Angela M. Lennox Exotic pet ownership is growing, and owners are increasingly presenting birds, mammals, reptiles, and fish for veterinary care. Of interest is the observation that pet reptile ownership alone has seen a 23.3% increase from 2012 to 2022, according to an AVMA survey (AVMA 2024). Euthanasia is performed more frequently in an all‐exotic practice compared to traditional pet practice, partially because fewer owners elect routine care. Many exotic species (not all) also have shorter lifespans and commonly hide signs of illness until very advanced. Veterinary visits are related to exotic pets suddenly presenting for signs of illness (“he was fine yesterday”) that are clearly severe or end‐stage conditions. When neither definitive treatment nor euthanasia is chosen or appropriate for a sick exotic pet, a palliative care plan should be developed, implemented, and adjusted as the patient’s condition changes (Lennox 2020). It also must be mentioned that the owner’s emotional attachment to exotic pets (e.g. reptiles, small mammals, birds) can be as strong as for dogs and cats, and this fact should be assumed, respected, and protected. The expected lifespan of exotic pets varies tremendously from a few years for hamsters to possibly a century for large tortoises. Table 3.1 presents general information on what has been published on exotic pet life spans. Life spans are affected by poor husbandry, which is encountered frequently, especially in species where ideal captive diets are unknown. In addition to pet exotic animals, many veterinarians are presented with ill or injured wild birds, mammals and reptiles; for all but minor conditions, euthanasia is both appropriate and often required by state and/or federal wildlife laws. Recommendations for euthanasia techniques for exotic animals were updated in the 2020 AVMA Guidelines for the Euthanasia of Animals (AVMA 2020). Numerous experts in exotic animal medicine contributed to the updates which resulted in marked improvements from earlier versions, including more recommendations and pivoting away from techniques such as freezing for reptiles/fish and thoracic compression in birds. Updated guidelines considered recommendations for traditional pet species, modified for behavioral and physiologic/anatomic differences between various classes of exotic animals including birds, rabbits and rodents, reptiles, fish, and even invertebrates. The AVMA Euthanasia Guidelines have shifted from intravenous (IV) injection techniques which have proven problematic for many exotic patients, in particular the smaller ones with hard‐to‐locate veins, as well as many reptiles and any patients that are hypothermic or hypovolemic. Table 3.1 Average lifespans for exotic pets based on limited published and anecdotal information. Poor husbandry is a common cause of morbidity and mortality in exotic pets, and lifespans can be much shorter than expected. While vascular access for diagnostic testing and for administration of fluids and certain drugs are routinely performed in exotic patients, this often requires significant practice and an understanding of diverse anatomy. In practice, most patients are sedated for venipuncture and vascular access to mitigate stress and increase chances of success. Since the goals of euthanasia include minimizing stress and discomfort, no patient should be conscious of restraint for an IV injection unless required (e.g. anesthetics and sedatives are unavailable). Using a non‐IV approach for euthanasia is doable even for practitioners unfamiliar with these types of animals. The challenges that remain include reducing the stress of handling, performing brief restraint for intramuscular (IM) or subcutaneous (SC) administration of anesthetics, and delivering pentobarbital in a manner most appropriate for the species. Practitioners should remember that drug absorption and distribution (both anesthetic and euthanasia drugs) is slower in patients that are cold, hypovolemic, and/or dehydrated, especially in reptiles. For this reason, a brief period of rewarming and even rehydration is highly recommended. Equipment used for exotic euthanasia appointments will vary widely depending on the species and chosen method. Medical supplies can include needles, syringes, IV or injection extension sets, tape, and in rare cases where other options are not available, a chamber suitable for induction of anesthesia with inhalant anesthetics. A stethoscope, and for reptiles, an ultrasonic doppler, are important to aid in confirmation of death. Physical euthanasia methods will require more specific equipment and are covered in Section 3.4. Needle size is chosen based on size of the patient and volume of drug to be administered. For many very small patients, a 29‐gauge needle insulin syringe can be used for both pre‐euthanasia anesthetic and euthanasia solutions. The viscosity of pentobarbital varies significantly. For small exotic patients, products that are less viscous and able to be administered via very small syringes are preferred. Beyond the medical supplies