Cattle Practice 9.1

Cattle Practice FEBRUARY 2001 Volume 9 Part 1

BCVA 2001 1 CATTLE PRACTICE VOL 9 PART 1 Figure 1 describes the relationship between the components of risk analysis. HAZARD IDENTIFICATION The first component in the identification of chemical hazards involves the diagnosis and surveillance of toxic diseases and chemical contamination. Residues can only occur in meat and animal produce such as milk as a result of exposure of food animals to chemical agents. Chemical agents may cause disease in food animals but may also present a significant public health risk when exposure in food animals is entirely subclinical. The range of potentially hazardous chemicals includes essential nutrients, intentionally administered chemicals including medicines and supplements, other agrochemicals including fertilisers and pesticides, and environmental contaminants including plant and microbiological toxins, other natural elements in soil and water, and chemicals released by industry. The route of exposure of food animals to medicinal products can be oral, parenteral or dermal but the usual route of exposure of food animals to other chemical contaminants is usually oral, either through contamination of their intended diet or environment. As a result most environmental investigations concentrate on contamination of soil (including natural geochemistry, fertilisers and occasionally aerial contamination), feedingstuffs (including pasture, supplements and purchased feeds), water supply, bedding and housing. Clinical poisoning can be detected by disease surveillance but subclinical contamination of food animals can only be detected by residues surveillance or knowledge of the presence or release of a specific contaminant. Residues surveillance can be used to intercept contaminated produce before it enters the food chain but this requires that the test procedures are sufficiently rapid and inexpensive to be performed on all potentially contaminated produce. Chemical Food Safety Risk Analysis Livesey C.T., Veterinary Laboratories Agency, Weybridge, Surrey INTRODUCTION The objective of this paper is to describe the risk analysis and other procedures necessary to protect the human food chain from chemical contamination of food animals and to describe some of the challenges we face in food animal production. Risk analysis is the term used to encompass all processes relating to the identification, assessment, management and communication of hazards and risks. A hazard is a substance or circumstance with the potential to cause an adverse effect whereas risk is the probability of the adverse effect occurring and relates to the level of exposure to a hazard in a particular circumstance. In the context of chemical food safety the hazards are chemical residues in food, which for food animals includes meat and animal products such as milk. There are two systems/protocols in current use in risk analysis. One system is that described by the Office International des Epizootics (OIE) International Animal Health Code (Office International des Epizootics) which is based on the method described by Covello and Merkhofer (Covello VT et al) and is generally used in the field of veterinary public health and international trade. The alternative is the Codex system (Codex Alimentarius Commission), which is based on the method described by the National Academy of Sciences (National Academy of Sciences, National Research Council, 1983) and is often used by regulatory toxicologists, including those working for the Food Standards Agency which has branches in England, Scotland and Wales. The terminology used in this paper will not conflict with either of these two systems. The main differences between these two systems are that the OIE protocol separates hazard identification from risk assessment and includes release assessment (intended to describe the probability of a hazard being released from a particular source) as a separate category within risk assessment. The OIE protocol is also more logical to apply to the identification and investigation of hazards in general, field investigations, the control of toxic or infectious diseases and more directly amenable to developing into a quantitative risk assessment. Figure 1. The four components of risk analysis. Hazard Identification Risk Assessment Risk Management Risk Communication

CATTLE PRACTICE Where the effects of contamination are immediate or severe, as with antibiotic contamination of milk intended for yoghurt or cheese production or aflatoxin contamination of animal feed, surveillance has been designed to intercept contaminated produce. It would be impractical, prohibitively expensive and unnecessary to design all residues surveillance to intercept contaminated produce. For most environmental contaminants occasional low level exposure is unavoidable and harmless and surveillance is usually designed to monitor that contamination is within acceptable limits. For veterinary medicines, pesticides and some environmental contaminants there are statutory surveys, commissioned by the authorities responsible for risk management, to monitor that the chemicals are being used in the approved manner or exposure to natural contaminants is as expected and within acceptable limits. Hazard Identification will always be incomplete. The potential presence of most hazards identified will have been anticipated and both disease and residues surveillance are utilised to identify them. Occasionally, hitherto unexpected contamination, such as the dioxins contamination identified near Bolsover in 1994, is detected by random surveillance but unanticipated hazards are usually only identified if their presence is apparent and causes animal disease. Passive disease surveillance cannot detect subclinical contamination and residues surveillance programmes are unlikely to detect unanticipated hazards because the survey is unlikely to take account of their (unanticipated) presence. Therefore unanticipated hazards which cause only subclinical contamination of food animals are unlikely to be detected. In addition, not all clinical contamination incidents are reported to the regulatory authorities because they may be overlooked, misdiagnosed or the symptoms are considered too mild to be of any consequence. The diagnosis of food animal disease caused by chemical contaminants is the responsibility of farmers, veterinary surgeons, agricultural advisors and surveillance organisations such as the Veterinary Laboratories Agency (VLA). Sometimes exposure to a hazardous chemical is suspected following accidental release of the chemical and under these circumstances the persons who have knowledge of the accident also have a moral, in some instances a statutory responsibility to inform farmers and regulatory authorities. The second component of hazard identification is identification of the source of contamination. For administered chemicals such as veterinary medicines and agrochemicals there are usually records or detailed recollection of recent use but identifying sources of natural contamination is more difficult. Environmental contaminants are unavoidable and BCVA 2001 VOL 9 PART 1 "hot spots" of contamination are heterogeneously distributed making environmental sampling a very uncertain process. Food animals are usually managed in groups so the distribution of contamination in a herd of cows can provide important insight into the source of contamination. In addition it should be assumed that where one or two animals have been poisoned, the rest of the group may have also been exposed although exposure for most animals may be subclinical. Accordingly contamination of the entire herd should be assessed and investigations not restricted to clinically affected animals. There are significant resource implications for carrying out herd and environmental investigations and obtaining rapid and accurate analysis of the samples. Sampling groups of animals and heterogeneously contaminated environments is a skilled procedure and appropriate laboratory facilities must be immediately available. Retaining resources for emergency response is very expensive. RISK ASSESSMENT Paracelsus (1493 to 1541) is considered by many toxicologists to be the father of modern toxicology. He identified that "All substances are poisons; there is none which is not a poison. The right dose differentiates a poison from a remedy." This statement remains broadly correct to this day and includes most essential nutrients because these are also potential poisons if excessive quantities are ingested. As a result the assessment of risk arising from exposure to a chemical is directly related to assessing the dose of a chemical received by the target species. In addition, the risk assessor must know the effect of the chemical on the target species at the particular dose rate and this "consequence assessment" can also be described as the "doseresponse characteristic" of the chemical agent. With this information the risk arising from a particular source of contamination can be assessed and control measures recommended. The risks associated with chemical incidents are initially assessed by FSA staff and in incidents where there is insufficient information to fully assess the risk a precautionary, provisional assessment is made. The FSA can obtain advice on risk assessment from independent organisations to contribute to the risk assessment of a particular chemical or assist with a specific contamination incident or investigation. The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) is the main independent expert committee in the UK but other international committees also carry out risk assessments especially the Joint FAO/WHO Expert Committees on Food Additives (JECFA) which deal with medicines and contaminants and, within the EU, 2

CATTLE PRACTICE the Scientific Committee for Food and Scientific Committee for Animal Nutrition. Risk assessments carried out by JECFA or the COT produce comprehensive statements of sources of contamination, dose-response effects and acceptable levels of exposure which enable risk managers to assess the risk pertaining to a particular incident in which the exposure is known. For intentionally administered chemicals such as medicines, the licensing process requires the pharmaceutical company to submit a comprehensive dossier of toxicological information. This includes a no adverse effect level (NOEL) determined in experimental animals and an acceptable daily intake (ADI) for humans which is derived from the NOEL by incorporating safety factors to allow for the uncertainties in extrapolating the experimental data to humans. For other agrochemicals and pesticides, the toxicology data required for licensing is less comprehensive because exposure of food animals to these chemicals should only occur following accidental contamination of their food or environment. Accidental contamination should rarely occur if a product is used in the recommended manner and good husbandry practice is followed by the farmer. For natural and environmental contaminants to which exposure is perceived to be relatively hazardous, such as heavy metals and dioxins and relatively toxic essential nutrients such as selenium and vitamin A, there are adequate toxicology data to set maximum acceptable exposure limits for humans. However, because of the presence of unavoidable environmental contamination or, for chemicals which are also essential nutrients the need for a minimum daily intake, it is usually not possible to use such large safety factors when extrapolating from NOEL to ADI. For most natural and environmental contaminants, such as plant toxins, the toxicology information is incomplete because there is no commercial incentive for the toxicology studies to be carried out and as a result the R&D must be publicly funded. For most of these chemicals the perceived risks are small and the usual approach to assessing risk is to determine the range of environmental contamination that is unavoidable and assume that background contamination is both unavoidable and acceptable. This is overruled if it becomes clear that a certain level of natural exposure causes adverse effects. It is very important that information on the toxicology of all chemicals is shared internationally and this is especially important for the natural and environmental chemicals for which data are incomplete. Assessing exposure is clearly a critical component of risk assessment but it is frequently impossible to determine the release and distribution characteristics BCVA 2001 VOL 9 PART 1 of a chemical contaminant accurately especially when contamination has been caused by an environmental incident such as a fire or explosion. Excessive contamination is usually accidental and heterogeneously distributed and in some cases the evidence of environmental contamination may have already been eaten. Blood sampling potentially exposed animals should identify the extent and severity of contamination in a group and may also help to identify the source. In addition, if there is sufficient information on the pharmacokinetics of a chemical, blood concentration data can be used to predict the time necessary for excretion. RISK MANAGEMENT Risk management is the process of controlling risk and organisations carrying out risk assessments usually also recommend methods of eliminating or reducing risks relating to specific hazards. For some chemicals, especially those which are administered directly to food animals (e.g. medicines and feed additives) it is possible to eliminate exposure but for naturally occurring substances, where exposure of food animals and humans is frequently unavoidable, risk management seeks to limit exposure to a level defined as safe. The international forum for the risk management of chemical food safety is Codex Alimentarius and within the UK it is the FSA which is responsible. Similar risk management functions are performed by the Veterinary Medicines Directorate for veterinary medicines and the Pesticides Safety Directorate for pesticides. For veterinary medicines an EC Regulation (Council Regulation) lays down a Community procedure for establishing maximum residues limits (MRL) of veterinary medicinal products in foodstuffs of animal origin. The MRL is calculated by dividing the ADI by the human intake of potentially contaminated food. This apparently simple sum must take into account the potential variation in the range and quantities of foods consumed, all possible sources of the particular contaminant and the range of foods potentially contaminated. Following use of a medicine, the withdrawal interval (WI) is the time which must elapse before the tissue concentrations of the medicine fall below the MRL and is determined in target species. The metabolism, distribution and excretion of all chemicals varies between species, to a lesser but sometimes very significant extent between breeds and may also be affected by the route of administration, dose, and the physiological function, including disease status and pathological processes in the target animal. As a result the extra label use of medicines (ELDU) must be tightly controlled. The approach in the EU is the Prescribing Cascade ( AMELIA 8) which prescribes an arbitrary 28 day WI following ELDU. 3

CATTLE PRACTICE Agricultural pesticides are controlled by specifying approved use and application rates but the MRL specified differ from the MRL derived for veterinary medicines. Pesticide MRL are those concentrations which would be expected to occur in crops following the approved use (including the type of crop, application rate and period between application and harvest) of the pesticide. This use of apparently identical terminology can be confusing. The control of other contaminants such as heavy metals and dioxins is in principle like the control of veterinary medicines except that the toxicological information available for most contaminants is inferior. There are national and international limits for a number of common and perceived high priority chemical contaminants. The national Lead in Food Regulations (The Lead in Food Regulations 1961) and The Arsenic in Food Regulations (The Arsenic in Food Regulations 1959) have been in existence for several decades. However, new EU Regulations, being discussed in Brussels, will set maximum limits for a range of food contaminants including ochratoxins, aflatoxins, lead, cadmium and mercury. The FSA takes the lead in these negotiations for the UK. The precise MRLs have not yet been agreed but it is likely that for lead and cadmium entirely natural exposure could cause some meat or produce, especially offal, to exceed the MRLs when exposure is subclinical in food animals. As for risk assessment there is a need for international co-operation to ensure that MRL and WI information is effectively shared for medicines and contaminants to facilitate international trade agreements and the management of contamination incidents. The Global Farm Animals Residues Avoidance Databank (g-FARAD) is an international organisation of veterinary toxicologists all involved in providing advice and carrying out research on chemical food safety, especially on residues transfer and clearance. Development of g-FARAD and similar organisations should be encouraged. The general provisions of the Feedingstuffs Regulations (The Feeding Stuffs Regulations 1995) and the Food Safety Act (The Food Safety Act 1990) require food producers to adopt good practices which assure the production of safe food. This includes restricting food animal exposure to contaminants. The Feedingstuffs Regulations specify limits in animal feeds and ingredients for a wide range of nutrients and contaminants and this document is continually revised in line with decisions made nationally and internationally, especially in the EU. The Food Safety Act makes it an offence for anyone to sell or offer for sale food which is injurious to health or so contaminated that it is unfit to use for human food. Farmers must show "due diligence" in the actions they take to prevent contaminated produce leaving their farms. This includes veterinary BCVA 2001 VOL 9 PART 1 consultations to obtain expert advice on the diagnosis and control of chemical poisoning and contamination. As a result, all agricultural veterinarians should not only be aware of these regulations but must also provide advice and therapy which ensure farmers are able to comply with them. This is especially pertinent to On Farm Quality Assurance schemes where vets recommend good practice and, if audited, also need to show that they too are following good practice. A minimum requirement is for the investigation and diagnosis of diseases on farms and for farmers to report any possible contamination to their customers. This is also specified in farmers' contracts with their dairies as part of the dairies' responsibility to undertake "due diligence" to detect and avoid potential food contamination. Most precautions necessary to avoid contamination and the procedures necessary to deal with potential incidents can be categorised as "good practice". A HACCP system may be too complicated to apply and administer and is probably inappropriate for the relatively variable and uncontrolled environment that exists on farms. However, an approach which prescribes good practices should be developed to provide a framework for farmers, advisors and auditors to follow. If taken to a logical extreme, the actions required by the Food Safety Act could mean that no produce enters the food chain from any farm with undiagnosed disease. This is clearly impractical but there is a responsibility on farmers and vets to investigate and report unusual diseases and all suspected and known contamination incidents. If this is done in a responsible manner the FSA will also be able to exercise pragmatic judgements on when the movement and sale of produce needs to be restricted. If, following the identification of a contamination incident, producers are unwilling to co-operate voluntarily, The Food Safety Act and The Food and Environment Protection Act (FEPA) (The Food and Environment Protection Act 1985 ) can both be used to enforce controls. FEPA is used to ring fence a contaminated area or environment which may involve live animals as well as food. RISK COMMUNICATION Figure 1 indicates that risk communication is continuous and should involve all stakeholders, including regulators, consumers and experts in the processes of Risk Analysis. The objective is to identify all concerns and perceptions, make all relevant information available to all stakeholders and present advice on risks and risk avoidance. Risk is not entirely avoidable and the term "safe" can be defined as "the level of risk which consumers are prepared to accept". The perception of risks varies considerably with different types of hazard but also between individuals depending on many factors such 4

