Michael Dutton A growing area of pet ownership currently includes what are termed exotic pets. The American Veterinary Medical Association (AVMA) categorizes these as specialty and exotic pets (AVMA 2018). Table 15.1 shows ownership of exotic pets and trends from 1996 to 2016. As a comparison, almost 70 million dogs and 74 million cats in the United States were owned in 2016 (AVMA 2018). Table 15.1 Exotic pet ownership and trends (AVMA 2018). Exotic pets are popular for several reasons. They are unique pets and for their owners that uniqueness is desirable. Exotic pets may be the only choice in certain situations. If an owner has a fur allergy, owning a bird or reptile may be the only viable option. In some cases, the smaller exotic companion mammals (ECMs) such as hamsters or gerbils are viewed as “starter” pets for young children given their small size and minimal housing requirements. Certain exotic pets undergo a period of being trendy or a fad. This can be seen in Table 15.1 for ferrets, who were very popular in the early 2000s but now number half of what they did in 2006. The suitability of having exotic animals as pets can be determined by considering two questions. The first question is how domesticated is the exotic animal? That is, pets that are bred, kept by humans, and are tame. The common ECMs, along with chickens, probably meet the definition of domestication the best. The other suitability question is the ability to keep the exotic pet in an environment that closely mimics its natural state. This pertains to housing, diet, and environmental enrichment. The capacity to meet these requirements often depends on the owner’s resources and finances. Whereas the housing requirement for a rabbit is minimal, appropriate housing for a reptile taking heat and humidity requirements into account can be costly. Often, notably for the avian or reptile and amphibian groups, the cost of purchasing the pet is only a small component of the overall cost of ownership. Providing appropriate husbandry, especially the housing component, can be a significant initial and ongoing cost. In some cases, the owner is reluctant to maintain appropriate husbandry due to the costs. Not having appropriate housing can severely impact the health of an exotic animal, so it is paramount that all costs are considered before obtaining an exotic pet. Chapter 8 discusses the cost of ownership of pets in more detail. Resources for owners include the Internet, experienced exotic pet owners, local enthusiast clubs, pet store personnel, and veterinary staff. Veterinary specialists in exotic pet medicine exist worldwide, but they are a small minority of veterinarians. Of the approximately 105,000 veterinarians in the United States, approximately 13% are specialists (AVMA n.d.). In the United States, the American Board of Veterinary Practitioners certifies specialist veterinarians in avian practice, ECM practice, and reptile and amphibian practice: about 120 are avian specialists, about 25 are ECM specialists, and about 20 are reptile and amphibian specialists (AVMA n.d.). Requirements to obtain veterinary specialist status are numerous and rigorous including years of experience and training, peer-reviewed publications, extensive continual education, and successfully passing a comprehensive examination. In the United States, specialists must also complete ongoing requirements to maintain their certification. Exotic pet owners expect to obtain veterinary care at a level commensurate with the care of dogs and cats (Rosenthal 2006), therefore the veterinary profession should provide similar services and levels of care for these exotic pets as they would a traditional pet. It is estimated that of the 15% of US veterinary practices that see exotic pets, most of these offer minimal services beyond examinations and vaccinations (Kohles 2010). So, there is a significant disparity between what veterinarians should provide, what the public expects, and what is occurring in reality. As training in veterinary school is quite limited (Rosenthal 2006), the primary means of obtaining proficiency with exotic animals is via continuing education and training of the current staff or to hire exotic pet-competent veterinarians and staff (Doneley 2005). Although most canine and feline practice equipment and medications can be easily used for exotic pets, the ethical question is whether a minimally competent or exotic pet-incompetent veterinary staff should be performing veterinary services on these unique animals that have special needs and complex enrichment requirements. An analogy is whether you should offer equine services if you are primarily a canine and feline practitioner. Most small animal veterinary graduates have taken equine classes and had hands-on training but decline to treat horses once in practice due to a lack of experience, expertise, and