themselves, access to towels for wrapping and swaddling is very important. Many exotic animals are less tolerant of handling and the presence of strangers. They can be safely moved and supported using towels or small blankets and returned to familiar enclosures (if available) equipped with hide boxes following handling and injections. All interactions with exotic pets presenting for euthanasia should be as brief as possible and conducted in a quiet space keeping voices and movement slow and calm. Once handling and injection are completed, consider leaving the room while anesthetics take effect. This is particularly important for highly stressed pets. Many owners of exotic pets wish to be present during euthanasia. In the author’s practice, owners are given the choice between staying with the pet for injection of anesthetics, injection of euthanasia solutions, or both, or not being present for any of the procedure. Many exotic pets are bonded to or are at least familiar with their owners and appear to benefit from their presence. Some exotic species such as rabbits, guinea pigs, rats, and birds are naturally social and may have a bonded companion. Accommodations can be made for companions to accompany the pet presenting for euthanasia, which is likely comforting for the ill pet and may be beneficial for the companion. Several experienced exotic pet owners, including volunteers with a large national rabbit rescue, have reported a quicker time to return to normal behaviors in surviving rabbits allowed to be present for the euthanasia of a companion. In select cases, owners may be able to hold ill pets for injection of anesthetics, depending on the size of the patient, ability to resist, and general temperament. If there is any possibility of excessive patient movement, brief separation for injection and immediate return to the owners may be safer, especially in very small animals. This eliminates the owner’s risk of inadvertent needle sticks and bite injuries during injection. Exotic pets vary in their tolerance for entering carriers, traveling in vehicles, and handling in a novel location like a veterinary hospital. In‐home euthanasia can be considered, and some national home euthanasia companies are now offering limited services for exotic pets. Depending on species and patient condition, some consideration can be given for pre‐visit pharmaceuticals (PVP) prior to home euthanasia or travel. PVPs provide mild to heavy chemical relaxation. For example, gabapentin has been shown to reliably mitigate stress in rabbits at 30 mg/kg PO (Conway 2023). Gabapentin can also be considered for exotic cats using pet feline dosing strategies. However, in a study of gabapentin in Amazon parrots, 15 mg/kg IV produced only mild transient sedation for 20–30 minutes (Baine 2015). Effects on other mammal species, other birds, and reptiles are unknown. Midazolam can be considered for pre‐visit anxiolysis and has been used in mammal, bird, and reptile species, although mostly without formal studies. Administration can produce effects via multiple administration routes including intranasal, per rectum and oral. Providing injections for owners to use at home is problematic but could be considered under special circumstances. The injectable formulation can be given orally, but human patients find it extremely bitter, which may complicate administration (Isik 2008). More palatable oral formulations available for humans could be considered, or specific flavors could be compounded for veterinary patients. Intranasal midazolam has been suggested for birds, and while effective, may be challenging for owners to administer (Mans 2014). Common pets in this group include rabbits, guinea pigs, ferrets, rodents, hedgehogs, sugar gliders, and more. Depending on state and local regulations, some owners may present primates, mini‐pigs, exotic cats, and other exotic species. Many exotic pets are tame and accustomed to human presence and at least limited handling. In general, the less handling the better. SC and IM injection sites for exotic mammals are identical to those that might be considered for dogs and cats, and depend on the size of the patient, and the location most accessible during brief restraint. These commonly include the SC space over the back, and the hind limb musculature. This author does not usually inject anesthetics while the owners are holding the pet, especially smaller pets, due to risk of human needle injury. Some very ill exotic mammals will tolerate quick IM or SC injections without actual restraint (e.g. sitting quietly in the carrier or covering part of the body with a towel). Specific details for how to prepare individual species for pre‐euthanasia anesthetic injections are presented below. Ferrets generally relax using a scruff technique and can be injected IM into the pelvic limb musculature or SC over the dorsum. Like all exotics, they can move quickly even when sick. So, handlers should be ready to react swiftly yet safely so as not to cause harm. Early veterinary literature recommends firm towel restraint (burrito