CATTLE PRACTICE as socio-economic group, age, sex and previous experience. Consumers are more likely to accept unavoidable risks and inconvenient control measures if risk communication is carried out effectively and the relationship between regulators, farmers, the food industry and consumers is transparent and based on trust. Transparency in the management of food safety has become essential although the changes in attitude and actions necessary to achieve this are initially frightening and inconvenient. CONCLUSIONS Residues surveillance has an important role in risk management but is of limited use as a method of intercepting chemical hazards before they enter the food chain. Disease surveillance is essential for identifying expected and unexpected hazards but unexpected, subclinical hazards are unlikely to be detected. The Food Safety Act requires that meat and animal produce are not injurious to health or otherwise contaminated in such a manner as to render them unfit for human food. This places an onus on the farmer and veterinarian to identify, investigate, control and report potential hazards. Investigating potentially contaminated environments is complex and expensive and some exposure to natural and environmental contaminants is unavoidable. Most environmental contamination incidents involves oral exposure of the food animals and possible sources include the soil, water supplies, feedingstuffs, housing and bedding. Therefore diagnosis of disease or detection of residues in a single animal has implications for the rest of the herd which shared the same environment. International co-operation between scientists and regulators is needed to improve the availability of toxicology data and safety information such as NOEL, ADI, MRL and WI. BCVA 2001 VOL 9 PART 1 Controlling exposure to administered chemicals and agrochemicals is achieved by adhering to the instructions for approved use and following good husbandry practices. A "good practice" system should be developed to provide a framework for farmers, advisors and regulators to monitor and control chemical contamination on farms. The development of risk communication should improve hazard identification by encouraging farmers and vets to report suspected incidents, facilitate risk management by improving consumer understanding of risks (including those which are unavoidable) and enhance the transparency of risk analysis and the trust between the agricultural industry, regulators and consumers. REFERENCES Amelia 8 Guidance to the Veterinary Profession. Medicines (restrictions on the administration of veterinary medicinal products) Regulations. 1994. SI. No 2987 HMSO. Arsenic in Food Regulations 1959 SI. No 831, HMSO. Codex Alimentarius Commission. Principles and guidelines for the conduct of risk assessment. CAC/GL-30, 1999. Council Regulation (EEC) No. 2377/90 Covello VT and Merkhofer MW 1993. Risk Assessment Methods: Approaches for Assessing Health and Environment Risks. Plenum Press, New York and London. Feeding Stuffs Regulations 1995 SI. No 1412, HMSO. Food and Environment Protection Act 1985 Chapter 48, HMSO. Food Safety Act 1990 Chapter 16, HMSO. Lead in Food Regulations 1961 SI. No 1931, HMSO. National Academy of Sciences, National Research Council, 1983, Risk Assessment in the Federal Government: Managing the process. NAS-NRC Committee on the Institutional means for the Assessment of Risks to Public Health. National Academy Press, Washington DC. Office International des Epizootics (OIE) Import Risk Analysis Section (1.4) of the International Animal Health Code, May 1999. 5

CATTLE PRACTICE BCVA 2001 VOL 9 PART 1 6

BCVA 2001 7 CATTLE PRACTICE VOL 9 PART 1 received an epidural injection at the first intercoccygeal space (this was identified as the second movable space when the tail was lifted up and down). The drugs administered were 0.10mg/kg morphine (morphine sulphate 10mg/mL preservative free; Martindale Pharmaceuticals; Romford, Essex) and 0.05mg/Kg xylazine (Rompun™ Dry Substance 50mg/mL preservative free; Bayer plc; Bury St.Edmunds, Suffolk) and they were administered at one week intervals. The sequence of epidural injections were as follows:- Using dividers set at a five centimetre distance, one centimetere squared areas were clipped on dermatomes one to five (see below). 23G 1" needles were placed just through the skin at the two sites on each dermatome, the electrodes were attached and thresholds were obtained using the Grass S48 Stimulator (Grass Medical Instruments). Dermatomes one to five correspond to the following areas:- The Antinociceptive Effects of Epidurally Administered Morphine and Xylazine in Calves McCormick I.B1., Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA. 1Present Address: Hird & Partners MsRCVS, 10 Blackwall, Halifax, West Yorkshire, HX1 2BE. INTRODUCTION Animal welfare committees within the European Union are aware that there is a problem with the provision of adequate analgesia to farm animals, principally due to the lack of drugs with marketing authorisation. The aim of this study was to determine the antinociceptive effects of epidural xylazine and morphine in calves. These drugs may be useful for the provision of post operative pain relief in calves after surgical procedures, for example after the repair of an umbilical hernia. The onset, duration and spread of analgesia are thus important parameters to consider whether these drugs could be used in a clinical situation. Caudal epidural analgesia is routinely used in cattle for a variety of surgical and obstetrical procedures (Caron J.P., LeBlanc P.H., 1996) and epidural xylazine has been used in calves (Lewis C.A., et al 1999). Xylazine has a marketing authorisation in food producing animals, morphine does not, yet it is regarded as the standard analgesic to which other pain relieving drugs are compared and has been administered via epidural injection in goats (Hendrickson D.A., et al 1996). METHODS AND MATERIALS The study was approved by The Royal Veterinary College Ethics Committee, under the Home Office license number PPL 70/4846. Six Hereford cross calves (2 male, 4 female) aged between four and six weeks of age were housed seperately in individual pens and fed a commercial calf rearing diet and hay. They were also fed milk (artificial milk replacer) twice a day. Water was available ad libitum. After a two week acclimatisation period, preliminary trials were carried out on three calves; two received epidural morphine and the other xylazine. Each calf ABSTRACT The study evaluated in calves the antinociceptive properties of xylazine and morphine when administered via an epidural injection. The antinociceptive effects of the drugs were assessed by measuring the increase in voltage over the baseline electrical threshold values at five chosen dermatomes using an electrical stimulator at specified time intervals. Morphine appeared to be the more effective drug, although it warrants further investigation as an epidural analgesic in calves. KEYWORDS: Epidural, Calves, Morphine, Xylazine Calf Preliminary Week 1 Week 2 One Morphine Morphine Xylazine Two Morphine Morphine Xylazine Three Morphine Xylazine Four Xylazine Morphine Five Xylazine Morphine Six Morphine Dermatome Position Anatomical Area One Caudal Tail Two Sacral 5 Anal region & Caudal Scrotum Three Sacral 1&2 Dorso-Caudal Rump Four Lumbar 4 Lateral Thigh Five Lumbar 2 Posterior to second Lumbar vertebra

CATTLE PRACTICE Those calves receiving morphine were assessed at thirty and sixty minutes post injection and then hourly thereafter. Those receiving xylazine were assessed at fifteen minute intervals for the first hour, then thirty minute intervals for the next two hours and hourly thereafter. After four hours, if the electrical thresholds were back to baseline for two consecutive measurements then a threshold value was no longer measured at that particular dermatome. Measurements were taken until all values reached baseline or eight hours of antinociception had lapsed. Heart and respiratory rates were monitored using a stethoscope and an assessment of behaviour made. Behaviour was scored as follows:- The calves were weighed in a calibrated weigh crush prior to each injection, following which their back lengths were measured using a flexible measuring tape from the occiput to the sacro-coccygeal junction. This information allowed the total volume being injected to be calculated using the following formula:- 0.13 X Back Length = Total Volume Injected (S.Watts personal communication) The final volume to be injected was made up using 0.9% saline so that the drugs injected did not contain any preservatives. The area over the first coccygeal vertebra and the second coccygeal vertebra (C1-C2) was clipped and surgically prepared. Each calf was anaesthetised with isoflurane (Isoflurane-RM™, Merial UK, Harlow, Essex) and oxygen (BOC Gases, Worsley, Manchester) via a mask and lack circuit. The calves were then placed in sternal recumbency and the epidural injection given via a 19G 1" needle. To ensure correct placement of the needle in the epidural space, 0.5ml of 0.9% saline was injected with no resistance. The bevel of the needle was always pointing towards the head and the injection was administered at a rate of 1 ml per four seconds. As the injection was being given, the isoflurane was discontinued and the calf was given 100% oxygen for at least three minutes. Timings for all further measurements were taken from the time when the injection was completed. Results were expressed as a voltage increase over the baseline electrical threshold values at each dermatome with respect to time. The mean +/- standard deviation and range of voltage increase over baseline at each dermatome for both morphine and xylazine was calculated using Excel (Microsoft Office 97). Paired t-tests were performed for morphine and xylazine at each dermatome at hourly intervals using Statview (SAS Institute). Significance was set at p< 0.05. BCVA 2001 VOL 9 PART 1 RESULTS The mean +/- standard deviation and range of avoidance thresholds for xylazine and morphine at the different dermatomes over time are shown in Tables 1. It was shown that morphine had a significant antinociceptive action from 1 to 9 hours post injection at dermatomes 1 & 2, at 1,3,6,8 and 9 hours at dermatome 3, at 1 to 7 hours at dermatome 4 and at 3 and 6 hours at dermatome 5. Xylazine had a significant antinociceptive action for 1 to 3 hours at dermatome 1, from 1 to 5 hours at dermatome 2, at 5 hours at dermatome 3, from 1 to 4 hours at dermatome 4 and at 1,2 and 5 hours at dermatome 5. Morphine's duration of action was longer than xylazine, although it's onset was slower. Behaviour scores comparing xylazine and morphine show that the calves receiving epidural xylazine were more sedated that those receiving morphine. See Figure 1. DISCUSSION The results of this study showed that epidural xylazine and morphine produce antinociceptive effects in calves in response to the electrical stimulation applied. It showed morphine had a longer duration of action than xylazine over the test period. The difference in duration of action probably reflected the different pharmacokinetic and pharmacodynamic properties of the drugs, and in turn are attributed to their physiochemical properties. Xylazine provided analgesia by 15 minutes in all dermatomes, a quicker onset than morphine. Results regarding the onset of xylazine analgesia agreed with that of previous studies. Zaugg and Nussbaum (1990) state that in all cattle, the tail and perineal area became desensitised to skin prick within 10 minutes after epidural xylazine. Mohammed and Liman (1998) state the loss of sensation to pin prick 10-15 minutes after epidural xylazine in sheep. Skarda et al (1990) suggests analgesia induced by intercoccygeal epidural xylazine administration takes 15-20 minutes to be achieved in cattle. Caulkett et al (1993) suggests that the onset of systemic effects after epidural xylazine showed some variability in cows, yet the onset of surgical analgesia for a caesarian section was 22.6 +/- 4.7 (mean +/- SD) minutes. A possible explanation for this quicker onset may be due to systemic uptake of the xylazine. This could explain why all 6 calves became sedated, ataxic or showed impaired motor function within 15 minutes of the epidurtal xylazine administration. It can be seen from Figure 1 that the xylazine behaviour scores are much greater than the morphine behaviour scores. St. Jean et al (1990) states that all cows were rapidly sedated after epidural xylazine and that this was probably attributable to the central alpha2-adrenergic 8 Behaviour Score Sedation One Normal Two Slightly Sedated Three Very Sedated

CATTLE PRACTICE BCVA 2001 VOL 9 PART 1 9 Dermatome Time (hrs) 0 0.25 0.5 0.75 1.0 1.5 2.0 2.5 3.0 4.0 5.0 6.0 7.0 8.0 9.0 Morphine 0 0 1.7b ± 1.2 (0-3) 3.3 b ± 0.8 (2-4) 3.3 b ± 1.5 (2-6) 3.0 b ± 1.3 (2-5) 3.0 b ± 0.9 (2-4) 2.5 b ± 1.2 (1-4) 2.5 b ± 1.5 (0.4) 2.7 b ± 1.0 (1-3) 1.5 b ± 1.0 (0-3) 1 Xylazine 0 2.3 ± 0.8 (1-3) 3.5 ± 2.3 (0-7) 3.0 ± 1.7 (1-5) 3.7 a ± 1.2 (2-4) 2.5 ± 1.0 (1-4) 3.0 a ± 1.8 (1-6) 2.5 ± 2.1 (1-6) 2.2 a ± 1.8 (0-5) 0.7 ± 1.2 (0-3) 0.6 ± 0.9 (0-2) 0.3 ± 0.6 (0-1) Morphine 0 0 0.7 b ± 0.8 (0-2) 1.8 b ± 2.6 (0-7) 2.2 b ± 1.8 (0-4) 2.3 b ± 1.4 (0-4) 2.7 b ± 1.8 (1-6) 2.2 b ± 0.8 (1-3) 2.7 b ± 2.0 (0.6) 2.7 b ± 1.6 (0.4) 3.4 b ± 2.6 (2-8) 2 Xylazine 0 1.8 ± 1.5 (0-3) 1.2 ± 1.0 (0-2) 1.2 ± 1.6 (0-4) 2.7 a ± 2.1 (1-6) 1.7 ± 1.6 (0-4) 2.5 a ± 2.0 (0-6) 2.3 ± 1.9 (0-5) 2.0 a ± 1.1 (1-4) 2.0 a ± 1.8 (0-5) 2.8 a ± 0.8 (2-4) 2.0 ± 2.1 (0-3) 0 Morphine 0 0.5 ± 0.5 (0-1) 1.3 b ± 0.8 (1-3) 1.3 ± 1.4 (0-4) 1.0 b ± 0.9 (0-2) 0.8 ± 2.0 (0-5) 1.5 ± 0.8 (1-3) 2.0 ± 1.3 (0-3) 1.2 ± 1.6 (0-4) 1.8 ± 1.2 (0-3) 1.5 ± 1.4 (0-3) 3 Xylazine 0 0.8 ± 1.2 (0-3) 1.2 ± 1.2 (0-3) 0.7 ± 0.8 (0-4) 1.3 ± 1.8 (0-4) 1.5 ± 1.8 (0-4) 0.8 ± 1.2 (0-3) 2.0 ± 2.8 (0-6) 1.3 ± 1.8 (0-4) 1.3 ± 1.5 (0-4) 2.0 a ± 1.2 (1-4) 1.2 ± 1.6 (0-4) 0 Morphine 0 0.5 ± 0.8 (0-2) 1.8b ± 1.2 (0-3) 2.5b ± 2.0 (0-4) 3.5 b ± 1.0 (2-5) 2.0 b ± 1.3 (0-3) 2.8 b ± 2.1 (1-6) 3.5 b ± 1.4 (2-6) 1.8 b ± 0.4 (1-2) 1.5 ± 1.5 (0-4) 1.8 ± 1.0 (0-3) 4 Xylazine 0 1.0 ± 1.1 (0-1) 1.3 ± 1.6 (0-4) 2.2 ± 1.2 (1-4) 1.3 a ± 1.2 (0-3) 1.7 ± 1.0 (0-3) 1.7 a ± 1.0 (0-3) 1.5 ± 1.4 (0-3) 3.0 a ± 1.1 (2-5) 2.2 a ± 1.5 (0-4) 3.0 ± 3.4 (0-8) 1.2 ± 1.3 (0-3) 0 Morphine 0 0.2 ± 0.4 (0-1) 0.3 ± 0.5 (0-1) 0.3 ± 0.5 (0-1) 0.7b ± 0.5 (0-1) 0.5 ± 0.5 (0-1) 0.7 ± 1.2 (0-3) 1.0 ± 0 1.3 ± 1.0 (0-2) 1.0 ± 0.8 (0-2) 1.5 ± 1.0 (0-2) 5 Xylazine 0 0.8 ± 1.0 (0-2) 1.0 ± 0.8 (0-3) 0.7 ± 0.8 (0-2) 0.7 a ± 0.8 (0-2) 0.7 ± 0.5 (0-1) 1.3 a ± 1.2 (0-3) 1.7 ± 1.4 (0-3) 2.2 ± 2.4 (0-6) 0.7 ± 1.0 (0-2) 1.6 a ± 1.1 (0-3) 0.5 ± 0.6 (0-1) 0 Table 1. The mean ±SD and range of the increase in electrical thresholds over baseline values at dermatomes 1-5. Figure 1. Cumulative behaviour scores of xylazine and morphine with respect to time. a = Significant difference from control (time = 0) values for xylazine. b = Significant difference from control (time = 0) values for morphine.

