Birds, small mammals, and reptiles are growing in popularity as pets, with mammals such as rabbits, ferrets, and rodents representing the largest nontraditional group typically presented for veterinary care.1
Specialty designation is now available for interested practitioners by the American Board of Veterinary Practitioners’ Exotic Companion Mammal specialty (ABVP-ECM), the European College of Zoological Medicine’s Small Mammal specialty (ECZM-Small Mammals), and the American College of Zoological Medicine’s combined Zoological Companion Animal Medicine (ACZM-ZCAM) specialty, which covers mammals, birds, reptiles, amphibians, and fish.
A Bird by Any Other Name?
Determining an ideal official name for this group of animals has been a subject of debate. The commonly used term officially adopted by the ABVP is exotic, but some animals, such as the domestic rabbit, are not particularly exotic in the strict sense of the word. The European college adopted the term small mammal; however, because rabbits are often no smaller than cats or even some dogs, this title is also not completely accurate. A third term, zoological companion animal is also problematic because some species are not intuitively associated with the traditional understanding of a zoo setting; the term was originally defined as referring to zoological medicine and not zoo animals only, but it is frequently misinterpreted. Zoological companion also suggests less-than-ideal situations, such as pet primates or large carnivores, which the 3 specialty groups do not encourage.
The problem is compounded by debate on exactly which species of mammals actually are suitable as pets and under what circumstances. A consensus on exotic companion mammal (ECM) was finally reached by the organizing committee assembled by the Association of Exotic Mammal Veterinarians (AEMV) for the formation of the ABVP specialty.
Special Practices and Practitioners
Regardless of designation, the demand for high-level care for ECMs has been growing, leading to an increase in exotic mammal specialists and practices dedicated to treating these pets over the past 20 years. The ABVP-ECM specialty was created in 2010, and there are currently 21 board-certified specialists worldwide2 and more than a dozen practices dedicated exclusively to exotic pet medicine.
Veterinary practices must commit time and resources (eg, continuing education [CE], in-house training, specialized equipment) to care for these patients, and practitioners must be willing to consult with experts or refer cases that are outside their individual comfort levels.
CE is critical for the veterinary team to develop and maintain skills for ECM medicine. Many CE opportunities are available from groups such as the AEMV and local veterinary associations and colleges, and at national conferences.
Special Pets & Owners
The 2012 American Veterinary Medical Association (AVMA) Pet Ownership sourcebook lists rabbits as the most common exotic companion mammal, followed by hamsters, guinea pigs, and ferrets,3 all which have been domesticated for many years and generally make excellent pets. The sourcebook also cites pet fish as the most commonly owned exotic animal, followed by rabbits, turtles, and poultry (see Table 1).3
Table 1. Specialty and Exotic Animals: Numbers per Household and Population3
Households (in 1,000)
Population (in 1,000)
Some exotic pets are growing in popularity (eg, sugar gliders, hedgehogs), while others (eg, ferrets) have been documented as decreasing.4 Clients occasionally present other more unusual mammals, such as various fox species, exotic cats, and exotic cat hybrids.
Some states allow ownership of native wildlife, and although some species make suitable pets others typically do not. Animals should be evaluated individually for their quality as a pet; for example, in the author’s experience, raccoons almost never make suitable pets, but opossums have few objectionable behaviors in the captive setting.
Exotic pet ownership regulations vary widely from state to state and can change frequently. Practitioners should also be aware that some practice liability policies may not cover actions involving illegally kept animals presented for treatment.
Most equipment required for a practice serving ECMs can be found in the traditional, well-equipped practice. Other specialized equipment can be easily modified from existing equipment or purchased from veterinary suppliers. See Table 2 for useful equipment and supplies that may not be found in a typical small animal practice.
