Introduction 0:03
For the love of goats! We are talking about everything goat. Whether you're a goat owner, a breeder, or just a fan of these wonderful creatures, we've got you covered. And now, here is Deborah Niemann.
Deborah Niemann 0:16
Hello, everyone, and welcome to today's episode! This is a very timely episode, because we're going to be talking about antibiotic use in goats today. And, you may know that coming up within a couple of weeks, you are not going to be able to get a lot of antibiotics over the counter anymore. So, we are joined today by Dr. Kevin Pelzer, a Professor of Large Animal Clinical Sciences at the Virginia-Maryland College of Veterinary Medicine at Virginia Tech. Welcome to the show again, Dr. Pelzer!
Kevin Pelzer 0:30
Thanks for having me!
Deborah Niemann 0:50
So, I'm really excited to talk about this, because there's a lot of misunderstandings and stuff about exactly how things are going to change. And, I found out you did a presentation or two on this already, so I thought you'd be the perfect person to talk about this.
Deborah Niemann 1:04
So, this is not the first time that antibiotics have been moved from over-the-counter to needing a prescription. I know when I got started with goats in 2002, you could go to the feed store or go online and buy pretty much anything—always felt like, anyway. You could buy a wide variety of antibiotics and other drugs for goats. And then, in 2017, things started to change a little bit. So, can we start off by talking about how things changed in 2017, and specifically what became by-prescription-only in 2017?
Kevin Pelzer 1:38
So, like you said in regards to changes within drugs and accessibility of drugs to producers, in 2017, the Food and Drug Administration asked for drug companies to voluntarily remove from their drug label "Use for growth promotion and feed efficiency" on antibiotics that were being placed in the feed for that specific reason. The amount of antibiotic that was placed in that for growth promotion and feed efficiency is quite different than the amount that we utilize when we're trying to treat individual animals. So, it was a small amount. But, a large number of animals were receiving antibiotics for the benefit of growth promotion and feed efficiency. And so, in 2017, the FDA asked—as I said—the drug companies to voluntarily remove that from their label. And, the reason being is that antibiotics can only be placed in feed if the label is approved for that. So, if all the drug companies took the "for growth promotion and feed efficiency" off the label, then people would not be able to use those antibiotics for that. And so, it'd be illegal to do so.
Kevin Pelzer 3:11
And, the reason the FDA did this was because of the increased amount of antibiotic resistance among bacteria. And, the main way that antibiotic resistance develops is because the bacteria are exposed to those antibiotics. So, just to see what effect that new rule had, in 2015, about 21 million pounds of antibiotics were fed to animals or were placed in animal feeds. Go forward 6 years, in 2021 there were 13.2 million pounds of drugs administered through feed. That's still a lot of antibiotic. But, that's almost a 40% reduction.
Kevin Pelzer 4:05
And so, the other aspect that the FDA was trying to address was having oversight of how these drugs were used. And so, along with that 2017 movement, the FDA established what is referred to as the "veterinary feed directive." So, any antibiotic that currently is placed in feed needs to be under the direction of a veterinarian. So, what veterinarians are required to do is to designate a specific group of animals to receive a certain amount of antimicrobial product in the feed to be fed for so long for specific conditions. And so, that was the veterinary feed directive. So, that pretty much took care of addressing oversight for antibiotics being fed to animals.
Kevin Pelzer 5:04
What had not been addressed was oversight in regards to the use of antibiotics via injection or infusion or orally by individuals without any oversight of the use of those drugs. And so, the FDA then went and said that they were going to remove over-the-counter antibiotics. And essentially, what they're doing is, kind of the same way they did with the feed-grade antibiotics, they're asking the drug companies to remove the over-the-counter statement for antimicrobials. And, all those antimicrobials will now be labeled as many drugs—for example, Nuflor or Baytril or Zactran—"by prescription order of a veterinarian" on that label. And, as a result, June 11 is when that will go into effect in the United States. Canada hasn't had over-the-counter antibiotics since I believe, like, 2017 or 2015. And, California removed over-the-counter antibiotics back in 2018 on their own, so maybe the rest of the country is catching up with our international neighbor, as well as with California.