CATTLE PRACTICE effects of xylazine in ruminants. Caron and LeBlanc (1989) suggest systemic absorption of xylazine is likely, as treated cattle often showed signs of sedation. Lewis et al (1999) states that it was not clear from their study whether xylazine exerts its analgesic actions locally on the spinal cord or systemically after absorption, yet after a pilot study involving one calf receiving xylazine only by intramuscular injection, it appeared that epidurally administered xylazine was absorbed systemically. The onset of action of morphine was 30 minutes for 3,4 & 5 and was effective at all dermatomes by 1 hour. This is in agreement with the experiment by Pablo (1993) which states the onset of action of epidural morphine is approximately 30 minutes in goats. Natalini C.C., et al (2000) state that onset of analgesia varied from 4 to 8 hours from sacral to thoracic regions for epidural morphine in the horse. A possible explanation is that morphine has a low lipid solubility due to the presence of hydroxyl groups on its molecule, this hydrophilicity could be responsible for the slow transfer across the dura mater, prolonging the onset of action after epidural administration. The duration of analgesia produced by epidural morphine was not evaluated completely in the present study. It was decided that 8 hours antinociception was the time limit on the protocol. However, Natalini et al (2000) states that the time of effect of an epidurally administered opioid is influenced by the number of molecules retained in the cerebrospinal fluid and spinal tissue, and by the dissociation kinetics of the drug. They state the total analgesic time produced with caudal epidural morphine is variable, lasting 11 hours in the perineal, lumbar and thoracic regions and 10 hours in the sacral region. The respiratory rates of the calves were very variable and altered considerably in relation to the ambient temperature within the barn used to conduct the experiment. The heart rates were less variable, but nevertheless were not subjected to analysis. BCVA 2001 VOL 9 PART 1 CONCLUSIONS Xylazine and morphine both provide antinociception although from a clinical viewpoint morphine appears the more promising drug as it provides less systemic side effects. ACKNOWLEDGEMENTS The author wishes to thank Sarah Watts BVetMed CertVA MRCVS and Dr Kathy Clarke MA VetMB DVetMed DVA MRCVS for their guidance and assistance in carrying out this study and the British Cattle Veterinary Association for their financial support. REFERENCES Caron J.P., Leblanc P.H., Huhn J.C., Morin D.E., (1996) Sedation with xylazine and lumbrosacral epidural administration of lidocaine and xylazine for umbilical surgery in calves Journal of Veterinary Research 53: 486-489 Lewis C.A., Constable P.D., Huhn J.C., Morin D.E., (1999) Sedation with xylazine and lumbrosacral epidural administration of lidocaine and xylazine for umbilical surgery in calves Journal of American Veterinary Medical Association 214: 89-95. Hendrickson D.A., Kruse-Elliot K.T., Broadstone R.V., (1996) A comparison of epidural saline, morphine and bupivicaine for pain relief after abdominal surgery in goats Veterinary Surgery 25: 83-87 Zaugg J.L., Nussbaum M., (1990) Epidural injection of xylazine: a new option for surgical analgesia of the bovine abdomen and udder Veterinary Medicine 85: 1043-1046 Mohammed A., Liman M.S., (1998) Xylazine as an epidural anaesthetic agent in sheep Small Ruminant Research 27: 85-87 Skarda R.T., (1986) Techniques of local analgesia in ruminants and swine Vet Clinics of North America: Food Animal Practice 2: 636 Caulkett N.A., Cribb P.H., Duke T., (1993) Xylazine epidural analgesia for caesarian section in cattle Canadian Veterinary Journal 34: 674-676 St.Jean G., Skarda R.T., Muir W.W., Hoffsis G.F., (1990) Caudal epidural analgesia induced by xylazine administration in cows American Journal of Veteribary Research 51: 1232-1235 Pablo L.S., (1993) Epidural morphine in goats after hindlimb orthopaedic surgery Veterinary Surgery 22: 307-310 10

BCVA 2001 11 CATTLE PRACTICE VOL 9 PART 1 The aims of the survey were to elucidate the views of farmer clients in key areas of potential development for the veterinary profession. The questions ranged from topics such as fee structures, to the relative value of current services and the relevance of potential new or different services. The survey was intended as a base study to ascertain the key areas of interest to the farmer clients. There will be regional and farmer variations and the purpose of this survey was to identify common themes which individual practices could explore further with their farm clients METHOD The practices were chosen on the basis of likely cooperation with BCVA in the project, as the survey would involve some effort on behalf of the participating practices. Fourteen practices were chosen from England, Scotland, Wales and Northern Ireland. A standard letter and survey (Annexe 1) were included in with a covering note from the practice to all significant farmer clients within the practice. Given that some practices may have clients with only a small number of animals in their care, the inclusion of the hobby farmers was left to the discretion of the individual practices. The surveys were posted out by the practices and a free post envelope was included with the survey and BCVA Survey: What Do Our Clients Want From the Veterinary Practice? Orpin P.G., 82-84 High Street, Whetstone, Leicester. LE8 6LQ. ABSTRACT The farming and related supply industries are facing great changes. The reduction in farm income has resulted in a marked reduction in veterinary services on the farm. In recent years individual animal treatment has declined and there has been a move towards herd or group treatment. The large animal veterinary service may have to consider changing how both the veterinary service is provided, and charged for, to meet the demands of the farmer client. The farming client base is also changing with a proportion of herds increasing in size to increase income, some changing their farming system to organic systems and some leaving farming altogether. A few veterinary practices in areas of high stock density have changed their type of service and fee structures to high service charge and lower drug margin. Is this the future for the veterinary profession in the UK? In order for the veterinary profession to continue to succeed and to be of value to the farmer client it must identify the key requirements of the farmer clients and seek to deliver them. The needs of the farmer client will vary between regions, farm type and veterinary practice. BCVA Council commissioned a national survey of farmer clients in conjunction with Schering Plough Animal Health. The original survey was initially piloted in more detailed form for a single practice (Park Vet Group, Whetstone) in April 2000 in conjunction with Toby Marshall, Sales Representative for Schering Plough. This survey was adapted to be used on a wider scale as a simple one page survey as opposed to a more in depth four page assessment of the practice performance. Fourteen veterinary practices in the UK were chosen for the national survey from the membership of BCVA from geographically distinct areas of the UK (Figure 1) All the practices by their very nature have a significant proportion of cattle work. KEYWORDS: Survey, practice, management, marketing. Figure 1. Areas covered by survey

CATTLE PRACTICE accompanying letters. The participating farmers were asked to state the main type of farm enterprise they operated from 5 options over 100 dairy cows, less than 100 dairy cows, beef, sheep or pig farmer. The surveys were returned to Schering Plough for analysis by Excel spreadsheet. A total of 850 surveys were sent out from the 14 practices taking part. RESULTS 426 replies were received producing a response rate of 50%. The farmers replying were a good representative sample of those covered in the survey, many were mixed farms. A number of the farmers ticked more than one main enterprise, hence a larger number of farm types than replies (Fig 2). The results were analysed as a whole group for presentation of a total data set for the BCVA survey. The individual practice results were returned in confidence to the participating practices. The farmer surveys were then split and analysed to see if there were any meaningful differences between, for instance, large dairy clients compared with say beef or sheep farmers. This would give evidence as to whether a common fee structure and service was still appropriate or whether the practices may be better to segment the client base and offer different services and fee structures according to farm type. The data was initially analysed as a whole group of farm clients to identify any major trends in the following Tables 1-3. BCVA 2001 VOL 9 PART 1 Any questions that stimulated interest from the farmer client in the proposed development was further analysed to identify if there was any species bias. This would help elucidate if there was any particular client group who may be interested in the development over another. The majority (72%) of farmers were interested in the same fee structure with the same level of service. Indeed 21% of the farmers thought this was essential to pursue and this was the highest score in this category for the whole survey. 85% of the farmers would not find it useful if the profession reduced the quality of service and fees. The farmer client recognises that a high quality veterinary service is critical to the operation of the farm. Indeed 38% of clients would be interested or very interested in a higher quality of service at higher costs as long as it produced greater savings in disease control. This would obviously require good economic up to date costing of diseases to compare veterinary investment in health with savings on disease. However, a larger proportion of farmers would see an increase of fees as not useful. This is not surprising in the current economic climate. When posed the question should the profession "lower drug fees and increase service fees to compensate" 50% of the farmers would be interested or more than interested in this proposal. A third of farmers would not value this. This difference of opinion needs further examination and discussion. The vote appeared to be split with some farmers not interested (49%) as opposed to a smaller number viewing it as very interesting or essential to pursue (20%) Deferred, monthly or fixed headage payments were not seen as useful by a larger proportion of farmers as the modal value of all the questions relating to these were deemed to be not useful. The statements with the highest modal values related 12 Figure 2. 154 small dairy <100 cows 166 large dairy>100 cows 147 beef suckler 121 beef rearer 155 sheep 26 pig Total 614 farm types from 429 replies Fee Structures Don’t Know Not Useful Interesting Very Interesting Essential to Pursue 1 Provision of monthly payments to cover advisory work and spread the cost of advice 18.2 43.6 31.3 5.6 2.2 2 Lower drug charges and higher fees to compensate 14 35.5 30.2 12.4 7.2 3 Lower total fees with lower quality of service 7.7 76.8 9.5 2.3 1.4 4 Same fee structure same quality of service 17.1 10.3 34.7 16.5 21.4 5 Higher quality of service producing overall savings in disease control but increase fees 19.8 42.3 28.4 7 2.2 6 Deferred or spread payments to cover seasonal peaks in expenditure 11.2 43.5 25.4 14.4 5.4 7 Fixed monthly payments per head for routine service. Charged for additional work 15.6 52.7 21.4 8.6 1.8 Table 1. Fee Structures. The farmer responses expressed as a % of farmer responses for each question.

CATTLE PRACTICE to cost savings on drugs via buying groups or bulk purchase through the practice. Drug prices appeared to feature highly in the comments section and many farmers commented adversely about the relative cost of drugs in the UK compared to other countries, overpricing by pharmaceutical companies etc. (see Appendix 2). Over 80% of respondents would be very interested or consider it essential to pursue cost savings on fees or prescription drugs if all drugs (including merchant drugs through the practice). Over 80% would value setting up a drug buying group via the practice which would seek savings on specific high cost products. Any question relating to cost saving of any sort scores highly in the questionnaire which is not surprising given the economic climate within the farming industry. However, of almost equal interest were the prospects of setting up health partnerships to achieve specific targets together with comprehensive written health plans specifying how to tackle problems. A comprehensive written health plan would be interesting or more than interesting to over 70% of the respondents. Preventing disease rather than treating problem animals was also seen as a valued development with over 80% seeing this as an interesting option. This is obviously an area the farmer would like the vets to develop, given sufficient explanation the benefits of setting up a BCVA health plan may be a useful avenue to explore with dairy clients. Training and education are also seen as positive with only 75% of respondents seeing this as useful. Similarly practice educational meetings would be interesting or more than interesting for over 75% of respondents. Training for farmers to perform more tasks themselves was valued even more highly with BCVA 2001 VOL 9 PART 1 over 37% rating this as essential to pursue or very interested. Only 15% of farmers thought this would not be useful. This is frustrating given the demise of the Agricultural Training Board training courses. There is a need for continued training for farmers according to this survey: someone ought to be providing this for farmers. The provision of a practice foot trimmer was not seen as useful by 41% of clients. This may reflect the farm type or the need has been fulfilled elsewhere. However, a similar number would be interested or more than interested in this option. There may be opportunities in certain areas to develop paraprofessional operators linked to the practice in areas of high stock density. 40% of clients would value help setting up farm recording on farm although 43% would not value this development. Again this looks like the uptake would be on a small group within the client base rather than across the whole client base.The overall ratings were value for money was high in all the questions. The modal values were very good for routine herd health visits, emergency sick animal treatment, advisory and consultancy work and calvings and caesarean. Out of hours work had the highest modal value with over 60% of clients rating the vets as very good value for money. The overall rating for cost benefit for the vets was high with over two thirds of the farmers viewing the vet as good or very good value for money. Only 10% of respondents viewed the vet as unacceptable or poor value for money on terms of overall cost benefit. Indeed from the comments it is difficult to prove full cost benefit when the stock value are so low. SPECIES AND FARM TYPE 13 How would you value these developments Don’t Know Not Useful Interesting Very Interesting Essential to Pursue 8 Setting up health partnerships where the vet and farmer agree specific health targets to achieve 15.5 18.7 45.0 14.4 6.7 9 A comprehensive written health plan specifying what and how to best use drugs/tackle problems 10.4 18.7 38.7 22.1 10.30 10 Practice to employ a trained assistant to provide lower cost foot trimming to your farm 10.8 41.3 23.9 18.7 4.69 11 Assistance with setting up computerised recording at the farm 12.9 43.3 31.1 9.0 3.8 12 Regular educational meetings to keep you and your staff up to date with animal health matters 10.1 14.0 47.7 19.6 8.8 13 You to join a practice buying group to gain savings on specific high cost products 8.1 10.58 30.0 35.0 19.3 14 Ways of spending more time to help prevent disease than simply treating problem animals 8.5 7.0 45.3 26.3 13.1 15 Training and educational, you and your employees to perform certain veterinary procedures (eg AI) 9.4 14.79 37.6 28.2 10.01 16 Cost savings on POM drugs and services when purchasing all drugs (including PML’s) through your vet 10.8 4.3 30.8 34.2 20.00 Table 2. Future Developments. The farmer responses expressed as a % of total responses for each question.

