Hello, it's Anthony Chadwick from the webinar vet welcoming you to another one of our episodes of Vet Chat. Very fortunate today to have Fabian Rivers with us, who is a exotics vet, and we're gonna be talking today about how to recognise disease in exotic pets, obviously. Perhaps before we go into that, Fabian, tell us a little bit about yourself, where you've, come from, where you've qualified, etc.

And where you're, where you're at now, what you're getting up to. Hello, everyone. Obviously, my name is Fabian Rivers.

I'm a small animal and exotics vet in Birmingham, born and bred in Birmingham. I studied abroad. In the Czech Republic, in the second city in Borno.

And most of my work since I've graduated has been a mix around doing, kind of exotics works, mainly and focusing on that. But also done some TV work and some, you know, some writing, some opinion pieces and the retley community. So, it's quite a broad, diverse, approach to my 1st 4 years, but I've loved it.

Brilliant, and a bit of a following on on social media as well. I mean, what, what's the what are all the handles on social media so we know where to follow you? So I'm colloquially known as Dready vet, for obvious reasons, but, you know, if you type in Fabian Rivers, depends if it's serious or not.

If it's, it's the fun stuff, it's the dready vet, it's just Fabian Rivers if it's the more serious thing. Well, well, one of our value words at Webinar vet is the fun stuff, so, so I might, I, I may call you Fabian or I may call you dready vet, we'll see how it goes during the, during the conversation. Perfect, I'm absolutely fine with both of those.

It's, it's actually . You know, obviously practised myself, although I've not practised for the last few years, but it can be actually very difficult to recognise disease in some of these exotic pets, because as, as we know they are a prey animal so looking ill isn't always advantageous for you. So perhaps, you know, you're obviously in in practise seeing a lot of exotics.

Is is that a challenge with perhaps our, our rabbits, which is our third pet, but sometimes we kind of, If you look at university and so on, I'm not sure that they're given the time that they perhaps deserved in the curriculum, are they, or was it a bit different in Czech Republic? So yes, the answer is yes, they, they are primarily underdiagnosed, primarily poorly handled, animal. And I was very lucky when I studied at university, there's a big exotics, clinic at my university.

So I, the, the way it was structured at my university was I actually did a course, a mandatory eight-week course, in exotics, and I chose to do it as one of my finals, which was a 12 week rotation. So my entrance into exotics was actually really quite developed and it it meant within the 1st 6 months I was seeing quite a heavy exotics caseload at my, my first practise, which I'm still at at the moment. But yes, you know, there's a lot of research that's gone into understanding why prey animals and, exotic animals are so under diagnosed for a variety of different conditions.

And this, and, and there was a bit of research that said. The further the distance that an animal looks like a human, the harder it is for us to, to be empathetic with them. So for example, if you have your kind of brachycephalic breeze, their flat faces, you know, they have a split nail or they have a, a little bit of an itch, and then you get the client bursting through the doors and they want everything done.

There's a potential to think that actually it's because we have a kind of empathetic familiarity with that. But if, if we invert it and you think about, you know, a garter snake, you know, long body, very, there's no signs of any facial expressions, you have that, that block to being able to be empathetic to understanding. And as a result, as an exotic vet who sees, you know, all sorts of weird and wonderful creatures that provides a a a stumbling block.

So we, we now move to, to rabbits, right? You know, I can't tell you the amount of times that I've seen a rabbit that has been severely debilitated. Hypovolemic shock, barely moving, pale mucous membranes, you know, underweight, diarrhoea, and, and people have come in for their normal appointments and booked it, you know, 5 days ahead in advance, thinking that, well, we'll go to the vets, he might give us some antibiotics and off we got.

And so it, there is just this huge barrier all the time to explaining actually your rabbit, you know, hoppy or whatever is not doing very well, and we see that all the time. Do you, do you have many rabbits coming into the surgery called hoppy? Is that becoming a popular name amongst rabbits?

Because I think people need to make a bit more of an effort, if I'm being honest there. I completely agree, but it's it, what I would say is actually the more human names which shouldn't be applied to er bunnies is much more things, so we're seeing an increase of the of the name Dave. I'm not sure what it is about rabbits called Dave, but that is becoming such a popular thing we've seen very recently.

A big shout out, of course, to Amicus Vet centre that are lucky enough to have you in, in, in the practise, and I know you were saying in the Birmingham area, obviously a lot of people do refer cases, so vets who kind of also, you know, confident with dogs and cats, but maybe less so with some of the more exotic creatures. I think most of us, you know, have some knowledge of, of rabbits, but obviously when you start moving into snakes and amphibians and reptiles and things, then, then people feel. Less sure.

