Introduction

Exotic animal practices range from small business animal clinics to large-scale enterprises fully dedicated to exotic animal medicine, and the latter potentially encompass the care of animals in pet stores, wildlife rehabilitation centers, and even small zoos. At first glance, establishing a business relating to exotic animals may appear to be a daunting process, but with a basic medical knowledge and experience in standard veterinary practices, any veterinarian can develop a flourishing client base. Clearly, a postdoctoral education and advanced training are both highly beneficial, but making a profit largely depends on understanding client needs. This presentation will focus on how to establish a successful exotic animal house call practice for private owners and animal facilities, alike.

Client Source & Publicity

Internet

Exotic animal owners come in many incarnations: the young family member with a starter hamster, educated hobbyists, professional breeders, and of course, the keepers of private zoological collections. As with domesticated animals, there are fan pages on the internet for nearly every species of small (and not so small) mammal, bird, reptile, amphibian, and fish. A common conversation thread on these websites involves recommendations by a veterinarian that regularly examines or treats specimens of the species in question. While those owners residing in major cities may be fortunate enough to find such specialists in their area, there remains a relative paucity of veterinarians in greater metropolitan regions, leaving many owners virtually without options. Introducing yourself as an exotic animal veterinarian via the above websites is thus an excellent way of establishing contact with the community at large (i.e., a greater client base).

Trade Shows, Contests & Club Meetings

Across the nation, reptile expos may be the most commonly occurring animal shows, but shows pertaining to various other taxa abound. These often permit veterinary clinics to rent a table during the event in order to promote their businesses relating to the group of animals being sold and exhibited. There are, in addition, many regional clubs (e.g., bird clubs, herpetological clubs) seeking lecturers to speak before the group. Attending shows and lecturing to clubs allows veterinarians to connect directly with prospective clients.

Breeding Facilities, Zoos, Aquariums, Museums & Wildlife Rehabilitation Centers

There exist a surprisingly large number of private (and even public) zoos (i.e., menageries) and small business animal breeders that seek veterinary services only on an "as needed" basis. This strategy may satisfy the needs of some facilities, but most would likely benefit from more standardized care (e.g., preventative medicine protocols, assistance with local, state, and federal compliance) as well as from the establishment of an informal veterinary clinic. In fact, monthly, or even weekly, all-inclusive visits are appreciated and sought after once initiated. Private facilities may generally be found via internet searches; however, others require more intensive research to locate. Although these facilities may not be in immediate need of medical assistance, alerting them of your existence can lead to future business opportunities.

Emergency Clinics & Exclusive Small/Large Animal Clinics

Specialty and emergency hospitals appear to be opening everywhere, very few with exotics departments, however. Seven such hospitals exist in the core of the New York City metropolitan area, but only two offer care of exotic animal patients. Unfortunately, the majority of small animal clinics in New York City refer these cases to specialty hospitals, ultimately having to turn these clients away with seemingly no practical options. Having a veterinary contact trained in exotics medicine to which these cases may be referred, is greatly appreciated by the referring facility as it affords clients a sense of relief.

Research Facilities

As mandated by federal law, university and independent laboratories using animal subjects (e.g., primate colonies) must have veterinary supervision. Larger facilities often have a veterinarian(s) on staff, but smaller facilities regularly contract a local veterinarian, thus risking a higher turnover rate due to lack of interest. There are also opportunities to serve as the veterinary member of IACU committees for a small stipend.

Standard Publicity

Other strategies for establishing one's client base are as standard as basic publicity, which may be accomplished via advertisements, a webpage, e-mail communications, or simply word of mouth. Additionally, leaving business cards or flyers at local establishments (e.g., pet stores) also helps.

House Call Service

A veterinary practice can assume the form of a simple house call service or the latter may be offered as a supplemental service by a standard veterinary clinic. While "house calls" are common for large animal veterinarians, for whom they serve a practical purpose, these are far less common in small animal practice. In either instance, however, it may be prudent to offer a house call service for multiple reasons.

Small Pet Owners

 Environmental review. A majority of concerns pertaining to the ownership of small exotic animals relates to husbandry. Firsthand inspections of the enclosure and ambient factors (e.g., location, noise level, weather exposure, etc.) will allow the veterinarian a much better assessment than one based simply on the client's description. Offering professional counsel on husbandry guidelines will only improve the quality of life of the animal long term, while saving the client a substantial amount of money, otherwise spent on unnecessary diagnostics.