confidence. It is incumbent on the minimally skilled veterinarian to either improve their competency or seek a referral option for their exotic patients for the health and well-being of the exotic pet. A minimally capable or inexperienced veterinarian should not be treating these complex patients. Veterinarians may argue that suboptimal veterinary care is better than no care. That position is no longer justifiable given the myriad ways veterinarians and their staff can improve their skill set. For the veterinarian who wants to be proficient in exotic pet medicine, these are means of achieving this: To be competent in exotic pet medicine requires time, money, and resources on the part of the veterinary staff. If the veterinarian and staff are unwilling to invest in improving their skills, then one must consider whether this is an appropriate veterinary service to offer. Although there is discussion within the veterinary community whether exotic animals are appropriate to have as pets (Hess et al. 2011), exotic pets comprise approximately 22% of the veterinary companion animal market (Kohles 2010). If the veterinary staff feels that having exotic pets or a particular set of exotic pets is not appropriate, then that facility should not see those species. Veterinary teams that commit to treat exotic pets should do so fully and completely, realizing that owners can be as committed to their gerbil as to a dog (Brown and Nye 2006). In the author’s experience, the human–exotic pet bond is as strong as that seen with dogs, cats, and horses. As with other species receiving veterinary care, the veterinarian’s role can be defined as providing the client with four pieces of information: the diagnosis, the treatment, the prognosis, and the cost. All decisions made after this information has been provided are for the client, and the client alone, to make. If veterinarians do not make value judgments regarding an animal’s worth, it is often surprising what an exotic pet owner will pursue (Doneley 2005). From a business aspect, ancillary services such as vaccinations, preventive medications (such as heartworm and flea/tick preventives), and dietary products play minimal if any role in income generation. In the author’s practice, the average transaction fee (ATF) for exotic pets is 30% less than for dogs and cats. Possible ways to increase this ATF include delegating select services to staff such as beak trims, freeing up the veterinarian’s schedule for more in-depth exotic pet services. Increasing your competency through training and addition of specialized equipment (such as a ventilator for anesthesia) can increase the ATF. For the veterinarian willing to commit to full-service and advanced exotic pet care, the overall gross revenue from exotic pets can be equal to a similar dog and/or cat practice. Treating exotic pets presents challenges for the veterinary staff and practice. One important consideration is the high number of emergencies and fatalities that occur since exotic pets are usually presented late in the course of their disease. Many of these diseases are due to inadequate husbandry on the part of the owner. The poor prognoses associated with these circumstances can add to the emotional toll on the veterinary staff, who may justifiably wonder what the outcome would have been “If only we were able to see the pet sooner.” Regularly seeing animals succumb to preventable problems can be emotionally draining and lead to compassion fatigue. Another concern is public health and safety of the pet, owner, and veterinary staff. In this category are zoonoses and pet biosecurity. Many exotic pets have zoonotic potential to humans. As an example, Salmonella is a known pathogen in turtles. Biosecurity relates to the owner’s ability to maintain an appropriate hygienic environment and precautions to minimize spread of pathogens between pets or from pet to owner. Professionals should directly address the biosecurity of the pet’s veterinary care. As in other species, the Five Freedoms should be the guiding principles for assessing the welfare of an exotic pet (Webster 2016). Briefly these are: For exotic pets, all five need to be addressed in the context of their species-unique needs. Examples include the following: EMODE is a concept that combines the Five Freedoms along with public health and safety concerns to determine the ease of maintaining an animal that maximizes its wellness (Warwick et al. 2014; Webster 2016). Table 15.2 presents a comparison of exotic pets to dog and cat ownership to illustrate that exotic pets are more difficult to manage on the part of owners and veterinary staff. Table 15.2 EMODE includes considerations regarding both the care of the animal with respect to its biological needs as well as human health and safety concerns (Warwick et al. 2014). Invertebrates Fishes Amphibians Reptiles Birds Mammals (unusual) Mammal – primates Domesticated animals Dogs and cats Veterinarians typically see one or more of three large groups of exotic pets. These include avian pets, ECMs, and reptiles and amphibians. Under the avian grouping, a significant subset includes backyard or small flock poultry patients. ECMs include species such as rabbits, ferrets, and rodents. Fish are the most common exotic pet, but the vast majority do not receive veterinary care due to the low perceived value of fish compared with the cost of veterinary care and the limited knowledge about the availability of veterinary services for aquatic animals (Loh et al. 2020). These two deficient areas should be addressed by the veterinary community to improve veterinary care for fish. For the purposes of this chapter, fish and less common and illegal exotic pets will not be covered. Properly owning and maintaining a bird entails a number of requirements common to owning any exotic pet. These include proper diet, housing, environmental enrichment items, and easily cleaned food and water bowls. Purchase prices can range up to several thousands of dollars. Usually, the size of the bird and the abundance or scarcity of a particular bird species determine the price when purchased through a pet store or breeder. Prices can be discounted when purchased through rescues or the Internet. These latter venues are common sources since many birds parrot size and larger have more than one owner through their lifetime. The main reasons for relinquishment are noisy, messy, and potentially destructive behaviors (Hoppes and Gray 2010). Birds may be relinquished to a new owner who may not be any better suited to handle these problems by providing the appropriate husbandry and resources to ameliorate any behavioral or medical concerns. Improving owner retention is a multifaceted problem that has no clear answer. Remedies such as fines or restricted laws have not been effective (Perdomo et al. 2021). One area that veterinarians can significantly impact is owner education on the behavioral and husbandry needs of birds before and after purchase. The Internet can play a vital role here through the use of species-specific websites (www.theparrotforum.com as one example), although some sites are not well curated. Reaching out to the public by attending pet expos, giving lectures at hobbyist clubs, and engaging with pet stores is beneficial for all stakeholders. Many locales mandate a “veterinarian of record” where the veterinarian is required to assist the store in managing their exotic pets. In these instances, reviewing client education materials and discussing issues you commonly see with new owners is advised. From a business perspective, leaving a professionally designed brochure for the veterinarian’s services to be provided with each sold exotic pet can gain a new client for the practice. Probably the most common ethical issue for veterinarians caring for these birds is improper husbandry, especially diet. Therefore, a thorough investigation of the bird’s environment, diet, lighting schedule, and enrichment is paramount as part of the veterinary visit. If it is a recently acquired bird, the new owner may not have any knowledge of these items from the prior owner. As a veterinarian consulting on a new bird with an unknown history, it is prudent to assume the worst: an all-seed diet, limited cage space, poor lighting, and poor enrichment as a baseline. Having a thorough discussion about these potential shortcomings with owners can help determine what areas to prioritize. This history taking can occur by avian-knowledgeable staff or online surveys in addition to time spent in the exam room with the veterinarian. The veterinarian must also gauge how much information or education is too much at one time for the owner. If the goal is to have an educated client who can better care for their pet, then splitting up large amounts of information may be best. In the author’s experience, most owners are very appreciative of any information the staff can provide. We are seen as the experts by the client. Avian pets are the most likely species to show signs of maladaptive behaviors because of poor husbandry. The most visually evident maladaptive behavior is feather destructive behavior (FDB). It is beyond the scope of this chapter to explore the pathophysiology and possible treatments for FDB. Briefly, the lack of appropriate environmental enrichment along with possible poor dietary choices lead birds to excessively pluck their feathers. FDB is a coping mechanism based on a stereotypical behavior (Rubenstein and Lightfoot 2014). It does not occur in birds in the wild, leading one to assume there is some deficiency in the captive environment. Therapies include appropriate diet, adequate sleep, lighting, and environmental enrichment to replace normal flock behaviors (Stelow 2021). Many times, FDB