6–7
Cecae, 192 Coccidiocide, 173 Cycloid scale, 191
Cecotrope, 112 Coccidiosis, 74 Cystitis, 103–104, 184
Cedar shavings, 181 Coccygeal vein, 54, 56–58 Cystocentesis, 92, 93, 121, 150, 172
Cell-mediated immune response, 190, Cockroach, 27 Cytology, 51–52, 73, 88, 170
194 Coeliotomy, 67 Cytoplasm, 53, 193–194, 209
Cell rupture, 53 Coelom, 17
Cellulitis, 73 Coelomic cavity, 49, 51, 67, 193, 210
Cellulose-based product, 192 Coin, 83
D
Cephalic vein, 90, 91, 97, 117, 119, 125, Cold, 2, 67, 81, 109, 168 Dander, 139–140
148, 154, 171, 184 Collard greens, 44, 45 Dandruff, 123
Cephalosporins, 129 Colloidal fluid, 125 Darkness cycle, 42, 196
Cerebrospinal fluid (CSF), 120–121 Color, 196, 213 Dechlorination, 45, 48, 202, 213
Cerumen, 170 Commensal organism, 200 Declawing, 80, 83, 108–109, 114
Cestode, 27, 62, 124, 174 Companion avian species, 1. See also Defecation, 82. See also Feces
Chameleon, 49 specific topics on Dehydration, 42, 70, 73, 87, 96, 104,
Characin, 191 blood withdrawal, 20 125, 159, 170, 185, 193
Cheek pouch, 137 grooming, 8 Dental disease, 83, 187. See also Teeth
Cheese, 5 identification, 10 Dependovirus, 72
Chelation therapy, 32–33 internal parasite, 26 Depression, 73, 95, 103, 185
Chelonian. See also specific topics on medicine, 4 Derivative, 62, 129
anesthesia, 65 radiology, 24 Dermatitis, 104, 153–154. See also
blood sample, 56 Complete blood count (CBC), 21, specific types of exotic animals
physical examination, 47 52–53, 89, 91, 99, 101–103, 120, bacteria, 113
radiography, 61 148–149, 172, 183, 209 concurrent facial, 124
restraint, 46 Computed tomography (CT), 25, 122 contact, 43
Chemistry panel, 101–103 Conduction fabric warming unit, 28–29 facial, 124
Chemotherapeutics, 216 Conjunctivitis, 15, 71, 72, 104, 157–158 fungal, 113
Chicken, 83 Constipation, 152, 185 ulcerative, 160
Children, 181 Contralateral gland, 101–102 Dermatologic disease, 170
Chin gland, 107 Contrast, 25 Dermatomycosis, 175–176
Chirping, 180–181 Convection heater, 28–29 Dermatophyte, 132, 161–162, 170
Chitin, 168 Copper, 202 Dermis, 191, 213
Chloramine, 202, 203 Coprophagy, 112 De-scenting, 80, 87
Chlorhexidine, 61, 71, 73 Corn, 4, 83, 168 Desert species, 41
Chloride, 193 Cornea, 15–16, 117, 170 Dewlap, 108, 113
Chlorine, 202, 203 Coronavirus, 82, 104 Dexamethasone, 95
Choana, 14–15, 24 Corticosteroid, 99, 104 Dexmedetomidine, 64, 174
Cichlid, 192 Coughing, 86, 100, 105, 176 Diagnostic imaging, 25
Cilia-associated respiratory bacillus, 160 Crabbing, 180–181 Diagnostic sampling. See also specific
Cisapride, 128 Crane, 14–15 types of exotic animals
Claws, 46, 51, 66, 143, 146–147, 168. Cranial nerve, 88 anal tape test, 152
See also specific types of exotic Cranial vena cava, 89, 90, 97, 171, 183. blood collection, 19–21, 52–60, 89–
animals See also specific types of exotic 91, 117–120, 147–149, 171–172,
clear, 114 animals 183
nonretractable, 80 Crepitus, 170 blood marrow aspiration, 21, 91–92,
sharp, 108–109, 114 Cricket, 44, 68 120, 149–150, 172, 183
trimming, 109 Critical care unit, 29 cerebrospinal fluid, 120–121
Climbing, 182 Crocodilian, 47, 47–48, 65, 71 cystocentesis, 121–122
Clindamycin, 129 Crop, 16, 24 diagnostic imaging, 25

