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The most common reason that
antimicrobial drugs are given to beef cattle is to treat or
control respiratory disease, although other conditions (such as
foot rot, pinkeye, wooden tongue, diphtheria, etc.) are also
treated, to help the animal fight off bacterial infection. Kelly
Lechtenberg, DVM, PhD (consulting veterinarian at Midwest
Veterinary Services in Oakland, Nebraska) specializes in bovine
medicine and has worked with many issues regarding use of
antibiotics. “The BRD (bovine respiratory disease) complex is a
syndrome that is usually a bacterial infection combined with
viral infection and various stress factors,” he says. Viruses
are not affected by antimicrobial products, but antibiotics are
usually given to the sick animal to treat or control bacterial
infections. Commonly used
products today include Draxxin (Pfizer), Nuflor
(Schering-Plough), Excede (Pfizer), Baytril (Bayer), Micotil (Elanco),
LA-200 (Pfizer), Tetradure 300 (Merial), Naxcel (Pfizer). It is
important to recognize that all of these products, except for
LA-200, must be used by or under the direction of a veterinarian
and all require a prescription. There are also some over-the
counter antimicrobials that are still used by stockmen and they
include penicillin G, sulfas, tylosin, various versions of
oxytetracycline and erythromycin.
Draxxin (tulathromyicin), is one
of the newer products and is a long-acting drug that has been
very useful for combating respiratory disease. It is labeled for
use both as a therapy and as a control (to prevent disease). “We
can legally administer this product to cattle that we as
veterinarians believe are at risk of developing disease,”
explains Lechtenberg. For instance, it can be given to stressed
animals after a long transport, upon arrival at their
destination.
“Draxxin carries a bovine
respiratory disease label and could be used at weaning if calves
are stressed, especially in large cow-calf operations where even
though it’s a closed herd large groups of calves may be
co-mingling—not from different sources but from different
ranches in their own operation. There might be significant
trucking and stress moves,” he says.
People ask, “‘How long after I
administer Draxxin can I be comfortable that we still have
therapeutic levels in the lung, or when should I have to
re-dose?’” Lechtenberg’s reply: “In my hands, the duration of
effectiveness for this drug is at least 10 days.” If an animal
has not responded adequately to my first therapeutic regimen, I
re-evaluate my diagnosis and then if I feel that additional
treatment is necessary, I usually switch drugs and go to a
different class of antibiotics. This is not a universally held
opinion, but it has served me well,” he says.
“In the same drug class (macrolides)
we also have Micotil (tilmicosin). It’s been around longer, and
is also a long-duration therapy product (at least 3 or 4 days).
One cautionary note with Micotil is that it has more human
safety considerations,” he says. Micotil can be fatal to humans
if accidentally injected. This is especially important for the
cow-calf operation, where the stockman may be putting a syringe
in a saddle bag or taking the drug to treat one calf—often
grabbed in the pasture or crowded into a gate corner or wherever
you can get hands on the animal—without ideal restraint
conditions. A feedlot operator, by contrast, will be putting the
animal in a treatment facility where there’s less risk for
struggle and accidental injection of a human. It is important to
realize that Micotil can be used safely, and Elanco has provided
very specific instructions for doing so.
Erythromycin is another macrolide
class antibiotic, but it isn’t used as often because it is very
irritating to muscle tissue and requires daily administration.
“Due to its inflammatory effect on the muscle, it is my opinion
that there is no place for injectable erythromycin in modern
cattle therapy,” he says.
Phenicol class drugs are potent,
broad spectrum antibiotics that are important tools for
antimicrobial therapy. Nuflor (florfenicol) is the
representative of this group that is labeled for use to treat
BRD and foot rot in cattle. “Nuflor’s effective duration of
activity in my experience is at least 4 days when given at the
highest label dose,” says Lechtenberg.
With respect to respiratory
disease, the main question stockmen or feedlot cowboys ask, for
any of these drugs, is how many days should I give the drug to
work before I decide to change due to lack of response? “First,
it is important to confirm the diagnosis and make sure that we
have realistic expectations of therapy. With all other questions
answered and all appropriate supportive care provided, I’ll give
Draxxin and Excede at least a week (up to 10 days), Nuflor 4
days and Micotil 3 days,” explains Lechtenberg. It is important
to understand that there can be value in leaving cattle alone to
adapt to their pen and feeding conditions without being
excessively irritated over zealous therapy. It is very, very
important that your veterinarian work with you in designing
treatment protocols, which have many considerations such as
this.
