The Use of Drugs in Food Animal Species

Christie Balcomb, BVSc, DACVIM
YourVet Maui
1476 S. Kihei Rd, Kihei, HI 96753
(808) 879-5777
Email: Christie@yourvetmaui.com

The use of medications in food-producing animals can have some challenges, as current demographics seem to be shifting for more people to have livestock as pets and other food-producing animals that are treated more as companion animals than in the past. Livestock are being kept as pets in more urban settings and will likely be seen by veterinarians that treat solely companion animals. Some owners are more willing to pursue medical and surgical treatment for these animals such as backyard chickens or pet goats. However, the Federal Drug Administration (FDA) designates “food animals” as any species that are raised and used for food production or consumption by humans. The species considered to be Major food animal species include: Cattle, Swine, Chickens and Turkeys. Minor species include sheep, goats, camelids, aquaculture species and honeybees, and rabbits. There are several important regulatory distinctions made between Major and Minor food animal species.

“Food-producing animals” are animal species or classes that are used to create a food or food by-product that does not require slaughter, such as milk (also used to make cheese and butter), eggs and honey.1

It is important to note that the FDA does not recognize the owner’s intended purpose of the animal, such as companion miniature pigs versus commercial pig breeds, and all fall under the classification as a Major food animal species. So, even if the animal is considered by the owner as a pet, rather than a production animal, the government regulations and restrictions still apply. Unfortunately, veterinarians cannot always guarantee the outcome and disposition of an animal for the rest of its life.

Extralabel drug use (ELDU) is allowed under the American Medicinal Drug Use Clarification Act (AMDUCA) of 1994, as long as certain requirements are met, including the existence of a valid Veterinary Client Patient Relationship (VCPR). 2-4

Extralabel use is defined as the use or intended use of a drug that is not in accordance with the approved labeling in regards to:

  1. Species
  2. Indication
  3. Dose rate
  4. Dose frequency
  5. Route of administration

For ELDU in Food Animal Species, the following requirements must be met:

  1. There is no approved animal drug labeled for use for that species, indication, dose rate and concentration. [An approved human drug must not be used in extralabel fashion if an approved animal drug exists that can be used in an extralabel fashion]
  2. There must be a diagnosis based on evaluation of the condition suspected
  3. Establish an appropriately extended withdrawal time prior to sale or consumption of milk, eggs, meat or edible products
  4. Maintain records to identify the treated individual
  5. Take precautions to ensure that the established extended withdrawal times are met to prevent any violative residues are found in products to enter the food chain

As clinicians, we are often faced with challenges, as many of the species that we treat are not listed on the label of many veterinary medications, and thus we need to use drugs in an extralabel fashion.  As such, we are also very dependent on scientific data and utilizing the Food Animal Residue Avoidance Database (FARAD) is an essential tool to ensure that we are following the appropriate requirements of ELDU as defined by AMDUCA.

FARAD is a USDA-funded university-based consortium that is overseen and operated by faculty and staff within the Colleges of Veterinary Medicine at the University of California-Davis, the University of Florida, Kansas State University, North Carolina State University and Virginia-Maryland College of Veterinary Medicine. FARAD is a great resource for veterinary practitioners to provide guidance and advice to avoid violative residues in animal products intended for human consumption. The program provides a hotline for requests, as well as online submission of withdrawal times, and a wealth of information on the use of medications in both major and minor use species.  It is highly recommended for any extralabel drug use in a food animal or food-producing animal species to submit a request for appropriate withdrawals to avoid violative residues. For example, the labeled dose rate of procaine penicillin is considered now to be subtherapeutic, and thus it is common for clinicians to use much higher dose rates or frequency of administration, and thus the withdrawal times can extremely prolonged compared to what is listed on the label.5 Current updates on prohibited and restricted drugs used in food animals can be found on their website: http://www.farad.org/prohibited-and-restricted-drugs.html.

The purpose behind many of the major and minor designations and regulations is to protect public health and food safety. Drugs and drug classes that have been prohibited for use in these species have been found to cause potential disease or harm to humans through exposure, or do not have an acceptable analytical method established. Other restricted drugs include classes of antimicrobials that are considered important for human health, and extralabel use of these medications may put the public at risk if antimicrobial resistance develops. In the next few years, it is likely that these regulations will grow to include other antimicrobial classes, or restrict their use further in an attempt to slow the tide of antimicrobial resistance in bacteria.