224 index
feces examination, 152 Drowning, 45 Enzyme-linked immunosorbent assay

injection site, 184 Drugs, 31, 198. See also specific types of (ELISA), 71, 94, 103
microbiology, 21–24, 60–61, 122, Dysecdysis, 42, 68–69 Eosinophil, 53, 54, 194
150–151, 172, 183–184, 210 Dyspnea, 86, 100, 102, 103, 160 Epaxial muscle, 96, 124, 154, 184, 211
parasitology, 25–27, 61–62, 94, 122– Dystocia, 32, 46, 167 Epidermis, 48, 68
124, 152–154, 173–174, 185, 211 Epiphora, 124
radiology, 24–25, 61, 93, 122, 151, Epithelium, 9, 15–16, 26, 30, 69, 213
173, 184, 210–211
E Equilibrium, 213
splenic aspirate, 92 Ear, 87, 94, 108, 115, 146, 149, 166, 170 Erythrocyte, 52–53, 193, 209
urinalysis, 172, 184 canal, 123 Erythromycin, 129, 190
urine collection, 92–93, 121–122, external, 49, 123 Erythron, 103
150 internal infection, 129 Escaping, 136–137
Diagnostic testing, 14 marginal vein, 117 Esophagus, 27–28, 211
Diaphragm, 46–47, 67 mite, 116, 123, 170 Evaporation, 199
Diarrhea, 24, 26, 69, 72, 95–96, 99, 113, Earthworm, 27, 44 Exercise, 82, 103, 112, 136, 176, 181,
124, 176. See also specific types of Echocardiography, 25, 103, 176 182, 203
exotic animals Eclectus, 26 Exercise wheel, 136, 142, 168
Diazoxide, 102 Ectoparasite, 25, 49, 61, 69, 116, 122, External parasite, 94, 147. See also
Diet, 103, 112, 128, 136, 168, 182, 192 152–154, 215 specific types of exotic animals
calcium, 44, 69 Edema, 49, 71 Eyes, 15, 49, 87, 116–117, 145–146, 159,
critical care, 125–126 Egg, 5, 26 166, 181, 206
deficiency, 30 Egg-binding, 32 closed, 19
diversification, 6–7 Elasmobranch, 214 lid, 15, 88
feline growth, 82–83 Electrocardiography (EKG), 103, 213 prolapse of, 145
fiber, 82 Electrocautery unit, 9, 46 sunken, 87, 170
meat-based, 103 Electrolyte, 52, 159, 193
nutrition, 12 Elizabethan collar, 31, 97, 126
pellet, 5 Elizabethan grip, 14
F
phosphorus, 69 Emaciation, 185 Fan, 109
preventive, 185 Embryonic death, 12 Fasciculation, 69
protein, 70 Empirical therapy, 99 Fasting, 27, 98, 102, 174, 185, 212
recommended daily, 182 Enamel, 136 Fat, 44, 82–83, 87, 168, 192, 203
requirements, 43 Endocrinopathy, 87 Feathers, 2, 6
seed, 4–5, 30, 143 Endoparasite, 62, 74, 211, 215 blood, 9–10
supportive liquid, 125 Endoscopy, 99, 129 disease, 33
vitamin, 30 Enilconazole, 175 flight, 10
Differential count, 54, 210 Enrofloxacin, 68, 159, 161, 185 grooming, 8
Differential diagnosis, 46, 51, 83 Enteritis, 72, 104 growing, 9
Digestive growth test, 24 Enterotomy, 99 head, 31
Digestive system, 4, 112, 192 Enterotoxemia, 158, 159 losing, 31
Digging, 83 Enucleation, 159 parrot, 10
Digital gram scale, 15, 146 Environmental concerns. See also specific picking, 2, 6, 31
Discoloration, 208 types of exotic animals plucking, 28
Disease, 29–34, 174. See also Health birdcage, 12 pulling, 31
maintenance; specific types of dry, 138 quality, 15
Disinfection, 176 filter, 194–203 wing, 10
Disorientation, 72 fish tank, 194–196 Feces, 26, 143, 150, 152, 168, 173, 211,
Disposition, 12, 49, 79, 139 heat, 40–41 215
Dissociation, 64 humidity, 42, 69, 166 bloody flea, 123
Distemper vaccine, 94–95 moisture, 42 character, 12
DNA, 199 nutrition, 203 contact dermatitis, 43
Dog, 112, 114, 141, 181 temperature, 40, 60, 66, 109, 167– direct saline smear, 62, 211, 215
Domestication, 79 168, 195 examination, 26
Dorsalis muscle, 166 transportation, 203–204 floating, 26, 27, 62, 94, 124
Doxycycline hyclate, 161 water quality, 199–203 ingestion, 112
Draft, 2 Environmental temperature range litter box, 111
Drooling, 129 (ETR), 38, 40–41, 69 loose, 26
Dropper, 154 Enzyme, 52, 192 malodorous mucoid, 26
index 225
nematode, 27 restraint, 212 bacteria, 29–31, 129

newspaper, 8 surgical and anesthetic assistance, delayed emptying, 96
oral exposure, 75 212–214 disease, 99, 122, 187
parasite, 62 taxonomy, 190 disorder, 158
pasting, 17 therapeutics, 211–212 epithelium, 30
physical examination, 12, 26, 26–27, zoonotic disease, 216–217 etoxicosis, 33
45, 124, 152 “Fish handler’s disease,” 217 flora, 158
polymerase chain reaction testing, 100 Fish tank, 81, 189, 194–196, 204 foreign body, 49, 99
sample, 8 Fistula, 16 gastric ulcer, 99
soiling, 17 Flea, 94, 122, 123, 152–153, 173 motility, 128
staining, 24, 88 Flora, 184 parasite, 211
strong-smelling, 111 Fluid therapy, 125, 159 stasis, 25, 127–128
Feeding, 112, 125, 128, 192, 203, 211 Fluke, 174 ulcer, 82, 99, 104
Feet, 18–19, 112 Fluoxetin, 187 Gastropod, 196
Feline infectious peritonitis (FIP), 104 Fly, 44, 94, 123–124 Gastrotomy, 99
Femoral vein, 56, 171 Fly-strike, 94, 112 Gecko, 44, 49
Femur, 92, 120, 125, 149, 172, 174, 185 Follicular stasis, 46 Genitalia, 108, 137
Fenbendazole, 153, 174, 190 Food, 43–44, 126–127, 139. See also Genitourinary system, 103–104, 206
Ferret. See also specific topics on specific types of Gerbil. See also specific topics on
anatomy, 80–81 baby, 83 cage, 142
anesthetics, 98–99 brand, 84 health maintenance and disease,
cage, 81, 84 decaying, 199 159–160
diagnostic sampling, 89–94 dry, 182 parasite infestation, 153
disease, 99–105 leftover, 197–198 restraint, 145
health maintenance, 99–105 live, 203 Gill
history, 83–85 medicated, 211 arch, 191
husbandry, 81–83 moist, 182 biopsy, 207, 211, 215–216
physical examination, 86–89 Footpad, 100, 108, 109, 157, 171 clip, 215
restraint, 85–86 Foraging, 6 color, 213
surgical procedure, 98–99 Force-feeding, 159 epithelium, 213
therapeutics, 95–97 Foreign body, 16, 32, 49, 82–83, 196, examination, 207
Ferret-cell origin vaccine, 94 210 filaments, 207
Fiber, 112, 113, 143 gastrointestinal tract, 49, 88, 99 fluke, 215
Fibia, 172 intestinal, 88 plate, 191
Fibroadenoma, 160 physical examination, 99 Gingival disease, 83
Fibroblast, 215 swallowing, 25 Glass refraction, 42
Fighting, 80, 112, 136, 167 Fracture, 24, 87, 115, 117, 122 Globe, 145, 159, 170
Filter, 189, 205 pathologic, 185 Glossitis, 72
biologic, 196–198 splinting pathologic, 69 Glottis, 16, 49, 63, 155, 157
carbon, 211 wings, 17 Glucose, 82, 159
chemical, 196–199 Free-roaming, 82, 83, 111 Goitrogen, 45
combination, 197 Freshwater coldwater species, 195 Gonopodium, 193
mechanical, 196–197 Freshwater system, 201–202 Gout, 70
sand, 197 Frog, 45, 48–50, 64 Granuloma, 15
water, 182 Fruit, 5, 44, 45, 128, 168, 182 Grass, 112–113, 128
Fin, 205, 206, 208, 211, 213, 215 Fundic gland, 170 Gravel, 195–196
types of, 191, 193 Fundus, 87 Grazing ark, 109
Fine needle aspiration, 88 Fungus, 24, 29–31, 70, 73, 104, 175, 190 Greater wax moth larva, 44
Fipronil, 25 Green beans, 44
Fish. See also specific topics on Green iguana, 38, 42–43, 46–47, 51, 58.
anatomy, 190–194
G See also specific types topics on
diagnostic sampling, 206–211 Gape, 49 Griseofulvin, 175
disease, 214–216, 217 Gas, 99, 191 Grit, 4
health maintenance, 214–216 Gastritis, 99 Grooming, 98, 143, 180. See also specific
history, 204–205 Gastroenteritis, 32, 129, 153, 158 types of exotic animals
husbandry, 194–204 Gastrointestinal (GI) tract, 81–82, 94, Guinea pig. See also specific topics on
identification, 192 96, 115. See also specific types of anesthesia, 155, 158
physical examination, 205–206 exotic animals background information, 143–144