CATTLE PRACTICE VARIATIONS The data was also examined by studying the questions according to farm type. Instead of looking at all the responses the questionnaires were analysed according to the respondents that found the statement BCVA 2001 VOL 9 PART 1 interesting, very interesting or essential to pursue. This would be useful to see if there were any particular group of farmers that would benefit from any of the particular developments. The data is expressed in Table 4. The main areas of divergence were related to the 14 Table 3. Value for money. The farmer responses expressed as a % of total responses for each question. Value for money Unacceptable Poor Adequate Good Very Good Not Applicable 17 Routine herd health and fertility visits 5.2 1.1 13.3 25.4 27.2 26.1 18 Emergency sick animal treatment during the working day 2.7 0.71 5.2 31.3 59.4 0.91 19 Advisory and consultancy work 4.5 1.4 13.5 35.1 40.6 5.0 20 Calvings and caesarian sections 4.9 0.23 7.0 28.1 50.2 9.7 21 Out of hours emergency work 4.0 0.5 6.5 26.4 60.3 2.5 22 Lame cow diagnosis and treatment 7.0 1.1 12.9 30.8 26.3 21.8 23 Overall rating in terms of cost benefit 6.5 3.8 22.7 40.8 25.9 0.5 Table 4. Species and Farm Type Variations Fee Structures All farms Dairy <100 cows Dairy >100 cows Beef Suckler Beef Rearer Sheep Unit Pig Unit 1 Provision of monthly payments to cover advisory work and spread the cost of advice 39 43 48 34 39 30 42 2 Lower drug charges and higher fees to compensate 50 47 60 43 46 46 42 3 Lower total fees with lower quality of service 13 13 19 12 14 15 0 4 Same fee structure same quality of service 73 69 69 76 68 74 77 5 Higher quality of service producing overall savings in disease control but increase fees 38 38 40 39 32 31 62 6 Deferred or spread payments to cover seasonal peaks in expenditure 45 51 46 46 45 47 42 7 Fixed monthly payments per head for routine service. Charged for additional work 32 35 46 22 28 25 50 How would you value these developments All farms Dairy <100 cows Dairy >100 cows Beef Suckler Beef Rearer Sheep Unit Pig Unit 8 Setting up health partnerships where the vet and farmer agree specific health targets to achieve 66 65 78 64 62 58 81 9 A comprehensive written health plan specifying what and how to best use drugs / tackle problems 71 68 78 71 68 70 88 10 Practice to employ a trained assistant to provide lower cost foot trimming to your farm 47 52 52 51 52 39 38 11 Assistance with setting up computerised recording at the farm 44 47 49 45 46 42 35 12 Regular educational meetings to keep you and your staff up to date with animal health matters 76 75 81 73 74 76 88 13 You to join a practice buying group to gain savings on specific high cost products 81 82 87 78 87 80 73 14 Ways of spending more time to help prevent disease than simply treating problem animals 85 86 88 86 85 81 96 15 Training and educational, you and your employees to perform certain veterinary procedures (eg AI) 76 77 81 75 81 74 88 16 Cost savings on POM drugs and services when purchasing all drugs (including PML’s) through your vet 85 88 89 83 86 84 92

CATTLE PRACTICE degree of intensification of the farm. Areas relating to disease control and disease prevention were most valued by the large dairy and pig farm. For instance 96% of the positive respondents from pig farms thought that disease prevention was the best approach compared to 80% of sheep farmers. Pig farmers appeared to be more receptive to higher fees as long as there were overall savings in disease control. This difference was marked between the intensive pig unit (60%) and the sheep farm (30%). There was a marked difference of opinion between large dairy farms and the remaining farms as to whether the profession should have lower drug prices and higher fees to compensate. 60% of positive responses from large dairy would value this compared with 40-47% for the remaining farms. The pricing of drugs appears to be a sensitive area for large dairy clients. Payments per head on a monthly basis for routine work was valued by pig and large dairy clients (50- 45% respectively) but not of major value to the remaining farms. Not surprisingly, spreading payments to cover seasonal work was more valued by small dairy farms and sheep. However, it must be remembered that the overall interest in this proposal was not high with over 44% of total clients not seeing this as useful. Overall there were great similarities between farm types in most areas. CONCLUSION The survey revealed several interesting areas for the veterinary profession to consider. The farmers responding were primarily interested in improving the health of their stock by education and preventive medicine. Written health plans were seen as a useful development. The more intensive the unit the greater the interest. There is a need to educate farmers in the key areas of tackling disease and use of medicines effectively and this may be the best way to motivate the farmer to commit to preventive medicine programmes. This is a new market opportunity for the profession to embrace or develop further. The challenge will be to provide this at the same time as delivering value to BCVA 2001 VOL 9 PART 1 the client and income to the practice. Certainly this type of work may be less costly to provide as the work is pre-planned. The service the vet provides is highly valued by the responding farmers and any reduction of service, even if this was accompanied by a reduction in fees was not valued. The farmers appeared to be highly service critical and the majority appeared to want to retain the same fee structure and quality of service. This appeared to be uniform across all farm types. This puts a tremendous onus on the colleges and the vets already in practice to educate and develop the next generation of vets who have less clinical exposure and increasing demands from the clients. In the future retaining the depth of expertise in all areas of large animal work may be difficult and vertical integration with more specialist vets may be required. Training farmers to do tasks for themselves appeared to be more popular than trained paraprofessionals doing veterinary work at a lower cost for the farmer. Perhaps the individual practice should take a greater potential to bond with clients by providing not only the traditional new product presentations but also help co-ordinating skill and husbandry training at a cost to the client. Certainly in a small survey in my own practice 75% of clients were happy to pay towards training courses. However, medicine prices appears to be a sensitive area and there appeared to be a division amongst the respondents as to whether lowering drug charges and higher fees to compensate would be a good option. This appears to be particularly true of the large dairy farmers surveyed. This would presumably depend on the ratio of service to drugs for each farmer and how it may suit his or her own circumstance. The cheapest drugs for the farmer is the drugs he does not have to use and with better planning and preventive medicine vets would be able to rationalise drug usage better by spending more time on preventive approaches and less resources on treatment. Again herd health planning has a role. This needs to be sold to the farmer as an investment in future health rather than an extra cost. There was also a strong interest in cost savings on drugs by bulk purchasing or increased purchases of other PML (merchant) drugs such as wormers. This 15 Value for money All farms Dairy< 100 cows Dairy> 100 cows Beef Suckler Beef Rearer Sheep Unit Pig Unit 17 Routine herd health and fertility visits 53 72 69 41 50 39 77 18 Emergency sick animal treatment during the working day 91 95 94 90 91 86 81 19 Advisory and consultancy work 76 81 80 75 75 76 92 20 Calvings and caesarian sections 78 92 89 78 78 68 58 21 Out of hours emergency work 87 95 93 87 85 81 77 22 Lame cow diagnosis and treatment 57 71 69 51 55 41 54 23 Overall rating in terms of cost benefit 67 69 69 68 73 64 85

CATTLE PRACTICE could be achieved by either cross selling or packaging. If, for instance, clients purchased dry cow therapy and fly control this could provide a saving on both products. Farmer helps the practice: vet helps the farmer. There is an opportunity to link service with, for instance, laboratory or subsidised investigations tied into the product support. There is constant need to emphasise both the price of an individual item also the value of the overall package of product, support and knowledge. There may be an option to consider a segmentation of the client group with a different pricing structure based on, for instance, lower drug charges for certain clients in return for increased commitment to the practice in other areas. For instance, clients committing to regular herd health visits may have different terms than clients that choose to use the services of lay scanners. Certainly the needs of the large dairy client are going to be different from the hill sheep farmer. Other potential areas which may be useful to consider are educational or training packages for clients. Small group training of say 10-15 farmers can be done on a low cost basis. Hire of room may be negligible as this often can be done at the practice or on farm and the course material may be used again for different groups. This type of approach will also seek to bond clients to the practice and elevate discussion above the price of a bottle of drugs that the farmer may not even need if the husbandry was of high quality. There may be an option to increase fees for certain procedures which is contrary to the anecdotal feedback received from farmers direct who are generally always quick to complain about vet fees. Pig farmers would be more receptive to this than the extensive farmer. Perhaps this is due to the greater ease of calculating disease cost in the intensive unit. If this were to be done then it is common sense to provide this together with an increased output of services of value to the client. The more valued client can understand the bigger picture of value versus total cost. Adjustments in fees are possible in a radical manner as long as the client sees that there is going to be a value in pursuing this route for him or her. As a profession we have been slow to explain the cost of providing the 24 hour 365 day rapid response service which is so valued by the client. This is a useful exercise to do as part of say the next client meeting. The client often views veterinary fees as a cost and BCVA 2001 VOL 9 PART 1 the use of computer software to split up the veterinary bill into key cost areas is easily achieved with a little thought. This has been set up using the Premier Vet System and is run on a quarterly basis for clients (see Appendix 2). Again this helps explain where the investment in health is being made (preventive approaches) as opposed to treatment of disease (salvage approach). Certainly, whatever options a practice chooses to take it must not jeopardise the basic service which is valued so highly. In order to achieve this we must retain a profitable agricultural industry, maintain the high standard of education in the veterinary schools and continue the investment in the large animal sector within the profession. In order for this to be achieved the large animal practice must retain a core profitability and be able to justify its presence on its own merits compared with the small animal sector. If this is achieved it will facilitate future investment in technology, continued education and staff to deliver the much needed health planning and preventive medicine for the future. Reducing the quality of service is not an option if client satisfaction is to be assured and the challenge for the veterinary profession is to avoid a decline in service quality as the farm demography and service requirements change. This has been covered in more detail in a previous paper (Orpin 2000). The eventual outcome of the large animal vet will be determined by the degree of division of the large animal practice by external influences (regulatory change, macro economics on agriculture) and the willingness of the practice to seek to develop new services and market opportunities for the benefit of the clients that remain in agriculture. ACKNOWLEDGEMENTS To the farmers and vets who took the time to deal with the surveys. Thanks to Schering Plough Animal Health who provided the enthusiasm for the initial survey and the assistance with the analysis and support for the project. I am especially grateful to Andy Stewart who put his full support behind the project and delivered the data on time (just) and finally to Dee, Gill and Lorna in the BCVA office who helped produce the paper within four days of publication! REFERENCES Orpin P.G. Future of Cattle Practice: Possible Solutions. Cattle Practice Vol 8:2 p75 s 16

CATTLE PRACTICE BCVA 2001 VOL 9 PART 1 17

CATTLE PRACTICE To members of BCVA BCVA Survey of future requirements of Veterinary Practices You will be aware through BCVA newsletters and other communications that farm animal veterinary practice is under various pressures and will undoubtedly have change in the coming years. The financial constraints of livestock farming and the reduced values of animals are having an immediate effect on practice workload. Now, the government has added to the burdens by suggesting that veterinary medicines are overpriced, and that some of the tasks currently performed by veterinary surgeons should be deregulated to allow others to perform them. There is also a pilot trial testing the practicality of competitive tendering for LVI work, and the possibility of moving TB testing to lay persons. All in all, farm animal practice is under threat. However, BCVA believe that practice has a future, albeit somewhat different from the current situation. We need to define what practice will be like in the years to come, and then manage the changes that will inevitably occur in order to secure a future. BCVA are to take a proactive role in promoting farm animal veterinary practice. Our first task is to find out what the farming public wants from their veterinary surgeon and discover their reaction to some of the possible scenarios. This is to be done by asking approximately 16 selected veterinary practices to send out the enclosed questionnaire to their farm clients. The results will be collected by BCVA and pooled to give a composite picture of over 1000 farms. Each individual practice will have their own results, but these will not be available to anyone else. We are only interested in the national picture. Practices have been selected for their varied geographical location and work type. Schering Plough have kindly offered to provide assistance with the provision of the questionnaire and the collation of the data. They will have access to the results but anonymity will be assured. They will be allowed the right to use the results in their future marketing strategies. In any case, the complete results will be published in Cattle Practice and presented at the October meeting of BCVA. This will help other practices and members plan their future. Your local Schering Plough representative will be contacting you shortly in order to arrange distribution. I enclose a letter from BCVA which you may find helpful to circulate with the questionnaires. It explains the motives and the reasons for the questions. However, please feel free to write your own if you think it more appropriate. Experience with previous surveys of this nature, and in the pilot trail of this one, shows that the response rate is markedly improved by offering a prize or other incentive to stimulate returns. A restaurant meal or similar gift has proved effective. The reward for the practice is a useful survey of their own clients' views, as well as the composite picture which will be more widely available. We are aiming to circulate the questionnaires in July and collect results in August. The figures will be processed during September for presentation at the October BCVA meeting in Glasgow. We hope that you can help with this market research, and very much appreciate your involvement. I believe that the results will be both useful and enlightening for your practice and for the membership as a whole. Yours sincerely, Richard Sibley President British Cattle Veterinary Association BCVA 2001 VOL 9 PART 1 18

CATTLE PRACTICE BCVA 2001 VOL 9 PART 1 19 Covering the Period 1st October 1999 - 1st October 2000 Breakdown Number Amount Fertility Checks (PD/PNC) 13 318.00 Fertility Exam/Treatments 38 639.85 Obstetrics/Uterine Tx 10 177.26 Udder Health Dry Cow 7 533.13 Mastitis Treatments 26 836.54 Footcare Footbaths etc 0 0.00 Lameness Treatments 3 52.46 Consultancy/Advisory Time 1 21.20 Adult General Vaccination 1 297.33 General Veterinary Drugs 68 715.70 General Veterinary Work 16 304.61 Visits 25 315.05 Equine Work 0 0.00 Small Animal Work 12 262.00 Sheep Work 0 0.00 Lab/Investigation 2 53.93 Youngstock Prev/worm/vacc 4 252.30 Youngstock Treatments 12 367.76 Discounts 12 -260.17 Unknown 98 0.00 Total work within period 4886.98 APPENDIX 2 Financial Report