method) for rabbits to prevent kicking and injuring the back. However, experience shows that highly stressed rabbits may react negatively to firm restraint which accelerates the stress response. The majority of rabbits respond well to minimal handling after placement on a towel or nonslip surface, or with a towel covering the eyes. For the rare rabbit that struggles for even an SC injection, a towel wrap can be considered (Figures 3.1–3.4). This group of patients can often be gently guided with a towel without actual restraint, with a brief hold (often a towel covering the head) during injection (Figures 3.5–3.7). Hedgehogs are unique. All but the very calm or markedly debilitated hedgehogs will roll into a defensive ball with handling. Injections of anesthetics can be given into the mantle, or muscle/fat layer covering the dorsal body, which when contracted, produces the defensive posture. A pharmacodynamic study of intra‐mantle hydromorphone demonstrated analgesia for up to 4 hours, demonstrating that administration into the mantle can result in adequate drug uptake and efficacy (Peterson 2024). Figure 3.1 Gentle scruffing of a ferret for IM injection of anesthetics into the pelvic limb musculature. Scruffing is a natural behavior in the wild between mother and kits. If tolerated and the patient can safely swallow, ferrets can be distracted with veterinary high‐calorie supplements during the process. Source: Angela Lennox, DVM. Figure 3.2 Simple IM injection of anesthetics into the pelvic limb musculature of a debilitated ferret sleeping in a familiar bed the owners brought from home. Source: Angela Lennox, DVM. These mammals vary tremendously in size, from mini‐pigs to large farm‐sized pets. Larger more mobile pigs are powerful and can injure would‐be handlers. Some may attempt to bite or use tusks to avoid restraint. Livestock sorting panels can help guide larger pigs into a corner or small area for injection. A 22 g butterfly catheter is placed into the dorsal muscle of the neck allowing more ability to complete the anesthetic injection, especially in a highly reactive pig. Oral midazolam, diazepam, or acepromazine at canine dosages may be useful in pigs willing to eat. Additionally, there are reports of owners offering higher‐proof alcohol or beer along with favorite foods prior to the veterinary visit for euthanasia. The AVMA Euthanasia Guidelines include information on the use of firearms for humane euthanasia of livestock, which may not be appropriate for companion pigs when other methods are available. Figure 3.3 SC injection of anesthetics into a calm rabbit using minimal restraint. This approach should be selected whenever possible. Source: Angela Lennox, DVM. Figure 3.4 Injection of anesthetics into the caudal limb musculature in a rabbit not tolerating minimal restraint techniques. The head and face are covered in a towel. Some highly stressed rabbits may require a firmer, complete towel wrapping exposing only area to be injected. Source: Angela Lennox, DVM. Figure 3.5 Use of a small cloth for brief restraint of a sugar glider for injection of anesthetics. Source: Angela Lennox, DVM. Figure 3.6 Use of a small cloth for brief restraint of a guinea pig for injection of anesthetics into the pelvic limb musculature. Rodents generally do not tolerate scruffing well. Source: Angela Lennox, DVM. The restraint of some exotic mammals may not be safe, depending on the level of debilitation. These include larger primates, pet raccoons, exotic cats, foxes, coatimundi, and others. Severely ill patients may not require special handling, but caution should be used at all times. Patients still able to resist handling may be guided from the carrier into an appropriately sized squeeze cage for injection of anesthetics The movable side of the cage is slowly advanced until the injection can be given, and then the cage side is released. Once the injectable anesthetic is given, staff may leave the room while anesthetics take effect. Ideally, any animal which has been given an injection is still monitored even from afar or through an observation window (Figure 3.8). Figure 3.7 IM injection of anesthetics into the mantle (composed of muscle and fat) in a hedgehog. Sicker hedgehogs incapable of rolling into a defensive ball may allow simple IM injection of anesthetics into the pelvic limb musculature. Source: Angela Lennox, DVM. Figure 3.8 Use of a squeeze cage for safe injection of anesthetics into a pet serval cat alert enough to resist and bite. Debilitated large and potentially dangerous exotics may not require a squeeze cage, but caution should be used at all times. Source: Angela Lennox, DVM. Birds include a wide range of species including easy‐to‐handle pet chickens, to small finches to very large and powerful parrots or even birds of prey. Some will accept the presence of strangers, but many may be fearful or act defensively. In all cases, the goal is to complete the restraint and anesthetic injection as quickly as possible and release the bird (Figures 3.9–3.11). Chickens, other poultry, and