226 index
blood collection, 147–148 rate, 29, 50–51, 185 Hob, 79, 89, 93, 101
cage, 140–141, 144 sound, 51 Hock, 108, 112, 130
environmental concerns, 140–141 two-chambered, 191 Home management, 46, 84
external parasites, 152 ultrasound image, 25 Hot rock, 40
health maintenance and disease, 136, vessel, 149 “Hot spots,” 40
157–158 Heartworm, 94, 103 House mouse louse, 154
history, 143–144 Heat, 109, 127, 168, 185, 381 Housing, 111–112, 115, 144, 159, 168.
internal parasites, 154 ceramic, 41 See also Cage
restraints, 144–145 environment, 40–41 Human influenza virus, 100
zoonotic diseases, 161–162 external, 185 Humerus, 120
Gular fold, 49 lamp, 182 Humidity, 42, 69, 109, 166
Gulping air, 207, 216 pad, 68 Humoral defense, 190
Gut protectant, 99 radiant, 41 Hunting, 79, 203
Gyrfalcon, 30 rock, 68 Husbandry. See also specific types of
sensitivity, 2 exotic animals
supplemental, 168 bird band, 10–11
H thermostatically controlled, 204 dysecdysis, 68–69
Hair, 80, 83, 84, 87, 109, 116, 132, Heat-related death, 140 environmental concerns, 1–4, 38–
137–138, 147 Hedgehog. See also specific topics on 43, 81–82, 109–112, 140–142,
ball, 113, 127–128 anatomy, 165–167 167–168, 194–203
clipping, 127 cage, 168–169, 176 grooming, 8–10, 46, 83, 114, 143,
comb, 179 diagnostic sampling, 171–174 168, 182
losing, 153 disease, 175–176 microchipping, 10–11
Hammock, 82, 84 health maintenance and disease, nutrition, 4–7, 43–45, 82–83, 112–
Hamster. See also specific topics on 175–176 114, 142–143, 168, 182, 203
antibiotics, 159 history, 168–169 prey bite, 68
cage, 137, 142 husbandry, 167–168 thermal burn, 67–68
ectoparasite, 153 physiology, 165–167 transport, 7–8, 45, 83, 114, 143, 168,
health maintenance and disease, restraint, 169–170 203–204
158–159 surgical and anesthetic assistance, Hyacinth, 14
life expectancy, 159 174–175 Hydration, 16, 31, 42, 87, 117, 129, 146
restraints, 145 therapeutics, 174 Hydrochloride, 95
Hand-feeding, 16 zoonotic diseases, 176 Hydroxide, 202
H2 antagonist, 99 Hematochezia, 81 Hygrometer, 42
Harderian gland, 159 Hematology, 21, 51–52, 84, 208 Hyperkeratosis, 26, 69, 100, 173
Hardwood shavings, 141–142 Hematopoiesis, 88 Hyperplasia, 102
Harness, 82 Hematuria, 89, 184 Hypersalivation, 88, 99, 102, 158, 167
Hay, 81, 109, 112–113, 141–142 Hemipene, 51, 54 Hypersensitivity, 31, 95, 166
Health maintenance. See also specific Hemorrhage, 105, 157 Hyperthermia, 29, 109
types of exotic animals Hemostasis, 9–10, 67, 143, 185 Hyperuricemia, 70
bacterial infection, 29–31 Hepatomegaly, 17, 88 Hypervitaminosis A, 70
fungal infection, 29–31 Herbivore, 43–45 Hyphae, 216
husbandry, 67–69 Herpesvirus, 33, 72–73 Hypnotization, 121
infectious disease, 70–74 Hetastarch, 125 Hypoglycemia, 98, 174
malocclusion, 129–130 Heterophil, 53–54, 194 Hypotension, 125
parasite, 215 Hibernation, 167 Hypothermia, 28, 41, 98, 174, 182, 195
“sore hock,” 130 Hiding, 82, 83, 140, 142, 168 Hypovitaminosis A, 30, 69–70
ulcerative pododermatitis, 130 Hissing, 180–181
urogenital disease, 103–104 Histologic diagnosis, 72
“wool block,” 127–128 Histopathology, 215
I
Heart, 65, 117, 171, 191, 193, 208. See History. See also specific types of exotic Ich, 215
also specific types of exotic animals animals Identification, 10, 12, 24, 37–38, 210
attack, 13 environmental concerns, 12 Ileitis, 159
beat, 89 health problems, 12 Ileus, 88, 99
echocardiography, 25 medical, 84, 169 Ilium, 149
location of, 50 nutrition, 12 Imidacloprid, 122, 152–154
murmur, 17, 51 physical examination, 12–13 Immune system, 30, 41, 43, 190, 195
physical examination, 49 restraint, 13 Immunofluorescent antibody testing, 176
index 227
Immunoglobulin, 190, 193 J direct, 181