CATTLE PRACTICE APPENDIX 3 A Representative Sample of the Comments on the Surveys Fees Structures • We already have higher fees, when will we get lower drug charges. • How about same vets lower drug charges. • We have no problem with vet's fees or drug mark ups. However, we think that the vets or BCVA should organise themselves better when it comes to purchasing drugs. These are the real criminals who have been ripping us off for years. • Lower fees would help in current climate. • Fees and drugs too high, only use vet in emergency. • Tied to one vet so no competition. • Vets cannot give a lower service as they always do their best, but lower drug prices would help as these represent the larger part of our bill. • Present veterinary costs are too high and do not reflect the profitability of farming at this time. • The price of drugs is too high for cattle at today's prices. • Lower drug charges. • The drug manufacturers are overcharging vets. The UK is seen as Treasure Island by the drug companies. • Lower fees same service. 40% cut same as milk. • Present day stock values will not pay for further treatment. Developments • A homeopathic vet would be a great asset. • I wish vets would involve themselves in homeopathy. • We need the choice to treat our animals with natural medicines and need some advice on homeopathy. Value • Depends on the vet you get. It all depends on getting the right vet. There is too much variation in skilled diagnosis and treatment. • We have only 50 ewes on low stocking density so have not needed emergency vet treatment. • I have no complaints about the charges and the service could not be better. • There is no cost benefit of treatment, it is simply humanitarian treatment. General • The questionnaire is a complete waste of time. How do you know which vet it relates to? What we require is a quality product at a reasonable price unlike what we get, pittance for a good quality product. • Relating to higher quality of service. Should vets not. BCVA 2001 VOL 9 PART 1 20

BCVA 2001 21 CATTLE PRACTICE VOL 9 PART 1 consumer concerns about the methods, safety and ethics of food production and its impact on the environment. Meanwhile, whilst this change has been going on, the food supply chain has increased hugely in complexity, reflecting developments in food business practices at the national level and globalisation of food supplies. We all now accept, and indeed expect, season-less food supply and 'meal solutions', which we can access 'instantly' in our own homes, in the workplace or through a wide range of convenient outof-home points of sale - restaurants, fast-food shops, vending machines and so on. Food Problems Nonetheless, the changes in the nature of food chain have also brought some unwelcome consequences. Traditional, small-scale food production and manufacturing, with local supply and consumption in the home, by its nature, limited the risk of things going wrong in a big way. However, modern methods of food production, because of the complexity and length of the food chain, raise a new range of food risks, and when a problem occurs it can be widespread and very far reaching. It is calculated that the average chicken now travels approximately 1250 miles between production and consumption! As compared with traditional systems of food production and supply, modern systems need to be more closely managed and well controlled and to use technologies that allow food risks to be minimised. This presents an ongoing challenge for all those working in the food chain (including veterinarians) because the biology of diseases and microbiological threats is continuously evolving and changing. Thus the tasks of protecting the food chain and of developing technologies that will minimise risk are of key importance and will never be complete. The Food Standards Agency: Effect on the Cattle Practitioner Thomas P.C., Artilus Ltd, 33 Cherry Tree Park, Balerno, Midlothian, EH14 5AJ. INTRODUCTION Given the robust independence of mind of most cattle veterinary practitioners, I was tempted to wonder whether the organisers of this meeting had left out a question mark at the end of the title they had given me. However, on reflection, I concluded that the reference to the Food Standards Agency (FSA) was convenient shorthand for a range of developments which will have, and indeed are already having, an influence on cattle veterinary practices. Thus, in what follows, I have attempted to put the development of the FSA into context, outline its purpose and significance, and consider some implications for cattle practitioners of recent developments in food policy. The views and opinions expressed are my own, but they derive from a familiarity with the FSA as well as with the food and agricultural industries. Food Habits The past few decades have seen vast alterations in the food market in the developed countries of the World. In the European Union there has been a fundamental shift from the austerity of the 1950s, when food was in short supply, to a situation where food is now abundant, presented in ever increasing variety and readily affordable for most of the population. Alongside this there have been enormous changes in the way that we produce, manufacture and retail food products, and in consumer habits in food purchasing and consumption. The consequences can be seen all around. Scale and efficiency of operation have increasingly dominated thinking in the food supply chain, whilst consumers have become focused on convenience, price and the ubiquitous factor of 'consumer appeal'. Moreover, the latter has broadened in its meaning to encompass not only the traditional considerations of taste, flavour, texture, chemical composition and nutritional value but also ABSTRACT This paper briefly summarises the background to the development of the Food Standards Agency (FSA), which came into being on the 3rd April 2000. It then considers the remit of the FSA to protect public health from risks which may arise in connection with the consumption of food, otherwise to protect the interests of consumers in relation to food. There is an outline of the structure and organisation of FSA and of the methods of working that have been established. The latter place emphasis on putting the consumer first, being open and accessible in the public provision of information and maintaining a position of independence. Finally, the paper considers the implications of the development of the FSA for cattle pratitioners, covering matters of client confidentiality, evidence-based treatment, disease prevention, medicine records and continuing professional development. KEYWORDS: Food standards, Food regulation, Practice management.

CATTLE PRACTICE Consumer Confidence Consumers - and everyone falls into that category - understandably demand the highest quality and standards of food production and supply. Thus the emergence of a seemingly continuous catalogue of food 'scares' in the late 1980s and early 1990s had a fundamental impact on public opinion. Some of the so-called 'scares' were in fact serious and significant food safety or quality issues. But, with the high levels of Press and campaign group coverage that attended almost every food problem, consumers at large began to fail to distinguish between the important and the incidental. As a consequence, there was a wholesale loss of public confidence in the food regulation system and an overwhelming feeling that 'something needed to be done'. A signal issue was the BSE crisis, which in the eyes of consumer organisations highlighted the apparent conflict in the Ministry of Agriculture Fisheries and Food (MAFF) representing the interests of both the agricultural industry and consumers. This led to calls for a separate food body to represent the interests of consumers and, following the election of New Labour to Government, to the establishment of the FSA. THE FSA Technically, the origins of the FSA can be traced to a discussion paper commissioned by Tony Blair before the election and produced by Professor Philip James, the (then) Director of the Rowett Research Institute, in May 1997. When the new Government was appointed the report was used as a basis for consultation leading to a White Paper 'The Food Standards Agency: a Force for Change', which was published in January 1998. There followed further public consultation leading to the Food Standards Bill being introduced to Parliament in June 1999 and receiving Royal Assent in November 1999. Finally, the FSA became operational on the 3 April 2000, after a three-year period of extensive consultation, planning and development. BCVA 2001 VOL 9 PART 1 Aims and Values The FSA represents a major new development in UK regulatory structures and some radically new thinking. It is a body at arms length from Government, with a wide range of direct and indirect powers and a comprehensive responsibility:- To protect public health from risks which may arise in connection with the consumption of food, and otherwise to protect the interests of consumers in relation to food. The nature of the FSA is reflected in its published core values, which are to:- • put the consumer first. • be open and accessible. • be an independent voice. For the first time in UK history, the primary consideration of the regulation of the food chain now takes place outside the closed framework of Government Departments, and with a degree of openness, transparency and public involvement that has been hitherto unknown in such matters. The FSA has already set a standard in providing the public with an unprecedented level of access to information, particularly via the Internet, through holding its Board and regional Advisory Committee Meetings in public and through an expressed commitment to public consultation. Structural Organisation The FSA staff are based in the UK Headquarters in London and the Scotland, Wales and Northern Ireland Executive branches in Aberdeen, Cardiff and Belfast. These latter staff have a distinctive role in ensuring that the FSA policies and approaches are applicable throughout the UK and in providing expert resources locally to advise and assist the legislative programmes of the Scottish Parliament and the Welsh and Northern Irish Assemblies. The range of the FSA's responsibilities is indicated broadly by the structure of the two Science Groups that are located at its Headquarters (Table 1): these 22 Group, Division or Unit1,2 Food Safety Policy Group Enforcement and Food Standards Group Additives and Novel Foods Division Food Labelling Standards and Consumer Protection Division Animal Feed Division Local Enforcement (Policy) Division Chemical Safety and Toxicology Division Local Enforcement (Support) Division Contaminants Division Meat Hygiene Division Food Chain Strategy Division Veterinary Public Health Unit Microbiological Safety Division Food Emergencies Unit Nutrition Division Research Co-ordination Unit Table 1. Structure of the Science Divisions of the FSA Headquarters. 1. Additionally, there is a Corporate Strategy Group, incorporating: Finance, Procurement and IT Division; Personnel and Establishment Division; Communications Division; and Legal Division. 2. The Meat Hygiene Service (MHS) is an Executive Agency of the Food Standards Agency.

CATTLE PRACTICE illustrate the scope of the organisation and its detailed areas of scientific focus. As can be seen, the FSA deals with almost all aspects of the food chain which are relevant to food safety and quality, dividing its resources between policy development on the one hand and enforcement on the other. In some policy areas its work relates to MAFF, which has a continuing responsibility for representing the interests of the food and agricultural industries, and to the Pesticides Safety Directorate (PSD) and the Veterinary Medicines Directorate (VMD). Each of the latter has its own areas of responsibility: for the VMD this includes important functions related to the market authorisation and regulation of veterinary medicines. In regulatory enforcement, the FSA works closely with the Local Authority Environmental Health Officers and also specialist agencies such as the Meat Hygiene Service. In its scientific functioning, the FSA has the facility to call on the specialist capabilities of other Government Departments and Agencies, as well as drawing on the expertise of the Independent Scientific Committees and Working Parties which exist to provide advice (Table 2). Therefore, so far as the food chain is concerned, the FSA is not only in a position to lead in the scientific considerations but also to act as a scientific and policy co-ordinator. Functional Operation Seen from a public and industry standpoint the main functions of the FSA are to:- • provide advice and information to the public and to the Government on food safety from farm to fork, and on nutrition and diet. • protect consumers through effective monitoring and enforcement. • support consumer choice through promoting accurate and meaningful labelling. BCVA 2001 VOL 9 PART 1 Right from the outset the FSA has set the criteria it will use in undertaking these tasks. First, it has indicated that unless very urgent action is required it will base its decisions on the best advice available, consulting widely and obtaining independent advice from its expert committees. Where appropriate, it will commission research to support its functions but it will also be prompt and publicly open about its advice to Government. Time will tell how well these arrangements will work, but the fundamental principles are sound. There is already a real sense of commitment that the FSA will provide the best scientific advice available, and where there are personal consumer choices to be made, it will strive to ensure that the public has full and transparent information on which to base decisions. This approach has been welcomed on all sides, but whether a balanced and open public debate on food policies can take place under the intense pressure that is sometimes created by the British media and campaign groups has yet to be fully tested. IMPACT OF THE FSA In many respects the development of the FSA can be seen as part of a wider European movement, which is reflected in the statutory food bodies in each EU Member State. Most important is that the recently published EU White Paper on Food Safety1 sets out plans for the establishment of an overarching European Food Authority, whose basic principles and approaches have a strong resonance with those already espoused by the FSA. As judged from the published consultation responses, the EU proposal is likely to find support, and the prospect of a pan-EU network of food agencies linking with a EU Food Authority now seems a realistic prospect. It is difficult to predict exactly how such a model will operate, but it is certain that the changes in the 23 Committees Food Advisory Committee (FAC) Expert Group on Vitamins and Minerals (EVM) Advisory Committee on Novel Foods Committee on the Medical Aspects of Food and and Processes (ACNFP) Nutrition (COMA) Advisory Committee on Animal Feeding Spongiform Encephalopathy Advisory stuffs (ACAF) Committee (SEAC) Advisory Committee on the Microbiological Committee on the Carcinogenicity of Chemicals Safety of Food (ACMSF) in Food, Consumer Products and the Environment (CoC) Committee on the Toxicity of Chemicals in Food, Committee on the Mutagenicity of Chemicals in Consumer Products and the Environment (CoT) Food, Consumer Products and the Environment (CoM) Working Parties Chemical Contaminants in Food Food Additives Dietary Surveys Food Authenticity Nutrients in Food Radionuclides in Food Chemical Migration from Materials in Contact with Food Table 2. Independent Advisory Committees and Working Parties

CATTLE PRACTICE political approach to food, both in the Member States and at EU level, will create a quite different climate of regulation than has existed in the past. This will impact throughout the food production and supply sectors, as well as on retailers and consumers; there are probably four key points that should be stressed. Firstly, the policies that are now being adopted by the FSA and others are overtly designed to provide farm to fork coverage of the food chain. This terminology may have initially appeared as convenient shorthand to indicate that the approach was all embracing, but already its practical consequences are beginning to be seen. For example, the proposed new EU hygiene regulations2 for animal-derived foodstuffs, for the first time, extend the controls into primary production on the farm. Thus 'farm to fork' is already finding regulatory expression. Secondly, the approach of the FSA stresses openness, transparency and public involvement and this sets a tone that will have far reaching effects both on public and private organisations. For example, it will become increasingly indefensible for any organisation operating in the food chain, or involved in consumer affairs, to maintain 'closed systems' of policy making. Increasingly, 'evidencebased' policies, meaning policies that can be justified on scientific and/or ethical grounds will become expected and commonplace. Thirdly, both the FSA and the Government have placed emphasis on decisions being made on sound science, taking account of the best advice available and accepting a precautionary approach where appropriate. There is also beginning to be a public recognition that regulatory controls on the food chain must be proportionate to risk and must not overburden industry in a way that prevents it from being internationally competitive. The recent draft FSA report on BSE controls3, commented on the concern amongst consumers and the industry that imported food produce may come from animals whose production is subject to less stringent controls than apply in the UK. Finally, the remit of the FSA goes beyond considerations of consumer safety and embraces consumer choice and assurance. In this there is more than tacit acknowledgement that it is not sufficient just to provide consumers with food that is safe to eat. Consumers also need information on which to make informed choices about food quality and the ethics of food production. EFFECTS ON CATTLE PRACTITIONERS As I have already indicated, the direct effects of the FSA on cattle practitioners are likely to be less than the indirect effects that will arise from the changes in BCVA 2001 VOL 9 PART 1 public policies and industry attitudes, which will be conditioned by the FSA's activities. However, with all the usual reservations about the difficulties of predicting the future, the following areas are some where the role of cattle practitioners is likely to change over the next few years. Openness The veterinary profession has traditionally, and correctly, had great respect for client confidentiality, although working at the interface of private business and protection of public health. However, in the future veterinary clients will need to be more open with their customers, this will require the veterinary profession to re-examine its confidentiality procedures and its role in providing independent validation for the claims of its clients. Evidence-based Treatment Farmers are increasingly going to need to explain and justify their animal production systems or to work under closely specified production contracts with food manufacturers and retailers. They will therefore make new demands on their veterinary practitioners for information. Evidence-based diagnosis and treatment will become the norm. Practitioners should anticipate this not only by reviewing their own approaches to diagnosis and record keeping but also by considering the information that they supply to their clients, and their practice information back-up. Disease Prevention Many veterinarians are already deeply concerned about the trend towards reduced market availability of animal medicines. However, irrespective of that, it is reasonable to anticipate further food-retailer pressures for reductions in medicine use. These, by implication, will bring an increasing emphasis on disease prevention programmes; practitioners who are not already active in this area should be planning the kind of services they can provide. Medicines Records Under the terms of Statutory Instrument No 74, veterinary surgeons now have a legal requirement to keep records on the sale and supply of all POM and PML 'veterinary medicinal products intended for administration to animals whose flesh or products are intended for human consumption'. Additionally, there is an increasing range of farm quality assurance schemes or farm-production specifications that stipulate approved regimes for the use of medicines. Against this background, veterinary record keeping is likely to become an even greater consideration, both for statutory purposes and as an increasing feature of farm assurance. 24