The cephalosporins are another
class of drugs, introduced for cattle therapy about 20 years
ago. These include Naxcel, Excenel and Excede. “Naxcel and
Excenel are shorter acting versions of ceftiofur than Excede
(about 1-2 days depending on the regimen) but a wonderful
product in respect to residues. The ceftiofur products have
relatively short slaughter withdrawal times. They are very good
for respiratory disease and foot rot. Treating foot rot is one
of the big uses for cephalosporins because this keeps your
slaughter options open for adult cows,” he says. If an older
animal gets foot rot and you want to try therapy, but realize
that you might have to butcher or sell the animal, you won’t
have to wait so long on withdrawal time.
Another class of antibiotics is
the fluoroquinolones, which includes Baytril (enrofloxacin) and
A180 (danafloxacin). “These are different variations of this
class, and both can be very effective. It is important to
realize that these are treatment only drugs. No use of these
products for prevention or control (or any extra-label use) is
legal,” he says.
“Baytril and A180 have some
restrictions, which producers need to remember. They carry
warnings on the label, saying it is illegal to use them in any
extra-label fashion, such as for baby calf diarrhea or for
control of BRD,” explains Lechtenberg.
All of these newer drugs require
a prescription from your veterinarian. You should not be using
them without advice from and consultation with your vet. The
only drugs you can legally purchase over the counter without a
prescription (from a feed store, catalog supply company, etc.)
are penicillin, some sulfas, tylosin, and the tetracyclines.
“There is some talk that this will change, but at this point in
time they can be purchased over the counter,” he says.
“When your veterinarian is setting up a metaphylaxis program to
treat stressed cattle before they get sick (if they feel that it
is appropriate for your situation,) and deciding whether to use
Micotil, Nuflor, Draxxin, Excede, or oxytetracycline, they will
take various risk factors and herd history into consideration.
If a particular operation is considered to be at risk for having
cattle suffer from Mycoplasma pneumonia, it is likely that a
product will be selected with proven efficacy against M. bovis.
Mycoplasmas do not have a cell wall, so selection of a product
that inhibits the synthesis of a cell wall as its mode of action
will not likely be selected,” explains Lechtenberg.
If the calf is slipping
backward—not making progress in recovery, you should work with
your veterinarian to re-evaluate the diagnosis. He or she will
likely start by working through some of these questions:
- Is this in fact respiratory
disease or does the calf have other issues?
-
Is
the infection primarily viral in nature? If so, the antibiotic
is fine to use (to keep bacterial load down) but the real
problem is viral disease. In that instance, changing
antibiotics won’t do much good.
-
Is
the disease condition too chronic to reasonably expect
resolution? In newly weaned calves that are still on the
ranch, this is generally not the problem, since the stockman
will usually be dealing with a calf that’s sick for the first
time (unless they are detected after an extended period of
illness). In that instance, you generally expect the response
to be pretty good.
The Old Reliables
Most ranchers are very familiar with the traditional drugs that
have been in use a long time, like sulfa boluses, long-acting
oxytetracycline, penicillin, and injectable tylosin. “There are
still some appropriate applications for these products, however,
in many cases; more effective therapies exist with new products
to treat the same infections. In many cases the effectiveness is
similar to several years ago, but in other situations, the new
products are simply superior,” he says.
“Many farms or ranches have not
had the pressure experienced by large feeding operations that
are always bringing new cattle in, with a lot more pathogens
than you have on the home farm. With antibiotics we are trying
to support the animal in its fight with disease, even though
they will primarily succeed or fail on their own ability to
fight off the infection,” says Lechtenberg.
Some of the older, less expensive
products still do have a place. If they still work on your
ranch, there’s no reason to not use them. If they don’t work
very well, then you can switch to the newer, more expensive
drugs. “The rule of thumb in the feedlot world is that we shoot
for about an 85 to 90 percent success rate (response to therapy,
in the animals treated). In the cow-calf world, however, this is
not good enough, but to expect 100 percent response rate is
unrealistic. In the cow-calf environment, regarding respiratory
disease, if you are getting 95 percent success in response to
therapy, this is great, and I wouldn’t go changing antibiotics.
We expect some cattle to fail, and the first time you have a
calf that needs re-treated doesn’t mean you had antibiotic
failure,” he explains.
“Your veterinarian should be
involved in this process—for diagnosis and treatment
recommendations. Generally speaking, if the cattle are
responding well to an inexpensive program, with low relapse
rate, there’s no need to change just because there’s a newer
antibiotic available,” he says.