Kevin Pelzer 6:32
One thing that I point out is that even though these drugs aren't supposed to be sold over the counter after June 11, the FDA has said that they will allow the antibiotics that companies have on hand to market those drugs after June 11. And, they've extended that out to, like, 6 months for that. So, just because June 11 is the kind of drop-dead date for these over-the-counter antibiotics, you may still find some on store shelves after that date, as long as they don't have that new label saying "for prescription only."
Deborah Niemann 7:18
Oh, that's good to know! So, some of the drugs that are going to be affected now are what exactly?
Kevin Pelzer 7:26
So, the drugs that are going to be affected are drugs that are considered of human health importance. So, penicillin is one of those. So procaine penicillin G, the long acting Dura-Pen—or the benzathine penicillin—will be removed. Oxytetracycline, which probably is the biggest seller of all these antibiotics, is tetracycline, which is Liquamycin or LA-200, Noromycin 300, Bio-Mycin 200, as well as the Terramycin Scours Tablets. So, those will become prescription, as well. And then, there's the sulfa-based antimicrobials, like sulfamethazine and sulfadimethoxine, so Di-Methox and SulfaMed, both the oral and the bolus forms of that compound. Tylosin, which is Tylan 50 or Tylan 200. And then cephapirin, which is the product that's in mastitis tubes ToDAY and Tomorrow. So, those are the essentially the main drugs that are going to be prescription-only. Things like Kopertox, and the vitamins, the fly sprays, and those kinds of things will still be available; it's only the drugs that are antibiotics that are going to be removed.
Deborah Niemann 8:59
So, somewhere that people might be a little bit confused here—because if you've been at this for a while, you know that, like, sulfa drugs were used for coccidia for a while. But, that is also an antimicrobial, whereas CORID is strictly used to treat coccidia. So, CORID is not used in human medicine. So, it will still be on the market, correct?
Kevin Pelzer 9:20
Yes. I'm glad you brought that up, because amprolium is a product that I commonly tell people to go to the feed store to get to treat coccidia, and that, as you said, is not an antibiotic, and so it's not of importance in regards to bacterial resistance. So, CORID will still be available, just like the vitamins and the fly sprays and the various other topicals that you find at the feed store.
Deborah Niemann 9:48
Okay. And, one of the things that may be challenging for some people—because, I know I get a lot of emails from people who say, "I don't have a vet near me. If I did, I'd call them, which is why I'm asking you." And, I always just tell people, like, right up front, like, "You really need a vet," because there are going to be times that you are going to need diagnostics, or you're going to need a surgery, or you're going to need a prescription drug that you will need a vet for. And so, this is not anything new, that people really need to find a vet that will see goats that knows how to treat goats, but now even more than ever, people really need to establish a veterinary-client-patient relationship. Can you explain exactly what that means?
Kevin Pelzer 10:30
Yeah. So, the veterinary-client-patient relationship is a relationship that exists when a veterinarian has recently seen and is personally acquainted with the keeping and care of the animals by virtue of an examination of the animals and/or by medically appropriate and timely visits to the premises where the animals are kept. So, this relationship can be developed in two ways. Essentially, the veterinarian looks at individual animals—for whatever reason—and develops a relationship with the client, or the veterinarian has been out in either an advisory capacity or providing herd-health-type procedures, like ultrasonography, or maybe de-horning baby goats, castrations, and that type of thing. So, any of those events would count as a veterinary-client-patient relationship.
Kevin Pelzer 11:35
And, essentially what the FDA wants to accomplish is that the veterinarian will know the type of animals you have, kind of your goals for production, where your animals go in regards to marketing, or your products in the case of milk and cheese. And, they have a sense of, you know, your capabilities of administering antimicrobials and keeping the appropriate records for those drugs. So, it's not like tetracycline and penicillin are going off the market; it's just that you'll have to now have a prescription from a veterinarian to purchase those.
Kevin Pelzer 12:21
And, I doubt if, like, Tractor Supply or Southern States... Rural King might be out in the Midwest, but I know there are other national kind of, like, Farm & Fleet stores where people were getting antibiotics previously. My impression is that those companies—because in order for them to distribute antimicrobials, they will have to have a pharmacist on staff. My impression is that they're not going to do that. And so, what you're going to wind up doing in regards to acquiring antimicrobials is you can still go through the drug catalogs or the pharmacy catalogs, such as Jeffers, or Valley Vet, Mid Maryland, those kinds of things.