CATTLE PRACTICE There is presently no legal requirement to record the use of GSL medicines but practitioners, with an eye on food assurance, might give serious consideration to extending their practice records to cover all medicine use. Certainly, anyone introducing a new computer recording system would be wise to consider all-medicine recording as a development. The draft EU hygiene regulations, mentioned earlier, will probably take 2-3 years to come fully into force. However, they raise the interesting prospect of all hygiene regulations being based on the Hazard Analysis Critical Control Point (HACCP) approach, with an increased degree of 'own-check' safety programmes. In the farm context, this could offer a range of new business opportunities for cattle practitioners in devising and applying HACCP-based systems of control. CPD As the foregoing points illustrate, in future cattle practitioners are likely to become more closely involved in the day to day business operation of their clients' farms. Rather than providing an emergency service their role will move closer towards that of a business consultant, specialising in animal health but also contributing to the business objective of assuring the quality of the farm's production. In many larger, BCVA 2001 VO L 9 PART 1 forward thinking farm businesses this kind of arrangement is already in place and it will continue as a trend as farm businesses consolidate under the pressure of market forces. For practitioners, the prospective role offers genuine new opportunities, but it also presents significant challenges. Many practitioners will need to develop new or improved skills in communication, data handling and information transfer, as well as in on-farm team working. But most of all they will need to reposition their professional services in the market and to review their skills-set in relation to the market requirements. That will almost certainly involve an investment of time and effort in Continuous Professional Development (CPD) - but in the changing market circumstances that would be time and effort well spent. REFERENCES 1Commission of the European Communities (2000) White paper on Food Safety. COM (1999) 719. Brussels 12.1.2000. 2Commission of the European Communities (2000) COM (2000) 438. Brussels 14.7.2000. 3Draft Food Standards Agency Review of BSE Controls (2000) http:/www.bsereview.org.uk 4Statutory Instrument No 7 (2000) Medicines. The Retailers Records for Medicinal Products Regulations 20000. HMSO, London. 25

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BCVA 2001 27 CATTLE PRACTICE VOL 9 PART 1 • Nutritional - deficiencies of the anti-oxidants Vit. E and selenium. • Toxins and drugs e.g. Ionophores such as monensin. • Lack of myocardial perfusion e.g. in hypertensive states. • Prolonged tachyarrhythmia. • Infection leading to myocarditis. • Immune/sautoimmune mediated diseases. BACKGROUND In the Department of Veterinary Clinical Studies and the Department of Veterinary Pathology at the University of Glasgow Veterinary School, details of the clinical and pathological findings of all cases examined have been collected in a database extending back to 1972. The first case of BDC was diagnosed in 1986. Since 1986, 263 bovine cases of major cardiac pathology have been presented to the Department of Veterinary Clinical Studies. Nine of these cases were confirmed to have dilated cardiomyopathy. SIGNALMENT AND HISTORY Three animals were pedigree Holstein, the remaining six were Holstein-Friesian. All nine animals were female with an age range of between 2 and 6 years at the time of presentation, the mean age being 3.6 years. The duration of illness was short with a range of 1 to 5 weeks between the reported onset of clinical signs and death or euthanasia. Similarly, the average hospitalisation time was also short at 3.7 days due to the rapid deterioration in clinical signs. One animal was seven months pregnant and four animals were within onemonth post-partum. Bovine Dilated Cardiomyopathy - A Retrospective Study of Cases Examined at the University of Glasgow Veterinary School Between 1986-2000 Armstrong S., Division of Farm Animal Medicine and Production, University of Glasgow Veterinary School, Bearsden Road, Bearsden, Glasgow, G61 1QH. INTRODUCTION Dilated cardiomyopathy is a primary dysfunction of the myocardium of unknown aetiology and has been reported in many other species e.g. humans, dogs, hamsters, rabbits and most recently in farmed salmon (Rodger and Turnbull, 2000). Bovine dilated cardiomyopathy was reported first from Australia in 1969, although this was a distinct type of dilated cardiomyopathy affecting newborn "curly-coated" Poll Hereford calves. Since then, the condition has been widely reported from a number of countries and occurring in a range of breeds (See Table 1). Pathological mechanisms proposed for dilated cardiomyopathy include:- • Hereditary - autosomal recessive gene. An inherited predisposition has been postulated from studies carried out in Japan (Watanabe, S. et al., 1979), Australia (Cook, R.W. 1981) and Canada (Baird, J.D. et al., 1986). ABSTRACT The first case of bovine dilated cardiomyopathy (BDC) seen at the University of Glasgow Veterinary School was diagnosed in 1986. Since then, a further eight cases have been examined. Clinical features of BDC include a short duration of illness with a rapid deterioration into congestive cardiac failure, characterised by severe subcutaneous oedema. Post-mortem findings of subcutaneous oedema, hydrothorax and/or ascites, generalised dilation of all four cardiac chambers, hepatomegaly with a classic 'nutmeg' appearance and swollen kidneys were consistent findings in all nine cases. Diagnosis of BDC was confirmed by histopathological examination of the myocardium revealing large variations in myocyte fibre diameter, increased interstitial fibrosis and vacuolation of the myocytes. Table 1. First reports of Bovine Dilated Cardiomyopathies. Year Country Breed 1969 Australia Poll Hereford 1979 Japan Japanese Black 1982 Japan Holstein 1982 Switzerland Simmental-Red Holstein 1985 Canada Holstein 1987 Sweden Friesian 1990 Australia Friesian 1991 U.K. Holstein-Friesian 1992 Switzerland Rotbunte

CATTLE PRACTICE CLINICAL FINDINGS Subcutaneous oedema was found in all nine cases, either as presternal, submandibular, ventral or limb oedema. Ascites or hydrothorax were clinically detectable in the live animal but examination was sometimes impaired by large amounts of subcutaneous oedema. A heart murmur was audible in four cases and the heart sounds were muffled in three other animals. Four animals had distended jugular veins and an excessive level of jugular pulsation was noted in one case. Two cases had palpably enlarged livers and diarrhoea was a presenting sign in two cases. BIOCHEMISTRY RESULTS Biochemical analysis results are available for seven of the nine cases examined. • Urea: The range of results from these cases was 6.3- 22.4 mmol/l (ref range 0-9 mmol/l). Four animals were azotaemic. • Creatinine: The range of results obtained was 113- 180 mmol/l (ref range 53-132 μmol/l). Four animals had concentrations above the normal range. • Bilirubin: Results ranged from 9-66 μmol/l (ref range 0-8 μmol/l). Five animals had markedly elevated bilirubin concentrations. • Liver enzymes: Four animals had markedly elevated alkaline phosphate (ALKP) and aspartate aminotransferase (AST) activity. - ALKP: Results ranged from 181-654 u/l (ref range 20-280 u/l) - AST: Results ranged from 77-873 u/l (ref range<140 u/l) HAEMATOLOGY RESULTS Haematology results were all within normal reference ranges. POST-MORTEM FINDINGS All nine cases had either ascites and/or hydrothorax as well as subcutaneous oedema. Uniformly enlarged hearts with dilation of all four cardiac chambers were consistent findings in all nine cases. In four cases, the heart weight and body weight was recorded allowing calculation of the ratio of heart weight to body weight to be calculated. This ranged from 0.6% to 0.8% (normal value 0.4-0.5% of bodyweight). However, the large volume of oedema present resulted in an elevation of body weight, the heart weight to body weight ratio calculated may thus be an underestimation of the true enlargement of the heart. BCVA 2001 VOL 9 PART 1 The liver was very enlarged with a typical "nutmeg" appearance indicative of chronic venous congestion in all cases. The kidneys were swollen with a granular or pitted surface in seven animals. HISTOPATHOLOGY In the myocardium, interstitial fibrosis and significant variation in myocyte caliber were found in all nine cases. Vacuolation of myocytes was noted in three cases. Congestion of the central vein with atrophy of the hepatocytes in the surrounding area were consistent findings in the liver of every animal. In each case, there was also focal interstitial nephritis or fibrosis in the outer renal cortex. CONCLUSIONS BDC is an emerging disease entity that is being more frequently diagnosed in Holstein-Friesian cattle in the U.K. The aetiology of this condition is poorly understood but a genetic predisposition involving an autosomal recessive gene seems likely. From this study, animals most at risk were female with a mean age of 3.6 years. Pregnancy and parturition may also be risk factors. More research needs to be carried out on the epidemiology of BDC and to identify the genes involved in the development of this disease. ACKNOWLEDGEMENTS Pablo Nart, Clinical Scholar in the Department of Veterinary Pathology Referring Veterinary Surgeons Farmers Staff of the Department of Veterinary Pathology Past and present colleagues in Veterinary Clinical Studies REFERENCES Baird J. D., Maxie M. G., Kennedy B. W., Harris D. J. (1986) Dilated (congestive) cardiomyopathy in Holstein cattle in Canada: genetic analysis of 25 cases. In: Annual report, Centre for Genetic Improvement of Livestock, Department of Animal and Poultry Science. Black D. H., Robinson T. C. (1991) Cardiomyopathy in adult Holstein Friesian cattle in Britain. Veterinary Record, 129: 435. Bradley R., Jefferies A. R., Jackson P. G. G., Wijerate W. V. S. (1991) Cardiomyopathy in adult Holstein Friesian cattle in Britain. Journal of Comparative Pathology, 104: 101-112. Cook R. W., Whittington R. J. (1988) Cardiomyopathy and woolly haircoat syndrome of Poll Hereford cattle. Australian Veterinary Journal, 65: 341-344. Watanabe S., Akita T., Itakura C., Goto M. (1979) Evidence for a new lethal gene causing cardiomyopathy in Japanese Black calves. Journal of Heredity 70: 255-258. 28

BCVA 2001 33 CATTLE PRACTICE VOL 9 PART 1 cases about double the normal values. Haematologically, there was a moderate neutrophilia (16.9 x 109/l), with other parameters unremarkable. Although a firm diagnosis was not made, the owner declined further investigation and the animal was treated for possible brain abscesses with fluorphenicol at 20 mg/kg q 48 hour over a 21 day period. There was no response to this treatment and the calf was re-examined three weeks later. The owner reported that the calf had become photophobic and the crustous dermatitis on the dorsal pinnae had worsened. The area of skin that had been shaved for the lumbar tap was severely sunburned, with the appearance of an eschar. Given the appearance of photosensitisation, in company with the episodic seizures, a tentative diagnosis of BCEPP was made. Blood was taken from the affected calf and from six apparently unaffected calves from its cohort and sent to the Porphyrin Unit in the Department of Medical Biochemistry, University of Wales Medical School. Total porphyrin concentration in the plasma of the affected calf was 467 nmol/l, in comparison with a mean value of 8.0 nmol/l in apparently unaffected calves. Total erythrocyte porphyrin concentration was 552 μmol/l in the affected calf, again high compared to the mean concentration in unaffected calves of 2.2 μmol/l. Hence, the diagnosis was confirmed. There is no treatment for the condition, although some affected animals have become less severely affected over time. Few cases of BCEPP have been reported in the United Kingdom and the prevalence is not known, although the disease is the subject of control programmes initiated by the Limousin breed societies in the United States, Canada and Australia. It is likely that many cases of BCEPP are misdiagnosed and that some commercially available bulls in the UK could be carriers of the abnormal gene. If practitioners see or have seen any cases of BCEPP, we are very interested in discussing them - please contact David Barrett at the address above. Protoporphyria in a Limousin Calf (Abstract) Jonsson N.N., Armstrong S.C., Department of Veterinary Clinical Studies, University of Glasgow Veterinary School, Bearsden Rd, Glasgow G61 1QH. Bovine congenital erythrocytic protoporphyria (BCEPP) is an autosomal recessive disorder previously described in Limousin and blonde d'Aquitaine cattle. It is caused by an abnormality of ferrochelatase, the enzyme responsible for the final reaction in the synthesis of haem from protoporphyrin IX and iron, which results in reduced enzyme activity. This causes an accumulation of high concentrations of photoactive protoporphyrins in plasma, with consequent photosensitisation. Episodic seizures have also been noted in some affected cattle and it has been suggested that this might be due to competition by increased concentrations of δaminoluvulinate with the neurotransmitter γaminobutyric acid. This paper describes a clinical case of BCEPP in a Limousin bull calf that was presented with predominantly neurological signs. The three months old pedigree bull calf was first presented to the referring veterinary surgeon after a two week history of ill thrift, altered demeanour and ataxia, with intermittent collapsing. Although not observed in ictus, after collapsing episodes, the soil around the calf was found to be disturbed, consistent with paddling of the legs. No abnormalities were evident when the referring veterinary surgeon examined the calf and it was treated with a course of corticosteroid injections and multivitamins. Although no seizures occurred during this treatment, the animal deteriorated after medication was finished and it was referred to the University of Glasgow Veterinary School for further investigation, three weeks after it was first examined. The calf weighed approximately 100 kg and was assigned a body condition score of 2.5 on a 1 to 5 scale. It appeared slightly stuporous and there was a 5 mm erosion on the nasal plane that had been present since the last seizure two days previously. The dorsal margins of the pinnae were slightly crustous. No other abnormalities were detected. Cerebrospinal fluid was taken and found to have elevated protein concentration and white blood cell counts, in both