Violations of these regulations could end up with a consequence of drug residues in food products, which may have health implications for the humans consuming these products. Any products sold to the product could be considered a liability issue due to sale of an adulterated product into the human food chain.6 For those food animals considered as pets, administration of a prohibited antimicrobial may result in transmission of bacteria with resistance to that microbial to the rest of the flock or to the owners, themselves. Other options of antimicrobials with similar spectrum of activity may be available to use in ELDU, rather than these prohibited drugs.

In conclusion, as veterinarians that may practice on both companion and production animals, it can be challenging to adhere to FDA regulations for certain medications, such as the prohibition of any ELDU of fluoroquinolone antibiotics in any food animal species. It can also be uncomfortable to mention the term “food animal” species to a client who has a sanctuary for farm animals that will not be entering the food chain, and some clients may be offended. However, as part of the ELDU requirements, keeping records with some acknowledgement of withdrawal times for food products must be written. It may be more palatable to clients if there is a written statement about the FDA requirements based on species, but understanding that this animal is considered a pet. Finally, FARAD can be an extremely useful resource in case of determining withdrawal periods in case of historical administration, or pre-emptive research to provide the best estimate based on scientific literature. The FARAD digest publications have useful summaries of ELDU in backyard poultry, small ruminants and other species.6-10 FARAD is not a regulatory or governing body, but a program to help support veterinarians maintain public health and food safety.

FARAD Contact Info
Website: www.farad.org
Hotline: 1-888-873-2723

Please also feel free to contact Extension Veterinarian Jenee Odani to discuss any issues: jsodani@hawaii.edu or (808) 956-3847.

Drug or drug class Special considerations
Antiviral drugs – adamantane and neuraminidase inhibitors Prohibited ELDU in all poultry
Cephalosporins Except for cephapirin, any ELDU in MAJOR species (cattle, swine, chickens, turkeys) is prohibited. ELDU in MINOR use species is permitted.
Chloramphenicol Any use is prohibited in food animals
Clenbuterol Any use is prohibited in food animals
Diethylsilbesterol (DES) Any use is prohibited in food animals
Fluoroquinolones ELDU is prohibited in all food animal species (MAJOR and MINOR)
Gentian Violet Any use is prohibited in food animals
Glycopeptides Any use is prohibited in food animals (e.g. vancomycin)
Indexed drugs 11 Some use permitted in MINOR species
Medicated feeds Any ELDU prohibited – Veterinary Feed Directive 2017
Nitrofurans Any use is prohibited in food animals (e.g. topical use of nitrofurazone)
Nitroimidazoles Any use is prohibited in food animals (e.g. metronidazole)
Phenylbutazone Prohibited in dairy cattle >20 months
Sulfonamides * Use in milking sheep and goats is discouraged; Prohibited in dairy cattle >20 months, except for approved labeled use
Table adapted from FARAD http://www.farad.org/prohibited-and-restricted-drugs.html, updated 7/16/2018

 

References:

  1. FARAD. Available at www.farad.org. Accessed on 9/30/2018.
  2. US FDA. Animal Medicinal Drug Use and Clarification Act (AMDUCA) 1994. Available at: https://www.fda.gov/animalveterinary/guidancecomplianceenforcement/actsrulesregulations/ucm085377.htm. Accessed on 9/30/2018
  3. Extralabel drug use in animals. 21 CFR 530.
  4. AVMA. VCPR. Available at: https://www.avma.org/KB/Resources/Reference/Pages/VCPR.aspx. Accessed 9/30/2018.
  5. DeDonder KD, Gehring R, Baynes RE et al. Effects of new sampling protocols on procaine penicillin G withdrawal intervals for cattle. JAVMA 2013, 243:10, 1408-1412.
  6. Marmulak T, Tell LA, Gehring R et al. Egg residue considerations during treatment of backyard poultry. JAVMA 2015, 247:12, 1388-1395
  7. Webb A, Baynes RE, Craigmill AL et al. Drugs approved for small ruminants. JAVMA 2004, 2224:4; 520-523
  8. Baynes RE, Payne M, Martin-Jimenez T et al. Extralabel use of ivermectin and moxidectin in food animals. JAVMA 2000, 217:5, 668-671
  9. Riveiere JE, Tell LA, Baynes RE et al. Guide to FARAD resources: historical and future perspectives. JAVMA 2017, 250: 10, 1131-1139
  10. Davis JL, Smith GW, Baynes RE et al. Update on drugs prohibited from extralabel use in food animals. JAVMA 2009, 235:5, 528-534
  11. US FDA. Index of legally marketed unapproved new animal drugs for minor species. https://www.fda.gov/AnimalVeterinary/DevelopmentApprovalProcess/MinorUseMinorSpecies/ucm125452.htm. Accessed 9/30/2018.