Immunosuppression, 153, 156 fluorescent, 196
Jaw, 48
Importation, 27, 79 full-spectrum, 41
Jugular vein, 20, 54–56, 58, 62, 89–91,
Impulse purchase, 107 visible, 41, 196
96–97, 117, 119–120, 149, 154,
Inappetence, 99, 100 Lime sulfur dip, 152, 175
171, 183
Incandescent lamp, 41 Lincomycin, 159
Jumping, 115
Incision, 67 Linea alba, 66
Incisor, 117, 166 Lipidosis, 128
bottom, 129 K Listeriosis, 120
guinea pig, 158 Kale, 44, 142, 157 Lithium heparin, 52–53
hamster, 137 Keel bone, 16–17 Litter, 82, 84, 111, 113, 169
open-rooted, 158 Ketamine, 64, 174 Livebearer, 193
primary, 107 Kicking, 108, 114, 115 Liver, 25, 88, 124, 192
upper, 129 Kidney, 88, 191, 193, 213 Lizard, 46–47, 47, 49–51, 54–56. See also
Inclusion body disease, 72 Kilovoltage peak (kVp), 93 specific topics on
Induction chamber, 155, 169, 174, 183, Knott’s test, 94, 103 anesthesia, 65
185 Koi, 189–190, 217 blood collection, 54–56
Infection, 41, 70–74, 191, 192, 195. See blood sample, 54–55
also specific types of grooming, 46
Infestation. See specific types of L transportation, 45
Infraorbital sinus, 29 Laboratory animal, 139 Locomotion, 49, 86, 191, 205
Ingesta, significant, 88 Laceration, 92, 94 Logarithmic scale, 201
Ingluvitis, 16 Lacrimal gland, 160 Longevity, 167
Inguinal gland, 107 Lactation, 112 “Lumps,” 141, 151, 157–158
Inguinal ring, 166 Lamellae, 191 Lung, 17, 46, 49, 66, 72, 149
Initial assessment, 13 Lameness, 157 Lungworm, 174
Injection sites, 184 Large intestine, 176 Lymphadenopathy, 88, 102
Insect, 4, 68, 168 Larvae, 26 Lymph-diluted sample, 90
Insulin, 82, 102 Laryngoscope, 98, 126, 174 Lymph node, 56, 117, 146, 151, 157–158
Insulinoma, 82, 98, 100, 102, 104 Laryngospasm, 127 types of, 87, 170
Integumentary system, 170 Larynx, 127 Lymphocystis, 215
Intelligence, 139 Lateral flank sebaceous gland, 124, 137 Lymphocyte, 53, 54, 72, 193–194
Interaction, 2 Lateral saphenous vein, 117, 119, 125, Lymphoma, 87, 100, 102
Internal parasite, 154. See also specific 148–149, 171, 184 Lymphosarcoma, 175
types of exotic animals Latrine, 82, 111
Interstitium, 193
Intracoelomic (ICO), 62, 211–212
Lavage, 67 M
Laxative, 33
Intramuscular (IM), 62, 63, 95–96, 124, Lead, 32, 202 Macaw, 5, 7, 9, 14, 17, 33
154, 184, 211–212 Leech, 61 Maggot, 94, 123, 123–124
Intranasal growth, 15 Leg, 17–18, 103, 112, 114–116, 121 Magnesium, 202
Intraosseus (IO), 62, 95, 125, 127, 154, Leg band, 12 Magnesium ammonium phosphate, 103
174, 185 Lens, 15 Magnetic resonance imaging (MRI),
Intraperitoneal, 96, 154 Lesion, 24. See also specific types of 25, 122
Intravenous (IV), 58, 62–63, 90, 95, 97, Lethargy, 95, 99–103, 176 Malocclusion, 8, 117, 122, 136, 157, 158
120, 125, 127, 171, 184, 211–212 Lettuce, 44, 45 health maintenance, 129–130
Intubation process, 126, 127, 155–157, Leukemia, 175 Mammary tumor, 160–161
174 Leukocyte, 52, 194 Mandible, 47, 69, 206
Invertebrate, 44 Leukogram, 194 Manubrium, 147
Ion, 191, 198 Leukon, 103 Marsupial, 183
Irradiation, 41 Leukopenia, 92 Marsupium, 179
Isoflurane, 24, 27–28, 65, 93, 97, 98, Leuprolide acetate, 101 “Masked down,” 98
120, 122, 127, 169, 174, 183, 185, Lice, 25–26, 152 Mass, 17, 49. See also Tumor
214 Lidocaine, 71, 157 Mast cell tumor, 87
Itching, 123 Life expectancy, 115, 159–160, 189 Maxillae, 206
Itraconazole, 73 Lightbulb, 40–42, 68 Mealworm, 44
Ivermectin, 25–26, 62, 123, 152–154, Lighting, 13, 40–42, 204 Meat, 83
173, 174 artificial, 181, 196 Mechanosensory structure, 192
Medetomidine, 64

228 index
Medial tibial artery, 183 Mouth, 102, 206 Netting, 205

Medical history, 46, 84, 169 Moxidectin, 122, 152–154 Neurofibroma, 175
Medical therapy, 107 Mucocutaneous junction, 17 Neurology, 72, 88, 117, 123, 175
Medication, 4, 63, 116, 122, 124, 174, Mucosa, 16, 146, 158 Neutering, 80–81, 87–88
190, 193, 211 Mucous, 48, 49, 66, 87, 103, 117, 146, Neutrophil, 54, 194
Medullary cavity, 21 190–191, 191 Newspaper, 3, 8, 168
Melena, 82, 99 Multivitamin, 182 Newt, 59
Mentation, 205 Muscle, 44, 64, 69, 96. See also specific “New tank” syndrome, 200–201
Metabolism, 63, 65–66, 167–168, 195. types of Nitrate, 196, 199–200, 200, 202
See also specific types of exotic Musculature, 191–192 Nitrite, 197, 199–200, 200, 202
animals Mustard, 44, 45 Nitrogen, 191, 197–200
environmental temperature range, Mycobacteria, 24 Nocturnalism, 136, 141, 165, 181
41, 66, 69 Mycoplasma, 151 Nodulectomy, 102
thyroid, 45 Mycoplasmosis, 71, 104–105, 160–161 Noninfectious disease, 216
Methemoglobinemia, 200 Mydriatics, 87, 170 Nonteratogenic alternative, 175
Metronidazole, 26, 99, 153, 185, 190 Mynah, 26 Nose, 116, 159, 170
Mice, 68. See also specific topics on Myositis, 104 Nuclear ratio, 53, 209
cage, 140, 142 Nucleus, 194
ectoparasite, 153–154 Nut, 143
health maintenance and disease,
N Nutrition, 4–7, 12, 189. See also specific
160–161 Nails, 90, 140, 170–171. See also specific types of exotic animals
restraints, 145 types of exotic animals disease, 69–70
Miconazole cream, 73 bleeding, 9 disorder, 44
Microbiology, 51, 60–61, 71. See specific caps, 46, 114 filter, 203
types of exotic animals clippers, 143, 182 history, 46
Microchipping, 10–12 electrocautery unit, 9 osteodystrophy, 185
Microenvironment, 2 examination, 18 requirements, 82, 143
Microflora, 176 hemostasis, 9 supplement, 45
Microscopic slide, 21, 53, 92 nonretractable, 83 value, 43
Microscopy, 72 overgrowth, 9
Microsporidian, 74 physical examination, 18
Midazolam, 121, 156 trimming, 8–10, 32, 83, 90, 114,
O
Midbody swelling, 73 143, 168, 182 Obesity, 88, 108, 112–113, 115, 128,
Mineral, 6, 7, 9, 44–45, 62, 81, 87, 94 Nape, 85 168, 185, 203
Misting, 42 Nare, 15, 48–49, 87, 146, 206 Ocular system, 159
Mitacide, 154 Nasal discharge, 15, 69, 72, 86, 100, discharge, 15, 69, 71, 122
Mite 122, 170 disease, 187
ear, 116, 123, 170 Nasal sinus, 122 trauma, 116
guinea pig, 152, 161 Nasolacrimal duct, 124–125 Odor, 80, 83
hamster, 153 Nasotracheal technique, 127 Olfaction, 44, 100
infestation, 166, 170 Nebulization, 175 Omnivore, 43
mange, 173 “Neck stretcher,” 31 Onchiectomy, 83
mice fur, 153 Necropsy, 104, 192, 210 Opercula, 191, 206, 211
nasal, 153 Necrosis, 16, 27, 74, 117 Ophthalmic wash, 159
poultry, 26 Necrotizing stomatitis, 72 Ophthalmology examination, 15
quill, 173 Nectar, 6 Opioid, 98
rabbit fur, 123 Nematode, 62, 124, 153, 211 Opisthotonus, 72
sarcoptic, 152 commensal oxyurid, 153 Opossum, 27
scaly leg, 26 feces, 27 Opportunistic infection, 69–70, 73, 104,
snake, 72 intestinal, 174 167, 200, 213, 217
tropical rat, 153 Neonatal death, 12 Oral cavity, 15–16, 27, 85, 87, 146, 170,
Moisture, 42, 66, 146 Neoplasia, 88, 92, 99–102, 159, 167, 174–175, 206, 211. See also specific
Molar, 117, 158, 166 170, 210 types of exotic animals
Mold, 215–216 internal, 175 discharge, 49, 72
Molecular diagnostics, 72 reproductive tract, 169 feces, 75
Molting, 2, 12, 80 Neoplastic cell, 172 medication, 63, 116, 124
Monocyte, 53–54, 194 Neoplastic disease, 159 parasite, 49
Monosodium urate crystal, 70 Nesting, 108, 181–182 physical examination, 117
index 229
vitamin A deficiency, 69 disease, 196 hands-off, 12–13, 49, 205

