Dairy Pharmacology – When Good Drugs Go Bad :: The Bullvine - The Dairy Information You Want To Know When You Need It

When the headlines scream that yet another drug used by agriculture is deadly …. I must admit that I only continue to read until I discover whether or not it affects my particular herd, family or lifestyle. If not. I let it go. However, I must also admit, that this “what’s in it for me?” attitude hasn’t provided a huge record of success in herd health or personal health. It seems that we always find out the real truth too late. And whose fault is that?

Who is Accountable? Who is Responsible?

Part of the problem is that we are always looking for the information that supports our current status quo. We don’t accept responsibility for managing our own health and cross our fingers that our comfortable routine won’t cause actual harm. However, in my case, there isn’t a lot of scientifically documented evidence that says that copious amounts of coffee, no exercise and daily cheats on the diet are going to add up to good health. Nevertheless, I remain optimistic…at least until after receiving bad news in the doctor’s office. Then, like many, I hope for the pill that will take away the problem and unpleasant responsibility that’s on my shoulders. If one pill works, that’s marvelous! If not, I will take two and, once again, hope for the best!

SO What’s the Bad News in the Barn?

It’s a similar scenario in the barn. Before we invest in changes in our setup, systems or animal health management, we look for the drug that will make it “easy”. Of course there are protocols and procedures to follow. But even that doesn’t ensure 100% compliance, because each situation is different and there can always be human error. If something works! Let’s use more of it!!

Mastitis is a Big Problem. Ceftiofur is a Powerful Answer.

Every now and then a drug comes along that seems to hold all the answers. The antibiotic ceftiofur, which was introduced in 1989, is one of those. It is strong. It has a short withdrawal time. These two features add up to considerable savings for dairy farmers. For some, it means keeping a cow milking longer – and thus preserving her value at the slaughter stage, regardless of whether or not this is beyond the prescribed uses of the antibiotic.

Mastitis is a costly problem. It doesn’t respond quickly to treatment, thus causing additional costs in milk production, vet bills, labor and cow health. Any treatment is costly. And, to date, something 100% effective has not been found.

In practice, administering any antibiotic for several consecutive days is a practice that is used to treat many types of infections. Until recently no antibiotic had been approved and labeled for use beyond three consecutive days. Ceftiofur hydrochloride was given FDA approval for infusing up to eight consecutive days for treating clinical mastitis caused by coagulase negative staphylococci (CNS), Streptoccus. dysgalactiae, and E. coli.

In 2004, Dr. Steve Oliver and his colleagues at the University of Tennessee studied the effectiveness of the antibiotic in three research herds and reported their results in the Journal of Dairy Science. “Ceftiofur proved to be the most effective when it was administered for 8-days, with an overall infection cure rate from all types of pathogens of about 66%. Cure rates for the 5 and 2-day administration times were reduced to about 54% and 39%, respectively. The non-treatment group had an 11% spontaneous cure rate. While ceftiofur is not labeled for treating Staph. aureus infections, the researchers found that the cure rates of infections caused by Staph. aureus were 36% for the 8-day treatment group, but only 17% for 5-day, 7% for 2-day, and 0% for the no treatment groups.”

But Now The Ceftiofur Bad News! Ceftiofur could spawn antibiotic-resistant bacteria

The U.S. Food and Drug Administration cautioned in 2012 that ceftiofur could pose a “high public health risk,” The warning is the FDA’s strongest kind. Twenty three years after approval this warning is issued and we immediately ask, “If this is true, why didn’t we know? Why wasn’t I told? The answer of course, “We didn’t know, and I wasn’t told, because it can take 10 or 20 years or longer for such a problem to appear.” Unfortunately the bad news is double-barrelled in the implications for dairy. First of all ceftiofur is very strong. Secondly, it is frequently used improperly.

These two issues cause a third problem and that is raising serious concerns, “The threat that Ceftiofur could pose to public health.” This particular drug belongs to a class of antibiotics considered critically important in human medicine. The concern is that ceftiofur in animals could spawn antibiotic-resistant bacteria, superbugs that can infect people and defeat conventional medical treatment, even when the drug is used as directed.

The stakes are especially high because the drug is part of a crucial class of antibiotics called cephalosporins. The class includes ceftriaxone, a drug that’s vital to treating pneumonia, meningitis and salmonella infections in children, according to the FDA. The use of one type of cephalosporin can compromise the effectiveness of others in the same class.