One of the newer formulations of
oxytetracycline is Tetradure 300. “This is injectable
oxytetracycline that contains 300 milligrams per milliliter,
compared to 200 mg/ml products such as Biomycin 200, LA-200, and
generic equivalents. The higher concentration in the formulation
results in higher concentrations and longer duration of
concentration when administered at the same volume to the
animal,” he explains.
The drug companies have focused
on several things in creating various products, not only looking
at the spectrum of activity (the types of bacteria the drug will
kill) but also putting the drug into carriers that don’t require
excessive volume. “The characteristics of products that
Lechtenberg prefers are:
- Safe to animals
-
Safe
to the people using the drug
-
Tissue friendly (no or minimal injection site reactions)
-
Highly effective (low failure rate)
-
Subcutaneous route of administration
-
Low
volume
-
Low
viscosity (easy to administer)
Tylan-200 (tylosin) is still available (Elanco). “When given
intramuscularly it is very irritating to the tissues. There are
some programs that still use a significant amount of tylosin
intravenously. The IV usage is extra-label. The most common use
of that drug, however, is in feed to prevent liver abscesses,
and it is sometimes used in a salt/mineral product for pinkeye
control. There’s also a powder foirm used for pinkeye treatment
in baby calves,” he says.
“Sulfas are used in the form of
boluses for baby calf diarrhea, boluses for pneumonia and foot
rot, and injectable formulations for pneumonia and foot rot,”
explains Lechtenberg. It is very important that the injectable
sulfa available for cattle be administered intravenously,
according to the label.
There are many options, today,
and more choices for selecting a product that fits a specific
need. “When I graduated from veterinary school we only had the
penicillins, sulfas and tetracyclines. This is why there were
many products used extra-label and products were compounded in
veterinary clinics and pharmacies. Today, we have numerous
products with excellent safety and efficacy data.”
Penicillin is still used, but one
of the biggest concerns about penicillin is that it generally
needs to be given in higher than label dosage to be effective.
Even though you can purchase it over the counter, in order to
use it extra-label you need to have a prescription from your
veterinarian. Penicillin is frequently used above label
directions for certain indications (foot rot). There are other
infections, such as clostridial infections (e.g., blackleg)
where you need to consult you veterinarian for some
substantially altered dosing regimens. Any time that penicillins
(or other OTC antibiotics) are used in an extra-label fashion,
they also require the prescription of your veterinarian, even
though the product can be purchased without a prescription.
“Penicillin is safe. But when used off label, someone must be
responsible for residues,” he says Thus you need to work with
your veterinarian for proper withdrawal time for the higher
dosage.
Costs
Some of the newer drugs are more expensive than the older ones.
Categorically, the newer generation products will cost more,
running 2 to 3 times higher than the older products, partly
because less volume or fewer doses are needed. The new products
try to compete cost-wise on a therapeutic regimen.
Lechtenberg explains, “All of
these drugs we’ve talked about so far are injectable. When ever
the label allows, the route of injection should be
subcutaneously, in keeping with NCBA’s guidelines for beef
quality.”
“We must be ever conscious of
providing supportive environmental care and be ready to
euthanize cases to prevent suffering if required. Your
veterinarian will be able to help establish criteria and
recommended humane procedures for euthanasia if necessary.”
GIVING INJECTIONS
Most antibiotics, vaccines, anti-inflammatory drugs and some
vitamins and minerals are given to cattle by injection, so it is
important to know how to administer them properly. Always follow
label directions and/or your vet’s advice for giving any
injectable product regarding dosage, route of administration and
injection site, timing (if it should or can be repeated), etc.
Improper use of any injectable product may be ineffective at
best, or dangerous/life threatening at worst.
Most vaccines and antibiotics are
given intramuscularly (IM) or subcutaneously (SubQ). Some
medications are given intravenously (IV). The animal should be
adequately restrained before you administer any type of
injection. If an animal is moving around, it’s difficult to give
the injection; the product may be wasted or the animal may be at
risk if not properly injected.
Use a clean needle and syringe of appropriate size for the
injection. If using a single dose syringe, select a small one
for a small injection and a larger one for a large dose. It’s
easier to measure accurate dosage for a small shot with a small
syringe. For a large dose you need a larger syringe to
accommodate the larger volume.
Injection Sites
For vaccines, IM and Sub Q injections should be given in the
triangular mass of muscle on the side of the neck. The
acceptable area starts about 3 fingers’ width behind the ear,
extending down to a few inches in front of the shoulder, staying
away from the top of the neck (which contains a thick ligament)
and the bottom of the neck where windpipe, esophagus and jugular
vein are located. An alternative choice for SubQ injections,
especially on small calves, is the area of relatively loose skin
behind the shoulder blade.