So big shout out to Amicus. I remember when I was newly qualified and I had a guinea pig coming in who just didn't look very well. And of course the first thing I did was said, well, You know, as you've said, it's an animal, it's a mammal.

Let's just give it a proper clinical examination. I was very thrilled, you know, in the early stage of your career when you make a diagnosis, you do high fives and everything, and Applaud yourself, and this was a a guinea pig with congestive heart failure, you know, you could hear it had a very bad heart murmur and actually you can apply first principles to all these things. A dog and a and a guinea pig aren't that different in in some ways, of course they're a lot different in other ways, but they all, they both have hearts, for example, as far as I'm aware.

Most of them. Absolutely, and you're, you're absolutely right, and I think this is the one thing that I have been pushing, especially in the last, say, 2.5 years, is that your skill set as a smallies vet, as a large animal vet is extremely transferable.

And I, I, I would say that, you know, there's always a case of being, you know, if I'm a specialist or always in my area of, of, of, of, you know, passion, that I get to say, well, why didn't you do this and why didn't you see that? And I, I guess there's always this, this thought process about. Well you see it all the time, so it's easy for you, but I would say that I disproportionately, I see so many cases that do not need any sense of particular, you know, skill set, you know, it's a lot of it is, is very rudimentary basics.

And if you're brave enough to go and have a go, like, like you said with the congestive heart failure in a guinea pig with a heart murmur or whatever. There are so many transferable skills from day to day because the basic physiology of a mammal at least is the basic physiology of a mammal and and you can apply basic principles. I, I suppose one of the issues then when you've made that diagnosis is then treatment.

And of course, you know, treating a rabbit or a guinea pig compared with treating a human with maybe a human drug or a dog drug, it's that ability to get the dosing right. So I suppose you're using a lot of compounding companies to to help you with getting correct medication because obviously if you overdose, that can lead to big problems as well, can't it? Yes, it can, but I would say there are ways to get around that because often we're giving, you know, drugs which are relatively stable.

I mean not all drugs you can, you know, crush the tablet form, but a lot of them you can. And so we have a mix of compounding situations and it depends what you compound with and how long it's it it it's viable for. But the other way round.

That is actually, we sometimes do say, you know, break a tablet of, for example, in a bird for a canazole into quarters, put it in a bit of water and of that mixture, as long as you've made it really, really dilute, you can give 0.2 of that every 12 hours. And we have found in situations where we can't have a, a compounding situation, that works just as well.

And, and, you know, people are able to apply that as long as you're very clear about those rules. But we have formularies, you know, if you're part of the BSAVA there are formularies, out there. The exotics formula is part of that package, you know, you've got, the carpenter, there's so many different ways you can seek out support for giving the right and most appropriate drugs.

But when it's all said and done, Fabian, isn't exotic medicine just about enrofloxacin? Is it just as simple as that? If I have to find you, I will find you and I will hurt you, but no.

Yes, but what I would say is that we have to be, there has to be some stewardship around antibiotics, and what we are doing a lot more within my practise and I would say probably most exotic practises around the country at least, is that we're shifting away to kind of having this custodianship around er antibiotics and obviously if it's the, the thing that's licenced. Then you have to use it as your front line, but actually, if you're able to justify why you're giving a different approach, you know, doing your, your, your culture sensitivity testing, for example, and doing the, you know, your, your due diligence, we're using a much larger variety of things because that is what's required. And then this is why we do, you know, the worker.

And you know, if you're able to justify it with clients, especially in animals that do not show you the signs, you're able to justify it and you're able to get the results, and then you're able to use a wide diverse group of drugs, and that's really helpful. Cos obviously a lot of these animals don't have a lot of licenced products, so the cascade actually can be a friend in that case, can't it? And just in case we start getting complaints in, that, I was being tongue in cheek about and refluxen, and I think we probably should.

Just remember that before the, before I start getting hate mail. I'm, I'm, I am a believer in antibiotic stewardship. It was really interesting.

It's becoming more and more important when I was in practise in veterinary. In dermatology, how much antibiotics could be misused, and I think the message is finally getting through that. Use them properly at the right dose for the right length of time.

Or, you know, if you can using topical treatments, so, do you use a lot of topical treatments in, in, in perhaps your rabbits and so on? Loads. I, I mean, even in, even in reptiles, reptiles by design have really filthy skin, you know, that's that's basically where you start.