Table 2. Specialized Equipment Useful for ECM Practices
Location in Practice
Front office/reception area
A special area away from barking dogs and the sights and smells of predators, if possible
Various safe enclosures (eg, cardboard carriers) for patients not safely caged
| | Examination room |
Towels of various sizes
A gram scale
Containers or platforms to weigh patients in comfort
Small otoscopic cones
Pediatric or neonatal stethoscopes
Human fingernail and toenail clippers
| | Treatment room |
Smaller needles and syringes (eg, 27G, 1 mL)
Smaller catheters (eg, 24G, 26G )
| | Surgery |
Small noncuffed endotracheal tubes (eg, 2.0 and higher)
Small hemostatic clips
Atraumatic towel clamps
An ultrasonic Doppler for surgical monitoring
A combination monitor that can detect very rapid heart rates (up to 300 bpm)
Specialized equipment for rabbit and rodent dentistry
Safe warming pads or other devices
Smaller diameter thermometers or temperature probes
| | Hospital |
Small animal incubators
Small plastic animal containers with secure lids
Specialized food for commonly encountered patients
Hand-feeding and recovery syringe-feeding formulas for herbivores, omnivores, and carnivores
Small feeding-tip syringes in a variety of sizes
| | Resources |
An updated version of an exotic animal formulary5
At least 2 ECM textbooks published within 5 years
Membership in the Association of Exotic Mammal Veterinarians, which includes a subscription to the Journal of Exotic Pet Medicine and access to conference proceedings and a forum
Contact information for the nearest specialist (abvp.com)
Examine With Care
The examination room should be quiet, with no cracks, crevices, or furniture in case the small patient escapes and tries to hide. Team members must learn handling techniques for each species and feel comfortable and competent before approaching an exotic pet. This is important for their own safety and the patient’s safety, and to instill confidence in the client, who likely will not return if he or she witnesses inexperienced or uncertain restraint and handling. All equipment should be ready and accessible to allow for a quick, efficient examination that reduces patient stress.
Prepare the Practice
The practice should be quiet and free from the sights and sounds of other patients (eg, cats, dogs). This can be difficult, so some practices usher potentially stressed exotic pets directly into a consultation room. A variety of caging that can accommodate patients as small as a mouse or as large as a 3-kg rabbit is now available. Smaller patients can be housed in small, secure plastic containers with lids that are partially positioned on warming devices when necessary, with monitoring to prevent overheating. Large rabbits can be kept in cages suitable for small to medium- sized dogs. Small mammal incubators or critical care units are ideal for circulating warmth and delivering oxygen. Keep ECMs on clean, light-colored towels to help identify the quantity and character of urine and feces.
See Table 3 for some of the commonly encountered ECM illnesses.
Table 3. Commonly Encountered ECMs and Their Illnesses*
Rabbit Gastrointestinal Syndrome (RGIS)
Acquired Dental Disease (ADD)
Traumatic spinal injury
Not generally a primary condition but often secondary to other underlying disorders
Requires a full workup, including radiographs and possibly CT, for accurate diagnosis
Can be upper or lower; multiple organisms can be implicated
Commonly seen in intact female rabbits
Most commonly Cheyletiella (ie, walking dandruff)
Varied manifestations (eg, neurologic signs, renal diseases, cataracts)
Caused by jumping and sudden twisting in sedentary animals; can occur during restraint for handling and examination
| | Guinea pigs |
Ovarian cystic disease
Mites (Trixacarus caviae)
Can be upper or lower; pneumonia can be difficult to treat
Can present with alopecia, but often only with weight loss and lethargy
Limb and incisor fractures are most common
May cause seizure-like activity
Often is nonpruritic
| | Rats |
Incidence is greatly decreased in females with early ovariectomy
Usually is a complex of bacterial and other organisms and difficult to eradicate
Most commonly seen in hairless rats or rats housed with companions
| | Ferrets |
Adrenocortical diseases (ACD)
Chronic GI disease
GI foreign body
Often presents as symmetrical alopecia; vulvar enlargement is common in females
Often presents as hindlimb weakness
Multiple forms and locations have been reported
Most commonly presents as inflammatory bowel disease, with underlying infection the likely origin
Rubber objects are most common, with a higher incidence seen in younger animals
| | Hedgehogs |
Neoplasms of all types and affecting many tissues are very common
| | Sugar gliders |
Obesity and hypocalcemia are most common
*Seen in the author’s practices
Improvements in Care
Improvements in the quality of ECM medicine are reflected in the increase in textbooks and professional journals (eg, Journal of Exotic Pet Medicine, Journal of the American Veterinary Medicine Association) that publish articles related to ECMs.
ECM medicine can be an interesting and rewarding addition to a traditional practice. The addition requires significant investment in team training and CE and should not be taken lightly, but the increasing knowledge about standards of care, access to experts and specialists, and quality of available resources make it an attainable goal.
Editor’s note: Dr. Angela M. Lennox, a graduate of Purdue University, has practiced exotic animal medicine exclusively for more than 20 years, frequently lectures nationally and internationally, and has authored exotic animal medicine books and book chapters.