cannot be resolved completely, and the pets live with this abnormality through their life. FDB has been estimated to occur in 15% of captive birds (Chitty 2003). Poultry, through years of breeding and human interaction, are considered domesticated. Treating poultry typically falls into two categories. The first category is where the veterinarian is expected to serve the common good of the small flock intended to produce meat or eggs with the understanding that poor performing (e.g. no longer producing eggs) individuals may be culled and others euthanized to determine an etiology to benefit the remaining flock members and the owner’s financial interest. Ethically, this can be termed the “greater good” theory or utilitarianism and is practiced in most production animal endeavors. Husbandry concerns include appropriate housing, protection from predators, diet, and environmental enrichment. Most small flock poultry are housed outside in protected coops that can be easily accessed in inclement weather, fed prepackaged diet from the local feed store, and can forage in the yard. As with any pet, the owner has an ethical obligation to meet the Five Freedoms. In my experience, these poultry generally have these basic needs met. The second category is the chicken who is considered a personal pet and thought of as akin to a dog or cat with the concurrent human–animal bond. Many times, this pet chicken is one who started as a flock member but due to personality or uniqueness evolved to “pet” status during its lifetime. Most of these chickens are past their prime egg laying years and are laying few, if any, eggs. Most chickens live no longer than five years. Medical and ethical concerns for these pets are the same as for “flock” chickens in terms of husbandry, diet, and environmental enrichment. Because of the bond between owners and pet chickens, in the author’s experience, many pet chicken owners are willing to pursue veterinary services. A common medical issue is due to reproductive disease requiring a salpingohysterectomy (removal of the oviduct, but not the ovary), which is an extensive and expensive surgery. Treating obvious reproductive diseases such as egg peritonitis with only medical therapy can be unrewarding and prolongs potential suffering of the pet chicken. Many times, the humane action is to euthanize the pet chicken in these cases. Although international conservation treaties (Convention on International Trade in Endangered Species of Wild Fauna and Flora [CITES] n.d.), national law (Fish and Wildlife Service [FWS] n.d.), and local municipality rules exist to prevent this, it is estimated that two to five million birds are illegally traded per year (Bergman 2009). The global illegal pet trade is estimated to be worth US$10 billion per year (Harris et al. 2015). This trade is causing depletion of a number of wild bird populations (Peng and Broom 2021). Approximately one-third (>400) of all globally threatened bird species are thought to be affected by overexploitation for food or the cage bird trade (BirdLife 2008). Veterinarians should ideally promote the purchase of captive-bred birds, but most owners do not consult with their veterinarian prior to the purchase of a pet bird. Corporate pet stores are regulated by most states, leaving expos, Internet searches, and flea markets as likely sources for the purchase of a wild-caught bird. Many times, captive-bred birds are free of various diseases wild-caught birds may carry. It is imperative for the veterinary staff to inquire about the origin of the pet bird, although the actual origin does not lessen the veterinarian’s responsibility to treat the pet and serve as an educational resource for the owner. Most US state laws do not require the veterinarian to report wild-caught birds to the authorities. However, some states do prohibit ownership of certain species of birds due to the fact they may be considered an invasive species if the pet escapes. It is up to state regulations whether these illegally owned birds need to be reported to the authorities. In the author’s experience, owners of illegal pets do not seek veterinary care to avoid any legal repercussions. By discussing the issues with wild-caught animals (e.g. depletion of wild populations, animals not adapted for human ownership, a high number of animals die during capture and transport, and zoonotic disease potential) with veterinary clients, some pressure may be exerted on the illegal pet trade. It appears that regulations regarding the illegal pet trade can have some effect, as evidenced by a 90% drop in the illegal bird trade in the European Union since a 2005 ban (ScienceDaily 2017) Unlike pet birds, many common ECM species are thought to be domesticated. Almost all ECMs are captive-bred from hobbyists or companies dedicated to breeding them. The major welfare concern of ECM’s is the provision