It’s about a relationship

by Sally Colby

When the Veterinary Feed Directive (VFD) was finalized and put into effect in 2017, some livestock producers were concerned that they’d no longer be able to purchase OTC (over-the-counter) antibiotics to treat sick animals.

Those producers were relieved to find that the VFD pertained mostly to medically important antibiotics – antibiotics used in human medicine – that were being used to promote growth and prevent disease. Under the 2017 VFD, antibiotics added to feed would now require a VFD, and antibiotics added to water would require a veterinarian’s prescription. A VFD can only be obtained with a valid Veterinarian-Client-Patient Relationship (VCPR) and requires that all products be used under veterinary supervision and according to instructions.

For the past five years, producers have continued to purchase OTC antibiotics via mail order or from feed or farm supply stores, and for the most part, used them judiciously. Even though OTC antibiotics didn’t require veterinary involvement, producers often contacted a vet to ensure they were treating sick animals correctly.

What some producers may not be aware of is that in September 2018, the FDA’s Center for Veterinary Medicine unveiled a five-year action plan for supporting antimicrobial stewardship in veterinary settings. In 2021, GFI (Guidance For Industry) #263 was published, and included a plan to categorize all antibiotics – injectable, intramammary, topical and oral – for use only under vet supervision.

According to the FDA, the action plan “is driven by the concept that medically important antimicrobial drugs should only be used in animals when necessary for the treatment, control or prevention of specific diseases.”

The goal of the original VFD and the five-year plan is to slow the development of antibiotic-resistant bacteria so that antibiotics used in human medicine remain effective. The background for this action is based on ongoing, extensive research by scientists with the National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) under the CDC. These scientists track and study changes in antibiotic resistance among bacteria that are commonly transmitted via food and water, contact with animals, contact with people and contact with the environment.

Although an individual’s personal risk of becoming infected with resistant bacteria might be low, people can become infected with bacteria by handling or eating raw or undercooked meat or poultry, eating raw fruits and vegetables that have been in contact with animal feces through irrigation water or other means, through contact with food animals and their feces or through drinking water contaminated with animal feces.

The five-year plan means that as of June 2023, antibiotics that have been available without a prescription will now require the producer to work with a veterinarian to obtain appropriate antibiotics. This isn’t all bad. Many producers are already working regularly with their vet and have developed a herd health program that includes regular veterinary visits.

Regular veterinary visits help to establish a basis for treating sick animals. For example, if the herd vet visited a farm in autumn and the producer noted some incidence of pneumonia in cattle housed in a bank barn, the vet would see the cattle and prescribe treatment along with possible management changes. If the producer notices pneumonia in cattle several months later, the VCPR has already been established, and if the veterinarian believes the problem is the same as in the past, will likely prescribe appropriate treatment via a phone call.

Although GFI #263 has been published, a two-year grace period will allow pharmaceutical companies to transition and label antibiotics as “prescription only.” GFI #263 will be effective in June 2023 and will apply to all animal species. Once this GFI is in place, the use of all medically important antimicrobials approved for use in animals will require veterinary oversight.

For those producers who don’t yet work regularly with a veterinarian, now is the time to establish a relationship with a vet – a VCPR. Having this relationship means the vet agrees to treat your animals and you, as the producer, agree to follow the veterinarian’s instructions and keep accurate treatment records. Treatment records are important because they provide feedback for the veterinarian that allows them to better assist the producer in developing a treatment plan and what changes might be made to prevent disease. Remember that vets are also under scrutiny – if a prescription is written and the farmer obtains the drug but doesn’t use it as prescribed, the veterinarian can be responsible for that decision.

Producers should be aware that veterinarians cannot diagnose or treat conditions unless it’s within the context of the VCPR. The VCPR will make it more likely that a producer can obtain necessary medication without a farm visit, but it’s up to the vet to determine whether the diagnosis and treatment can be determined over the phone.

The veterinarian should be licensed in the state where the livestock reside, but this requirement has pointed out a severe shortage of large-animal vets. Some entities have programs in place to recruit large-animal veterinarians to underserved areas in exchange for debt relief for student loans.

Now is the time – establish a relationship with a large-animal vet and engage their help in making herd health and management decisions. You’ll be much better prepared in the event of herd illness.

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