Oral suspension, 124 external parasite, 25–26, 61–62, 94, hands-on, 15, 49, 205–206
Oral treatment, 154 122–124, 152–154, 173 heart, 49
Oral ulceration syndrome, 105 feces, 62 lung, 17, 49
Oranda, 216 filter, 215 nare, 49
Orange, 142, 157 gastrointestinal, 211 oral cavity, 15–16, 85, 117
Orbit, 16, 145 internal parasite, 26–27, 62, 94, 124, parasite, 52
Organic debris, 196 154, 173–174, 185 perching, 12
Oropharynx, 127 oral cavity, 49 restraint, 12
Osmoregulation, 193, 202 ova, 62 sex, 51
Osmosis, 193 physical examination, 52 Physiology, 114, 185. See also specific
Osteodystrophy, 69 skin, 215 types of exotic animals
Osteoporosis, 185 treatment, 31 change, 43
Osteosarcoma, 175 Parathormone, 69 information, 136
Otitis media, 161 Parathyroid gland, 69 parameter, 84
Otoscope, 117, 123, 129, 146 Parrot, 2–7, 13. See also specific topics on value, 107, 167, 181
Ova, 62 external parasite, 25 Pikas, 107
Ovariohysterectomy, 103, 160 restraint, 13 Pill, 124
Ovary, 193 transportation cage, 7 Piña colada mix, 124
Overbite, 8 Parturition, 139–140 Pine box, 182
Overcrowding, 161 Pathogenic organism, 24 Pine shavings, 112
Overfeeding, 199 Pathology, 176 Pinworm, 152–153
Overstocking, 199 Peas, 203 Plantar surface, 18, 130, 146
Oversupplementation, 45, 70 Pectoral girdle, 50 Plants, 44–45, 195–196
Oviduct, 32 Pectoral muscle, 16 Plaque, 16
Ovulation, 81 Pedal reflex, 28 Plasma biochemical reference value, 21
Oxalate, 44 Pellets, 5, 141–143, 168, 182, 203 Plasma chemistry analysis, 51–53, 70
Oxygen, 28, 67, 95, 183, 191, 196 Pelvis, 120 Plastron, 51
cage, 86 Penicillin, 129, 158–159 Playing, 182
depletion, 201 Penis, 81, 89, 93, 108, 121, 179, 193 Plugging, 172, 183
diffusion, 201 Perch, 3–4, 7 Plunger, 21
dissolved, 201 Perching, 12 Plywood, 109, 112
insufficient, 199 Perianal region, 88 Pneumonia, 49, 61, 69, 71, 72, 104,
therapy, 175 Permit, 80 160–161
water, 198 Per os (PO), 62, 95, 211 Pododermatitis, 140, 151, 157
Personal injury, 13–14, 47 Poikilotherm, 204
Pesticide, 181 Polychromasia, 53, 209
P Pet carrier, 7–8, 12, 114, 116, 143 Polymerase chain reaction (PCR) assay,
Packed cell volume (PCV), 16, 53, 87, Phagocytic macrophage, 193 71–73, 100
94, 117, 209 Phlebotomy, 147 Polyoma virus, 33
Palatine vessel, 58 Phosphate, 202 Pond, 189
Palpation, 49, 87–88, 170 Phosphorus, 45, 69 “Pool noodles,” 31
Palpebral reflex, 28 Photochemical synthesis, 42 “Poop soup,” 6
Pancreas, 102 Photoperiod, 42 “Poor-doers,” 41
Pancytopenia, 92, 101, 103 Photosynthesis, 201 Porphyrins, 159
Panniculus carnosus orbicularis muscle, Physical activity, 116 Portal system, 192
166 Physical examination. See also specific Posterior chamber, 15
Panting, 18 types of exotic animals Postmortem culture, 210
Paper, 141–142, 168, 182, 196 anesthesia, 190 Posture, 116, 146
Papilla, 15–16, 17 avian restraint device, 14 Potato, 44
Papilloma, 17 awareness of surrounding, 12 Pouch, 179, 181
Papillomatosis, 33 breathing, 12 Poultry, 83
Paracloacal gland, 179 disposition, 12 Praziquantel, 27, 154, 174, 190
Paralysis, 88, 115, 175 external, 116 Preanesthetic agent, 169
Paramyxovirus, 72 feces, 12, 26–27, 45, 124 Precipitation, 112
Parasitology. See also specific types of foreign body, 99 Predator-control program, 4
exotic animals fundus, 87 Prednisone, 95, 102, 104
apicomplexan, 73 gill, 207 Preen gland, 17

