Rabbit with crusting lesions on ears

Re: Rabbit with crusting lesions on ears

Mark Rowland — Sun, 21 Oct 2012 15:09:59 GMT

[quote user="bob lehner"]

I'm very impressed - clearly all excellent advice - but I often wonder, reading the responses from the exotics experts, where do you find the clients with such commitment and willing to spend such a lot on their rabbits/GPs/ferrets etc. I'm absolutely no expert in this field, but as a normal GP vet I've seldom met a bunny etc.owner in this league. Am I alone - what do the other GPs out there find ?? Or do the clients wanting/willing to spend a lot just naturally gravitate to the experts ?

[/quote]

Hi Bob,

I thing many practices are missing a trick on this issue, whilst I agree many clients would shy away from bloods, xrays and skin biopsies for crusty ears, I can convince them quite easily that if ectoparasites have been ruled out then dermatophytosis can easily and cheaply be tested, especially as it has zoonotic implications. We have many sorts of client at the practice. Referrals, people who are happy to spend and those less financially endowed. What they all want is value for money, just as the dog and cat clients do. Herein lies a great advert for a bit of exotic cpd as the pet owning demographics have changed and we as a profession have to follow that change. Colleges mostly do not have the time to get the exotic teaching on board which is where post graduation learning plays its part. Clients dont mind spending money if it is spent wisely imo. I would encourage any practice owner to consider tapping into this resource as an extra source of income especially in harder times. I think basic exotics can become a valuable source of extra turnover without any extra special equipment. It actually generates a lot of goodwill too, you will be surprised how many clients with sick post hibernation tortoises will pay for blood samples and its a nice skill for the vs to learn also.

My 2p anyway

Re: Rabbit with crusting lesions on ears

Dagmar Steele — Thu, 18 Oct 2012 08:21:14 GMT

thanks guys, I find that very challenging too and it's just good to hear it's not only the fault of my communication skills :-)

Re: Rabbit with crusting lesions on ears

Mark Holmes — Wed, 17 Oct 2012 22:03:35 GMT

[quote user="Stephen Courtney"]

I find it really hard to cope with the variation in expectation between one client and the next regarding how they want their rabbits/ mice/ rats / ferrets / gerbils / hamsters etc treated.

I think Marie hit the nail on the head, on the whole if someone wants all the stops pulled, for a very important furkid of whatever species, they are likely to gravitate towards a vet who can/ will oblige at the level they want.

Equally clients who see these as £10 easily replaceable pets for small children who have grown up and no longer give a sh*t about their bunny, are hardly likely to go for much more than ivermectin, neglect and then euthanasia if the bunny is lucky

It isn't always easy to tell the difference either. i have had some distraught owners of flystrike bunnies who spend fortunes getting them sorted, educate themselves and become model owners, and the next case someone can't be bothered to treat and expresses surprise that we charge to euthanase, and also to arrange cremations....aargh!

[/quote] And oh can't they get offended if you a) try to find out how they would like you to proceed or b) Suggest something that doesn't suit their perception of what is necessary.

Re: Rabbit with crusting lesions on ears

Stephen Courtney — Wed, 17 Oct 2012 21:56:59 GMT

I find it really hard to cope with the variation in expectation between one client and the next regarding how they want their rabbits/ mice/ rats / ferrets / gerbils / hamsters etc treated.

Re: Rabbit with crusting lesions on ears

Louise6732 — Wed, 17 Oct 2012 20:52:50 GMT

Bob, I find the same to an extent. Most people want the 'quick fix' althought I've just had a rabbit in for 2 nights for mucoid enteritis signs and the hosp and treatment came to about £200 and O' was fine with this. I've also had a rabbit with a foreign body obstruction whose O' paid approx £500 for ex lap and enterotomy (sadly rabbit died, as seems to be the case with foreign body obstruction in rabbits, reading around about it at the time) The owner really impressed me, when I gave him the estimate and prognosis he said 'Well, he's our pet, we've got to take responsibility for him and give him a chance' which I found really refreshing! Some people won't even think that way about cats and dogs!

Louise

Re: Rabbit with crusting lesions on ears

Marie Kubiak — Wed, 17 Oct 2012 20:31:38 GMT

[quote user="bob lehner"]

[/quote]

I think the more dedicated owners do tend to migrate more towards vets with an exotics interest which helps us, plus a lot of my cases are second opinion/referral which selects for a more invested owner, as does having reasonable consult fees to reflect the time taken which are probably higher than other practices for small furries etc. I do certainly still get a depressing amount of clients that want a quick, cheap fix to balance out the ones who will invest though. I find exotics is generally lower turnover overall than cats/dogs so I can run myself ragged while my small animal colleagues do some boosters, the odd Xrays and a couple of sets of allergy bloods and turn over more.

One of the main problems is a lack of insurance options for exotics - rabbits have a few companies that will cover them (some exceptionally bad cover included) but most exotics have only a single company that will insure them and they have low payout ceilings and high premiums which puts people off and means full work ups depend on owners having money readily available. The other is as you say some people just aren't prepared to spend on something that they see has cheap and disposable.

Marie

Re: Rabbit with crusting lesions on ears

bob lehner — Wed, 17 Oct 2012 19:35:59 GMT

[quote user="Marie Kubiak"]If there are possible lesions elsewhere and no other obvious cause then perhaps look at widening the investigation - for atypical rabbit skin cases I tend to do do blood profile, chest Xrays and skin biopsy (normal area and pathological sites both submitted). I would also do skull Xrays (lateral and 30 degree obliques in this case to assess bullae and any dental changes to look for potential cause of pain).[/quote]

Re: Rabbit with crusting lesions on ears

Mark Rowland — Wed, 17 Oct 2012 13:23:40 GMT

I would probably opt for a dermatophyte culture before any more work up if it were me Good luck

Re: Rabbit with crusting lesions on ears

Marie Kubiak — Wed, 17 Oct 2012 13:01:13 GMT

Any companion that could be overgrooming the ears? Any chemicals used near him (disinfectant/ shampoo/aerosols)? What do the ear canals look like as he may just be self-traumatising the pinna if there is deeper irritation. Not eating hay may be an indication of facial pain (middle ear disease being one potential cause that could cause both discomfort on chewing and self-trauma)

If there are possible lesions elsewhere and no other obvious cause then perhaps look at widening the investigation - for atypical rabbit skin cases I tend to do do blood profile, chest Xrays and skin biopsy (normal area and pathological sites both submitted). I would also do skull Xrays (lateral and 30 degree obliques in this case to assess bullae and any dental changes to look for potential cause of pain). Sebaceous adenitis, hepatocutaneous syndrome, lymphoma and thymoma associated dermatis can occasionally present with ear lesions though most have more generalised skin changes.

Marie

Re: Rabbit with crusting lesions on ears

Mark Hedberg — Wed, 17 Oct 2012 12:59:03 GMT

Not a rabbit expert; but I've noted a few rabbits that wouldn't eat hay because either they 1) were eating so much pellet they just weren't hungry; or 2) were basically expected to eat the hay they were sitting/weeing/pooing in all day. (Don't think this has much to do with the ears, just thought I'd throw this out there.)