For antibiotics, the neck is a
preferred location (whether the product is to be given IM or
SubQ). If a large IM dose must be given and there’s not enough
area on the neck to absorb all the injections (since the product
must be split into multiple sites no closer than 4 inches apart
if the total dose is more than 10 cc, to have adequate tissue to
absorb the medication), an alternative site is the back of the
thigh. Also, if more than one product is being given at the same
time, the sites should be at least 4 inches apart.
Most shots should be put into the
neck, to avoid injecting into parts of the body that will
eventually become important cuts of meat. Any scarred or damaged
tissue can be more readily trimmed from the neck than the rump,
for instance, at slaughter. If there’s scar tissue (gristle) in
the neck it’s not as critical, since the neck muscle is usually
made into hamburger. Today there are also some new long-acting
antibiotic products that can be injected under the skin on the
back of the ear (being careful to avoid the major veins), to
avoid damage to any meat. In future, injections may become
easier and safer, without use of needles. New devices are now
being tested that will administer injections through intact skin
by use of compressed air.
The rump is no longer acceptable
for injections, even though these thicker muscles are much
better for absorbing an injection, particularly if a large dose
of antibiotic must be given. Many types of injections
occasionally create scars or an abscess, which would damage the
best cuts of meat if put into the rump. It’s better to put an IM
injection into the neck, splitting a large dose into 2 or more
sites if necessary. If an animal needs multiple injections or
repeat treatment, vary the injection sites on subsequent
injections.
Sometimes it’s a tradeoff between
what might be ideal from a carcass standpoint and what’s
practical or best for the animal. Due to the large volume of
some antibiotic injections or a need for multiple treatments in
the course of a severe illness, it may not be feasible or humane
to put all injections into the neck. That area can become so
sore and swollen that a calf might not want to raise his head to
nurse, or any animal might be reluctant to lower the head to eat
or drink. Stress of discomfort can diminish effectiveness of the
treatment, making the animal slower to recover. Your first
concern is to save the animal. If both sides of the neck are not
adequate to absorb all the IM injections, the back of the thigh
can be used, putting the injection at right angles to the leg
(less risk of hitting the nerves that run down the back of the
muscles).
Intramuscular Injections
IM injections are given with a needle long enough to go deep
into the muscle. For an adult cow you need a needle at least 1.5
inches long and 2 inches is better—especially for a large dose
such as an antibiotic product. Use a 16 gauge needle; it’s large
enough diameter to go through a cow’s thick skin without bending
or breaking. Don’t use anything larger than 16 or there’s more
chance for tissue damage and for the product leaking back out.
For a calf use a smaller needle; 18 gauge and 1 to 1.5 inches
long is best. Diameter is determined by gauge size; the smaller
the number the larger the needle.
The biggest mistake people make
when vaccinating cattle, especially when running a lot of cattle
through the chute, is not taking time to do a good job. Hurried
work and improper injection may result in some animals not being
adequately vaccinated (if some or all of the product leaks back
out), and also increases the risk of tissue damage, abscesses,
reactions, etc. To reduce chances of leakage after the
injection, keep the needle inserted for at least 2 seconds after
the injection, before removing it from the muscle. Another way
to prevent leakage is to pull the skin taut across the injection
site with one hand while you inject with the other, then release
the skin after you remove the needle. The skin then moves over
the hole and closes it. You can also rub the injection site
briefly afterward to help distribute the product within the
muscle and reduce the pressure so it’s less apt to ooze back
out.
When using a trigger-type syringe
for IM shots, it’s easy to thrust the needle into muscle and
pull the trigger. When using a smaller or disposable syringe,
detach the needle and press your hand firmly against the skin to
desensitize the site so the animal won’t jump when you insert
the needle, then thrust it in quickly and forcefully. A new,
sharp needle always goes in easier and causes less pain and
damage than a dull one. If the animal jumps, wait until she
settles down before attaching the syringe to the inserted needle
and giving the injection. If the needle starts to ooze blood,
meaning you’ve hit a vein, take it out and try a slightly
different spot. Never inject an intramuscular product into a
blood vessel.
Subcutaneous Injections
Originally, SubQ injections were used because a particular
product was highly irritating to muscle tissue or designed for
slower rate of absorption. Today, however, due to concerns about
carcass quality (trying to avoid IM shots, where possible) more
injectables—including some antibiotics as well as vaccines—are
being approved for subcutaneous use and no longer must be given
IM. When you have a choice, according to label directions, it’s
best to inject the product under the skin rather than into
muscle, for less tissue damage. IM shots are more likely to
develop a serious abscess if a needle is dirty. An infection
introduced by a SubQ shot is merely beneath the skin and an
abscess more readily breaks open to drain.
