Each day, you and your employees work hard to keep your cows healthy and productive, to provide them with the best care when they are sick and to avoid mistakes that could lead to violative drug residues. Over time and without critical review, those best intentions could result in practices that might not be the best or might even be illegal. That’s what three veterinary student interns, supported by Zoetis Inc., observed when they assessed health management on 105 dairies.
Using a tool developed at Washington State University as part of a project funded by the U.S. Department of Agriculture, the interns observed the diagnosis, treatment and record-keeping practices for mastitis, metritis, pneumonia and lameness of 80,000 cows. They compared what they observed with stated and recorded drug use, as well as reviewed drug labels to assess the appropriateness of therapies and completeness of treatment records.
These dairies all had ongoing relationships with their veterinarians and believed they had good records. With an average herd size of 860 cows, the study group reported a mean milk production of 82 pounds per cow and bulk tank somatic cell count of 186,000 cells/mL. They could easily be called “well-managed” dairies. But the findings identified opportunities to improve health management practices and aid in drug residue avoidance.
1. Fewer than 50 percent of the dairies had written treatment protocols. And of those with written protocols, only half were actually applying treatments as written. While up-to-date, written treatment protocols do not magically improve health management, they are an indication that the dairy’s health management team performs regular reviews to ensure the consistent, effective implementation of best practices. Active evaluation and feedback reduces protocol drift and residue risk while improving health and productivity.
Opportunity: Ask your veterinarian to oversee health management on the dairy, and be willing to pay for those services. As health professionals, veterinarians are uniquely qualified to take the lead in developing, implementing and evaluating health care protocols. Regular review, at least every six months, ensures everyone is aware of what is happening on the dairy and whether it is working.
2. Not one dairy had complete treatment records. Complete medical treatment records as described in the Pasteurized Milk Ordinance include: animal identification; date(s) of treatment; drug given and dosage given; route of administration used; and meat and milk withdrawal time, even if zero. In the case of a residue violation, the investigator also will determine what disease was being treated and whether treatment was recommend by a veterinarian. Aside from regulatory compliance, complete treatment records support informed health management decision-making.
Opportunity: Work with your veterinarian to develop and implement specific protocols for keeping complete treatment records. Be willing to pay him or her for this important service. Record the disease being treated, not just the drug that was given. If you don’t know what is being treated or multiple diseases are lumped together with one treatment, you can’t evaluate treatment effectiveness. Record who gave the treatment, even when no treatment is given, because accountability reduces protocol drift. The decision to not treat should be recorded and evaluated, too.
3. Dairy management software was under-utilized for health records. Nearly 90 percent of dairies used an on-farm dairy management software. Yet only a little more than half of them used it to record the diseases evaluated. And even when disease episodes were recorded, the treatment often wasn’t. Common dairy management software can track milk and meat withdrawal times of treated cows, but fewer than half of dairies make use of those features. Often, this is true because no one knows how to properly set them up.
Opportunity: Take some time to become more familiar with all the functions of your computer software. These tools can help standardize your records for easy use and review. The software is designed to make record-keeping easier, improve the quality of your health records and reduce our residue risk. You also can ask your veterinarian to help you make the best use of your dairy management software, and be willing to pay for his or her guidance.
4. Nearly 60 percent of herds treated metritis with an antibiotic not labeled for that use (extra-label use). For a drug to have a specific use on its label, the U.S. Food and Drug Administration (FDA) requires that it has been shown to be safe and effective for that use. Extra-label drug use is allowed with a veterinarian’s prescription if the product labeled for that use is not clinically effective. Accurate, consistent health records are needed to evaluate the clinical efficacy of treatments whether or not they have a label for a given use. Without evidence, biased perceptions can result in penny-wise but dollar-foolish treatment decisions.
Opportunity: Ask your veterinarian to help you establish accurate and consistent health records on the dairy that allow you to make informed decisions, and be willing to pay for those services. Don’t let the last catastrophic treatment failure or miraculous cure (perceptions) guide therapy. Until you have better evidence, go with the labeled product. The FDA says it works, and it’s the law.
Capitalizing on these opportunities should improve the quality of health records that are the basis for the consistent, effective management of health on the dairy and for avoiding violative drug residues. Including your veterinarian helps establish and maintain the veterinary-client-patient-relationship needed for prescription and extra-label drug use, and it ensures the health and productivity of your herd.
John Wenz is a member of the veterinary medicine faculty and field disease investigation unit at Washington State University.