“There is a very clear link between ceftiofur use and ceftriaxone resistance,” said Paul Fey, a professor of microbiology at University of Nebraska Medical Center. “We know that ceftiofur-resistant salmonella are clearly ceftriaxone-resistant.”

Are We Getting ALL the Facts?

Question: Are Dairy cows to blame?

Answer: Some 32.5 million head of cattle were slaughtered in 2013, of which about 3.2 million were dairy cows.

Question: Is there full disclosure of all the numbers?

Answer: The residues reported by Reuters represent only one part of USDA’s inspection program and come from the sampling of suspect animals that appear sick or ill as they come in for slaughter.

Question: Are the numbers being selectively reported by both sides?

Answer: Perhaps. The Reuters news states, “Violations involving high levels of ceftiofur in meat rose by 323 percent between 2008 and 2013 – from 98 violations to 415. (of the 33 million slaughtered?) Last year alone, more than a quarter of all 1,634 residue violations were for ceftiofur – more than four times its share of violations in 2008, the analysis shows. Violations involving ceftiofur have continued at a similar rate during the first half of 2014.”

Roger Saltman, Group Director, Cattle and Equine Technical Services at Zoetis Inc., doesn’t dispute those numbers. But he says the residues reported by Reuters represent only one part of USDA’s inspection program. “The numbers Reuters reports comes from the sampling of suspect animals that appear sick or ill as they come in for slaughter. Reuters did not report residues from USDA’s statistical sampling program, which identified only three antibiotic positive animals from healthy animals during the first six months of 2014. And none of those positives were for ceftiofur.”

Nevertheless, Antibiotic Residues in Meat Are Still a Concern

Who is responsible? The producer of the product. The user. The regulators. The dairy farmer. While fingers can be pointed at each one, it’s probably most realistic to say that anyone connected with ceftiofur use needs to step up to the responsibility plate. False or misleading advertising is the start. Then, ceftiofur should not be used for unethical prolonging of a cows life merely to get her off the farm and recoup some money. Of course, the administering of Ceftiofur must be for the right reasons and under the right usage. Regulators need to be more conscientious. While there is huge expense to testing, there is enough information and scenarios to target where and when better information, and protocols need to be identified. Stronger fines might also act as a deterrent. With regards to Ceftiofur, the Reuters report does suggest USDA inspectors are doing a good job of scrutinizing suspect cows. The odds of finding a residue by marketing questionable animals—resulting in a condemned, valueless carcass–go up substantially.

Recognize the Risks

Every drug has risks. As with most things, whether it’s good or bad depends on the circumstances. For instance take aspirin. — if you have a bleeding ulcer, it’s a bad idea. If you have a headache, or are taking a low dose on the advice of a physician for cardiovascular health, it may well be a good idea. Taking the whole bottle at once is bad in any case.

This may be the case behind the Reuters report that. “Time is money for a farmer with a gravely ill cow on his hands. Interviews with farmers, veterinarians and field researchers, and a review of FDA warning letters, show ceftiofur has been administered to animals by farmers eager to keep a sick animal alive long enough to sell it.”

Act on the Information – Antibiotic Residues in Meat Are Still a Concern.

Meat withhold times are four days for Excenel RTU and Naxcel, and 13 days for Excede. When given in the muscle or subcutaneously, ceftiofur does not transfer into milk and thus there is no milk withhold. Dairies can’t lay all the blame at the feet of the manufacturer of the drug. Saltman urges dairy farmers to strictly follow drug treatment protocols and withhold time. “Before putting her on the truck, make sure you know what you’ve treated her with and that she has completed the full withdrawal time,” he says. “And if she still appears sick, don’t market her.” It’s unknown if extremely sick animals might metabolize antibiotics differently. “The dairy farmer should ask, ‘Would I put her on my own table?’” says Saltman. “If the animal is sick, the answer is no” says Saltman. “The animal should not be marketed until she’s healthy. And if she doesn’t recover, she should be humanely euthanized on the farm”

The Bullvine Bottom Line

When it comes to the Bottom Line, there is no Bottom Line. It’s one thing if you misuse a drug through lack of information or understanding. It’s another thing entirely if you make choices for personal gain or unethical reasons. That goes below a bottom line to completely unethical. Regardless of who is the “most” right or wrong, if you are anywhere on the spectrum between production to consumption, you must share the responsibility. And the appropriate ACTION!