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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Antimicrobial Resistance Pits the AVMA Against the FDA ... and Against Me, Too

July 16, 2010 / (15) comments


Ever wonder why the antibiotics in your food supply have led the powers that be to step in and actually quantify your risks? I do, just as any veterinarian worth his or her salt should.

Because the antibiotics that are being fed to the animals you eat are probably interfering with the ability of these drugs to work as well as they might should you suffer a life-threatening infection. 

The issue of antimicrobial resistance — when the overuse of antibiotics means they no longer do their thing — has been gaining ground among human and animal doctors for decades now. Here’s the issue in a nutshell: If we feed antibiotics to animals to prevent infections, are we thereby abusing the drugs we might need to keep humans safe in the future? 

The answer is simple, if disquieting: We don’t rightly know. Given that it’s tough to prove direct links in so chaotic a system, the evidence may not become available for some time. However, the scientific establishment, including the human medical profession, does agree that antibiotics used to promote animal growth through disease prevention is almost certainly contributing to antimicrobial resistance.

To consider otherwise is to reject the obvious, they say. Slavishly adhering to the demands of rigorous evidence in a case where people are dying and antibiotics are becoming less helpful every day is asinine, they argue. Hence, the call for abandoning the routine use of antimicrobials in animal feed — if, that is, the goal has little to do with actually treating a disease.

Introducing the characters: The AVMA — as in, the American Veterinary Medical Association, my profession’s leading organization, of which I am a card-carrying member; the FDA — as in, the Food and Drug Administration, whose job it is to oversee the safety and efficacy of food and drugs that are consumed by American humans and animals, alike; and Me, in my capacity as columnist for Veterinary Practice News.

The AVMA argues for the unrestricted use of antimicrobials in animal feed, citing animal welfare and food safety concerns.

The FDA is with the American Medical Association (AMA) and other human medical-based groups, who argue against the non-therapeutic use of antibiotics in animal feed. In other words, if an animal is sick you treat it with drugs and observe proper withdrawal times for the use of its milk, meat, or eggs. But you don't treat food animals indiscriminately with drugs as a way to pack on the poundage more efficiently.

To underscore its point, the FDA recently issued a new policy guideline on the subject. Here's what The New York Times had to say a couple of weeks ago on that score:


Federal food regulators took a tentative step Monday toward banning a common use of penicillin and tetracycline in the water and feed given cattle, chickens and pigs in hopes of slowing the growing scourge of killer bacteria.

But the Food and Drug Administration has tried without success for more than three decades to ban such uses. In the past, Congress has stepped in at the urging of agricultural interests and stopped the agency from acting.

In the battle between public health and agriculture, the guys with the cowboy hats generally win.


Which is exactly why I dedicated my monthly column in Veterinary Practice News to the subject. In so doing, I was looking to pose this question to my profession:


Aimed at promoting growth and preventing disease in an industrial setting, the use of antibiotics in farm animals has been a boon to animal agriculture. Our protein now grows bigger and faster on less feed in less space. It succumbs to fewer diseases. Our dependence on therapeutic drugs that might necessitate long withdrawal times is reduced.

For the public this might seem a slam dunk. Not only is our protein cleaner, but since animals cost less when we raise them on antimicrobials, supermarket-sized chunks of them cost less, too. In fact, feeding an American family a diet rich in animal proteins has never been as inexpensive as it is today.

But at what cost?


Since I was looking to get a response from my profession, I guess I shouldn't have been surprised that I touched a nerve at the top: 


Editor:

Though antimicrobial resistance is a topic of interest for everyone, including veterinarians and the American Veterinary Medical Association, articles such as the May 2010 Reality Check column by Dr. Patty Khuly ["Just Say 'No' to Big-Ag Antibiotics?"] do little to educate our colleagues or the public.

In fact, we are concerned that her remarks will serve only to further divide our profession by spreading inaccurate concepts that are not supported by the science. For example, large-animal veterinarians are generically lumped into a category she calls "industry oriented" and Dr. Khuly refers to all farming as "industrial," disregarding the fact that the vast majority of large farms are family owned.

We also must be aware that we will need to double the global production of animal protein in the next 40 years if we are going to meet the growing demand. That can only be accomplished by production agriculture utilizing all the current and newest technology.

Insinuating that antibiotics are nothing more than a mechanism to compensate for poor husbandry, bad management practices and making a quick buck is insulting to our colleagues who use antibiotics therapeutically to ensure animal health and welfare in addition to providing a safe and healthy food supply.