230 index
Premedication, 155 surgical and anesthetic assistance, 86, 117, 129, 146
Premolar, 158, 166 126–127 bacterial infection, 29–31, 150
Prepuce, 79, 92, 108, 137, 166 therapeutics, 124–126 capacity, 19
Probe, 40, 51, 65–66 zoonotic diseases, 130–132 compromise, 145
Probiotic supplement, 158 Rabies, 84, 95, 112, 167 depression, 28
Progenitor cell, 91 Radiation, 40–42, 69, 196, 216 disease, 99–100, 116, 122, 160, 175,
Prostate, 81, 88, 101 Radiography, 51, 61, 70, 99, 101–103, 187
Prostatomegaly, 81, 82 174, 176 distress, 25, 145
Protein, 44–45, 82–83, 112, 143, 168, survey, 104, 196 epithelium, 30
190, 192, 197, 199, 203 Radiology, 25, 32. See also specific types fungus infection, 29–31
diet, 70 of exotic animals infection, 161
high-quality, 82 Radiopaque dye, 125 monitor, 29
plant-based, 103 Radiosurgery, 28, 67 organs, 192
salivary, 139 Raisins, 143 problems, 81, 168
Proteincatabolism, 191 Ramus, 47 rate, 29, 171
Protozoa, 26, 62, 124, 152–153 Ranavirus, 72–73 sound, 17–18
Proventricular dilatation disease, 25, 33 Range of motion, 18, 49 Restraint. See also specific types of exotic
Pruritus, 94, 154, 173 Rat. See also specific topics on animals
Psittacine species, 26–27, 33. See also cage, 139 fear of, 13
specific types of ectoparasite, 153 free-flying, 13
Psychology, 2 health maintenance and disease, 160 head, 13
Psychotropic drugs, 31 life expectancy, 160 quill, 169
Pulse, 146 restraints, 145 rear leg, 121
Pulse oximeter, 65, 213 “Real identity,” 38 Retained spectacle, 69
Punctum, 124 Recovery, 67 Retina, 15
Puncturing, 205 Recumbency, 13, 121, 157 Retrovirus, 72
Pupil, 87, 170 Red blood cell, 52–53, 209 Rhinitis, 72, 161
Pyogranulomatous inflammation, 73 Regurgitation, 73, 127, 155 Rib cage, 46
Pyrexia, 100 Rehydration, 69 Righting reflex, 72, 98
Reinfestation, 26, 173 Ringworm, 161, 170
Renal system, 33, 70, 74, 104 RNA, 199
Q Reproduction, stimulated, 6 Roaming, 109
Quadricep, 124, 184 Reproductive tract, 6, 17, 80 Rodent, 68. See also specific types of
Quality, 15, 41, 191–192, 202 cycle, 195 cage, 139–142, 144, 157
Quarantine, 70 disease, 103, 122, 187 diagnostic sampling, 147–154
Quill neoplasia, 169 disease, 157–161
anointing, 165 structures, 117 health maintenance, 157–161
“ball of,” 165 Reptile and amphibian, 45, 48, 59–60, history, 143–144
defense, 165–166 63–67. See also Amphibian; husbandry, 140–143
hypersensitivity reaction, 166 specific types of nutrition, 142–143
losing, 170, 173 blood collection, 52–54, 52–60 physical examination, 146–147
restraint, 169 cage, 42–43, 46 restraints, 144–146
superimposed, 173 diagnostic sampling, 51–62 surgical and anesthetic assistance,
disease, 67–74 155–157
health maintenance, 67–74 therapeutics, 154
R history, 46 zoonotic diseases, 161–162
Rabbit husbandry, 38–46 Roundworm, 62
anatomy, 107–109 physical examination, 49–51 Ryukin, 216
cage, 108, 112, 116 restraint, 46–47
diagnostic sampling, 117–124 surgical and anesthetic assistance,
disease, 127–130 63–67
S
health maintenance, 127–130 taxonomy, 37–38 Salamander
history, 114–115 therapeutics, 62–63 blood samples, 59
husbandry, 109–114 transportation, 45 restraint, 48
physical examination, 116–117 zoonotic diseases, 74–75 surgical anesthesia, 64
physiology, 107–109 Respiratory sinus, 29 Salivary gland, 160
restraint, 115–116 Respiratory system, 42, 49, 66, 69, 73, Salivation, 136, 165, 174, 180–181
index 231
Salmonellosis, 74–75, 176 environmental temperature range, 38 Strawberry jam, 124

Salmonid, 191 erythematous, 95 Stress, 13, 42–43, 67, 99, 109, 168, 181,
Salpingectomy, 32 parasite, 215 194, 204
Salt, 193 scraping, 153, 170, 211, 215 chronic, 99
Salt gland, 49 shedding, 68–69 external, 30
Saltwater system, 193, 201, 203 sloughing, 70 psychological, 136
Saphenous vein, 90, 91, 96, 149, 154 thinning of, 87 Styptic powder, 83
Scales, 49, 191 vitamin A deficiency, 69 Subcarapacial vein, 56–57
Scaling, 83, 87 Sleeping, 2, 82, 112, 181 Subcutaneous (SC), 62, 80, 95–96, 125,
Scaly face, 26 Sling, 82 174, 184–185
Scent gland, 80, 179 “Slobbers,” 136 Subordinate, 107
Scooping, 191 Sloughing, 70 Substrate, 3–4, 40, 43, 111–112, 114,
“Scotch Tape” test, 123 Small intestine, 99, 176, 196 168, 169, 196, 201. See also specific
Scraping, 153, 170, 207–208, 211, 215 Smelling, 100 types of exotic animals
Scratching, 75, 80, 83, 108, 132, 143 “Smudgeocyte,” 53, 209–210 fish tank, 195
Scrotal sac, 107–108, 137 Snake. See also specific topics on nontoxic box, 182
Scrotum, 166 anesthesia, 65 recycled paper, 111, 114
Scruffing, 85, 91, 116, 121 blood collection, 58 Sucralfate, 99
Scurvy, 157 transportation, 45 Suffocation, 46–47, 202
Secondary nutritional Sneezing, 86, 100, 104, 180, 181 Sugar, 82, 168
hyperparathyroidism (SNHP), “Snuffles,” 122 Sugar glider, 183–187
44, 69 Soaking, 69 cage, 181, 185
Sedation, 47, 56, 64, 85, 89, 96–97, Sodium, 193 diagnostic sampling, 183–185
120–124, 127, 147, 155, 168 Sodium bicarbonate, 213–214 disease, 185–187
Seed, 4–5, 30 Sodium thiosulfate, 202 health maintenance, 185–187
Seizure, 44, 69, 72, 102, 160 Soft-Paws, rubberized, 109 history, 182–183
Selamectin, 173 Songbird, 5 husbandry, 181–182
Self-anointing, 167 Sound, 72, 180–181, 192 physical examination, 183
Self-grooming, 180 Spaying, 80–81, 87 restraint, 183
Self-mutilation, 153, 187 Spinach, 44 surgical and anesthetic assistance,
Semitendinosus muscle, 154 Spinal cord, 47, 114–115, 191, 205. 185
Sendai virus, 160–161 See also Quill therapeutics, 185
Sensitivity, 2, 68, 109 Spleen, 88, 92, 102, 193 Sulfadiazine, 27
Septicemia, 215 Spray millet, 6 Sulfadimethoxine, 173, 185
Serum chemistry analysis, 89, 91, 99, Squamates, 71 Sulfate, 213
103, 120, 148–149, 172, 183 Squamous cell carcinoma, 170, 175 Sulfonate, 213
Sevoflurane, 24, 27, 65, 98, 169, 174, 185 Squamous metaplasia, 69 Sunlight, 41–42, 81, 181
Sex hormone, 101 Squash, 44 “Sun-loving” species, 40
Sexing, 46, 51, 79, 83, 114, 137, 166, Staining Superficial vein, 171
169, 193 acid-fast, 176 Superworm, 44
Sexual dimorphism, 51 Diff-Quik, 193, 208 Supplementation, 45, 68–69, 84, 142,
Sexual maturity, 111–112, 179–180 fluorescein, 87, 170 144, 158
Shampoo, 83 Gram, 24, 60, 158, 176, 208, 210 Supportive care, 31, 73, 100, 105, 161
Shedding, 42, 68–69 Wright-Giemsa, 193 Supportive fluid therapy, 175
Shell, 47 Staples, 126 Surgical procedure and anesthetics. See
Shock, 31 Starvation, 174 also specific types of exotic animals
Shyness, 165 Steering, 191 debridement, 157
Sialodacryoadenitis virus, 160 Sterilizer, 42, 199 inhalant, 64–65, 65, 89, 98, 174,
Signalment, 46, 83, 84, 169 Sternum, 16, 147, 149 213–214
Silicate, 202 Steroids, 95, 101 injectable, 98, 155, 174, 214
Silvadene cream, 68 Stimuli, 213 monitoring device, 29
Sinus arrhythmia, 89 Stocking, 201, 213 out of water, 212
Skeletal deformity, 49 Stomach, 88, 192, 196, 211 preparation, 175
Skin, 16, 49, 87, 94–95, 116, 190, 206 Stool. See Feces in water, 212–213
abnormality, 147 Strangulation, 168 Surgical scrub, 28
dander, 139–140 Stranguria, 89, 101, 184 Suture, 66–67, 212
elasticity of, 16, 87 Straw, 81, 111, 141 Sweets, 82