For a SubQ injection, lift a fold of skin on the neck or
shoulder where skin is loosest, and slip the needle in between
the skin and muscle. If using a trigger-type syringe, aim it
alongside the animal so the needle goes under the skin and not
into the muscle. For a small calf, it may be easiest to give a
SubQ injection under the loose skin of the shoulder, and if
there’s any local reaction it won’t make his neck sore (and
hinder his desire to nurse).
Giving injections SubQ rather
than IM allows you to use a shorter needle (¾ inch if using a
trigger type syringe, or up to 1 inch if using both hands to
tent the skin and slip the needle underneath) so it’s less
likely to bend or break. In the confined space of some chutes,
insert the needle at an angle so you can use a one-handed
technique with a syringe gun, rather than both hands to tent the
skin. There’s less risk of getting your hands injured (jammed
between the animal and the chute) or accidentally hitting
yourself with the needle, if you can do it one handed.
Intravenous Injections
Some medications are more effective (acting faster and more
readily absorbed) if given IV. Some are very irritating to
muscle tissue and must be given IV. It’s not difficult to give
IV injections, but they must be done properly. Chances for
problems are greater, as is the speed with which a serious
problem may develop, so you must know which products can be
given IV (follow label directions) and know what you are doing.
Large volumes of fluid or medications given too swiftly can put
too much load on the heart, and some drugs speed up the heart.
Heart rate should be monitored when giving fluids or certain IV
medications, and rate of administration adjusted accordingly.
Any large vein will work for an
IV injection, including the large veins under the tail, the big
milk vein ahead of the udder on a lactating cow, or the jugular
vein on either side of the neck (located in the groove above
windpipe and esophagus). A large needle (at least 16 gauge and 2
inches long or longer) works best for adult animals.
For IV injections, needles and
any other equipment (syringe or tubing) must be sterile. The
animal must be well restrained so it can’t move around during
the procedure. If using the jugular vein, find it and press down
on it with your fingers or fist to build up pressure (between
your hand and the animal’s head) so the vein stands up and is
easier to inject. Still pressing on the vein, insert the needle
into it at a point between your hand and the animal’s head, then
move the needle a little forward (inside the vein) parallel with
the neck. If blood flows freely from the needle, this shows it’s
in the vein and you can then attach your syringe (or tubing, if
giving fluid).
The most common problem is
pushing the needle too far, clear through the vein and out the
other side. Sometimes the animal moves and the needle slips out
of the vein. Don’t just assume it’s in the vein just because you
see some blood. Blood will flow rapidly and steadily from the
needle if it’s actually in the vein. Make sure the needle stays
in the vein when you give the injection or administer the fluid.
Injecting some products into tissues around the vein can cause
severe irritation and stress (and sometimes death, depending on
the drug). If the needle slips out of the vein while giving
fluid the tissues around the vein will start to swell. If the
needle slips out of the vein, take it out and start over. If
giving fluid, which means the needle must be in the vein awhile,
it’s best to use an IV catheter, which is longer than a needle
and more flexible, and stays in the vein better.
Needles
Always use a sharp, sterile needle. Use of disposable needles
ensures the needle will be clean and sharp, but avoid those with
plastic hubs because they are more likely to break. Use proper
diameter for the job; too large and it allows leakage, too small
and it may break or slow the procedure and more pressure is
needed to inject the material through it (never try to put a
thick product through a small needle). If it’s too long it may
bend or break. Too short and it may not deliver the product into
proper location.
Needles should not be reused
unless they’ve been boiled between uses. Exceptions are when a
large number of cattle are being vaccinated at once. In this
instance, care must be taken to make sure the needle stays clean
and sharp during multiple uses. Injections should never be put
into dirty hide (covered with mud or manure). Make sure the area
to be injected is clean and dry. Thrusting a needle through wet
or dirty skin will take contamination with it, creating risk for
an abscess at the injection site. It’s always better to
vaccinate cattle when they are dry, rather than wet from rain or
snow. Even if you are using the same needle multiple times on
several animals, always use a clean sterile needle for refilling
your syringe; never insert a used or dirty needle into the
bottle or you may contaminate the contents.
If a needle gets dull or dirty after being used on several
animals, exchange it for a new one. Needles are designed to cut
into the skin, not puncture it. After you’ve used a needle on 10
or more animals, it starts to dull and develop a burr on the
tip. Once it’s dull, you need more force to put it through the
skin, producing more tissue damage. Instead of cutting through
the skin, a dull needle punctures it and folds a small piece of
skin under, possibly carrying dirt or bacteria with it. If a
needle starts to get dull or gets a blunt tip from being bumped
on the chute, discard it for a new one, even if you’ve only used
it on one animal.