The Food and Drug Administration and Codex agree with the AVMA’s definition of "therapeutic use" to include disease treatment, control and prevention. Any large-animal veterinarian or expert in population medicine can corroborate that preventing a disease in a flock or herd with a lower dose, less important antibiotic is always preferable to waiting for obvious clinical signs and treating the disease with a higher dose, stronger antibiotic, which, in turn, has a greater potential to impact human health.

Dr. Khuly implies that her food animal colleagues are guilty of indiscriminate use of antibiotics routinely included in feed...

Larry R. Corry, DVM


Dr. Corry goes on from there for another 500 words or so. You can read the whole rambling thing here.

Dr. Corry urges me to "remember science," to which I can only say … pay attention to what the vast majority of the scientific community is saying. To ignore the overwhelming preponderance of scientific opinion against the AVMA's narrow view of the science is to see our profession's credibility dwindle. And I, for one, want to go on record that our profession isn't always best represented by the "guys with the cowboy hats."


Dr. Patty Khuly

 

 

 Pic of the day: "summertime." by dirkjankraan.com

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COMMENTS (15)
1
by hamishdad on 07/16/2010 06:43am

Thank you, Dr. Khuly, for taking a stand against the AVMA's position on the unrestricted use of antimicrobials in animal feed.

Here are comments from the AVMA in response to the EPA's recent evaluation of pet spot-on products and risk mitigation plan:

http://www.biospotvictims.org/EPA-HQ-OPP-2010-0229-1127.1_3_.pdf

I was very disappointed by the AVMA's comments. They pale in comparison to comments on this issue that were submitted to the EPA from the NRDC, the Humane Society of the United States, and Beyond Pesticides, and seem more interested in protecting their distribution channel than in protecting pets from the serious side effects of these products.

Shame on the AVMA for missing an opportunity to prevent the needless suffering and death of pets.

2
by Tasmin on 07/16/2010 07:45am

I attended the International Conference on Emerging Infectious Diseases earlier this week, and antimicrobial resistance was probably second only to pandemic flu in the number of talks devoted to it.

One of the speakers said something I found very interesting - that there have been no studies since the early days of antibiotic use in livestock feed that have definitively shown a benefit to the practice. His claim seemed to be that our husbandry practices have advanced enough that the use of antibiotics is no longer needed.

Also interesting - older studies that found an increase in resistant microbes on everything from barn mice to human workers when cattle were treated with antibiotics.

3
antimicrobials
by Kayteenm on 07/16/2010 08:28am

I have felt for years that this use of antimicrobials is not a good thing..for either us or the animals. If the conditions the animals are raised in were better there would be no need for them. I generally try to find meat raised without antibiotic use when I eat it and I do the same for my cats and dog.
Thank3 you for speaking out. Big Pharma also carries a big stick and has far-reaching influences so no small wonder Dr. Corry took a stand against you.
Keep up the good work and the wonderful blogs!

4
by Elizabeth on 07/16/2010 08:53am

Thank you for speaking out against the AMVA. I certainly agree that the unrestricted use of antibiotics in animal feed is irresponsible, careless, and dangerous.

As you point out, one of the consequences of using antibiotics to pump up food animals has led to ever-cheaper protein sources. However - and I don't mean to insinuate that I believe that you think this way - I think it's disappointing for the public to think of animals as nothing more than hunks of protein meant for consumption. Especially in privileged countries like Canada and the US, we are fortunate enough to have access to vegetable proteins that will never require the use of antibiotics to grow safely. A reduced reliance on animal proteins would reduce the overuse of antibiotics at its source. A well-planned diet low in animal products is an ethical, environmentally friendly, and healthy choice.

5
antimicobials
by kay morris on 07/16/2010 09:04am

This has been going on/for a long time. No they do not care about us or the animales. They (Pharma) will sell their Souls for money.Thank-you Dr. Khuly, We need more wake-up calls.

6
use of antibiotics
by amirek on 07/16/2010 09:11am

I agree--the use of antibiotics indiscrimminately is wrong and it is harmful. It's not only harmful to us, it's harmful to the animals. If they are constantly being medicated with antibiotics, there is no doubt in my mind that the very "scourges" that afflict the animals will eventually develop an intolerance to the antibiotics. Then what? The medical profession is rapidly running out of alternatives with which to treat many illnesses.