doves/pigeons generally do not bite, and can be gently cradled or wrapped in a towel, keeping the wings close to the body to prevent flapping. Parrots frequently bite unfamiliar handlers, and larger parrots can deliver serious bite injuries. Parrots are restrained with an appropriately sized towel or cloth with a firm contact point around the neck, taking care not to restrain firmly around the body. The trachea of birds is a complete ring. So, the risk of tracheal collapse is very low. Figure 3.9 Cradling a tame duck for IM injection of anesthetics into the breast muscle. When stressed or alarmed, ducks, chickens, and geese may flap powerfully. For this reason, it is best to firmly control the wings. Source: Angela Lennox, DVM. Figure 3.10 Gentle restraint of a large bird using the neck as the contact point, controlling wings with a towel. Care is taken not to compress the body of any bird which can result in injury and asphyxiation. The injection of anesthetics is given into the breast muscle, which is clearly visualized in this bird with feather‐destructive behavior. Source: Angela Lennox, DVM. Figure 3.11 Larger more aggressive birds may be pinned against the back of the enclosure to avoid complete capture and restraint. Once the head is secured, the breast muscle is located and injection completed. Source: Angela Lennox, DVM. Compressing the body may result in suffocation as the avian lungs are solid and do not inflate, and the body cavity must expand to allow air to enter, like a bellows. This is demonstrated by the fact that “thoracic compression” is a recognized euthanasia technique used in the field for wild birds and should not be inadvertently performed during firm handling (AVMA 2020). In the ideal hold, the fingers/hands (depending on size) firmly control the neck, and the towel wrapped gently around the body controls the wings and feet. The towel is quickly deflected to expose the pectoral muscles (breast muscles) and the injection is delivered quickly, then the bird is released. For large powerful birds that are challenging to towel, an alternative technique is to leave the bird in the carrier and gently press it against the back of the cage. The handler controls the head with the towel, locates the pectoral (breast) muscle by palpation, and injects the anesthetic rapidly before releasing the bird. Birds of prey owned by licensed falconers are accustomed to their handlers. These birds are generally transported and presented wearing a hood, which provides a calming effect. As falconers are usually adept at handling their birds, it’s often best to have them restrain (cast) the birds themselves, which allows the veterinarian to safely give the injection of anesthetics. This group of pets comes in a huge variety of body shapes and sizes, from very small frogs to large powerful iguanas and even larger snakes. Some tolerate handling while a rare few appear to seek out human companionship (e.g. some chelonians [turtles/tortoises] and bearded dragons); however, the majority do not prefer human contact. As with all exotics, restraint for administration of anesthetics should be efficient and quick to minimize stress (Figures 3.12–3.14). In most of these pets, IM injections are easier than SC, particularly in snakes. Handling techniques are modified depending on patient size and ability to resist. For lizards and amphibians (with limbs), wrapping the body in a towel and isolating the leg muscle for IM injection or the dorsum area for SC injection may be the best route. Snakes come in a huge variety of sizes and are best restrained with a hand below the head to control it, with as many assistants as necessary to control the rest of the body. IM injections are given along the epaxial muscles of the front half of the snake. Figure 3.12 Restraint of a bearded dragon using a towel for injection of anesthetics into the thoracic limb musculature. Lizards may be alert enough to bite during restraint and injection. Source: Angela Lennox, DVM. Figure 3.13 Restraint of a snake for injection of anesthetics into the musculature in the cranial ½ of the body. Snakes may require multiple handlers to ensure safety. Source: Angela Lennox, DVM.
3
Exotic Pet Euthanasia
3.1 Species‐Specific Considerations
Common exotic pets
Average lifespan in years
Rabbit
6–8 (up to 15 reported)
Guinea pig
4–6
Ferret
6–8 (up to 12 reported)
Chinchilla
10–20
Rat
1.5–3
Hedgehog
4–8
Hamster
1.5–3
Prairie dog
8–10
Sugar glider
4–7
Mini pig
15–18
Bearded dragon
7–10
Iguana
15–20
Leopard gecko
6–10
Chameleon
4–8
Ball python
20–35
Corn snake
20–25
Boa
15–20
Semi‐aquatic turtle
30–50
Tortoise
50–150
Land turtle
50–100
Frog
10–20
Large parrot
50–100
Medium parrot
20–80
Small parrot
10–20
Small bird
4–7
Chicken
8–12
3.2 Equipment and Handling
3.2.1 Handling Exotic Companion Mammals
3.2.1.1 Ferrets and Rabbits
3.2.1.2 Guinea Pigs, Rodents, Sugar Gliders, and Hedgehogs
3.2.1.3 Pet Pigs
3.2.1.4 Unusual and Potentially Dangerous Exotics
3.2.2 Handling Birds
3.2.3 Handling Reptiles and Amphibians
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