of appropriate husbandry and diet. Appropriate diets are readily available at several locations such as pet stores. Because rabbits are social animals, they should be raised in groups of at least two with adequate space to hop and run around for several hours a day and have toys or objects to manipulate (Crowell-Davis 2007). The cost of ownership for a rabbit is low. Diets are inexpensive and easily located. Housing needs are minimal since many roam throughout the house. They can be litter box trained, which removes a hygienic concern for the owner. Many rabbits live 8–10 years. Frequently seen medical issues are related to substandard husbandry. Education of the owner is paramount to improve the rabbit’s quality of life. Two physiological characteristics predispose rabbits to common medical issues. The first is they are hind-gut fermenters where fermentation of high-fiber, low-energy food takes place in the cecum of the gastrointestinal tract. Rabbits also exhibit cecotrophy, which is the ingestion of cecotrophs (e.g. night stools) for nutrient extraction. When the normal movement of food is impaired because of insufficient fiber, abnormal gas and a slowing down of digestion can occur. This is called gastrointestinal stasis, which can be fatal. Rabbits also continually grow their teeth (elodont), requiring a constant wearing down by chewing fiber in the diet. When the diet is deficient in fiber, dental overgrowth occurs, impairing ingestion of food, which can result in starvation. From the rabbit’s perspective, chewing fiber and roughage provides enrichment (Baumans 2005). Rabbits can be very easily stressed, and ethically it is incumbent on the owner and veterinarian to minimize stress. Situations that can be stressful to a rabbit include (Australia Agriculture n.d.): The goal is to minimize stress by providing enrichment (such as chewing roughage), areas for the rabbit to retreat to if needed, areas to roam and explore at the rabbit’s pace, along with fresh food and water. Veterinarians should consider offering house call visits to minimize stressors. During the veterinary visit, discussion of how to mitigate other stressors can be completed. There are a number of useful rabbit care sites available on the Internet that both the veterinary staff and owner can review to help (https://rabbit.org/frequently-asked-questions). Ferrets are a common ECM due to their extroverted nature. Their small size (usually less than 1 kg) makes them an ideal exotic pet for small living quarters. Many localities have banned ferret ownership due to cases of biting children and an unsubstantiated assumption that they are a natural reservoir of rabies, and prospective owners should check local laws. Some localities also ban veterinarians from caring for ferrets and it is up to the veterinarian to determine how local laws pertain to their practice. Ferrets have a life span of eight years and commonly develop diseases such as hyperadrenocorticism (70% of ferrets affected) (Simone-Freilicher 2008), insulinoma (25%) (Chen 2008), lymphoma (11%) (Antinoff and Hahn 2004), and dilated cardiomyopathy. These diseases typically are not curable and there may be considerable expense in managing them. Ferrets as pets are less common now than 10–15 years ago possibly due to the emotional and financial burden of these conditions on owners. Most ferret illnesses are slow to develop, are usually visibly evident, and are chronic in nature. This gives owners time to research the illness, make financial arrangements for treatment, and deal with quality-of-life concerns at a more measured pace. Ill ferrets typically decline slowly, and the owner may not be sure if this is due to “old age” or progression of the disease. Therefore, it can be difficult for owners to determine when euthanasia is appropriate. This is where the veterinary staff can be invaluable in providing criteria about the pet’s quality of life. For the diseases listed in the previous paragraph, the veterinary conversation starts when the diagnosis is made. For these diseases, well-developed medical algorithms with expected outcomes, prognosis, and life expectancy are established. By being candid at the initial veterinary visit, both the client and veterinary staff can discuss options for treatment and when an appropriate time is for euthanasia. For example, the development of recurring hypoglycemic seizures while the ferret is being treated for insulinoma is usually a sign that euthanasia should be considered. As with other exotic pets, ferrets may transmit zoonotic diseases. One current concern is the potential for ferrets to carry severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) virus. Fortunately, the Covid-19 virus is poorly transmitted from ferrets and they do not seem to be a reservoir for human infection (Shi et al. 2020). This group includes the hystricognath rodents (guinea pigs and chinchillas) and myomorph rodents (rats, mice, gerbils, and hamsters). Guinea pigs live an average of 4–8 years, chinchillas average 8–10 years, while the myomorph rodents typically live no more than 2.5 years. Cost of ownership for rodents is low. Appropriate caging and diet are readily available. There are few special requirements (such as dust baths for chinchillas). The larger-sized rodents can roam free in the house while the smaller rodents are typically housed in species-appropriate habitats. Possibly due to their short lifespan, many of the myomorph rodents are treated symptomatically when they become ill, while the hystricognath rodents are more likely to receive extensive veterinary care for their ailments. Like rabbits, guinea pigs and chinchillas have elodont teeth where the incisors and cheek teeth continually grow. They are also hind-gut fermenters. The common medical problems that occur are the same as for rabbits, namely dental issues and gastrointestinal stasis. These disorders can be expensive to treat and often occur acutely, which can leave the owner emotionally or financially challenged to make medical decisions. In the author’s experience, recurring dental and gastrointestinal issues typically are treated by clients since the prognosis for full recovery is good. In rats, neoplasia is common, and is often mammary related. It can occur at a young age and the tumors can grow quite large becoming painful and impinging on the rat’s mobility. Preventive treatment is via ovariohysterectomy between three to four months of age (Hotchkiss 1995). Client education by the veterinary staff is the key to promote rat spaying. Spaying a rat costs approximately the same as spaying a dog, which typically lives five to seven times longer, and that cost can be a deterrent. Exotic pet surgery has a number of technical concerns such as the small size of the pet, tissues being more friable, and anatomic issues that are unique relative to dogs or cats. Additionally, most veterinarians have limited exotic pet surgery experience from veterinary college training. A common ethical issue for hamsters and gerbils is they are typically purchased as “starter” pets for young children. Studies have shown that companion animals help child/adolescent development in the areas of self-esteem, loneliness, intellectual development, and increased social competence (Purewal et al. 2017). It appears that these benefits are stronger with owning a dog or cat as opposed to other types of pets (Vizek-Vidović et al. 1999). While owning a pet can be a predictor for young adults to be more empathic, more prone to helping professions, and more oriented to social values (Vizek-Vidović et al. 2001), it can be argued that leaving the primary responsibility of pet ownership to a child increases the possibility of poor husbandry that is potentially harmful to the animal. When these animals are ill, veterinarians, for the most part, will take the child’s concerns into account but leave the final decision to the parent. Reptiles and amphibians are collectively called “herps” since the branch of biology dedicated to these two classes is herpetology. The cost of ownership varies by species and should be researched prior to purchase. Herps require extremely specific husbandry and often the cost of animal purchase is lower than the cost of appropriate caging, mechanical systems for heat and humidity, monitoring equipment, and maintaining an appropriate diet. The lifespan of herps varies greatly with some species living just a few years and others such as some tortoise species living 60–80 years or more. As with other long-lived pets, a transition plan is necessary, especially for the older owner. Most herps tend to be solitary and do not need large areas to roam. As such, their actual cage can be smaller than for a similar sized ECM or bird. One thing to consider is the eventual adult size of the herp. Most amphibians do not grow extensively, whereas reptiles can become quite large as they mature. Some snakes such as boas range from 3 to 13 feet in length at adulthood. All aspects of husbandry need to be increased as the reptile grows, so more or larger heat sources, more equipment to regulate humidity, etc. Unless husbandry is modified appropriately, overcrowding, nonhygienic environment, and lack of adequate nutrition can occur. Most illness (including death) is related to the owner’s failure to provide adequate husbandry. For the veterinarian, it can be challenging to find a proper balance between educating the owner and being sensitive to their emotional state associated with imparting bad news. Because husbandry is so important, a thorough review of the reptile or amphibian’s habitat and diet is of utmost importance. There are several informative websites that provide lists of particular species needs in terms of diet along