Always discard a needle if it
becomes bent. Bending weakens it and it may break. You don’t
want it to break off in the animal. Make sure the needle is
still attached to the syringe when you finish the injection. On
the rare occasion one breaks off in an animal, it may be
sticking out and you can grab it. Otherwise, mark the site so
your vet can surgically retrieve it—and do it as soon as
possible. A needle shaft can migrate several inches within an
hour, working deeper into the muscle or traveling laterally
under the skin. When working cattle, have a container by the
chute for disposal of used needles.
Some of the gun-type syringes
have flexible ends to minimize the risk for bent or broken
needles. If you use a trigger type syringe, make sure it’s easy
to use and well lubricated for quick ease of motion, especially
if you have small hands. The easier and faster you can give an
injection, especially if the animal has any room to move around,
the less likely you’ll end up with bent or broken needles. Make
sure you have good access to the injection site and your hand or
syringe/needle won’t be jammed into the bars or front of the
chute if the animal lunges forward or backward. Many of the new
squeeze chutes have access doors at the neck area or a neck
extension that holds the head and neck still while you are
trying to give an injection.
A Local Veterinarian’s Perspective
Certain illnesses and disease conditions in cattle are caused by
bacteria, and stockmen generally treat these with antibiotics.
Some types of antibiotics kill bacteria and others inhibit their
growth. Use of the proper antibiotic can help the sick animal
fight the infection. The important thing is knowing when an
antibiotic would be helpful (or not) and which drugs might work
best for certain conditions. This is why it is crucial to work
with your veterinarian for proper diagnosis and treatment.
Jeff Hoffman, DVM, raises cattle
and has a veterinary practice near Salmon, Idaho, a ranching
area where his clients are mainly cow-calf producers. Choice of
an antibiotic when an animal is ill should always be a case by
case situation; there are no hard and fast rules for what works
best. “We basically use antibiotics in beef animals for 3
purposes—prophylaxis (preventative medicine), metaphylaxis (a
combination of treatment and prevention, as when a group of
stressed calves arrive at a feedlot after a long transport, and
all of them are mass treated upon arrival), and
therapeutic—actual treatment of an illness. So you need to have
a plan about what you are doing,” he says.
“Most over the counter drugs
(penicillin, tetracyclines and some of the sulfas) list on the
label what they can be used for so you need enough knowledge to
know what you are treating. All the newer drugs require a
prescription to obtain, so you must be working with your
veterinarian anyway, on diagnosis and treatment. This is the
whole idea behind prescription drugs. An adequate label (to
cover everything it might be used for, or stipulations regarding
proper use) can’t be written,” he explains. In order to use a
prescription drug there also has to be a valid
doctor/client/patient relationship. The veterinarian must
diagnose and prescribe, before he/she will put a drug into the
client’s hands to treat the animal. Otherwise, these drugs are
not legal for stockmen to use.
“The 2 main classes of
antibiotics are bacteriocidal (that kill pathogens) and
bacteriostatic (that inhibit their growth). Bacteriodical
products include penicillin, the cephalosporins, aminoglycocides,
peptides, and trimethoprim. Bacteriostatics include the
tetracyclines, chloramphenicol (which cannot be used in food
animals), the macrolides, sulfonamides and tylosin,” says
Hoffman. Drugs from these 2 classes generally should not be used
at the same time. Some products can be used effectively
together, such as two bacteriostatic products (like tetracycline
and long-acting sulfa boluses, for treating pneumonia or foot
rot), because they are synergistic and work better together.
“But if you mix a cidal and a
static, they tend to cancel each other out. If the bacteria are
growing very slowly or not at all (due to use of a
bacteriostatic drug), the bacteriocidal drug won’t work to kill
them,” he explains. Thus you have to know what you are doing, or
follow your veterinarians advice on which drugs to use.
Another factor to be aware of
whenever you use antibiotic products is residues and observing
proper withdrawal time before the treated animal is sold or
butchered. Different products have different withdrawal times,
and the time frame is also contingent upon dose. If you overdose
the animal, withdrawal time would be longer than stated on the
label. It is illegal to sell an animal before an adequate
withdrawal time has elapsed, and any carcass containing drug
residues will be condemned.
