The clock is ticking on new rules that will require a prescription for livestock drugs that can currently be bought over the counter. This blog from the Beef Cattle Research Council looks at how to prepare and why antimicrobial resistance needs to be on everyone’s radar. The article has been edited for length, but the complete version can be found at www.beefresearch.ca.
If you haven’t done so already, the first few months of 2018 would be an excellent time to develop a relationship with a beef veterinarian.
Starting late in 2018, Health Canada is introducing a couple of important changes affecting the way animal antibiotic products can be accessed by producers. And having an established Veterinary-Client-Patient Relationship (VCPR) will be an important part of a smooth transition.
The key point is, starting Dec. 1, 2018, all livestock producers will need a prescription from a licensed veterinarian before they can buy a medically important antibiotic for therapeutic use in livestock production.
This applies to all beef cattle sectors using antibiotics — cow-calf operators, feedlots and feed mills (and really all sectors of animal agriculture including beef, dairy, hogs, sheep, horses, fish, and even bees). The new policy doesn’t just apply to injectable products, but also includes some boluses and calf scour treatments, as well as Component and Compudose implants.
At the same time, the new policy does not apply to certain antimicrobials such as the ionophores, which are not considered to be medically important in managing disease in humans.
Many of the antibiotics used for animals are already only available through prescription. However, some common products traditionally available without a prescription through farm and feed supply outlets will soon require a prescription. (An example is in-feed products such as tylosin and tetracycline.)
For cow-calf producers in Alberta, products will only be available from a veterinary clinic or licensed pharmacist. Commercial feed mills will be able to manufacture and sell a medically important antibiotic in feed pursuant to a veterinary prescription under current provincial regulation in macro premix, micro premix, supplement, or complete feed formulations. But dispensing details still need to be worked out.
Producers who have established a VCPR— that veterinary/client/patient relationship — with a licensed veterinarian, will be able to obtain a prescription for a given amount of product for perhaps a full year (depending on the circumstance) enabling them to buy it as needed and for use according to advice of the veterinarian.
For example, a cow-calf producer in consultation with their veterinarian can determine, based on their records and herd history, they will likely need X number of bottles of tetracycline (like Liquamycin or Bio-mycin) to treat pink eye, or X number of bottles of Nuflor to treat foot rot throughout the year. A prescription can be written to cover that estimated need and then the producer can buy medication as needed up to the estimated amount, or up to the expiry date of the prescription.
Producers who already have a veterinary/client relationship likely won’t see any change in normal practices.
“I believe this is good legislation and the right thing to do for any industry that produces food,” said Craig Dorin, a veterinarian with Veterinary Animal Health Services in Airdrie. “It is important that antibiotics used in food animals have an appropriate level of regulation.”
Addressing the issue
These changes are being made because of increasing concern about antimicrobial resistance (AMR) in bacteria in animals as well as in humans.
Research indicates AMR is developing in beef cattle, and some antimicrobials used on the farm or in the feedlot are not working as well as they once did. Antimicrobial resistance is also developing in human patients, though there is no compelling evidence that antimicrobial use in Canadian livestock production is contributing to AMR in human medicine.
Reports say as many as 23,000 Americans die annually due to issues related to antimicrobial resistance to drugs and computer forecasts say that by 2050, as many as 10 million people globally could die from issues related to antimicrobial resistance.
Health Canada is seeking to better manage antimicrobial use and hopefully even reduce the amount of antibiotics used in animal agriculture with the aim of reducing or slowing the development of AMR in animal pathogens. It also hopes to demonstrate that products are only used when needed, at the appropriate dose and within the recognized withdrawal times. It will help stem a growing public perception that the livestock industry casually uses high rates of antibiotics without regard for animal, environmental, or human health conditions.
“It’s really about bringing the livestock industry in line with the way antibiotics are handled on the human health side,” said Keith Lehman, chief provincial veterinarian. “You need a prescription.”
No one should be surprised these changes are coming, said Murray Jelinski, a professor in large-animal clinical sciences at the Western College of Veterinary Medicine in Saskatoon.
“Whether anyone thinks it is a good or bad move is really irrelevant,” said Jelinski. “Europe, for example, is already ahead of Canada in this regard, and other countries around the world are moving in this direction — this is really a global movement hence it is incumbent upon Canada to do its part.”
Some have described the increasing rates of antimicrobial resistance (to currently used medicines) and the rise of “superbugs” as “one of humanity’s greatest concerns,” said Jelinski.
Most of the details for cow-calf producers in Alberta have been sorted out, said Dorin.
On-farm feed mixers — with a prescription — can buy micro and macro premixes, supplements, and complete feed from a commercial feed mill or from a licensed veterinarian or pharmacist under current regulation.
Other changes include new restrictions (which came into effect in November) on importing antibiotics manufactured outside of Canada. Producers had been able to import antibiotics and other animal health products under “own use” rules. Now, producers can no longer import medically important antibiotic products and need a prescription to access those products in Canada.
The regulations do allow for producer access to a range of veterinary drugs listed on Health Canada’s List B, which can still be imported by producers themselves for their own use, but not sold. This includes pour-on endectocides and growth implants such as Cydectin, Ivomec, Ralgro and Synovex to name a few. They must be finished products in commercial form, with proper packaging, and registered for use in Canada.
Growing awareness of using products responsibly has resulted in an 11 per cent reduction in the use of antibiotic products in Canada in the past year, said Jean Szkotnicki, president of the Canadian Animal Health Institute.
Producers need to plan ahead for these new rules, said Karin Schmid, beef production specialist with Alberta Beef Producers.
“Producers will need to establish the veterinary-client-patient relationship in order to obtain a prescription and maintain timely access to treatment of their animals,” she said.
They should also talk to their vet about common herd health challenges they may encounter, she added.
“Perhaps pink eye is a common problem at certain times of the year or in certain pastures, for example — so as part of the herd health plan you can anticipate some of those needs and have the prescriptions and medications in place so they are on hand when you need them,” said Schmid.
Having a VCPR and prescription in place are key elements in being prepared.
If a producer discovers on a Saturday afternoon a case of pink eye in an animal that needs to be treated, for example, they won’t have the option to run to a local farm supply outlet and pick up a bottle of penicillin. It also means, a producer can’t just stop in at a veterinary clinic and pick up an antibiotic from staff if there is no veterinarian on duty.
A VCPR doesn’t usually involve a formal written agreement.
But it means the veterinarian knows the operator, visits the farm or ranch to get an understanding of the operation, sees how animals are cared for, and is confident the producer will be responsible in following medical advice and properly use any products as directed. Establishing a VCPR starts with a producer sitting down with a vet to discuss his or her livestock operation and provide some record of animal health treatment protocols. It may or may not involve a farm visit.
The Alberta Veterinary Medical Association has five requirements for VCPR:
- The veterinarian has assumed responsibility for making clinical judgments regarding the health of the herd and the client has agreed to follow the vet’s instructions.
- The veterinarian has sufficient knowledge of the herd through examinations and ranch visits.
- The vet is readily available for followup evaluation or has arranged for emergency coverage, and continuing care and treatment.
- The veterinarian provides oversight of treatment, compliance, and outcome.
- Patient records are maintained.
The producer’s part of the VCPR is allowing the veterinarian to take responsibility for making clinical judgments about animal health, asking appropriate questions, and following instructions. The veterinarian’s part of the VCPR involves making judgments; accepting the responsibility for providing medical care; keeping written records; advising clients of the benefits and risks of different treatment options; providing oversight of treatment, compliance, and outcome; and arranging for emergency care.