They, they're dirty animals, and you'll be surprised how much you can get away with appropriate topicals, even when their physiology of, of their, you know, their scales is a little bit different, . But again, it goes back to basic principles. If you're able to clean an area and make sure that it's not got bacterial colonisation and contamination, you're able to maintain wounds a lot better than you probably would expect just throwing, you know, and refluxes in basically.

Yeah, no, absolutely, and, and of course with reptiles, there's, there's the difficulty of dysectiasis and so on, isn't there, that you, you know, you need to, that, that you have to get rid of that skin. Because that's gonna cause problems, isn't it, as well, if they don't shed properly. No, exactly.

There, there are lots of different kind of small, small minutia, but again. You can do so much. The principles of being a a medical practitioner, let's open it, open it even even wider, a medical, medical practitioner is that you don't want bacteria.

If you can clean wounds which are, are safe, if you can give the appropriate cult you know, afterculture sensitivity for, for bacteria, . And obviously the the appropriate antibiotics, you can do so much just off the basics and and that's what I'm trying to be a custodian of myself, for, for many of the practises er on our on our own. And chlorhexidine can be your friend, can't it?

Chlorhexidine, tadine, you know, just, just really have the basics. But again, you know, I'm, I'm pushing for universities to just do a little bit more with the basics really because, you know, the new grads are absolutely fantastic these days and. They really can be armed to be the the next step when it comes to exotics care, not just, you know, smallies and things like that and I, I feel like exotics is a big world, but it's, it's, it's a lot smaller than we, you know, give it credit for and there's just so much transferable skills.

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I was just noticing I'm looking out over my backyard and a wood pigeon just flew in, and I know obviously with an exotic pet, exotic pet, I'm sure you get a fair number of, of wildlife pigeons at all, but I'd like to talk about my favourite mammal that isn't a dog or a cat, but favourite probably UK wildlife mammal, the, the beautiful Eurasian hedgehog. I have a couple of them come into the garden, sometimes up to 3. They're more entertaining than I would say 90% of television.

I would much rather watch a hedgehog than watch a Birmingham City game, for example. So this is where, Antony, we're, we're, we're, we're gonna have to, we're gonna have to separate the two. We're gonna have to compartmentalise the topics here, because, if you're mentioning my fantastic.

Blues, then, then that's a conversation for another time, but let's come back to these Eurasian hedgehogs, shall we? Yes, they, we, I see a huge amount of them. I'm, I'm very fortunate to be connected to, quite a few different rescues that send.

Almost solely they're, they're, they're, the Eurasian hedgehogs, they're rescues to us. And you know, I, I see such a variety of different illnesses, and, and, and cases, on a regular basis, you know, anything from your, your, your average, you know, orthopaedic issues, all the way to, you know, all types of cancers and, and, and, and things of, of that nature, neoplasia. And so I'm, I'm very, very lucky and again one of the hardest parts of dealing with these guys is that as soon as you even look at them for too long, they ball up and then you think, oh, and there there are certain ways that you can try to get them to do that, but you know, invariably quite a few of them require some type of induction, usually by you know Sio or ISO, just to have a look at them.

And that's pretty unique to to them and them only. Yeah, and, and of course again it's, it's difficult to, to recognise those diseases because of that, you know, you need, you need to spend some time with them, don't you? What, what's the kind of.

I'd say the top 3 conditions that you would see, cause again cancer obviously less common. I mean, you know, things like fly strike can obviously be a problem with with these guys as well, can't it? Yes, so I would say that the top one that I see, for wild is actually, and it's, it's, it's weird, it's usually the hind leg, is, has been severed by something, be it a car or, you know, there's kind of strimmers or, you know, it's been, you know, been caught under the, the, the, the, you know, a door or something like that or it's got its leg.

The amount of times I've had to. Have a serious chat and discussion about the quality of life of a hedgehog that's got, you know, a profound break in its hind leg, and you know what, there is a big thought process about whether or not we should be amputating, you know, wild hedgehogs, hind legs or front legs based on, and, and so that always is a discussion, but I like to treat things on a case by case basis. So that's number one.

I think number 2 is, perfuse style. Diarrhoea, which is probably not a surprise. I think it's very important for people, if anyone's listening, they do get a, a wild hedgehog with profuse diarrhoea or or bloody diarrhoea to send off a sample.

I can't tell you the amount of times. I found salmonella, varieties of salmonella, in faecal samples that have been sent off and. You know, for a rescue centre at least, making sure that you're doing your due diligence with regards to making sure your hands are clean and doing things like that, is so important because we are dealing with, you know, some nasty strains of salmonella, which we don't want flying around humans any time soon.

