Small Animal/Exotics 20TH ANNIVERSARY Compendium March 1999

Highlights and Horizons in

Exotic Animal
Medicine
Michael J. Murray DVM
Avian and Exotic Clinic of Monterey Bay
Monterey, California

A sick bird is a dead bird.” “One of the best techniques for anesthetizing rep-
tiles is refrigeration at 5˚C for 2 hours.” “Treat rabbits like cats with long
ears.” “If the medication from the pet shop fails to work, flush the fish down the
toilet and go buy another one.”
Michael J. Murray
Today these statements sound horrifying, but 20 years ago they were close to
state of the art in exotic animal medicine. Since then, there has been a tremen-
dous explosion in the popularity of all types of exotic species; and practicing vet- Although the association’s formal lec-
erinarians have made incredible efforts to keep up with public demand. tures addressed avian medicine, there
were also many informal discussions
Expansion First as an Art, Then as a Science on mutual problems. This concept
Unlike many fields in veterinary medicine, exotic animal medicine has been continued to evolve and eventually
driven by practitioners and their response to client demands. As a result, most entered cyberspace in 1991, when the
changes in the practice of exotic animal medicine have been extrapolated from Veterinary Information Network was
other medical disciplines. A glaring drawback to this approach is its inability to formed for online discussions.
account for phylogenetic and species idiosyncrasies. For example, many drug Without a doubt, however, a more
doses administered to exotic birds have been adapted on a per-weight basis from significant event in the development
dose schedules for poultry, food animals, and horses. In addition, nutritional of exotic animal medicine was the in-
data for psittacine species has been extrapolated from data for poultry. Finally, troduction of isoflurane anesthesia in
equipment modification (e.g., using a party balloon as a rebreathing bag in non- 1985. Until then, the only anesthet-
rebreathing anesthetic circuits) has relied on the ingenuity of practitioners. ics used routinely in exotic species
Two events likely had the most significant impact on the practitioner’s ability were methoxyflurane, halothane, and
to manage exotic patients. Indirectly, the formation of the Association of Avian one of several parenteral cocktails
Veterinarians in 1980 not only had a profound effect on avian medicine but be- combining ketamine and another
cause of the organization’s inadvertent collection of practitioners with interest in compound. Although all of these
all nontraditional pet species, also impacted the growth of exotic animal practices. agents had advantages and disadvan-

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ANNIVERSARY
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 Compendium March 1999 20TH ANNIVERSARY Small Animal/Exotics