When I had chickens (hens), I only gave them antibiotics when needed. If one of them became ill, she was isolated and treated. If more than one became ill, they were isolated and treated. I didn't medicate the whole flock just to treat the one or two chickens. If the majority were ill, THEN I might. This is the problem, though--farmers generally hawe huge herds or flocks, so they may not be able to pinpoint which are ill. As a consequence, they medicate the entire population. Since that proved effective, they decided to just medicate on a constant basis, figuring they'd actually prevent illness before it happened, and thus save $$$.

The only way that I can see farmers stopping their practice of prevention medicating is to insist that they manage their animals more carefully. That might entail dividing the animals into smaller groups for monitoring more easily. This would be beneficial to the animals, because overcrowding is not a good thing. However, growing animals for food is like growing crops--farmers are concerned about their bottom line. The more healthy animals they can deliver for slaughter, the more money they make. It's not likely they will want to take on the added expense of monitoring, as it cuts into their bottom line. For them, the health of their animals is important, but mostly inasmuch as the animals are bringing them a profit. :(

7
The AVMA
by arlo muttrie on 07/16/2010 02:07pm

The main reason the AVMA exists is to protect the income of its members. This is not inherently evil--it is what most, if not all, professional organizations do.

I, too, was a card-carrying member of the AVMA, until I got out of private practice. The only reason I ever held membership in an organization in which I felt so out-of-place was so that I could buy liability and license insurance for a reasonable cost. Now that I no longer need those, I happily avoid belonging to an organization so firmly rooted in 19th-century values that Plessy vs. Ferguson probably seems logical to some of its members. Antibiotic usage, confinement rearing, tail docking... the list of issues where the AVMA has been behind current thought goes on and on.

Keep your membership, but remember the true cost.

Arlo

8
by lindanedd2001 on 07/16/2010 06:20pm

"The Food and Drug Administration and Codex agree with the AVMA’s definition of "therapeutic use" to include disease treatment, control and prevention."

Codex!! Whoa, that says it all for me. Look up Codex's real agenda and weep. Promoting chemicals of all kinds in our food supply and rejecting all natural substances, good nutrition, and health promoting substances. Codex has absolutely no credibility in my book and the FDA isn't far behind in the no-credibility category for me either. They sold out to Big Pharma long ago.

Thank you Dr. Khuly, for your courage to take the stand that you have on this issue!

9
by babysweet on 07/16/2010 06:49pm

This is far less about science than it is about logic.

If you take Tylenol at a low dose every day, its use to treat acute pain is greatly diminished.

If you expose regular bacteria to Tetracycline at a low dose every day, the bacteria develops a resistance.

We know this.

As for the Editor's letter, this part in particular caught my eye:

"For example, large-animal veterinarians are generically lumped into a category she calls "industry oriented" and Dr. Khuly refers to all farming as "industrial," disregarding the fact that the vast majority of large farms are family owned."


Ummmm... so apparently families can't own businesses that use industrial practices.

Riiiiiight.

My pet food of choice, Champion Pet Food, is family owned. Meaning that once it belonged to a man who eventually employed and then left his son in charge after his retirement.

Do I like that this company is not owned by a multinational company? Yes. Do I prefer that there is an individual to point a finger at if there is a problem or a concern? Yes.

But does the fact that this company is owned by an individual mean that the factories they operate are.... what exactly? They are industrial factories. They are not bakeries.

These "family owned" farms are operated as CAFOs. They are operated in an industrial fashion. They are not family farms. They are family owned.

The "industry" is just that. An industry that operates as one.

Involving individuals and families inspires a bit more confidence, but does not make the business any less industrious.

The Editor makes not a single factual, logical or even imaginable argument.

Kudos to you, Dr. Khuly, for standing up in this fashion - but shame shame shame on anyone in the veterinary community who does not respond to this letter as it should be responded to - with disbelief and anger.

It's clear to me from this statement that this "Editor" is either extremely biased, or simply in over their head.

10
Against nature
by P on 07/16/2010 08:04pm

The industrialization of our food supply is so wrong on so many levels including the abnormal raising of animals and the fact that often we feed them the wrong kind of food to keep them healthy. Cows were meant to eat grass with fuel from the sun for example, not corn. They are fed corn because of government subsidies and the fuel to feed corn is from petrochemicals. And the cows need antibiotics because their food and their living conditions make them sick. Routine antibiotics for these animals are a small part of an agricultural system that is against the way nature intended.

And there will be a day when antibiotics won't even work on the animals. Nature has its own way of evolving new organisms to meet overcome its challenges.

There are no antibiotics that work for me personally. None. Started when I was a kid and had severe reactions to penicillin, then sulfa, and later antibiotics one by one made me sick. So the miracle drugs for me at least are out.