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BCVA 2001 35 CATTLE PRACTICE VOL 9 PART 1 fetlocks and pasterns. The affected animals also have a wide-based stance. The percentage of the calf crop affected is variable and the literature reports prevalences of between 5% and 46% (Ribble and Janzen, 1987). EPIDEMIOLOGY AND PATHOGENESIS There is a suggested nutritional link between chondrodystrophy and the feeding of pit grass silage during foetal development. Gunn and others (2000) reported that the feeding of good quality grass silage with a high leaf content increased the risk of this condition. There appears to be a window of maximum susceptibility in mid-gestation, days 197 to 230 (Ribble et al, 1989), relating to the period of cartilage development. Post-mortem examination of the long bones reveals that the epiphyses are normal, but the diaphyses are short with abnormally thick cartilage. Aetiologies suggested include genetic defects, Vitamin D3 deficiency, deficiency of insulin-like growth factor 1, primary manganese deficiency, mycotoxin contamination of feed acting as a teratogen or a reduced bioavailability of trace elements. It has been established that the condition does not result from a primary genetic defect (Staley et al, 1994), however, it is hypothesised that there may be a breed predisposition or susceptibility in certain continental breeds (Proulx et al, 1992). Studies have ruled out deficiencies in Vitamin D3 and insulin-like growth factor 1 (Hidiroglou et al, 1992) in chondrodystrophy. It has been postulated that manganese deficiency may be involved in the pathogenesis of chondrodystrophy as manganese is a co-factor for enzymes involved in cartilage synthesis and the sulphation of bone matrix. Manganese deficiency may, therefore, result in restricted cartilage growth and disorganisation and reduced mineralisation of bone. However, a deficiency in manganese in cattle herds usually manifests initially as poor fertility and feeding trials have shown that a primary dietary manganese deficiency is not responsible for chondrodystrophy. It has also been hypothesised that increased concentrations of calcium, phosphate (Wilson, 1966) or iron (Matrone et al, 1959) might decrease manganese absorption and retention, thus reducing the bioavailability of manganese. "Chondrodystrophy in Calves - Case Studies" Milne M.H., Barrett D.C., Fitzpatrick J.L., Division of Farm Animal Medicine and Production, Department of Veterinary Clinical Studies, University of Glasgow Veterinary School, Bearsden, Glasgow, G61 1QH. INTRODUCTION This presentation was given to act as a clinical refresher and to raise awareness amongst those in the profession who were not familiar with the syndrome of chondrodystrophy. The need for such a paper became apparent at the BCVA meeting in July 2000, when it emerged that many practitioners were now seeing the condition for the first time. Chondrodystrophy has a worldwide distribution having been recognised in the USA, Canada, Ireland, South Africa, New Zealand and in the UK. The first case in the UK was recorded in the 1940's (Mee, 1995), however, in the late 1980's and early 1990's a few in-depth studies were carried out resulting in an increase in the amount of published work on the condition. The literature is somewhat confused by the fact that this syndrome has been reported under many different names including:- disproportionate dwarfism, congenital joint laxity and dwarfism, long bone deformity and 'acorn calves' (Mee, 1995). In the UK, chondrodystrophy is thought to be the most accurate description, as it best describes the underlying pathology of the cartilaginous tissues affected. The condition is thought to be of low prevalence in the UK, however, this may be due to under-reporting, as often veterinary advice is not sought by farmers experiencing this problem in their herds. In some instances this may be due to farmers' being unwilling to admit that they have produced these calves. In a study conducted in Scotland by Gunn (1992), 150 farms were reported to have an 'outbreak' of chondrodystrophy in cattle, two or more cases in one year, over a 15-year period. From this epidemiological study it was noted that there were more cases in the North of Scotland than in other areas and that it tended to occur in beef suckler herds. PRESENTING SIGNS Chondrodystrophy is a congenital condition that presents with differing degrees of severity. The condition involves deformity of the long bones, especially the humerus and femur, but abnormalities also affect the bones of the skull. This results in shortening and rotation of the limbs, along with disproportionate growth of the skull giving the head a 'domed' appearance and leading to superior brachygnathia and protrusion of the tongue. The most severe cases have difficulty standing and need to be given euthanasia soon after birth. Many cases demonstrate joint laxity of the hocks ('sickle hocks'),

CATTLE PRACTICE CASE STUDIES Three herd outbreaks of chondrodystrophy were studied: Herd A, a 200 cow beef herd (Limousin cross Friesian cows), Herd B, an 80 cow beef herd (Pedigree Aberdeen Angus and Blue Grey cows) and Herd C, a 300 cow dairy herd (pedigree Holstein). Investigations • Questionnaire on management practices (designed by George Gunn). • Blood sample affected animals for trace elements (Co, Cu, Mn, Fe, Zn). • Blood sample age-matched control animals for trace elements. • Hair pluck analysis for Mn content in affected and age matched control animals. • Hair pluck analysis for Mn content in dams of affected and age matched control animals. • Bone-ash analysis and radiography of bones of euthanased cases. • Feed analysis of grass silage. EPIDEMIOLOGY All three herds were spring calving, with most calvings in the months of April, May and early June. The winter ration for all three herds was pit grass silage with no additional concentrates being fed. Beef minerals were available for herds A & B. All affected calves from herd C were born to heifers, whereas, in herds A & B, heifers and cows in various lactations produced affected calves. RESULTS Blood samples revealed that all cases of chondrodystrophy had decreased concentrations of manganese, mean manganese concentration 0.88 μmol/l (+/- 0.09 mmol/l), however, the control animals also had manganese concentrations at the low end of the normal range of 3.3 - 3.5 μmol/l. Hair analysis showed all calves, affected and controls, and two out of eleven cows sampled, one dam with affected calf and one dam with control calf, had levels of manganese below the expected normal level of 0.21 mmol/kg. Post-mortem examination of six euthanased cases revealed that the bone-ash content was normal and radiographic density was also normal. Silage analyses showed an average Mn content of 56 mg/kg. CONTROL Advice for prevention of the condition in subsequent years included:- • Addition of alternative long stem roughage in the ration, i.e. hay, straw or haylage in addition to pit grass silage. BCVA 2001 VOL 9 PART 1 • Addition of concentrates in the ration. • Ensuring adequate delivery of trace elements during pregnancy by inclusion in the diet or the administration of a rumenal bolus, containing Cu, Co, Se, Mn, Zn, I, S, Vitamins A, D3, E. • Ensuring silage is of good quality and is stored adequately. These measures were employed largely on an empirical basis, but in an attempt to reduce potential problems with the bioavailability of trace elements or contamination with mycotoxins. After instigating some, or all, of the suggested control measures none of the farms experienced the problem in the subsequent year. SUMMARY Neither review of the published literature, nor the results of these case studies have revealed a definitive aetiology for chondrodystrophy in cattle. There is no evidence of a primary manganese deficiency. It is also clear that while beef suckler herds may be more commonly affected, the condition can also be seen in the calves of dairy heifers when they are managed in a similar way to suckler cattle. It is suggested that this condition may become more common in future due to farmers relying increasingly on home-grown forage-based rations. The increased interest in organic farming and its related feeding practices may also lead to an increase in the prevalence of this condition, whether it is due to a reduced bioavailability of trace elements or the presence of teratogens in the ration. ACKNOWLEDGEMENTS The authors would like to thank the referring Veterinary Surgeons, farm staff, Dr G. Gunn (SAC, Inverness) and the University of Glasgow Departments of Veterinary Clinical Studies and Veterinary Pathology. Miss M. Milne is employed as a Royal College of Veterinary Surgeons Trust Fund Millennium Residency in Production Animal Medicine and is a recipient of the Walker Memorial Award. REFERENCES Gunn G. (1992) A congenital chondrodystrophy syndrome of calves. Cattle Practice 1: 42-48 Gunn G., Caldow G. , Lowman B. (2000) Congenital joint laxity and dwarfism in cattle. Veterinary Record 147: 199-200 Hidiroglou M., Ivan M., Proulx J.G., Davicco M.J., Coxam V., Barlet J.P. (1992) Plasma 1,25-dihydroxyvitamin D, insulin-like growth factor-1, calcium, magnesium and phosphorus concentration in pregnant beef cows and calves from a herd with a known history of congenital joint laxity and dwarfism. Research in Veterinary Science 52: 32-37 Matrone G, Hartman R.H, & Clawson A.J. (1959) Studies of a manganese-iron antagonism in the nutrition of rabbits and baby pigs. Journal of Nutrition 67: 309-317 36

CATTLE PRACTICE Mee, J.F. (1995) Non-hereditary disproportionate dwarfism in a beef herd: Clinical and pathological features. Irish Veterinary Journal 48: 93-105 Proulx J.G., Ribble C.S. (1992) Congenital joint laxity and dwarfism in a beef research herd. Canadian Veterinary Journal 33: 129-130 Ribble C.S., Janzen E.D. (1987) Congenital skeletal deformity syndrome. Canadian Veterinary Journal 28: 4, 160 Staley G.P., van der Lugt J.J., Axsel G., Loock A.M. (1994) Congenital skeletal malformations in Holstein calves associated with putative manganese deficiency. Journal of the South African Veterinary Association 65: 73-78 Wilson J.G. (1966) Bovine functional infertility in Devon and Cornwall: response to manganese therapy. Veterinary Record 79: 20: 562-566 BCVA 2001 VOL 9 PART 1 37

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BCVA 2001 39 CATTLE PRACTICE VOL 9 PART 1 First lactation cows took less time to lie down (L1- L4) compared with older cows (26 sec versus 32 sec, P = .02), probably due to having a shorter preparatory phase (L1-L2) (18 sec versus 21 sec, P = .06), whereas stage of lactation had no effect on duration of lying down movement (P> .10). ). Time for rising was not affected by either stage of lactation or lactation number (P > .10). Cows in early lactation spent less time lying in total than cows in late lactation and dry cows (early: 576 min versus late: 820 min and dry: 761 min, P < .0001) and the maximum bout length was shorter (early: 92, late: 136 and dry: 176 min, P < .0001). The number of lying bouts decreased from early to late lactation and dry cows had the least number of bouts (14.3 versus 11.7 and 8.6 bouts/21.5h, P < .001). In conclusion, parity had minor effects on lying behaviour, whereas stage of lactation strongly affected lying behaviour. Discomfort while lying due to a high tension in the udder in early lactation may reduce the lying time and increase the number of bouts. However, early lactation cows may also spend longer eating which may affect their timebudget including lying behaviour. Effects of Stage of Lactation and Parity on the Lying Behaviour of Dairy Cows in Tie-Stalls Chaplin S.J1., Munksgaard L2. 1Scottish Agricultural College, Veterinary Sciences Division, Dairy Health Unit, Auchincruive, Ayr, KA6 5AE, Scotland. 2Danish Institute of Agricultural Sciences, Department of Animal Health and Welfare, Research Centre Foulum, 8830 Tjele, Denmark. This work has been previously published in the Proceedings of the International Congress of the International Society for Applied Ethology, held in Lillehammer, Norway, 17-21 August 1999, p193. Lying behaviour is often used as an index of cow comfort. However, there is very little published information about the effects of cow factors such as stage of lactation and parity on lying behaviour. Hence, the behaviour of 58 Danish Friesians in tiestalls was continuously recorded on video for 21.5 hours, starting between 12:00 and 14:30. The cows were in their first (n=29), second (n=14) or third lactation (n=15). There were 24 dry cows, 16 early lactation cows (<100 days in milk) and 18 late lactation cows (>200 days in milk), divided between the three age groups. Each lying down and rising event was split into four stages and the time of onset of each stage was recorded from the video. The four stages of lying were: L1) characteristic, rhythmic swinging of the head with the muzzle close to the ground, L2) one knee and shoulder lowered towards the ground, L3) weight taken onto both knees, L4) sternal recumbency with the legs and body still. For rising, the four stages were R1) sternum raised from the ground, R2) stretching forwards with the head and neck but flanks still resting on the ground, R3) weight taken onto both knees, back legs straightened, R4) standing balanced with four feet on the ground.

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BCVA 2001 41 CATTLE PRACTICE VOL 9 PART 1 Concentration Dependant Killing Activity of Baytril Curwen A.D1., Pirro F2., Ganiere J.P3., P Watson P1 1Bayer plc, Eastern Way, Bury St Edmunds, IP32 7AH. 2Bayer AG, Animal Health, 51368 Leverkusen, Germany. 3Ecole Nationale Veterinaire, 44307 Nantes, France. ABSTRACT In veterinary medicine, fluoroquinolones (FQs) have proven to be highly valuable antimicrobial drugs that combine antibacterial and pharmacokinetic properties in a unique way. Thus, they display an excellent therapeutic profile whilst being well tolerated. The first third generation FQ for veterinary use, Baytril®, has been widely used for the treatment of a broad spectrum of bacterial infections for more than ten years. Indications include respiratory and enteric diseases in cattle. Recent clinical research led to Baytril ® Max a single injection treatment for Bovine Respiratory Disease. This new formulation of Baytril has been developed to optimize enrofloxacin's concentration-dependent pharmacodynamic and bactericidal properties. This investigation was initiated to illustrate the rapid and concentration dependent mode of enrofloxacin's action in bovine respiratory pathogens. The time kill kinetics of a number of bovine respiratory pathogens were assessed in vitro. The results of this work clearly underline the concentration dependent bactericidal activity of Baytril: The higher the concentration the quicker the kill. As concentrations used within this work are easily achieved at the site of infection following administration of Baytril Max the microbiological effects seen in this work can be reasonably expected to happen in the animal. These characteristics, plus its favourable pharmacokinetics and wide margin of safety, make Baytril a rapid, reliable and effective therapy against many diseases caused by bacteria and Mycoplasma.