 

ALERT: Police Impersonator Scams

Please note there have been multiple reports of a scammer calling local vets’ offices and cell phones impersonating the police. They have used the name of Captain David Chang.

The Honolulu Police Department recommends that if a veterinarian receives a phone call from a police officer to be wary and ask for their badge number and office phone number. Do not give out any personal information. Then call HPD (or your local county police department) and verify that information before returning the phone call to their office. If you suspect an impersonator, call 911 and file a police report.

AVMF Extends Disaster Relief to Hawaii Veterinarians

AVMF Disaster Relief and Reimbursement Grants

 The American Veterinary Medical Foundation (AVMF) provides two grant programs to help veterinarians and the animals they care for during times of disaster. Grants are available to support victims of hurricanes, floods, tornadoes, earthquakes, volcanoes, wildfires or oil spills.

 Disaster Reimbursement Grants for Veterinary Medical Care

Purpose: The AVMF disaster reimbursement grants are for the purpose of ensuring the emergency veterinary medical care of animal victims of disaster.

 Awards: Up to $5,000 may be issued per grantee for out-of-pocket expenses incurred by veterinarians providing emergency veterinary medical care to animal victims of disasters.  AVMF reimburses for the actual cost of medical supplies purchased directly from a vendor. Modest boarding costs may also be covered. 

Disaster Relief Grant for Veterinarians

Purpose: The AVMF disaster relief grants are for the purpose of assisting veterinarians who have experienced an emergency need for basic necessities due to a disaster. The grants would cover items such as clothing, temporary housing, transportation and meals that were needed immediately following a disaster.

 Awards: Up to $2,000 may be issued per grantee for out-of-pocket expenses incurred immediately following a disaster. AVMF reimburses for the actual cost of items purchased directly from a vendor. Modest housing costs may be covered for emergency temporary shelter.

 Application Procedure

The applications are posted on the AVMF website. Applicants should follow the online directions for submitting the application and the expense chart. Limited funds are currently available and approved on a first come, first served basis.

Deadline:  Applications must be received no later than 120 days following the disaster.

 More Information: Please contact Cheri Kowal, Senior Manager, Programs and Operations, 847-285-6691 or CKowal@AVMA.org

RVT Applications Now Available Online

Applications for licensing registration as a RVT in Hawaii are available online here.

Senate Bill 2671 passed in 2016 which set the following requirements to qualify as a veterinary technician in Hawaii:

  1. Be at least 18 years of age
  2. Have successfully passed the Veterinary Technican National Examination
  3. Meets at least ONE of the following conditions:
    1. Has successfully completed a course of study at a program for veterinary technology accredited by the AVMA committee on Veterinary Technician Education and Activities;
    2. Be licensed, certified, or registered veterinary technician in good standing in another state having standards for registration comparable to those in this State; or
    3. Prior to July 1, 2021, submits a notarized document from an employer who is a licensed veterinarian and who certifies that applicant has five or more years of practical experience in Hawaii; provided that no reciprocity shall be given for practical experience gained outside of the State.

Information for licensing in Hawaii can be found on the Department of Commerce and Consumer Affairs Professional and Vocational Licensing website. Additional information can be found at the HVTA website. Information about the VTNE can be found here.

RVT in Hawaii Meeting May 15, 2018

The Hawaii Veterinary Technician Association (HVTA) is holding a general meeting on Tuesday, May 15, 2018, to discuss RVT in Hawaii, the application, and the grandfathering process. Members and non-members are invited to attend. Please RSVP by May 10th to hvta.info@gmail.com. The meeting will be held at the Kalihi-Palama Library.