with environmental optimal temperature zones for both day and night, humidity, and length of daily ultraviolet radiation or UVB exposure.1 The veterinary history should include when equipment was purchased, as many UVB lamps lose their potency approximately nine months after beginning use. The UVB frequency is not visible to the human eye. UVB meters can be purchased but may be costly. An alternative is to purchase a new bulb every six months. A common lizard disease is nutritional secondary hyperparathyroidism or metabolic bone disease due to inadequate calcium in the diet. Other lizard diseases include infectious stomatitis, dermatitis due to poor shedding, and gastrointestinal impaction caused by pica from eating the cage substrate. All of these are preventable diseases with proper husbandry. Unfortunately, frequently the first veterinary visit is due to illness. Ideally, the first visit would be a healthy pet exam and include a thorough discussion of husbandry. Promoting the veterinary skills of your facility to pet stores, online, and by hobbyist club visits can be one way to discuss the importance of that first well pet visit. Herps are a potential zoonotic hazard, and this should be discussed with their owners during the veterinary visit. One of the more common concerns is salmonellosis. The US Centers for Disease Control and Prevention (CDC) recommends that children under the age of five years not have herps as pets for this reason (CDC n.d.). The CDC also recommends owners over the age of 65 not have herps as pets since they are at higher risk for infection. The veterinarian should also be aware of any state or local restrictions as many states prohibit the private ownership of venomous snakes due to concerns of them acting as invasive species. Good husbandry is paramount to having a healthy and enriched exotic pet. Exotic pets present unique and specialized husbandry needs that both the owner and the veterinarian need to know. Each species in the group has its own unique husbandry requirements. For avian and herp pets, a common veterinary rule of thumb is that over 90% of medical issues are caused by improper husbandry. In a clinical setting, this results in much more focus on history taking including diet, size of enclosure, heat, humidity, and environmental enrichments. The proactive veterinary staff member sees this as a significant opportunity for client education. An experienced veterinary staff member can greatly supplement information obtained on the Internet for almost all clients, especially first-time owners of exotic pets. The staff should have at their disposal good client educational materials and a willingness to take the time to listen to the client and appropriately answer their concerns. For client educational materials, directing owners to specific websites is useful. Veterinary professional sites such as Veterinary Information Network (www.vin.com) have downloadable client education sheets that can also be used. Having client education handouts for common problems while discussing the issues with the owner is a time saver in a busy practice. Appropriate owner education starts from the first telephone call. In many cases, what triggers the call from the owner is some type of abnormal behavior or sign of illness. A physical exam appointment should be made at the earliest possible time. A rule of thumb in dealing with exotic pets is that by the time the owner recognizes illness, you must consider it already at a moderate to advanced stage. It is an extremely knowledgeable and attentive owner who notes early and minor illness. Once the appointment is made, a pet’s history form should be completed, and it should be detailed and very specific. Ideally, clients can complete these forms at home, or it can be more of a checklist that the veterinary staff member goes over with the client. Having clients write down what they are feeding or obtaining a picture of the food label is invaluable. For herps, knowing what equipment clients have and when they obtained it can be vital in determining if equipment failure may be an etiology for an illness. The examination process should be appropriate to the species. It should be conducted in a quiet setting and start with a visual assessment of the pet. Depending on that assessment, parts of the examination along with diagnostics may need to be staged to minimize life-threatening complications due to stress. Respiratory distress or recumbency should be treated with a grave prognosis and the owner should be informed of such. Fear Free LLC has a webinar that outlines many steps to make the exam process stress-free for birds.2 Similar concepts can be used for ECMs and herps. Most ECMs and herps travel without any overt signs of stress. Birds may be better handled via a veterinary house call visit. Alternatively, for an established patient, telemedicine may