And with the monocropping of mostly soybeans and corn in this country... with the uniform way they are raised and thousands of contiguous acres, all it is going to take for starvation of millions will be one resistant bacterium, or fungus, or insect, and the destruction of one crop will mean the starvation of millions. Think back to the potato famine in Ireland. Learn the lesson that nature needs variety of genes, acres, fertilization to be sustainable. Today we have destroyed variety. It has happened slowly so we don't notice our dependence on these crops. We are slowly putting ourselves at risk because we try to dominate nature and we can't.

Let's begin by putting more animals on pasture eating the food that nature intended. Rotating crops with pastureland. Using greater variety in breeds. Using the sun as fuel.

Thank you Dr. Khuly for trying to stand up for the principles of nature.

11
by dar on 07/18/2010 07:20pm

g'day
-here's more on the consequences of this dastardly practice:
Animal antibiotics are causing drug-resistant, killer infections
http://www.naturalnews.com/028031_antibiotics_infections.html

http://search.mercola.com/Results.aspx?k=Animal%20antibiotics

http://www.huffingtonpost.com/2010/02/10/animal-antibiotics-video_n_456514.html

cheers

12
Unique experience
by EAB on 07/19/2010 09:41am

I am a victim of the overuse of antibiotics. My story....

During the early 90's when I lived in South Carolina I had respiratory infections all of the time. The medical pros said it was because I didn't have tonsils (how about that, they DO serve a purpose!!) and I was "a yankee" who was not used to the high humidity. Every time I got bronchitis, they would load me up on antibiotics and steroids. After a few years of this I ended up with an exterior infection close to my thyroid. After the high dosage antibiotic pills, which SHOULD have worked didn't, the doc, puzzled, put me in the hospital. There they ended up using IV antibiotics that were so strong I was one step from intensive care while I was on them. I was in the hospital for a week.

As a result of this, I ended up one of the few males that contracted Hashimoto Thyroiditis, a condition where the body's own antibodies attack the thyroid itself.

But the real problem wasn't found until I went to a Traditional Chinese doctor. He said my annual bouts with bronchitis and ear infections, sinus infections, my thyroid issue, as well as other issues were because my body "head to toe" was full of infection. He further stated that not only was my body not able to fight this infection, but my body wasn't even trying to fight it. It was instead waiting for the next pill. Antibiotic overuse caused this.

I went through a year long regime of herbs and acupuncture treatments to get my immune system back. It worked. I haven't had bronchitis, sinus, or ear infection since 2004. When I do catch a cold in the chest, it stays a cold. I do watch my activities during humid weather, but outside of that, I am fine.

The thyroid issue is permanent, but is being treated (I won't bore you with this).

But the issue that caused my problem was demonstrated just yesterday. I was building a shed and tearing down an old one when I stepped on a rusty nail. I went to urgent care to get a tetanus shot. After I got the shot, the physician's assistant cleaned the wound, then gave me a prescription for antibiotics. I told her of my experiences and inquired why I needed them. She said "well, I just want to prevent any infection."

Independent of the tetanus issue, the wound was very small and was cleaned in short order. There was no need to prescribe antibiotics unless the infection was present and out of control. It seemed to me that this lady would hand 'em out like candy.

Back full circle to antibiotics in the food supply. To the experts, these antibiotics are harmless and are a miracle cure for all things that are infection. My experience, as documented here, shows that this is NOT the case. They are powerful and can cause your own body to quit defending itself. Bad news all around.

13
by EmilyPK on 07/19/2010 02:59pm

I, personally, don't support using antimicrobials as growth promoters. But it is the case the this is only one of many factors contributing to resistance--and the relative importance of each is not known. Certainly over-prescription and improper disposal of veterinary and human drugs is in the mix too.

p.s. your sign up system is a bit temperamental, and after registering I still have to fill in the CAPTCHA?

14
CAPTCHA
by Dr. Patty Khuly on 07/20/2010 09:08am

Yeah, it does that to me too. I'll let someone know. Thanks.

15
captcha
by vheuer on 07/20/2010 09:51am

Emily and Dr. K - I also have to obey the captcha system, even to edit a simple comment, and I work here (!) Often I still click "submit" and it won't let me go on until I have answered the math question. So...sorry for the inconvenience, but thank goodness, it is just a simple math equation.

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About fully vetted

Patty Khuly, VMD, MBA

Photo of Dr Khuly

Dr. Khuly is a former petMD blogger and small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. She authors pet health columns for USA Today, The Miami Herald and Vetstreet. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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