The art of adding exotic animals to your practice (Proceedings)

Nontraditional animal medicine is rapidly becoming an integral part of most companion animal practices. While traditional veterinary medicine is concerned with approximately eight species (and many veterinarians limit themselves to only one or two of these), exotic animal veterinarians are generally expected to be proficient in the care, husbandry, and medicine of hundreds (thousands?) of species. Following are the estimated number of vertebrate species (world-wide):

     • Mammals           4,000

     • Birds                  9,000

     • Reptiles              6,500

     • Amphibians        4,200

     • Fish                    19,000 (up to 25,000?)

In addition to these species, there are countless numbers of invertebrate species in the world, some of which are occasionally seen by exotic animal veterinarians.

In the U.S., the number of pet-owning households is now 64.2 million, up 10 million from 1992, according to the American Pet Products Manufacturers Association's 2003/2004 National Pet Owner's Survey. These pets include 77.7 million cats, 65 million dogs, 16.8 million small mammals, 17.3 million birds, 8.8 million reptiles, 7 million saltwater fish, and 185 million freshwater fish. Based on a 2002 survey, the percentage of pet ownership among U.S. households is: small mammals, 5%; birds 6%; reptiles 4%; saltwater fish, 0.7%; and freshwater fish, 13%.

There are many factors influencing the surge in interest and ownership in exotic animals. Restrictions on pet ownership in urban areas, in apartments and condominiums, and in dormitories, are often more lenient for selected nontraditional animals which are often confined to cases or aquaria. Many exotic animals (i.e., fish, reptiles, passerines, etc.) do not require much interaction and so are more compatible with our mobile and active lifestyles. Also, there is an increased interest in nontraditional animals because of television shows such as the "Crocodile Hunter" and "Animal Planet."

Because it is impossible to become expert in the medicine of such a large number of species, the emphasis in exotic animal medicine is on developing a logical approach to clinical problems rather than memorizing common disease presentations and treatments for a few species. The keys to success in nontraditional animal medicine are a firm understanding of basic disease processes and the ability to apply that knowledge to novel situations; the ability to extrapolate in a rational manner, a creative and open mind; and a sense of adventure.

Adding exotic animals to your practice: general information

The decision to add exotics to your practice is very important and requires a great deal of commitment. There are certain physical aspects (i.e., facilities, equipment, drugs, diets, grooming materials, etc.), that you will have to invest in before you start to see exotics. You cannot decide you want to "try it for awhile" and will invest in the tools "if things work out" and the endeavor remains refreshing and profitable.

• It will be very important to enlist and excite your associates, partners, and staff in the goal of adding exotics to your practice. You do not want to be the only one in a busy practice that sees exotic animals. It is not fair to you, to your associates, or to the clients. Owners of exotic animals need to have consistent care available to them just like anybody else.

• As a practitioner, you will have to decide which species you want to treat, and then you will have to study them. You must become familiar with the care and maintenance of each species, learn about the diets they should be fed, how they should live, their anatomy and physiology, their behavior, their common diseases, and how to treat them.

• Seeing exotic animals in practice is not like seeing dogs and cats. An exotic animal appointment involves not just an exam of the pet, but an indepth discussion of diet, housing, nutrition, etc. Taking a thorough history is often the most time consuming part of the visit. This history is very important because exotic animals are very adept at masking signs of disease and are often ill as a result of chronic inappropriate care.

• You will want to build up a network of referring veterinarians to consult with because even if you own every text and go to every meeting, you will still encounter something that is not described in any book more frequently than you might think. The best way to learn and to continue to improve our collective knowledge of exotic animal medicine is to share what we see and know.

Equipping the hospital

Equipping a hospital is the easiest part of getting ready to see exotics. A separate waiting room for exotics is always ideal, but is not always practical. If possible, create an area where exotic pet clients can wait that is not in direct contact with dogs and cats. Hospital caging should be designed specifically for the species it is to accommodate. Ambient temperature, humidity, and lighting should be considered for each species. Certain diagnostic and surgical tools, such as rigid endoscopic instrumentation and in-house diagnostic equipment, are indispensable in an exotics practice. A gram scale is probably the most important piece of equipment in an exotics practice. The presence of this type of equipment in the practice is worthy of mentioning in any hospital promotional material and helps to illustrate the practice's dedication to exotics care.5

For the dog and cat veterinarian, making the transition to include exotic mammals in the practice caseload is not difficult.3 The extent of special equipment needed varies with the degree to which the veterinarian plans to pursue this field of interest. Minor changes in the physical plant that provide an intensive care unit (ICU), special cages, or an exotics ward, and extra storage for foods is all that is needed. Converting an examination room to reflect your interest in exotic animals is an option that improves upon equipment use and efficiency and demonstrates this special interest to your clients.3 Appropriate housing must be considered for avian and reptile patients. A separate "hot room" that is quiet and can be maintained at 80-85F is ideal but not essential as long as individual cages are temperature-controlled.

Marketing

Promoting and marketing an exotic pet practice can be done directly and indirectly.5 Direct promotion includes advertising in the Yellow Pages or soliciting referrals from colleagues. Indirect methods include fostering repeat business from existing clients, generating referrals by pleasing colleagues and customers, and practicing at a level that gets attention.5

Direct

Although telephone directories and Yellow Page advertisements do not always reflect a practice's true suitability to exotics care, most clients, when realizing the need for veterinary care, look there first. Experience has shown that clients are better persuaded by a clear and simple message than by a large, flashy ad in which the hospital is promoted as being all things to all people.5

A hospital brochure has multiple benefits when marketing an exotics practice. An exotics practice has an advantage over traditional practices—the patients are more photogenic, or at least more colorful.5 The brochure should clearly indicate to the client that the doctor(s) and the facility can provide the specialized care that the particular exotic pet requires.5

In addition to proactive communication with the client before needed visits, one of the most effective tools in building client relationships is follow-up communication.

