Top 5 Mistakes New Exotic Animal Vets Make (And How to Fix Them!)

Treating exotic animals requires a different mindset than working with dogs and cats, and for many veterinarians, the learning curve can be steep. Unlike traditional small animal practice, exotic pet medicine comes with unique anatomy, physiology, and husbandry considerations that can make even routine cases feel complicated. 

If you're a veterinarian new to treating exotic species, you're bound to hit a few roadblocks - and that’s completely normal! In fact, there are a handful of mistakes I see new exotic vets make all the time (and trust me, I made these mistakes too). 

The good news? Once you're aware of these pitfalls, you can adjust your approach and build confidence in treating everything from rabbits and guinea pigs to reptiles and birds. Let’s dive into the five most common mistakes and, more importantly, what to do instead.

The Fear of Sedation: Why New Exotic Vets Hesitate and How to Overcome It

This one is tough, because, let’s face it, as exotics vets, we see more than our fair share of patient deaths. Our patients come to us much more debilitated and less likely to recover from seemingly mild illness because oftentimes, they have been hiding signs of illness for days or weeks. 

This means as soon as they get stressed by being in the clinic, the catecholamine release can be enough to push them over the edge. The simple act of restraint for sedation and then utilizing doses of drugs that we would utilize in a healthy patient can result in the patient going into cardiac or respiratory arrest. 

Just having this experience once is more than enough to put vets off of sedating very sick exotic patients. But let’s be real - if that patient died from sedation, it was going to die no matter what. The severe, debilitating systemic illness that brought it into your clinic killed it, not your sedation. 

I would argue that when utilized appropriately, sedation reduces stress, fear, and anxiety, therefore leads to better outcomes and less likelihood of cardiac arrest. 

The key is to go slow with all exotics patients. Many of my patients go directly into a quiet kennel or incubator with heat and oxygen after a brief visual exam and weight. While they settle we get history, set up for our exam and draw up sedation drugs. Once we obtain client approval, we quickly administer mild sedation via a quick IM injection and then immediately place the patient back into its cocoon. I also typically administer significantly lower doses of sedation relative to a healthy animal and I avoid drugs that may stress the cardiovascular system like alpha-2 agonists. 

Overlooking Husbandry Basics Leads to Treatment Failures

If you've tried treating exotics, but feel like you're getting nowhere, try taking a step back and starting with the basics. Not the basics of medicine, but the basics of what this animal needs to not only survive, but to thrive!

So many of the problems we see in exotics, particularly reptiles, stem from underlying husbandry and diet issues. Appropriate husbandry for one species can potentially kill another and our clients look to us to know the difference.

I'm not saying we need to memorize the POTZ for every species we see, but we should have a basic idea of requirements, or at least know where to find that information!

If we are simply treating exotics for the secondary problems they are coming in for, like metabolic bone disease, without addressing the underlying cause, we will likely provide the animal with temporary relief, and may even see some improvement. But if we don't address the primary husbandry deficiencies that are causing immunosuppression and secondary diseases, we are not going to see positive results in the long run.

When we take on these patients, the responsibility falls to us to educate the owner on the proper care to keep their pet healthy. If we fail to address underlying husbandry issues, we fail our patient and will see poor outcome after poor outcome.

Exotic Vet Fees: Stop Undervaluing Your Expertise

If I took a look at your fee schedule, I would guess the majority of you are not charging enough for your exotic pet visits!

Now I'm not talking about taking advantage of clients, but most of us are under the impression that we need to charge less to get exotic pet owners in the door. But does that really make financial sense? Let's break it down a bit.

To practice really excellent exotic pet medicine, visits are going to take longer than your typical small animal visits, even if it's for wellness/preventative care. Just getting a comprehensive dietary and husbandry history can take at least 15 minutes, not to mention performing a thorough, low-stress exam and discussing diagnostic and treatment options.

While we're talking about time, let's not forget all of the extra time you put into learning the differences between exotic patients and small animals, the resources you've paid for to stay up to date, and the extra training you've given your staff to be able to safely handle exotic patients. Oh - also that extra equipment and the specialized drugs you keep on the shelf just for your exotic patients (ceftazidime, anyone?)

If you don't value those investments, your clients won't either. Let me say that again - IF YOU DON'T VALUE THE TIME AND MONETARY INVESTMENT YOU PUT INTO BECOMING AN EXCELLENT EXOTICS VET, YOUR CLIENTS WON'T EITHER.

