Respiratory diseases in small mammals and exotic species

• Clinical signs of respiratory disease in small mammals

  • Lethargy
  • Poor coat
  • Anorexia
  • Audible clicking
  • Sneezing
  • Ocular discharge (e.g. porphyrin)
  • Dyspnoea/ abdominal heaving
  • Head tilt if middle ear involved.
• Clinical signs of respiratory disease in reptiles

  • Lethargy
  • Anorexia
  • Weight loss
  • Difficulty breathing
  • Open mouth breathing
  • Wheezes or crackles
  • Ocular and/or nasal discharge
  • Stomatitis
• Clinical signs of respiratory disease in birds

  • Lethargy
  • Anorexia
  • ’Fluffed up’
  • Crusting around nares
  • Periorbital swelling
  • Dyspnoea or ‘tail bobbing’
  • Voice change
  • Tachypnoea
• Common pathogens in small mammals

  • Guinea pigs - Bordetella bronchiseptica, Chlamydophila caviae, Adenovirus.
  • Rabbits - Pastuerella multocida, Bordetella bronchiseptica.
  • Rats and mice - Mycoplasma pulmonis, Pastuerella pneumotropica, Strep pneumoniae, Sendai virus.
• Common causes of respiratory disease in Reptiles

  • URT bacterial infections
  • LRT bacterial infections
  • Viruses
  • Fungal infection
  • Parasitic
  • Husbandry
  • Dental disease
  • Circulatory
  • Trauma
  • Space occupying lesions
  • Foreign bodies
• URT bacterial infections

  Can cause rhinitis and also affect structures outside of the respiratory tract e.g. conjunctivitis, stomatitis, periorbital abscesses
• LRT bacterial infections

  Can cause tracheitis, bronchitis, pneumonia
• Fungal infection


  e.g. candida, aspergillosis
• Parasitic


  • Lungworm (snakes)
  • Rhabdias
  • Ascarids
• Husbandry


  High or low temperature, high humidity levels, stress, poor ventilation
• Dental disease


  e.g. periodontal disease can lead to stomatitis
• Circulatory


  Uncommon but possible e.g. septic endocarditis, congestive heart failure
• Trauma


  Carapace injuries and other penetrating injuries to the lungs
• Space occupying lesions


  e.g. abscesses, tumours, reproductive disease, coelomic effusions, granulomas
• Foreign bodies


  e.g. plastic, wood
• Common causes of respiratory disease in birds

  • URT bacterial infections
  • LRT bacterial infections
  • Viruses
  • Fungal infections
  • Parasitic
  • Husbandry
  • Circulatory
  • Space occupying lesions
  • Foreign bodies
• URT bacterial infections

  Can cause rhinitis, sinusitis, conjunctivitis
• LRT bacterial infections

  Can cause tracheitis, bronchitis, airsaculitis, pneumonia e.g. Psittacosis (Chlamydia psittacosis)
• Viruses

  • Infectious Laryngotracheitis (chickens)
• Parasitic


  • Syngamus trachea (tapeworm in chickens)
• Husbandry

  Allergy, stress, low humidity, poor hygeine/ ventilation, hypovitaminosis A
• Circulatory

  Causes e.g. heart disease (pulmonary oedema), arteriosclerosis
• Space occupying lesions

  Tumours, organomegaly, reproductive disease, obesity, rhinoliths, pulmonary fibrosis, Choanal atresia, occluding fungal plaques
• Foreign bodies


  • Things around the home (causes granulomatous tracheitis)
• Diagnostic options for respiratory problems in exotics

  Imaging - radiography, CT, Endoscopy, Ultrasound.

  Bacteriology - (culture and sensitivity), can’t use for Mycoplasma infections as they don’t grow well in cultures.

  PCR testing

  Blood testing.
• Blood-work for respiratory disease in exotics


  Can be used to detect some things e.g. inflammatory process/infection, organ damage e.g. liver or kidney.

  Can be between normal ranges despite pathology of the respiratory tract.

  Can help determine severity and help with stabilisation (blood gases/ acid-base)

  Pre-GA for imaging - need to check for underlying conditions before anaesthesia.
• Diagnostic imaging for respiratory disease in exotics

  Identify areas of concern for further testing e.g. bacteriology.

  Identify the severity.

  Radiographs/CT can diagnose some conditions e.g. abscesses, neoplasia, congestion/consolidation.

  Endoscopy can be used to take biopsies and find foreign bodies.