232 index
Swim bladder, 192–193, 203, 210, 216 Territorialism, 107, 111–112, 136, Tropical species, 41, 66
Swimming, 168 139–140, 167 Tumor, 17, 87, 102, 160–161. See also
Swine (H1N1) influenza virus, 100 Territory marking, 107 specific types of
Syrinx, 28 Testicle, 179 Turtle, 40, 47, 73, 75
Systemic disease, 69 Tetracycline, 190 Tympanum, 49
Therapeutics, 124–126. See also specific Tyzzer’s disease, 159
T types of
Tablet, 124 Thermometer, 28, 40, 89, 171
Tachypnea, 207 Thoracic inlet, 16
U
Tachypneic, 216 Thrombi, 117 Ulceration, 208
Tail, 46–48, 55, 145, 149 Thrombocyte, 193 Ultrasonic (US) Doppler imaging, 25,
alopecia, 87, 94 Thrombocytopenia, 92 50–51, 65, 101, 102, 103, 104,
artery, 90, 91 Tibia, 92, 120, 125, 149, 174, 185 122, 213
caudal vein, 208 Tibiotarsal bone, 21 Undertank heating pad, 40–41
“whipping,” 46 Tick, 49, 61–62, 173 Un-ionization, 198
Tang, 192 Tiletamine, 64 Urethra, 93, 103, 108, 121, 137, 179
Tapeworm, 27, 152–153, 174 Tissue, abnormal, 24 Urinalysis, 103, 172, 184
Tarsorrhaphy, 159 Tomia, 49 Urinary tract, 69, 88, 92–93, 104, 121,
Tartar, 83, 87, 170 Toothbrush, 83 187
Tattoo, ink, 87 Toothpaste, 83 Urine, 45, 82, 88, 101, 111, 139–140,
Taxonomy, 37–38, 190 Topical cream, 68, 71, 94 168. See also specific types of
Teeth, 46, 51, 87, 146, 170 Torpor, 174 exotic animals
broken, 49 Tortis, 45 acidic, 103
brushing, 83 Total ammonia-nitrogen (TAN), 198 alkaline, 93
canine, 166 Toxicity, 48, 187, 196, 198, 207 collection, 92–93, 121–122, 150
cheek, 129, 136 heavy metal, 25, 32–33, 81, 202 culture, 103
front, 117 renal system, 33 diluted, 193
grinding, 99 systemic, 191 free-catch, 92, 172, 184
open-rooted, 136–137 tree, 181 output, 193
overgrown, 129 Toy, 3, 84, 182 physical examination, 45
peg, 107 Trachea, 25–28, 91, 127, 157 uncontaminated, 92
Teething, 85 Transilluminator, 49 Urolith, 103
Teleost, 191 Transportation. See also specific types of Urolithiasis, 103
Temperament, 139 exotic animals Uropygial gland, 17
Temperate species, 66 cage, 7–8
Temperature carrier, 83
ambient, 182 filter, 203–204
V
body, 27–29, 38, 40–41, 60–61, 89, media, 104 Vaccination, 94–95
195 stress, 204 diseases, 33–34
environmental, 40, 60, 66, 195 Trap compound, 199 history, 12, 84
fluctuation, 199, 204 Trauma, 31–32, 140, 157 injection, 80
freshwater coldwater species, 195 disease, 187 scruffing, 85
hot rock, 40 hand-feeding, 16 Vaginal speculum, 93
incubation, 61, 210 ocular, 116 Vascular ischemia, 117
indoor, 2 radiology, 24 Vascular “quick,” 114, 143
marine tropical fish, 195 spinal cord, 115 Vegetables, 5, 44, 83, 113, 142–143,
outdoor, 2, 109 wound, 69 168, 182
range, 41, 66, 182 Treats, 6, 142 Vein. See specific types of
rectal, 85, 89 Tree branch, 42 Venipuncture, 54–55, 89–90, 98, 117,
regulation, 2 Trematode, 62, 211 119, 174, 208
shedding, 69 Tremor, 72 Venom, 47, 165, 206
spiking, 34 Tricaine methane sulfonate (MS-222), Venous sinus, 20
surface, 40 63–64, 205, 207, 210–213 Ventilation, 2, 17, 81, 112, 142, 168
tropical freshwater fish, 195 Tricep, 154 Ventral abdominal vein, 55–56
water, 198 Trichobezoar, 99, 128 Ventral percutaneous approach, 184
Terminus, 15 Trimethoprim, 27, 68 Ventral shell, 51
Terrestrial existence, 166 Trochanteric fossa, 174 Ventricle, 191
index 233
Ventricular septal defect, 17 alkalinity, 202 fish tank, 194