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BCVA 2001 43 CATTLE PRACTICE VOL 9 PART 1 RESULTS AND DISCUSSION The High QDN diet resulted in a significant increase (P<0.02) in mean milk urea (Control 5.6 ±1.2, High QDN 7.2 ±1.2 mmol/l), plasma urea (Control 6.5 6 ±1.3, High QDN 8.26 ±1.4, mmol/l) and plasma ammonia (Control 85.2 ±3.54, High QDN 100.4 ±4.25 μmol/l). 16 Control and 15 High QDN cows became pregnant, embryo measurements from these cows are summarised below. There was no significant difference between treatments in the linear equation describing embryo growth for any of the embryo measurements, nor was there any significant difference in the distribution of the data points. Thus, this study found no significant effect of feeding excess QDN to lactating Holstein cows on either embryo survival or embryo growth. This is in contrast to the findings of McEvoy. (McEvoy et al 1997), but in agreement with the findings of Kenny. (Kenny et al 1999) who found no effect of elevated plasma urea and ammonia levels on embryo survival in beef heifers. REFERENCES Kenny D.A, Boland M.P., Diskin M.G., Sreenan J.M (1999). Procedings BSAS occasional meeting September 1999, 59-60. Laven R.A., Drew S.B. (1999) Veterinary Record 145: 693. McEvoy T.G., Robinson J.J., Aitken R.P., Findlay P.A., Robertson I.S. (1997) Anim. Rep. Sci. 47: 71-90 The Effect of Feeding High Levels of Quickly Degradable Nitrogen to the Lactating Dairy Cow on Embryo Growth Laven R.A., Biggadike H.J., Collins C.A., Mansbridge R.J., ADAS Bridgets, Martyr Worthy, Winchester, Hampshire, SO21 1AP. INTRODUCTION Increasing dietary protein intake can increase milk production, but may also reduce reproductive performance (Laven R.A., Drew S.B. 1999). McEvoy (McEvoy et al 1997) reported that feeding high levels of excess Quickly Degradable Nitrogen (QDN) to sheep resulted in an increase in embryo mortality but an increased fetal growth in surviving embryos. The objective of this study, which formed part of a larger project, was to investigate the effect of feeding high levels of QDN to lactating dairy cows on embryo growth and survival. MATERIALS AND METHODS 42 mature Holstein cows were group fed one of two diets. The Control diet was formulated to meet the metabolisable energy and metabolisable protein requirements for early lactation cows according to the UK systems (AFRC, 1993). All cows were fed this diet for 3 weeks, 21 cows were then randomly allocated to a diet supplemented with urea (High QDN). This comprised the Control diet plus 250 g urea per cow per day (equivalent, on a metabolic bodyweight basis, to that fed by McEvoy (McEvoy et al 1997)). The two diets were isoenergetic but the High QDN diet supplied 50% more QDN than the Control (95g/kg DM against 61 g/kg DM). At study start, all cows were non-pregnant and less than 112 days post partum, their mean daily milk yield was 37 litres. Milk samples were collected three times weekly for determination of urea concentration. Blood was collected for urea and ammonia measurement, three hours after feeding, three times during the week after urea introduction, and then weekly until 7 weeks post conception. Rectal scanning, using a B-mode ultrasound probe, was used to measure embryo size, weekly from week 4 to week 7 after conception. Control High QDN R2 Slope R2 Slope P B L 0.848 0.065 0.650 0.046 0.670 B W 0.867 0.031 0.880 0.036 0.178 H L 0.798 0.034 0.686 0.032 0.709 H W 0.837 0.036 0.790 0.036 0.910 (B=body, H=head, L=length, W=width)

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BCVA 2001 45 CATTLE PRACTICE VOL 9 PART 1 Post Mortem Findings 12 calves from 3 outbreaks were examined. Significant findings were:- • Low rumen pH in 4 calves from 2 farms (lowest pH was 3.4) • Rumen impaction in 2 calves from 2 farms. • Eosinophilic enterocolitis noted in 4 calves examined from 2 farms without evidence of parasitic infection. This raises the possibility of a dietary intolerance. • Lymphocytic/ plasmacytic typhlocolitis with Campylobacter species bacterial overgrowth noted in one calf. • Chronic active coccidiosis diagnosed histopathologically in one calf. • Oesophageal and lingual erosions were noted in three calves from two farms. BVDV not isolated from any carcass. • High liver copper levels (upto 44900 μmol/kg, RR 314-7850 μmol/kg) in nine calves from all three farms. This is an unexplained finding possibly due to chronic disease. No evidence of copper poisoning detected. Nutrition Home mixes (*): All home mixes gave 11.0- 12.5MJME/kgDM 4 gave 17-19% crude protein 1 gave 14% crude protein All had adequate vitamin/trace element inclusion levels. Straw (**): 1 farm poor quality, 1 farm available as bedding only. Hay (***): 2 farms poor quality / restricted access. Potential problems were identified with four of the diets, the most consistent problem being a high starch level. This may not be suitable for calves with developing rumens, particularly where intakes of long fibre are low. It was postulated that rapid rumen fermentation could lead to acidosis (noted on post mortem), chronic indigestion and scour. Other nutritional hypotheses have been put forward by A Summary of Investigations of Peri-Weaning Scour Syndrome (PWSS) Outbreaks in Scottish Dairy Calves Mason C., Crawshaw M., Barber D., Scottish Agricultural College, Veterinary Science Division (SAC VSD), Auchincruive, Ayr, KA6 5AE. Six outbreaks of PWSS were investigated during 1999-2000. SUMMARY OF SIGNIFICANT FINDINGS Clinical History • Disease onset aged 8-10 weeks. • Most cases started post-weaning and some persisted for up to 6 months. • 4 herds had a recurrent problem. • 2 herds showed self cure with no mortality. • 4 herds showed mortality up to 10%. • All were open herds. • No herds had a significant neonatal scour problem. Clinical findings • All Holstein Friesian calves aged 5 weeks to 6 months including heifers and bulls:- • Soft to diarrhoeic faeces with no blood. • Calves were non-pyrexic, eating, drinking and generally 'bright'. • Calves were ill thriven (condition score 1-2) and 'pot bellied' in many cases. • Calves in four herds showed progressive deterioration with no response to treatment resulting in death or culling. • Recumbency, low grade chronic coughing and conjunctivitis were found in isolated cases. Clinical Pathology Findings (all samples from clinical PWSS cases) 76 faecal samples were examined as follows:- • Bacterial cultures including Salmonella and Campylobacter species, worm egg and coccidial oocyst counts, ZN stained smears plus examinations for rotavirus, coronavirus, cryptosporida, giardia and motile protozoa. • No significant findings made. • Routine blood biochemistry was carried out and the only significant finding was Vitamin E levels below the reference range in 75% of samples. • Paired serology and antigen detection for Bovine Virus Diarrhoea virus indicated exposure to a persistently infected calf and seroconversion in the group, coincident with disease in one herd. • Laboratory findings at this stage do not point to a consistent, significant aetiological agent, deficiency or organ dysfunction. Proprietary coarse mix Proprietary pellet Home mixed coarse mix Straw Hay No. Farms pre-weaning. 3 1 2 33 No. of farms post weaning 10 5* 3** 3**

CATTLE PRACTICE (Orpin 1999). In general it is possible that dietary imbalances or inappropriate dietary constituents are likely to play a role in this emerging syndrome. The possibility of a dietary intolerance cannot be ruled out in some cases. Possible reasons for dietary imbalances could include:- • Increasing numbers of farmers home-mixing diets to reduce costs (seen in 5/6 farms investigated) • An increased reliance in these mixes on cheap home produced cereals at high inclusion rates in the diet, which may be inappropriate for young calves. • The quality of, or access to, the long fibre source for young calves is being overlooked in some cases. MANAGEMENT AND HUSBANDRY FACTORS OF POTENTIAL SIGNIFICANCE Weaning management • In all outbreaks calves were weaned by age (6-10 weeks old) and general appearance, not by bodyweight or the weight of solid food being consumed. • On all farms it was intended that calves should be eating 1-2kg of solid food at weaning, however in 4/6 herds calves were consuming less than predicted, in the worst case only 0.5kg per calf. • On 2/6 farms calves were fed milk ad-lib using automatic feeders which had no provision to gradually reduce the amount of milk fed while increasing the solid food intakes. Therefore calves in these cases were weaned abruptly. It was these calves that had the lowest solid food intakes at weaning. Treatment and Management • The only successful method of treatment was to return the worst affected calves to the pre-weaning milk diet for 3-4 weeks (Blowey 2000) and then gradually wean again once clinically improved. • Treatment with antibiotics had limited effect. • Supplementation with Vitamin E and Selenium preparations in response to the low blood levels made no significant difference. BCVA 2001 VOL 9 PART 1 CONCLUSIONS • PWSS is likely to be a multifactorial problem. • No consistent evidence of a recognised pathogen found in this study but a novel unidentified agent may be involved. Other workers have identified Giardia duodenalis (O’Handley et al 1999) and an as yet unidentified population of bacteria inhabiting gastric pits (Gunning 2000) in affected calves but their aetiological role remains undetermined. • Our focus on management and nutrition suggests that these factors do play a role in the pathogenesis of the disease. Several factors may be involved on an individual farm and may be different between farms but produce a similar disease presentation. Furthermore management and nutritional factors may predispose calves to infectious disease. • Preparing the rumen for the post-weaning diet appears important. In two thirds of outbreaks calves were eating less solid food than predicted at weaning. • Returning affected calves to milk and increasing solid food intakes pre- weaning have proved successful ways to treat and prevent the condition and offer further support to this theory • Many farmers recognise a growth check and a transient scour or ruminal distention after weaning (mild PWSS) and accept this as a normal occurrence. We may have been investigating a more severe manifestation of this (severe PWSS). • Difficult to explain the sudden onset of PWSS disease in two of these outbreaks where no recognisable change in management had occurred. ACKNOWLEDGEMENT SAC receives funding from SERAD. Thanks to Nick Offer and Mitch Lewis for help with the dietary analysis. REFERENCES Blowey R.W. (2000) Cattle Practice 8: 89-98 Gunning R.F. (2000) Veterinary Record 146: 384 O'Handley R.M., Cockwill C., McAllister T.A., Jelinski M., Morck D.W., Olson M.E.(1999) JAVMA 214: 391-395 Orpin P. (1999) Cattle Practice 7: 65-67 46

BCVA 2001 47 CATTLE PRACTICE VOL 9 PART 1 such as:- (i) Does the prevalence of faecal shedding on the farm have a direct bearing on meat contamination and human illness? (Woolhouse M.E.J). (ii) What is the effect on carcass contamination of mixing infected with uninfected animals during transport, in market yards or in lairage prior to slaughter? (Reid S.W.J). (iii) What is the relative contribution of faecal shedding and hide contamination to the presence of bacteria on carcasses? (Amyes S.) (iv) What events during harvest are the most important to meat contamination? (Dougan G.) (v) Would reducing meat contamination affect the incidence of sporadic disease in humans? (Levin B., Atlanta USA). Sampling of animals in Scotland has begun and will be conducted at intervals throughout the chain to obtain data for stochastic risk models and to provide a basis for the trace-forward/back studies. The sampling strategy has been formulated in collaboration with the Scottish Agricultural Colleges and is based on data from their recently published study of the prevalence of E. coli O157 on Scottish farms, funded by the Scottish Executive. Samples (faeces, hides, carcasses, meat, equipment) will be collected at each of the following steps, departure from farm, arrival at slaughter, immediately post mortem, carcasses and equipment on line and in chill. Throughout the study, identified human cases within Scotland will be subjected to rigorous traceback. This will build upon the current (separately funded) E. coli O157:H7 case-control study being carried out by the Scottish Centre for Infection and Environmental Health (SCIEH) and will involve the development of molecular markers. Information will be available from source farm, processing plant and Epidemiology and Evolution of Enterobacteriaceae Infections in Humans and Domestic Animals Peri- and Post-harvest Risk Identification and Quantification of Foodborne Transmission Mellor D.J1., Innocent G.T1., McEwen S.A2., Reilly W.J3., Taylor D.J4., Steele W.B4., Gunn G.J5., Ternent H.E1., Reid S.W.J1. 1Comparative Epidemiology and Informatics, Departments of Veterinary Clinical Studies, University of Glasgow Veterinary School, Bearsden Road, Glasgow, G61 1QH & Statistics and Modelling Science, University of Strathclyde, 26 Richmond Street, Glasgow, G1 1XH. 2Department of Population Medicine, Ontario Veterinary College, University of Guelph, Ontario, Canada. 3Scottish Centre for Infection and Environmental Health, Clifton House, Clifton Place, Glasgow, G3 7LN. 4Department of Veterinary Pathology, University of Glasgow Veterinary School, Bearsden Road, Glasgow, G61 1QH. 5SAC Veterinary Science Division, Drummondhill, Stratherrick Road, Inverness, IV2 4JZ. There is evidence that the infection status of production animals and their products can change during events that occur from the point of departure from farm to final consumption of meat. Current tenets are that risk reduction interventions must be placed at intervals along the entire food chain if the public is to be adequately protected. Knowledge of the dynamics of meat contamination is needed if we are to estimate the impact of interventions such as prevalence reduction in herds, hide cleanliness of slaughter animals, testing programmes for animals or meat product and segregated slaughter. Traditional experiments and observational studies have produced qualitative information in these areas, but new approaches are needed to improve understanding of the interrelationships among the variables affecting contamination of meat, to assemble existing data and to deal with uncertainties that exist. This study seeks to assess quantitatively, factors of importance in the contamination of meat products with EHEC and drug resistant Salmonella and E. coli, from the point of departure of cattle from farms, through transport, mixing, slaughter and processing, distribution and finally to consumption. The study will test a number of hypotheses concerning risk associated with the animal-human transmission, viz: (i) that the prevalence of infection in cattle at slaughter has direct bearing on the contamination of food product; (ii) that the source of animals is an important risk factor for the production of contaminated product; (iii) that human cases are associated geographically and temporally with specific cattle sources (Woolhouse M.E.J). These will be addressed in collaboration with other members of the WIPRAVE partnership under focused questions

CATTLE PRACTICE human case population, enabling us to test the hypothesis that human disease is directly associated with animal. Data from these sources and the literature will be used to build stochastic risk models of meat contamination and human infection. Stochastic simulation modelling has utility where the system under study is complex and when it is highly desirable to allow for variability and uncertainty in input variables. Risk models will form the basis for peri- and post-harvest Hazard Analysis and Critical Control Point (HACCP) strategies and Statistical Process Control (SPC) designs by incorporating interventions and their associated critical limits. Interventions are needed throughout the food chain to reduce risks of foodborne pathogens and these should be adaptable to HACCP systems. In many of the periand post-harvest points in the food chain, however, more knowledge is needed of the likely critical control points and their critical limits (e.g. Pathogen concentrations) and the risk models developed in this study would be used to specify the criteria for improving the microbial safety of meat. BCVA 2001 VOL 9 PART 1 ACKNOWLEDGEMENT Epidemiology and evolution of Enterobacteriaceae infections in humans and domestic animals: Coordinated by M.E.J. Woolhouse, Centre for Tropical Veterinary Medicine, University of Edinburgh, UK. Wellcome International Partnership Research Awards in Veterinary Epidemiology. REFERENCES Amyes S., Edinburgh. Transfer of resistance and virulence genes from food-producing animals to man. Davison H., Edinburgh. Epidemiology of antibiotic resistance in cattle. Dougan G., London. Novel molecular approaches to study Vero cytotoxin-producing Escherichia coli (VTEC) epidemiology. Levin B., Atlanta, USA. The population biology and epidemiology of antibiotic resistance plasmids and toxin-encoding phages. Reid S.W.J., Glasgow. Peri- and post-harvest risk identification and quantification of foodborne transmission. Woolhouse M.E.J., Edinburgh. Transmission dynamics in the field. 48