Another highly effective way of promoting an exotics practice is through media attention. Interesting stories of unusual clinical cases often attract the attention of television or newspapers, and the publicity obtained from such an appearance is something that cannot be bought. Also, the submission of articles on the husbandry or medical care of exotics to popular pet-owner-oriented publications also promotes the practice.5

Indirect

Although the most common form of indirect marketing is "word of mouth" for promoting a veterinary practice, a sound marketing strategy should not depend on this alone, especially without some prompting. Clients should be encouraged, directly or indirectly, to refer others.

Retailers are a good source for developing referral streams. A postpurchase veterinary examination is one of the most important things that should be done with any new exotic pet, and securing these visits is one of the best ways of building a clientele.5 Some practitioners offer the postpurchase examination as a "package deal" to the customers of shops with which they have good relationships, thereby allowing the buyer to procure a thorough examination at a reduced price.

In addition, many pet stores want to have a good working relationship with a local veterinarian, especially for the exotic pets they sell.4 Most stores are willing to improve their own husbandry with a little coaching, especially when they see the benefits of healthier stock and increased sales. Displaying practice brochures and business cards on the checkout counter brings new clients to the practice. Complimentary classes for new pet owners held after hours at the practice are a great way to assure excellent pet care and gain exposure for the practice.4

Establishing fees

There is a tendency for many veterinarians to price their services according to their perceived value of the animal. Fees should be set using the same guidelines that are used to set fees for other animals: practice overheads, time spent with the client and patient, and direct costs associated with each case.2 Once this is done, fees for exotic work are usually higher than those for dogs and cats. There is usually little resistance from the clients who are pleased to have someone available who is knowledgeable and competent with their pet.2

Client service and education

It is important that the exotic practitioner be seen as the best source for information on keeping these pets. Client handouts discussing nutrition, husbandry, common diseases, and recommendations for routine medical care can be prepared for the hospital. Brochures, a good web site, speaking at club meetings, etc., are also important means of getting this message across. Staff who enjoy and own exotic pets can be a valuable aid to the clinician. All staff members should be familiar with these handouts. In addition, assistants, technicians, and receptionists should be encouraged to attend continuing education seminars to become better educated in exotic animal care.

Knowledge in recommending exotic pets

Veterinarians are often asked by clients to make recommendations on specific pets for ownership; knowledgeable responses are a good client-builder. However, there are numerous considerations to address before veterinarians can make appropriate recommendations to clients on a potential exotic pet. What are the experience level, maturity, commitment, and financial resources of the client? Are there legal or ethical issues which should be addressed? For example, some cities, counties, and states have ordinances which restrict ownership of some pets. Also, some nontraditional animals are not suited for the general public because they are difficult to properly care for, house, or feed. What is the behavior of the animal (aggressive, unpredictable, burrowing/digging, chewing, etc.) and its stress level? And, finally, are there public health issues to address, such as safety issues with primates or large cats, or potential zoonotic diseases such as salmonellosis or chlamydophiliosis?

Continuing education

Conferences devoted entirely to specific subjects (eg, annual conferences of the Association of Avian Veterinarians [AAV], Association of Exotic Mammal Veterinarians [AEMV], or the Association of Reptile and Amphibian Veterinarians [ARAV]) or general veterinary conferences where exotic pet medicine is included as part of the program can be valuable because they provide a forum for exchanging information and enable practitioners to network.

Professional associations, such as the AAV, AEMV, and ARAV, foster a sense of belonging and sharing of information. Journals and publications, such as Veterinary Clinics of North America: Exotic Animal Practice and Exotic DVM, provide members the latest cutting-edge knowledge. Internet forums, such as the Veterinary Information Network and Exotic DVM Forum, provide a means of home study that can be tailored to suit individual requirements.

Other services

In addition to providing treatment for medical conditions and routine health care, exotic animal practitioners should consider adding other services that clients need and want. For a practice to be truly successful, it is important that a practice develop and implement preventive medicine programs for its patients. Also, some practices have offered behavioral consultations or training classes for bird owners.4 Grooming services should be offered for all species seen in the practice. Another useful service is the retail sale of recommended products.4 Many of the specialized diets recommended for exotic pets are difficult to find in the typical pet store. Offering a convenient source may result in better compliance with veterinary recommendations, better patient care, and a better bottom line. Other supplies, such as gram scales, bedding materials, thermometers, nail clippers, and toys can be offered for sale in a small retail section of the reception area.

Summary

Exotic animals are interesting, unique, and a growing part of the pet world, and adding them to your practice can be a very rewarding and exciting process for the veterinarians and the staff. The decision to see exotics in practice should be taken seriously with the same commitment to service and education as is given to dogs and cats to provide these animals and their owners with quality care.

References

1. Bradley Bays, TA. Equipping the reptile practice. Vet Clin North Am: Exotic Anim Pract 2005;8:437- 461.

2. Doneley, RJT. Ten things I wish I'd learned at University. Vet Clin North Am: Exotic Anim Pract 2005;8:393-404.

3. Fisher, PG. Equipping the exotic mammal practice. Vet Clin North Am: Exotic Anim Pract 2005;8:405 426.

4. Fiskett, RAM. Increasing efficiency and profitability of the exotic pet practice. Vet Clin North Am: Exotic Anim Pract 2005;8:475-486.

5. Harris, DJ. Promoting the exotic pet practice. Vet Clin North Am: Exotic Anim Pract 2005;8:469-474.

6. Nemetz, L. Equipping the avian practice. Vet Clin North Am: Exotic Anim Pract 2005;8:427-435.