Kevin Pelzer 13:13
So, the big downside to that is that if you get in an emergency situation, it's going to take 2 to 3 days in order for you to get your antibiotics with the prescription. So, that's one thing that kind of needs to be considered here when you're talking with your veterinarian how you're going to deal with these new rules and regulations.
Deborah Niemann 13:40
Exactly. And, I know the temptation for a lot of people now might be to just go online and stock up on everything that they can still purchase over the counter. Do you want to talk about why that is not a great idea?
Kevin Pelzer 13:54
Well, there's a couple of reasons why that's not a good idea. One is from a veterinary standpoint—and again, this goes with the FDA wanting some oversight in antimicrobial use—is that when you buy a bottle of penicillin to treat something, will the penicillin actually be effective for the condition that your animal has? So buying, you know, a bunch of tetracycline or penicillin at this point in time—when might you use that? And, is it going to be of benefit for the animal and then, for you? So, you might wind up buying three bottles of penicillin and never have a condition in which penicillin is effective, and so you've wasted your money on three bottles of penicillin.
Kevin Pelzer 14:45
The other thing is, is that there is a shelf-life or an expiration date on these antibiotics. And, usually the expiration date is somewhere between 6 months and 9 months, depending on the product. So, you know, stockpiling a lot, it may be good for 6 months, but then you'll have some drugs that lack potency after that period of time.
Deborah Niemann 15:12
Another thing I think is kind of interesting, too—and I think this may be where antibiotics got overused a lot. We talked about this a little bit in the episode that I did with Dr. Pesato on pneumonia in goats. And, that is that most people don't understand that it is only very specific antibiotics that work on very specific conditions or bacteria. Like penicillin. I have seen people in Facebook groups say, "Oh, don't even try penicillin, because everything's resistant to it." Whereas the reality is, penicillin only kills bacteria that have a cell wall. So, if the bacteria that this goat has doesn't have a cell wall, the penicillin is not going to work. And, your average person isn't equipped to figure out exactly which antibiotic is going to work in which situations.
Deborah Niemann 15:59
And, Dr. Pesato even talks in that episode about why penicillin should not be the first drug you reach for if a goat has pneumonia. Do you want to talk a little bit more about how specific antibiotics are used for very specific things? Like, you can't just go, "Oh, I'm gonna have a bottle of LA-200 in my cabinet and use that for everything that my goat has or gets."
Kevin Pelzer 16:20
Right. So, bacteria come in several different forms. And, as you mentioned, in regards to the cell wall, there's what they call "gram-positive" bacteria and "gram-negative" bacteria. So, penicillin pretty much was designed to work against gram-positive organisms. So that's, like, your staphylococcus and your streptococcus, that type of thing. The gram-negatives are organisms like E. coli, Salmonella, Pasteurella, which penicillin has very little activity against. And then, with tetracycline, tetracycline has been used so much that there's antibiotic resistance to the drug itself. It may have worked in the past, but now it doesn't work. And then, the other aspect is that—I'm sure what Dr. Pesato is referring to is that—oftentimes pneumonia in goats is caused by mycoplasma. And, there are very few drugs that work against mycoplasma, because their cell wall is very different compared to the cell walls of the gram-positive and the gram-negative bacteria. So, if you give them tetracycline for mycoplasma, it's not going to do any good for the animal. And, there are specific drugs that we could use for that condition.
Deborah Niemann 16:23
Yeah. He was saying... I forget what the drug was. But, he was saying that the best drug to treat it would actually be a drug that is already available only by prescription. So, if you have a goat with pneumonia, you really should be seeing a vet to get the best antibiotic, even prior to June 11, you know? That the over-the-counter ones just didn't work that well for it.
Kevin Pelzer 18:10
Yeah. From a veterinary standpoint, there's positives and there's negatives about this change in acquisition of antibiotics. The positive is that you will need to work with your veterinarian, and what that provides you with is using the correct drug at the correct dosage for that specific condition. And, if that is done, the outcome for those cases should be very good. Whereas before, like you said, people would give this, that, and the other, and now the condition is 3 or 4 days old, and then goes to the veterinarian, and then we would prescribe the appropriate drug. But, because the condition has gone on for so long, now that drug is not going to be effective, because of all the damage that's occurred in the first 3 or 4 days. So, I think animals will likely get more timely treatments, and the treatments will be more directed against the conditions in which they have.