Ventrum, 49, 51, 191 ammonia, 202 water, 194
Vermin, 4, 12 anesthetic, 213 “Wet-tail,” 158–159
Vertebrae, 17, 54–55, 124 automatic system, 12 Wheezing, 104
Vinegar, 17, 198 balancing, 191 White blood cell (WBC), 52–54, 56,
Viral disease, 33, 215 changing, 199, 199–200, 200, 203 172, 194, 210
Viral infection, 61 chemistry of, 205 White-gray slime, 190
Viral isolation, 72 chlorinated, 182 Wings
Virus, 70–73, 190. See also specific dechlorination, 213 feathers, 10
types of distilled, 48, 202 fracture, 17
Viscera, 46, 64, 70 exposure, 75 joint integrity, 17
Vision, 166 hardness, 202 physical examination, 17–18
Vitamin A, 30, 69–70 healthy, 196 range of motion, 18
Vitamin B, 112 mold, 215–216 towel, 14
Vitamin C, 136, 142, 144, 157–158 monitoring, 203 trimming, 32
Vitamin D, 42, 69 municipal supply, 202 Wire wheel, 168
Vitamin D3, 185 nitrate, 202 Woodchips, 141, 168
Vitamin K, 112 nitrite, 202 “Wool block,” 127–128
Vitamins, 7, 30, 44–45, 83 open system, 199 Wounds, 14, 67–69, 75
Vivarium, 40 pH, 198–199, 201–202, 202
Vocalization, 18, 28 pressure, 192
Voice box, 28 quality, 191, 192, 199–203
Y
Vomiting, 81, 95, 99, 127 sources, 84 Yawn, 85
Vulva, 79, 88–89, 101, 103, 166 temperature, 195, 198, 204 Yogurt, 128, 158
testing, 201–203
weight, 194
W Water-circulating heat pads, 66
Z
Walking, 82 Waterfowl, 17, 24–25 Zinc, 32, 81, 202
“Walk the bone,” 55 Water-recirculating heating pad, 98, 174 Zolazepam, 64
Walnut shell, 4, 168 Weakness, 102, 103, 176 Zoonotic disease, 38, 69, 161–162. See
Wart, 17 Weaning, 113, 140 also specific types of exotic animals
Waste, 196–197 Weight, 72, 80, 115, 175
Water. See also specific types of body, 5, 7, 15, 147, 149, 183–185

About the Authors
Dr. Thomas N. Tully Jr. graduated from Louisiana State University in 1982 with a BS in animal science.
After receiving his veterinary degree from the LSU School of Veterinary Medicine in 1986, he practiced
as an associate veterinarian at veterinary hospitals in Florida and Louisiana.
Since 1987, he has been on the faculty at the LSU School of Veterinary Medicine, teaching in the
Zoological Medicine Section of the Department of Veterinary Clinical Sciences. Currently Dr. Tully is
a professor in the Veterinary Clinical Science Department and is hospital section chief of the Bird, Zoo,
and Exotic Animal Service. He is a diplomate of the American Board of Veterinary Practitioners (Avian)
and the European College of Zoological Medicine (Avian).
Dr. Tully has coedited four books, Ratite Management, Medicine and Surgery, two editions of The
Handbook of Avian Medicine, and Manual of Exotic Pet Medicine; he has coedited two issues of Veterinary
Clinics of North America, and coauthored the text A Technician’s Guide to Exotic Animal Care. He has
authored and coauthored numerous chapters in other veterinary medical texts. He is also coeditor in
chief of the Journal of Exotic Pet Medicine.
Dr. Mark A. Mitchell graduated from the University of Illinois in 1990 with a BS in veterinary science.
After receiving his veterinary degree from the U of I College of Veterinary Medicine in 1992, he practiced
as an associate veterinarian in Champaign, Illinois, and worked on a Master of Science degree in wildlife
epidemiology. He received his MS in 1997 from the University of Illinois. Dr. Mitchell continued his
training in wildlife epidemiology at Louisiana State University and received a PhD in 2001. From 1996
to 2007, he was on the faculty at LSU, working alongside his friend and mentor Dr. Tom Tully.
In 2007, Dr. Mitchell returned to the U of I. Currently, he is a professor in the Veterinary Clinical
Medicine Department and is chief of staff of the Small Animal Hospital and section head of Companion
and Zoological Animal Medicine. He is a diplomate of the European College of Zoological Medicine
(Herpetology).
Dr. Mitchell has coedited two books, Manual of Exotic Pet Medicine and A Technician’s Guide to
Exotic Animal Care. He has also authored and coauthored numerous book chapters, scientific articles,
and abstracts. He is currently the editor in chief of the Journal of Herpetological Medicine and Surgery
and coeditor in chief of the Journal of Exotic Pet Medicine.

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Contents

CHAPTER 2. REPTILES AND AMPHIBIANS 37

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

Diagnostic Sampling, 51 Surgical and Anesthetic Assistance, 63

CHAPTER 4. RABBITS 107

Health Maintenance and Disease, 127 Malocclusion, 129

CHAPTER 5. RODENTS: Guinea Pigs, Hamsters, Gerbils, Rats, and Mice135

CHAPTER 6. HEDGEHOGS 165

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

Surgical and Anesthetic Assistance, 174 Neurologic Disease, 175

CHAPTER 7. SUGAR GLIDERS 179

CHAPTER 8. FISH 189

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

Chapter 2. REPTILES AND AMPHIBIANS

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

Chapter 5. RODENTS: Guinea Pigs, Hamsters, Gerbils, Rats and Mice

Chapter 7. SUGAR GLIDERS

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

Chapter 2. REPTILES AND AMPHIBIANS

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

Chapter 5. RODENTS: Guinea Pigs, Hamsters, Gerbils, Rats and Mice

Chapter 7. SUGAR GLIDERS

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

calcium source. The anti-mite tin that contains

Of course, if an owner has another species of bird

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

Figure 1.14 Companion birds should be transported

cage or pet carrier for easy cleaning and to evalu-

underlying germinal epithelium covering the

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

should be held in an Elizabethan grip around the

sharp beaks, which they routinely thrust toward the

The first and most important information the

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

tissue. The glottis is located at the base of the tongue

ers. Any bleeding, inflammation, or asymmetry of

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

examination, to determine symmetry and comfortable and observe it while discussing

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

Table 1.1 Avian Hematological Reference Ranges2

Red Blood Cells

White Blood Cells

Creatine Kinase [CK]

protocol should be followed for fungal and myco-

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

The names are derived from the irritation of the

© 2012 by Thomas N. Tully Jr. and Mark A. Mitchell

into the recommended position, about the mid-

Augustine Biomedical & Design, Eden Prairie,

HEALTH MAINTENANCE AND DISEASE

Respiratory and Gastrointestinal Bacterial/

CHAPTER 2. REPTILES AND AMPHIBIANS 37

CHAPTER 4. RABBITS 107

CHAPTER 5. RODENTS: Guinea Pigs, Hamsters, Gerbils, Rats, and Mice135

CHAPTER 6. HEDGEHOGS 165

CHAPTER 7. SUGAR GLIDERS 179

CHAPTER 8. FISH 189

5. How is the hydration status of a reptile evaluated?

7. How do you determine the sex of a snake, lizard, and chelonian?

8. How much blood can be safely collected from a reptilian patient?

9. Describe blood collection techniques used for reptilian patients.