“In our region, cow calf
operations are fairly isolated and not having a lot of cattle
coming in from other regions. For the most part I rarely use
antibiotics, and when I do I generally stick with the cheaper
traditional over-the-counter products. They work just as well as
the newer, more expensive products,” says Hoffman. There hasn’t
been as much problem yet with resistant strains of bacteria, and
the older products still work. It’s not like a feedlot, with
cattle intermingling from several sources.
“If antibiotics haven’t been
abused on a ranch and there are no resistance issues, the older
products work fine. In most cases, depending on the situation,
pneumonia can be adequately treated with LA-200 and sulfa, and
this is what I’ll use for the first line of attack. If I have a
herd-wide outbreak where I know the cattle are stressed and I
know they have other problems going on, I have at times gone
through and treated everything with Micotil, to head it off. But
usually on an individual case by case basis I don’t jump for the
big guns,” he explains. And in the majority of cases, he knows
the herd health and knows the cattle have been vaccinated,
covering all the viral diseases.
First of all, when dealing with
any disease condition, you need to figure out whether you are
dealing with bacteria or a virus, and if the herd health
management is good, and you know that a viral outbreak is less
likely. The herd husbandry makes a big difference in the health
of the animals. If stress levels are kept low and there’s a good
herd health program, there’s much less need for use of
antibiotics.
“Except in rare situations, I
almost never use antibiotic in scouring calves anymore,” says
Hoffman. Supportive care, like giving adequate fluids and
electrolytes, is more important. In some cases he will use
antibiotics, depending on the situation, but years ago a person
automatically gave scouring calves pills and a shot. He stopped
doing that some years back because it didn’t make that much
difference.
The animal has to fight off the
infection; the immune system of that individual animal is what
determines whether it can recover or not. Antibiotics merely
help buy time for the animal to mount its own defenses. The
state of the animal will also be part of the determining factor
regarding which antibiotic you choose. “In a really stressed,
immunocompromised animal, you’d want a bacteriocidal antiobiotic
that will kill the bacteria, because the body isn’t as able to
fight them off,” says Hoffman.
“Antibiotics by themselves are
never going to cure the problem. You are just helping tip the
scales in the right direction. This is why people with AIDS die.
If the body doesn’t have a viable immune system, no matter what
you do, that animal will die. Antibiotics by themselves won’t
cure the disease.” This is why it’s important to have good
health conditions, with proper nutrition (including adequate
trace minerals) and a healthy immune system, and a good
vaccination program to stimulate immunity.
Good supportive care can also
help tip the scale in the animal’s favor. “Banamine is helpful
in a case of pneumonia (and approved for this use), because it
decreases the incidence of lung lesions. It also reduces fever
and inflammation and makes the animal feel better,” he explains.
If they get back on feed and will eat and drink and get their
strength back up, they can fight off the disease quicker.
Regarding which antibiotic to use
in a specific case, he says the only way you absolutely know is
to grow a culture and do a sensitivity test. “Then you know
exactly what that bug is and can test it with different
antibiotics to see which one works best. You also have to know
whether it’s a drug that will get to the target organ (such as
the lungs, or wherever the infection is located),” he says.
Every situation is not ideal for figuring this out, however.
Usually you don’t have time to grow a culture before you start
treatment (the animal may be dead before you get the results),
so the veterinarian chooses something he/she thinks might work
in the meantime. A culture can help guide your decision in the
future if you might have multiple cases in that herd, however.
“You need to have enough knowledge to know that what you are
growing in the culture is the cause of the infection, and not
just a secondary bacterium that just happens to be there, too,”
says Hoffman.
Thoughts From a University
Professor
Dr. Geoffrey Smith, North Carolina State University, says there
are several good antibiotics effective against pneumonia-causing
bacteria. “This is a huge market for drug companies and there
aren’t any control trials done by independent researchers to
show that a certain drug works the best. All we have is drug
company data. There are 5 or 6 products that I consider good.
Some work better in some situations, and others work better in
other cases. The ones I use a lot are Micotil and Nuflor, but
you should not use Nuflor in calves less than 30 days of age
because it tends to make them scour. It’s hard on the GI tract,”
says Smith.
“Baytril is fairly good and some
people use it for pneumonia in calves. Another good one is A180
(Danafloxacin). It’s about the same as Baytril but it
concentrates in the lung a little better. In our region it’s
been about half the price of Baytril, so I use more of it than
Baytril. Slaughter withdrawal time is only 4 days for A180,
which is a lot shorter than some of the other drugs,” he says.