Exactly. And I would say the last one, and again there is no particular order, it's probably longworm, to be honest with you, and the side effects of that, . And again, incidentally, you do find them on faecal samples and you know, I, if you find a hedgehog that's got ticks, it's got fleas, it's not doing pretty, very well, you, you're likely to find a lung worm, to be honest with you.

And so there is a, there is a question about kind of routine, you know, long worm treatment for a variety of these guys, especially if they're quite profoundly ill. Bringing a hedgehog in, would you routinely deworm it or is that part of your process with a, with a sickly hedgehog coming in? I would say that there has to be a this context, you know, it's I would say no, it's not routine, but I would say that in absence of, because again, you know, if, if we're doing it as an individual practise, we normally say yes unless it's profoundly ill, because again, worming can sometimes cause its own side effects, and especially if you don't know the status of it, but.

If it is a, if it's healthy and you know, we're trying to get it to a rescue centre and we're doing our due diligence and we take a faecal sample and I look in-house and there's signs of X, Y, and Z, then probably yes. But you know, sometimes the context is not whether we worm or not, it's whether unfortunately, there's a platform for this one getting healthy basically in the food that we want it to. And you know, it, as you can expect, if someone is able to bring a hedgehog in at midday, that's been, it's the middle of the road, or it's a side of, it's a side, and without any issues, you know, you can imagine the type of disrepair that we see of these, these, these poor, these poor animals and you know, that is usually a bigger question, you know, what is the kind of likelihood we're gonna have a positive outcome.

It, it's what's the underlying disease, isn't it? Obviously it'll thrift in hedgehogs, seeing a hedgehog in the middle of the day, an underweight hedgehog before it goes into hibernation, all of these things are not good signs, are they? I, I do have to say I have been amazed in my garden.

I'm now an expert on hedgehog poo, just how much they can actually produce as such a small animal. We, we need you to have that title somewhere on a mantelpiece. I, I think I, I will, yeah, I will, I will talk about myself as an expert in hedgehog food going forward, I think.

But yes, it, it, yeah, being able to identify. Good quality poo is a really weird part of veterinary medicine as a wider thought process, but yes, it is, it is definitely part of, of, of my job, but I'm regularly saying to my nurses, for example, if I'm doing consults and we've got a couple in, I'm really saying what's the poo like? It was one of my favourite questions as well.

Exactly, and I'm always frustrated with the nurse who cleans a little bit too, expeditiously and, and leaves me with no, poo smears over the, the latest Daily Mail or something like that, do you know what I mean? Yeah. I, yes, we won't, we won't bring those two pieces together, I think.

We're, we're not too political on this, on this podcast, but . Yeah, I, I must admit that it was, it was an area that I was always, and of course if you have somebody that you don't want to speak to for much longer, especially at a meal, you can always put people off by by talking about some of the diseases and some of the conditions you've seen that day, can't you? It's an amazing way to get home for an early bedtime for sure.

I was really fascinated, obviously, to know what your thoughts is, you're seeing a lot of hedgehogs, obviously I see my small number in, you know, my garden, but how do you think hedgehogs are doing, one in the centre of cities like Birmingham, and do you have a feeling for what's happening perhaps in in rural areas? So I would say that there is a greater cognition or or understanding of the value of hedgehogs in urban areas because we're seeing so many of them. And you know, I guess.

In, in certain, in certain societies and communities we are trying to make more of an effort to facilitate that and that's been really positive and you know I've been asked a couple of times, you know, when it's suitable to go to certain schools to talk about, you know, wild Eurasian hedgehogs, and that's been a, a really positive, idea and thing that I've, I've wanted to be part of. But I would say in the, in the other sense is that in a rural situation, . I I'm not, I'm not sure there is necessarily that, that same cognition, but also that, you know, most of the issues that I do see, people will travel, you know, from outside, you know, the most typical urban places and bring hedgehogs to me.

And again, we're seeing them in a variety, a variety of different levels of disrepair. And you know, from, you know, the typical, you know, road traffic, accidents and, and, RTAs and all of that, that, that the malarkey. So it is, it's hard to get a real honest picture of what is going on between the two, but what is nice at least is when at a point when.

I guess they are becoming more and more at risk as a species in the UK in particular. I'm seeing more of an effort, especially in urban areas and in my community locally, to try and facilitate looking after them and, and, you know, being aware of them in a great. A sense, and that can only be a positive outlook and hopefully it's being managed around the UK.

They are, they are such a beautiful little animal, aren't they? And I think the country will be poorer if we if we lose them. So no, it's great the work you're doing, but I think also one of our themes at the Greens discussion forum that we're going to be doing in a couple of months is all about biodiversity and actually, you know, being able to keep the numbers of hedgehogs up, they.