Kevin Pelzer 19:18
The negative aspect of this from a veterinarian standpoint is, like you mentioned, people just don't have a veterinarian. And so, that's going to increase our caseload. The time that we have to work with individuals. The other aspect of that is the prescription writing. And then, the third thing is that producers won't be able to go to the store to get penicillin or tetracycline, if that condition that they have would be treatable. You know, I get calls, like, on the weekends, and somebody is saying that, you know, they have a goat that's cut its leg, and it's pretty deep, and they've cleaned it out, which is great. I ask if they've been boostered for tetanus recently, and if that's the case, then they don't need to get that at Tractor Supply; they don't need a booster. But, they probably need antibiotic, and if it hasn't gone into a joint or a tendon, penicillin or tetracycline would be an appropriate drug. But now, they won't be able to get that on the weekend. So, I think that's going to be a drawback in that respect.
Deborah Niemann 20:35
I always tell people that just because you don't have a vet within 15 minutes like you do for your dog or cat, doesn't mean you don't have a vet in your area. For most of my goat-owning years, I have not had a vet within an hour of me. And so, there were times I had to drive a couple hours to get to the university vet hospital. But, even though I do I have vets closer to me now, I still sometimes choose to drive to the Veterinary Teaching Hospital at the University of Illinois. Because, if I have an animal that's really, really sick, I know they've got the lab. They've got the diagnostics. They've got the specialist and everything. So, I really feel like that goat is going to get the best treatment possible, as quickly as possible, if I do that.
Deborah Niemann 21:15
So, we did a whole episode on utilizing veterinary teaching hospitals. And so, if you haven't heard that episode, and you're thinking like, "I don't have a vet near me," check that out. Because, a lot of people do have one within a couple hours. And, I've driven there even with goats in labor; I've driven there for three C-sections. And, I was always glad I did—especially with the third one, because she never would have survived a barn C-section, because she had a lot of complications, where she really needed all of that special—
Kevin Pelzer 21:41
Tertiary care.
Deborah Niemann 21:42
Yeah, exactly, and all of the humans around her, monitoring her and everything. So, definitely check out that episode if you have not heard that yet.
Deborah Niemann 21:52
Is there anything else that people need to know about this change before it goes into effect, or even after it goes into effect?
Kevin Pelzer 22:00
I don't believe so. I think the biggest thing is to establish a client-patient relationship with your veterinarian; get lined up as to, you know, your veterinarian can certainly fax you or email you a prescription; and then, you know, organize where you might purchase drugs. That's one thing that I've heard, is that "Veterinarians are gonna make all kinds of money off of these drugs." And, the truth is, we're not. In fact, handling drugs is not one of the things that we enjoy doing. And, a lot of clients already, you know, buy prescription drugs through pharmaceutical warehouses. And so, I would suspect that people will just start buying them through those channels. But, those channels need to be developed and, you know, figured out where you're going to actually purchase your products from going forward.
Deborah Niemann 23:04
Great! Well, thank you so much for joining us today and explaining this. Hopefully, it clears things up for people, and they've got a better idea of what they need to do going forward.
Kevin Pelzer 23:12
Thank you. Hopefully, there'll be more veterinarians out there. And, maybe I can convince some of my small animal students, that I always tell them that they're responsible for treating and relieving animal suffering, and that includes farm animals, and that they'll be willing to look at the sheep or the goat that's brought to their clinic.
Deborah Niemann 23:35
I really hope so! Every time I take a goat into University of Illinois, I'm always asking the students, "Are you planning to do farm animals? Aren't goats awesome?" Thanks so much!
Kevin Pelzer 23:44
Thank you!
Deborah Niemann 23:46
And that's it for today's show. If you haven't already done so, be sure to hit the "subscribe" button so that you don't miss any episodes. To see show notes, you can always visit ForTheLoveOfGoats.com, and you can follow us on Facebook at Facebook.com/LoveGoatsPodcast. See you again next time. Bye for now!
Transcribed by https://otter.ai