Yes, you may get a few clients that complain, but we know that's going to happen anyways.

As you build a reputation as an excellent exotics clinician, you will attract more and more unicorn clients who are thrilled to pay that exam fee - because you are willing and able to care for their beloved pet.

Breaking the Enrofloxacin Habit: Smarter Antibiotic Choices for Exotics

If this triggers you, keep on reading!

Coming out of vet school, if I had a sick exotic patient visit with a not-obvious clinical presentation, we joked that it had a "Baytril deficiency" and sent it home on enrofloxacin and meloxicam. Did they get better sometimes? Sure did! But was it good medicine? Well, I can't say it was the best...

Of course, antibiotics are going to be warranted sometimes, but many conditions in exotic pets are secondary to poor husbandry or have a viral, fungal, or inflammatory etiology. If we put these patients on antibiotics, and correct husbandry to help support the immune system, it may seem like the antibiotics worked, when in actuality, it was correcting the husbandry deficiencies that led to improvement.

It can be really tempting to send home antibiotics even when we know it's unwarranted because the owners want to feel like we are doing something to treat their pet.

If it is a really sick patient, antibiotics absolutely may be indicated, but do we need systemic antibiotics? Or would topical or localized treatment be appropriate?

If we decide to prescribe an empirical antibiotic, we should only be reaching for higher-tier antibiotics like enrofloxacin if the lower-tier drugs are contraindicated. Antibiotics like penicillin (but NEVER orally in herbivores!), doxycycline, and trimethoprim-sulfa are likely going to be better choices depending on what system we are treating and what type of bacteria we are targeting.

Ideally we are always performing additional testing like gram staining, culture/sensitivity or NGS DNA sequencing to help direct any further antibiotic therapy.

The Importance of Prophylactic Spays for Exotic Companion Mammals

Exotic companion mammals are prone to a variety of reproductive diseases, including neoplasia, ovarian cysts and hormonally-mediated pituitary tumors that cause mammary adenomas, to name a few.

Rabbits specifically are extremely prone to uterine neoplasia. In fact, uterine adenocarcinoma is the most commonly diagnosed neoplasia in companion rabbits.

Clinical signs include anemia, hematuria, mammary gland enlargement, decreased fertility, stillbirths, spontaneous abortions, a palpable caudal abdominal mass, and once the cancer has spread, anorexia, lethargy, dyspnea, and weight loss.

Up to 80% of intact female rabbits over the age of 5 years will develop uterine neoplasia. If we happen to catch it early (a mass effect or hematuria is often an incidental finding on physical exam), spaying the rabbit at that time can be curative.

If I suspect a uterine mass based on exam and clinical signs, I always check thoracic radiographs for visible metastasis as the lungs are the most common site of spread, however, it can also spread to organs adjacent to the uterus or via the blood to the brain, bones, and liver.

If metastasis has already occurred, we can often only provide palliative care to help keep the rabbit comfortable.

If we spay the rabbit before 1 year of age (my preference is at 6-8 months), we can almost completely eradicate the risk of this disease. Prevention is always better than treatment!

For guinea pigs, we can remove the risk of ovarian cysts and uterine neoplasia and in rats, we can significantly reduce the risk of mammary adenomas if we spay them before 12 weeks of age. 

When you are new to exotics, the anesthetic risks of these patients tend to scare us away from recommending preventative surgery. But if we approach these patients like our canine and feline patients, checking pre-op bloodwork to evaluate for contraindications to anesthesia, placing IV catheters for IV fluid support and easy venous access in case of an emergency, and making sure we have airway access, that risk reduces significantly. I would much rather spay a young, healthy rabbit, than an older, obese rabbit with comorbidities from uterine neoplasia. 

Level Up Your Exotic Vet Skills: Learn from These Common Mistakes

Stepping into the world of exotic animal medicine can feel overwhelming, and it’s natural to make mistakes along the way—I know I did! But recognizing these common pitfalls and adjusting your approach early on will set you up for success. 

Prioritizing stress reduction, emphasizing husbandry education, valuing your expertise, making intentional antibiotic choices, and recommending appropriate preventative care are all key to providing excellent exotic veterinary care. The learning curve may be steep, but with each patient, you’ll build confidence and skills that allow you to offer the best possible medicine. Keep learning, keep growing, and don’t be afraid to step outside your comfort zone - your exotic patients (and their owners) are counting on you!