They, it's all part of those food webs. If you start losing creatures and and plants within those food webs, then everything gets unbalanced, doesn't it? It does, it really, really does.

And you know, and this is why, you know, I'm very keen. I've done some work with, you know, trying to reintroduce species that haven't been in the UK for a very, very long time and, you know, some reptiles and wild amphibians that, you know, we haven't seen in the UK for a very long time because we need to have that, and we need to protect our wildlife, we need to protect our ecosystems that are around us and, you know. This is such an important part of of balance of our, our contribution as humans to our, our world around us and I'm very keen to, to propagate that because it seems to be that we're fighting a little bit of a losing battle sometimes.

Yeah, I mean, perhaps just to finish off, obviously within the exotics we we have the reptiles and the amphibians which you've just been talking about and. Sometimes there's a worry that people take these pets on without suitable training. In many ways, I, you know, I look at A cat is, is actually a very easy pet to keep, a rabbit, probably less so.

You're then moving on to reptiles, you know, the, the husbandry needs to really be spot on. So there's a little worry there, but also I'm fascinated by the sort of sustainability of, of, you know, how do we look after these in a sustainable manner, and I love the idea. That you were talking about something I hadn't really thought about or heard about before, these bioactive setups for for reptiles, perhaps finish off by telling us a little bit about what's going on in that area.

So it's, it's a relatively recent phenomena, in, I would say, particularly in the in in the reptile husbandry world, where we're talking a lot more about recreating a mini version of what they would er you know, what species would. What different species would experience in their natural habitat. And so what we always have tried to do is replicate something that was satisfactory.

And I would say in the last, you know, the last 3 years in particular. We are doing much more to facilitate that particular conversation. So for example, you know, your bearded dragon, instead of putting on a reptile carpet, for example, and having a place to hide and a heat lamp and a UV lamp, which are all completely satisfactory to a certain extent.

Actually we're talking about creating a, a viiv or a kind of an aquarium set up where we have layers of different types of soils and, you know, moss and plants and, you know, there's a sandy contingent to it and that we're having, you know, insects which, which thrive on different types of soils, for example, being allowed to exist in that environment and propagate. But also allow for that keen balance of, of, of, of, you know, the bearded dragon or whatever, you know, reptile it is to be able to eat those insects. And then they, they, they, and, and so you have, you're, we're building much more of a conversation about how do we make our vis and our setup sustainable.

And what is a beautiful part of that is it means that, especially if you've got a big enough space. That you don't have to do much. It exists on its own and you know, having a variety of, of, of, of tropical plants and a variety of different insects which kind of interdigitate with each other.

And it's such a, a beautiful change and shift away to what again, my first entrance into reptiles was. It's more natural, isn't it? It's a balanced ecosystem.

It is, it is, it's really, it's, it's balanced and it, what it, what it means is that we're creating a lot less waste. What it means is that we are keenly turning our minds to actually looking after plants, which is obviously a really great thing right now. It keenly brings us back to the value of creating a system which is self sufficient.

And you know, if we use our bioactive setups as a kind of small part of our, our value around sustainability around the world, we're actually, we're actually using that as a small reference point. Actually, this is, this is how it's supposed to be, and I feel that people who have bioactive setups tend to be a lot more aware of of the issues around, for example, climate change and waste and, and, and, you know, recycling and, and that is, that's a really good precedent for the future. And I would imagine from a welfare perspective, I as a bearded dragon, I'd prefer the bioactive setup than perhaps the more sterile, you know, everything's there, the animal's not being harmed by heat lamps and so on, but actually is is a very .

Motivating space for that animal to be in. Yes, there's no, there's no doubt about it, you know, brains, as we know, are pretty universal in what they like to do, and they like to be enriched. And even though, you know, we don't have a conception of a bearded dragon and it's showing that it's happy that it's doing things, or it's, it's unhappy, a bioactive setup means that their brains are being necessarily challenged to experience relatively new things compared to what.

You know, they experienced beforehand. And, you know, I would say on average, I'm much happier with the, the awareness and relative awareness, and it's a very subtle topic obviously of, of, of reptiles that come in from bioactive setups than when they're not. And, and I, I feel like, you know, in time there'll be more research into this, but I really wouldn't be surprised if bioactive becomes the only standard as opposed to the best standard.

Brilliant Fabian. I've really enjoyed our chat. I hope you have as well and yeah, really looking forward to to seeing you and speaking with you again.

Thanks very much. Thank you so much, thank you.