By now you’ve surely heard about the Veterinary Feed Directive, or VFD, issued by the U.S. Food and Drug Administration (FDA) and effective January 1, 2017. At the same time, you’re also probably aware of the advertising claims of multiple national restaurant chains touting their “antibiotic-free” food offerings.
The two are not a coincidence, says Mike Apley, Kansas State University professor of veterinary clinical sciences. “We have entered a new era of antibiotic use in food-animal agriculture,” he says. “How much access we have to antibiotic therapies in the future depends largely on our actions going forward from here.”
Why all the fuss?
Much of the concern regarding antibiotics stems from the rising global incidence of antibiotic resistance – antibiotics becoming less effective at killing bacteria or inhibiting their growth because of structural changes in the bacteria themselves. Antibiotics used in veterinary medicine which also are used in human medicine – these so-called “shared use” or “medically important” antibiotics--are the focus of the changes coming on January 1, 2017. Your veterinarian now will have to write a VFD for their use in feed, and a prescription for their addition to drinking water. No extra-label use of medically important antibiotics in feed will be allowed at all.
But Apley is quick to point out that antibiotic resistance is not just a concern for human health. “We rely heavily on antibiotics in veterinary medicine as well, and we want them to continue to work as effectively as possible in animals and people,” he says. He also notes the importance of recognizing that resistance does not necessarily mean there is no available treatment, only that the most common first-choice antibiotic may not work, and therefore it takes longer before one is used which will contribute to a successful therapeutic outcome. “Nonetheless, resistance is real,” he says, “and it does affect both veterinary and human medicine.”
An availability evolution
Resistance was not even on Apley’s radar when he began practicing veterinary medicine in central Kansas in 1987. When he returned to graduate school a few years later, much of his research dealt with antibiotics, but the emphasis was almost solely on treatment. “Our focus of antibiotic use at that time was on improving animal health and performance, without the thought that these valuable tools might have a finite lifespan,” he says.
In the 1980s, human and veterinary medicine had essentially declared victory on infectious diseases. But that began to change in the 1990s, when resistance issues started to surface in human medicine. The tide of ubiquitous antibiotic use began to turn, and animal agriculture became a primary target.
Today, the U.S. livestock industry finds itself essentially protecting its existing arsenal of available antibiotic therapies. Apley believes it is highly unlikely that many, if any, new classes of antibiotics will become available to food animal medicine in the future.
In addition to the new VFD regulations, another recent event changed a longstanding use of antibiotics in food-animal production. As of January 1, 2017, veterinary pharmaceutical manufacturers will have voluntarily withdrawn all of their medically important antibiotic product labels for growth promotion in livestock in the United States. All told, that represents 26 companies and 283 drug labels. The remaining prevention, control, and therapeutic label claims will require veterinary oversight in the form of a VFD for feed uses and a prescription for water uses. Clearly, what Apley describes as the “antibiotic heyday” of the 1970s and 1980s is over.
Still, Apley is adamant that antibiotics are a necessary part of food animal production. “To completely lose access to them would be catastrophic,” he says. Thus, an enhanced culture of responsible antibiotic use and professionalism will be required. For U.S. dairy operations, that likely will entail:
(1) Increased veterinary oversight – Your herd veterinarian of record is not only responsible now for all the antibiotics that are used in your operation, but he or she also is accountable. If misuse happens on your farm, your veterinarian also will be penalized.
That’s one of the reasons why veterinarians are taking the VFD, and antibiotic use in general, very seriously. The veterinary-client-patient relationship (VCPR) also is a highly valuable component of every dairy’s business. “Your veterinarian should be one of your most trusted advisors,” says Apley.
At the same time, he cautions that not every conversation with your veterinarian will be a comfortable one, nor should it be. “A part of a veterinarian’s job is to help the operation continue to evolve and adapt to new circumstances,” Apley says. “In many cases, I think the VFD discussion will help discern how much of an operation’s current antibiotic use is necessary, and how much is habit. Antibiotic stewardship starts with clearly identifying the disease and then doing everything possible to not have to use an antibiotic.”
(2) Case definitions for antibiotic use – Apley believes it is vital for every livestock operation to maintain a list of every drug on the farm, with a definition of how that drug should be used. Protocols for commonly occurring diseases on the dairy should be developed in conjunction with the herd veterinarian, clearly defining the specific course of treatment for each condition.
That practice already is in place at Dairy Dreams, a 2,800-cow facility near Casco, Wis., co-owned by Don Niles. Niles, who also is a veterinarian, says the process of developing case definitions with his entire management team and consulting veterinarians was time-consuming up front. But he wouldn’t want to run a dairy without them now.
“When you have a well-written case definition, you have an instant training tool,” he says. “If we bring a new person on, all of the details of disease treatment already are laid out for them, including recognizing symptoms, the medication to use, treatment length, and meat and milk withdrawal times.”
All health protocols at Dairy Dreams are set up in tables in Dairy Comp 305, which also is used to generate follow-up lists and periodically evaluate treatment success. The case definitions are a valuable risk-management tool, and promote strategic, pre-evaluated antibiotic selection and use – versus a “drug-of-the-day” or “each-employee’s-favorite” mentality.
(3) Alternatives to antibiotic therapy – Over the span of Niles’ 30-plus-year career, he has witnessed a promising evolution in dairy management that has naturally curtailed the use of antibiotics on dairies. “Today, we know a lot more about disease prevention through nutrition, cow comfort and environmental management,” he says. “We also have more tools at our disposal, including vaccines, teat sealants and immunomodulators, to keep animals healthy.”
He predicts practices like selective dry-cow therapy will be embraced by a growing number of dairies as they have fewer existing infections at the end of lactation, and more non-antibiotic tools to prevent new ones.
Like it or not, antibiotic use will continue to be used as a competitive issue in the food-marketing industry, says Apley, and farmers must be wary of how that has an impact on their ability to address infectious disease in animals their our care. But neither food purveyors nor consumer activist groups completely dictate how we can and cannot use antibiotics on dairies – at least not yet.
“The way we in food-animal agriculture demonstrate that we are responsible in the face of regulations will determine our future,” he says. “Right now, agriculture is still in the driver’s seat. We all need to work together to keep it that way.”
Note: This story appears in the January 2017 issue of Dairy Herd Management.