 Observation of natural behaviors. Some degree of abnormal responding will be elicited by the presence of the veterinarian. With appropriate acclimatization, however, natural behaviors by the animal may still be appreciated, as well as client-animal interactions.

 Minimizing transportation stress. Exotic pets are more inclined to be stressed when they are removed from their natural environments. Potential stressors include exposure to suboptimal (micro) climates, noise, other animals (i.e., not excluding conspecifics), novel or noxious odors, etc. Additionally, there will be less stress upon the owner who may have otherwise had an uncooperative patient for transport.

 Avoidance of nosocomial infection.

 Intimate client rapport. Clients who invite the veterinarian into their homes can establish stronger bonds with this individual, than they would in more conventional clinic environments. While this may have both positive and negative effects, it practically ensures that the client will continue to use his or her services and refer these to other prospective clients.

 Multiple cases. Exotic pet ownership often entails keeping multiple animals. When one patient is seen, owners are inclined to have their other pets examined as well, thus allowing for potentially developing conditions to be identified, which the owner may have overlooked.

Small Zoos, Breeding/Research Centers, and Other Like Facilities

These facilities are best serviced from scheduled veterinary consults, as this will facilitate examining multiple patients and circumvent difficulties inherent to transporting multiple and/or large specimens. Moreover, these facilities lack the staff coverage to allow for an employee to leave the premise for a veterinary appointment.

Equipment and Supplies

Downsides to a house call practice for small exotic pets include the inability to offer patients such medical services as mobile radiology, surgery, immediate lab testing, or hospitalization. For this reason, it becomes imperative for the practice to become associated with a clinic. Barring cases necessitating the above, the majority of house calls for small exotic pets require only a basic supplies pack comprised of (but not limited to) the following: Gram scale, ophthalmoscope with nasal speculum, beak speculum, rubber spatula, basic instruments (hemostats, needle driver, forceps, scissors), stethoscopes, alcohol, Nolvasan®, Betadine®, bandaging, gauze, cotton swabs, syringes and needles, Microtainer® tubes, blood tubes, cool pack, slides, cover slips, scalpel blades, injectables (antibiotics, anti-inflammatories, emergency meds, calcium, pentobarbital, analgesics, topical ointments, dextrose, etc.), Dremel, environmental thermometer, hygrometer, UVB meter, simple water quality test kit (for those seeing aquatic patients).

Those practices providing services to larger facilities will benefit from maintaining a small clinic or storage room to store supplies and equipment. Anesthesia and imaging units, oxygen generators, centrifuges, and microscopes can all be held on site or as part of a mobile van service.

Supply Companies

Customer accounts required by veterinary medical supply companies can be established in the individual veterinarian's name or business, and deliveries may be received at the practice or private residence. When servicing zoos, menageries, breeding facilities, or not-for-profit institutions an account with delivery options to these locations is convenient.

Support Staff

While it may certainly be possible for the exotic animal house-call practitioner to manage cases without the assistance of support staff, if his or her services can be afforded, a technician should accompany the veterinarian on all cases. The majority of concerns relating to exotic pet welfare are, however, husbandry related, and much of the visit will be spent discussing environmental issues. In general, animals examined will be fairly healthy and will require minimal handling, but when it is required, (e.g., for venipuncture), it is often possible to train owners in safe and effective means of patient restraint. Most large facilities, on the other hand, are staffed with individuals well versed in these techniques.

Labwork

Nearly all diagnostic laboratories offer services for exotic animal testing, and many, having multiple local branches, will make sample pick-ups on an as-needed or even daily basis from the location specified. For practices not affiliated with a clinic, it is usually possible to set up pick-ups at the practitioner's home or at the various facilities he or she services. Individual accounts may also be established for breeding facilities, zoos, aquariums, etc. Some laboratories also provide lab results on smart phone applications for easy access.

Record Keeping

Many electronic record keeping and point-of-sale systems (i.e., with applications for smart phones and tablets) are readily available, but these may represent a significant initial investment that is largely unaffordable for a small scale practice. However, the advent of smart phones, tablets, cloud systems, and applications that facilitate credit card payments has helped advance many small businesses. Patient records generated on word processing software can be stored in a cloud-based server and accessed via all forms of electronic media, as needed. Images of lab work, environment, and patient progress can also be embedded in these documents. The goal is for the practitioner to have ready access to patient records at all times. This type of record keeping may not afford a singular location for accessing all patient and/or client information, but it is significantly more affordable and convenient.