  Ultrasound is useful for heart scan, free fluid or to do FNA.
• Further testing for respiratory disease in exotics

  Bacteriology - culture and sensitivity (you can ask for specific antibiotics to be tested). Tell the lab about suspected pathogens in your form.

  Cytology - can be performed in-house and can guide first line treatments.

  PCR - e.g. Mycoplasma and herpes.
• Diagnostic sampling for respiratory disease in exotics

  Deep nasal swab (rabbits) usually requires sedation.

  Nasal flush (birds)

  Nasolacrimal duct flush (rabbits)

  Lesion/ oral swab (reptile PCR)

  BAL/Tracheal Lavage (2ml/kg).
• Management of small mammals with respiratory disease

  Inside or outside

  Any recent changes

  Dusty

  Diet

  Stress

  Any new pets
• Management of reptiles with respiratory disease

  Vivarium, draw or table

  Temperatures

  UV

  Humidity

  Diet and supplements

  Any recent changes

  Any new pets.
• Management of birds with respiratory disease

  Where is the cage

  Sprays or air fresheners

  Diet

  UV

  Recent changes

  Other pets
• General treatment plan for small mammals and exotics with respiratory disease

  Oxygen

  Fluids and supportive nutrition

  Nebulisation

  Bronchodilator

  Mucolytic

  Anti-inflammatory

  Treatment for specifics causes e.g. antibiotics, furosemide, acyclovir, antifungals, antiparasitics, husbandry changes, surgery etc.
• Treatment plan for small mammals with respiratory disease

  Rabbits and rodents are obligate nasal breathers, open mouth breathing is always an emergency.

  Supportive nutrition is particularly important for hind gut fermenters.

  Regular nebulisation can increase time between flare-ups

  Bronchodilators e.g. Terbutaline works well as a nebuliser.

  Mucolytic in food e.g. bromhexine

  NSAIDs e.g. Meloxicam can help with laboured breathing

  Rabbits are steroid sensitive so avoid using them if possible.
• Antibiotics to use in small mammals

  • Culture and sensitivity is ideal, or treat for the suspected pathogens.
  • TMPS e.g. first line and broad spectrum , licensed.
  • Doxycycline e.g. Mycoplasma in rats
  • Azithromycin (Macrolide), also reduces lung inflammation.
  • Enrofloxacin (fluoroquinolone), not without culture and sensitivity.
  • Metronidazole for anaerobic infections e.g. abscesses (combination).
  • Penicillin e.g. Streptococcus, Pastuerella (parenteral ONLY in rabbits).
• Treatment plan for reptile with respiratory disease

  If malnourished, you can use injectable vitamins or liquid ‘dosed’ supplements (e.g. Zolcal D) whilst hospitalised in the short team. Long term dietary changes will be needed as wall as this.

  F10 is particularly useful in reptiles, because fungal causes or secondary infections are common. Can be used as a mouth flush.

  It is vital to keep reptiles at their optimum temperatures for their immune system to be working optimally and for drug metabolism.

  Heat vs ventilation.
• Antibiotic use in reptiles

  • Culture and sensitivity ideally, or treat for suspected pathogens
  • Gram negatives are common pathogens
  • TMPS e.g. first line broad spectrum, licensed
  • Doxycycline e.g. Mycoplasma in tortoises
  • Metronidazole for protozoal and anaerobic infections.
  • Ceftazidime - injectable q72 hours
  • Enrofloxacin (fluoroquinolone) - not without culture and sensitivity.
• Treatment plan for birds with respiratory disease

  Oxygen is very important, they have a high oxygen demand

  Fluids and supportive nutrition, crop tubing is an easy clinical skill.

  Nebulisation is incredibly effective due to their airway anatomy.

  Treatments are fine multi-modal and given for a lone duration, lower respiratory tract can be hard to target.

  Birds have no diaphragm and a packed celomic cavity it is not uncommon for LRT clinical signs to be celomic disease instead.
• Antibiotics for respiratory disease in birds

  • Culture and sensitivity ideally, treat for the suspected pathogens
  • TMPS e.g. first line, broad spectrum, licensed.
  • Penicillin and co-amoxiclav e.g. first line, broad spectrum.
  • Metronidazole if anaerobic (not poultry)
  • Doxycycline e.g. Chlamydia psittaci
  • Enrofloxacin (fluoroquinolone) - not without culture and sensitivty.
  • Azithromycin (Macrolide) e.g. Chlamydia psittaci