be useful. The veterinarian needs to be cognizant of the rules governing telemedicine consultations in their area. Exotic pets are complex animals with species-specific needs. The mortality rates of captive exotics are high, quality of life is often compromised, and lifespans are often not reached (Free-Miles 2019). One estimate has the death rate of reptiles kept in captivity during their first year of acquisition at 75% (Toland et al. 2012)! Ethically, it can be difficult to justify keeping exotic pets in artificial environments, so it is necessary for the owner to maximize environmental enrichment. The concept of environmental enrichment is to provide pets a stimulating and appropriate environment to maximize their well-being (Rupley 2015). When done correctly, the exotic pet should thrive. Given the wide scope of exotic pet species, environmental enrichment for a particular species should be researched before purchasing the pet. If this cannot be provided, then the owner should be discouraged from owning an exotic pet. This is where the veterinary staff plays a key role in the health of the exotic pet. Of the three exotic groups, birds need the greatest amount of environmental enrichment while ECMs and herps are easier to provide appropriate enrichment for. If an owner cannot afford a suitable environment for an exotic pet, then a veterinary discussion on another, better suited, exotic pet should occur. Operant learning using positive reinforcement (rewards) to shape desirable behaviors and eliminate undesirable ones (Langlois 2021) is a great way to challenge these highly intelligent animals to learn new things while also developing a strong social bond with their owners. Exotic pets sometimes need to be rehomed. The reasons for rehoming are comparable with those for other traditional species and include moving, death of an owner, allergies, and inability to maintain a good quality of life for the exotic pet (Grant et al. 2017). In the case of larger birds, their loud vocalization, especially in the morning and night, is a common reason for surrender. Since some exotic pets are long lived, such as larger birds and tortoises, conversations with owners about plans for rehoming these animals in case of death should be approached during one of the veterinary visits. The goal is to prevent an exotic pet from being placed into a rehoming situation where the new owners are not capable of properly caring for the animal. Unlike dogs, cats, and horses, rehoming an exotic pet can be more difficult due to a paucity of available rescues and shelters. Having a list of local rescue shelters and a list of reputable clients who would take on an exotic pet is necessary for the veterinary staff. Also, one must be cognizant of what species is being rehomed where. Rehoming a macaw to a client who has never had a bird before would be discouraged since this species of bird requires more owner resources in terms of equipment, food, and time. For example, a macaw, if not properly approached and handled, can cause serious human injury from their bites. Again, the veterinary staff can do much of the research and client communication to make a rehoming situation successful. A common theme with Case Studies 15.1–15.4 is that many illnesses in exotic pets are largely prevented by proper nutrition, habitat, environmental enrichment, and an appropriate human-pet bond. Consequently, the veterinary staff must summon the courage to have difficult conversations that diplomatically discuss the failure to manage their exotic pet correctly. The author has found that actively listening to the client’s concerns, answering questions, and discussing ways to improve husbandry go a long way in improving the welfare of exotic pets.
15
Exotic Pets
Contemporary Exotic Pet Information
Percentage of US households who owned specialty or exotic pets
1996
2001
2006
2011
2016
Fish
6.3%
6.1%
7.8%
6.5%
8.3%
Rabbits
1.9%
1.7%
1.6%
1.2%
1.2%
Ferrets
0.4%
0.5%
0.4%
0.3%
0.3%
Reptiles
1.5%
1.6%
2.0%
2.5%
2.9%
Pet livestock
0.5%
0.4%
0.6%
0.6%
0.4%
Pet poultry
0.3%
0.3%
0.4%
0.9%
1.1%
Specialty and exotic pet populations on 31 December
Fish
55,554,000
49,251,000
75,898,000
57,750,000
76,323,222
Rabbits
4,940,000
4,813,000
6,171,000
3,210,000
2,243,609
Ferrets
791,000
991,000
1,060,000
748,000
500,801
Reptiles
3,479,000
2,875,000
3,854,000
5,298,000
6,032,066
Pet livestock
6,083,000
2,936,000
10,995,000
5,045,000
1,785,618
Pet poultry
4,423,000
2,894,000
4,966,000
12,591,000
15,367,327
The Veterinarian Skill Set
Overview of Treating Exotic Pets
Easy
Moderate
Difficult
Extreme
Exotic Pet Groups
Avian – Nonpoultry
Avian – Poultry
Birds in the Pet Trade
ECMs
Rabbits
Ferrets
Rodents
Reptiles and Amphibians
Husbandry and Role of the Veterinary Team
Environmental Enrichment
Where to Rehome an Exotic Pet
Case Studies
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