Euthanasia and Carcass Disposition

Due to the emotional significance to the client, at-home euthanasia is one of the most highly sought-after house call services. As long as appropriate protocols are followed, the euthanasia of an exotic animal is a rather standard procedure. However, handling of the remains will require some forethought and proper planning, should the client elect to use a crematory or professional burial service. The former may offer at-home pickup, which can be timed to coincide with the completion of the procedure. Alternatively, the practitioner himself can transport remains to an affiliated clinic for these to be retrieved there. Crematory and burial service providers offer veterinary clinic as well as direct client prices.

Licensing

State License

State licensing is dependent on the range of the practice. This will also afford the practitioner the option to serve as a relief veterinarian for more established facilities.

DEA License

With the passing of the Veterinary Medicine Mobility Act (2014), only one DEA license is required, irrespective of the state of primary practice or licensure.

USDA License

While not expressly required, a USDA license is undoubtedly beneficial as it is necessary for tuberculin testing and for signing export permits.

Pricing

Rates will vary depending on location and the veterinarian's discretion.

Visits to Exotic Pet Owners

As with clinic charges, the cost for a visit represents the main source of income; in New York City the average cost runs between $90 and $125. To compensate for travel time and expenditures and for the convenience of an at-home visit, the author charges $175 within the borough of Manhattan. For visits that entail travel times in excess of 30 minutes, a charge of $250 is assessed, while for visits requiring 1 hour or more, $350 is assessed. If the veterinarian is affiliated with a clinic, then prices are more likely to reflect the standard clinic prices. In comparison, prices for independent mobile veterinarians are substantially reduced given less overhead. However, it should be noted that prices set by mobile veterinarians should not seek to undercut stationary practices.

Day Visits to Animal Facilities

As most large facilities are not-for-profit and inherently generate a large volume of cases, these will expect some form of discount. Hence, it is often more efficient to charge a day fee based on a compromise between what the facility can afford and what the veterinarian can subsist on. Exotic animal veterinarians charge between $250 and $1000 for house calls depending on their overall caseload. Half-day charges can also be assessed at the veterinarian's discretion. Instituting a flat-rate charge means the facility should expect to purchase their own medical supplies to be made available to the veterinarian during his or her visit.

Support Staff

Procedural assistance from support staff is sometimes necessary, and thus, an additional charge may be assessed to compensate for their services. However, most clients will opt out of paying for support staff, if the nature of the case/procedure and abilities of the client are such that the client can assist the veterinarian. Moreover, without a staff member who is readily available, it may be difficult to secure assistance on an as-needed basis. Support staff compensation should be reflective of the additional convenience they provide to the client. The author assesses a $50 fee per staff member accompanying him to small exotic pet appointments. No charge is assessed for animal facilities.

Communication via Phone

Most veterinary facilities employ a receptionist that can field client calls and concerns and will encourage them to schedule appointments. For smaller operations, however, the veterinarian may need to take on these responsibilities. Most clients are respectful of a veterinarian's time and services, but some may seek "free" advice, purposefully avoiding scheduling appointments. Hence, a charge should be assessed for phone conversations with frequent callers, and for those that regularly extend beyond 5 minutes or are clearly intended to circumvent the system. The author charges $90 per hour (i.e., $1.50 per minute). A similar rate may be assessed for animal facilities as these are often receiving your best advice and/or verbal directives utilizing the supplies they carry. Some mobile exotic animal practitioners charge up to $250 per hour for such communications, especially for those facilities less frequented.

Alternative Forms of Communication

Clients also have the option of sending short e-mails and even text messages. On occasion a client will send a highly detailed written communication, abounding with questions they expect answered in short order. Lawyers will charge for the amount of time spent reading and preparing responses to these types of communications, and while medical professionals are more philanthropic in this regard, assessing fees should be at the veterinarian's discretion.

Accepting Payment

For mobile practices, the advent of smart phones and tablets (and associated applications) has made taking and processing payments simple and efficient. Any small business can now take credit card information and send receipts, for instance. Additionally, these media services afford a convenient way to log all payments (i.e., cash, check, or credit), and to have data compiled and subsequently analyzed.