tages, none had the safety net inher-
ent to isoflurane with its minimal
metabolism and less profound car-
diopulmonary effects. Safe anesthesia
made advances in exotic animal sur-
gery (including minimally invasive
endoscopy), diagnostic imaging, and
other diagnostic and therapeutic
techniques possible.
As the art of exotic animal medi-
cine expanded, the science followed.
Research on nutrition, pharmacology,
infectious diseases, clinical pathology,
and theriogenology was conducted
and study findings published. Re-
search was often thwarted by the very
small captive populations for many
exotic species, lack of significant pri-
vate industry interest, and the unique
physiology of many exotic animals
and their pathogens. For example, the
development of nucleic acid amplifi-
cation techniques and probes for di-
agnosing psittacine beak and feather
disease in 1990 was a breakthrough in
the management of infectious disease
in many exotic pets. Amplification
techniques have a high degree of sen-
sitivity and specificity and rapid re-
sults at a relatively low cost. Ironical-
ly, most research funding for using
this technology in exotic animal medi-
cine came from the aviculture com-
munity.
Technologic advances also influ-
enced exotic animal medicine. For
example, before the introduction of
endoscopic sheaths, practitioners of-
ten made antemortem diagnoses by
inference or by ruling out a series of
differentials, often by performing
major surgery (e.g., a laparotomy to
collect site-specific specimens from
the coelomic cavity). Endoscopic
sheaths allowed practitioners to use
minimally invasive techniques for
collecting diagnostic samples from
birds and reptiles.
Government Intervention
The government is not renowned
for its assistance to private practition-
ers; however, two legislative actions in
the past 10 years had tremendous in-
fluence on the practice of exotic ani-
mal medicine. In 1992, the Wild Bird
Conservation Act essentially forced
the end of importation of parrots for
the pet trade. Emphasis therefore was
placed on the importance of avicul-
ture in captive management and re-
production. Domestic production of
birds for the pet trade eventually
spilled over into markets for reptiles,
fish, and other exotic species.
In 1994, passage of the Animal
Medicinal Drug Use Clarification
Act permitted the legal prescription
of extralabel drugs (except in feed or
outside the veterinarian–client–pa-
tient relationship) by veterinarians.
The ability of exotic animal practi-
tioners to select from the entire spec-
trum of pharmacologic agents was fi-
nally secured.
Industry Response
The veterinary industry has also re-
sponded to the growing popularity of
exotic pets. Twenty years ago, only a
handful of textbooks contained any
information on the medical and surgi-
cal management of exotic pets. Today
all large (and most small) publishers
market a selection of books and jour-
nals dealing with exotic species.
The pet industry has begun to ex-
ploit the exotic pet phenomenon.
Formulated diets for the more com-
monly encountered species abound,
although many are based on little re-
search. A trip to any pet shop reveals
OWNERS’ OUTLOOK
■ Exotics Pets—Who Cares?
According to a 1996 national
survey conducted by the AVMA,
among households that owned
specialty and exotic pets, those that
owned ferrets were the most likely
to seek veterinary care for their pets
(49%); whereas those that owned
fish were the least likely (0.4%).
Average expenditures for exotic
pet–owning households per vet
visit increased from $40.12 in
1991 to $62.51 in 1996.
■ A Mixed Bag. Not only is the
average number of pets per
household increasing, but pet
owners are more likely to own
both cats and dogs than just
one species. The Morris Animal
Foundation’s Animal Health
Survey (1997) found that 39%
of pet-owning households around
the world had both dogs and cats
compared with 35% that had only
dogs and 21% that had only cats.
a plethora of supplements, habitat
enhancements, and toys for birds and
other exotic pets as well as books and
magazines for owners. Unfortunately,
much of this information is misguid-
ed and many products are inappro-
priate for the intended purpose or oc-
casionally dangerous to the animal.
Unfortunately, the veterinary com-
munity has failed to respond to the
growth of the exotic animal market
with the same vigor as the pet indus-
try. For example, pharmaceutical
products are rarely developed, tested,
and labeled for use in exotic species;
and most pharmacokinetic work is
still researched within academia.
Other attempts by private industry

98719901992
1990

1995
Nucleic acid
1991
Veterinary Information
1992
Association of Reptile
1993
First Diplomates in Avian
1994
Animal Medicinal

1998
amplification Network formed Veterinarians formed Specialty recognized by the Drug Use Clarification

1991
techniques American Board of Act ratified
developed Veterinary Practitioners
1994
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19891993 1997 1999
Endoscopic sheath system
introduced
Small Animal/Exotics 20TH ANNIVERSARY
to market specific products (e.g., biologicals) have not
been embraced by the veterinary profession.
What the Future Holds
The future of exotic animal medicine must involve not
only private practitioners but also private industry and
academia. Veterinary schools should integrate courses on
birds and other commonly encountered exotic pets into
their curricula. Information on the basic physiology of
many exotic animal species needs to be available in text-
books, and research into the pathogenesis of exotic animal
diseases remains to be conducted. Such research will need
private funding as well as the financial support of practic-
ing veterinarians and the public.
Compendium March 1999
Leaders in the field of exotic animal medicine should
scrutinize current continuing education (CE) techniques.
Traditional veterinary education progresses from the nor-
mal patient to the diseased patient to clinical management
of the patient. Often current CE emphasizes drug doses
for treatment rather than the pathogenesis of the disease.
CE lectures rarely define the normal anatomy and physiol-
ogy of exotic pets.
Finally, the future of exotic animal medicine depends on
the willingness of private practitioners to continue de-
manding the best care for their patients. The advances
made during the past 20 years have allowed exotic animal
specialists to manage patients with the same degree of pro-
fessionalism followed in the more traditional companion
animal practices.