“Draxxin is the newest product
and the good thing about this drug is how it concentrates in
lung tissue and stays there for about 8 to 10 days. The down
side is cost,” he says. The big market for it is in feedlots;
they have a lot of respiratory disease and use a lot of
antibiotics and have more total dollars at stake with each
animal lost. Feedlots use it in large quantities and can get a
better price break than veterinarians can get, says Smith. But
eventually it may become more affordable for the cow-calf
producer.
“With any drug, we need to
monitor how the calf is doing and if it’s not getting better
within a few days we need to give something different,” he says.
Cost Sampling at a Local
Clinic
Costs of drugs will vary from region to region and from time to
time. Here is what the most commonly used antibiotics are at the
Blue Cross Veterinary Clinic in Salmon, Idaho, and the cost to
the client on a certain day in January, 2008 (costs can vary
with each new order, however):
- LA-200 500 ml. $53.00
Baytril 100 ml. 95.00
Nuflor 100 ml. 64.00
Draxxin 100 ml. 350.00
Tribrissen tablets (100) 21.00
Abscesses & Scar Tissue
An abscess will usually show up as a lump, a few days after the
injection. It may grow larger then break and drain. If it
doesn’t break on its own it should be lanced and drained and
flushed. An even greater problem, however, is an abscess deep in
the muscle, since it may not be detected until the animal is
slaughtered. Scar tissue from a surface abscess can result in
significant carcass trim, but a deep abscess may contaminate the
meat around it and it must be trimmed even more drastically.
Even a poke into muscle with a
clean needle without injecting anything leaves a small scar and
a tough area in the meat. Sterile scar tissue in the muscle
after a shot can still be there months or years later.
Injections given to a calf may create lesions that must be
trimmed at slaughter 2 years later or even a dozen years later
when a cull cow goes to market. These sites contain more
connective tissue and fat than normal muscle, and the meat may
be less tender in an area up to 3 inches around the lesion—a
piece of meat the size of a grapefruit.
Reactions
When you give any kind of injection, always keep in mind the
possibility of an adverse reaction. These problems are most
common if a product is given in overdose or inappropriate
location. For instance, a product might be safe when
administered SubQ but fatal if injected into a blood vessel. A
few animals are sensitive to certain products and will react
even if the injection is given properly. The reaction may be as
mild as local swelling at the injection site that subsides in a
few days, or may be serious and life threatening if the animal
goes into shock.
Temporary swelling is usually
nothing to worry about, but if you inject the neck too close to
the shoulder, swelling makes it hard for the animal to walk.
That shoulder can’t be moved forward without discomfort. Some
types of vaccine are notorious for causing local swelling, and
some animals react more than others. To avoid making the animal
lame, put a neck injection well ahead of the shoulder, closer to
the head.
A more serious type of reaction
occurs when an animal is very sensitive to the product being
injected, producing a severe allergic response (anaphylaxis).
This may result in constriction of air passages and difficult
breathing. The animal may go into shock, collapse, and die.
Signs of severe hypersensitivity reaction may develop within 10
to 20 minutes or longer. Usually the more severe the reaction,
the sooner it occurs.
When using any injectable
product, keep an emergency antidote on hand, and know the proper
dosage to give. You may never need it, but if you do, swift
injection of epinephrine (adrenalin) and dexamethasone (a
steroid—safe for a non-pregnant animal) will usually reverse the
condition and enable the animal to recover. Always observe
cattle after vaccinating (or any other injection) and check them
for at least 2 hours for any signs of shock. If a certain animal
ever shows a serious reaction to a particular product, do NOT
give it again to that animal. A second exposure usually produces
an even greater reaction in the already sensitized animal, and
it may die.
Using any animal health product
in a way not specified on the label (at higher or lower dose,
more frequent intervals, in different location or route of
administration, or in a different species than intended) is
illegal without a veterinarian’s prescription. Even if it’s not
harmful to the animal, there may be more risk for residues. A
drug intended for another species (such as a non-food animal)
may leave residues in meat since withdrawal times have not been
determined. Detectable residue at slaughter is a violation that
results in condemnation of the carcass.
There are situations, however,
when a vet will prescribe a product in an off-label use for
certain purposes or to treat an unusual condition. This is
acceptable, according to the FDA, only if there is no approved
drug already labeled to treat that condition or if treatment at
recommended dosage or location would not be effective. There
must be a valid veterinarian/client/patient relationship for
this to be legal, which means the vet has a good working
relationship with the client and has seen and diagnosed the
animal and agrees to take responsibility for making a judgment
regarding health and treatment—and the client agrees to follow
the vet’s instructions. A record of any off-label treatment must
be kept, and withdrawal time before marketing for slaughter must
be extended in the case of some products or overdoses, with the
time determined by the veterinarian. |