Senate Bill 2671 passed in 2016 which set the following requirements to qualify as a veterinary technician in Hawaii:

  1. Be at least 18 years of age
  2. Have successfully passed the Veterinary Technican National Examination
  3. Meets at least ONE of the following conditions:
    1. Has successfully completed a course of study at a program for veterinary technology accredited by the AVMA committee on Veterinary Technician Education and Activities;
    2. Be licensed, certified, or registered veterinary technician in good standing in another state having standards for registration comparable to those in this State; or
    3. Prior to July 1, 2021, submits a notarized document from an employer who is a licensed veterinarian and who certifies that applicant has five or more years of practical experience in Hawaii; provided that no reciprocity shall be given for practical experience gained outside of the State.

Information for licensing in Hawaii can be found on the Department of Commerce and Consumer Affairs Professional and Vocational Licensing website. Additional information can be found at the HVTA website. Information about the VTNE can be found here.

Addendum May 26, 2018: Hawaii RVT application online here.

Hawaii Pet Expo May 12-13, 2018

Volunteers Needed!

The Hawaii Pet Expo is sponsored and organized by the HVMA and will be held from May 12-13th this year. It has been an annual event for over 25 years and is FREE and well received by the public, with an average of 10,000 people attending each year.  The purpose of the Expo is to promote responsible pet ownership and strengthen the bond between people and their pets through educational displays, live animal demonstrations, and the latest in pet services and products.  The HVMA is looking for veterinarians who will promote our profession in a positive manner and educate the public on the need for professional veterinary care. If you are willing to volunteer your time to promote our profession and interact with the public, please sign up!

  • HVMA Booth: Veterinarians will be on site to guide visitors through our booth featuring The Year of the Dog, as well as answer questions from the public.
  • Make and Take (Kiddie Craft) Booth:  Assist kids and their parents with making finger puppets and other paper crafts to take home.  Keep booth clean and organized.
  • Greeters:  Pass out programs and poop bags at the door.  Help to direct traffic in and out of the Exhibition hall.  Smile and welcome people.
  • Information Booth:  Help direct people to exhibits, answer questions, make announcements, store lost and found items, collect food and monetary donations for the Hawaii Food Bank, prep poop bags, run errands, coordinate volunteers, and help clean up pet messes that are reported or seen.
  • Show Marshals:  The “Poop Patrol”.  Patrol Exhibition Hall and grounds outside, picking up pet messes.  Empty overflowing trash and cigarette bins outside hall and transfer to dumpster in back.  The good thing about show marshaling is that you get to walk around the hall and check out all the exhibits, although you are supposed to be working, not shopping during your shift!  We always need a lot of show marshals.

Click here to sign up online.

Saturday and Sunday the shifts are as follows:  9:30-12:00 am, 11:30 to 2:00 pm, and 1:30 to 4:00 pm. Please indicate your t-shirt size (M, L, or XL) at sign up to receive a  Pet Expo t-shirt. Name tags will be provided. Vets are encouraged to wear lab coats or smocks to identify themselves as veterinary professionals.

 

Volunteers should sign up online or by calling Ohana Vet Hospital at 845-1762. Paper sign up sheets may be faxed to 848-1632.

Equine Influenza Virus (EIV) Outbreak on Hawaii Island

Alert to veterinarians statewide regarding an ongoing Equine Influenza Virus (H3N8) outbreak observed on the Big Island of Hawaii. The disease appears to be limited to Hawaii Island at this time. The HDOA Animal Disease Control Branch is monitoring the situation and if you have diagnosed EIV in a horse, please contact the deputy state veterinarian in your county to assist us with tracking the disease event.

Hawaii County: Dr. Kim Kozuma (808) 974-6503 or (808) 365-4346
Maui County: Dr. Rick Willer (808) 873-3559
Kauai and Honolulu Counties: Dr. Travis Heskett (808) 483-7131

Quick Facts about Equine Influenza

Etiologic agent: Influenza type A, H3N8.
Species affected: Currently, only horses. The literature suggests that dogs and cats can become infected.
Transmission:
• via droplets and aerosols formed by coughing and sneezing
• direct or indirect contact with nasal discharge
• shedding of the virus often precedes clinical signs
• short incubation period, usually one to three days
• virus is typically excreted only 7-10 days after infection
Clinical signs: Acute respiratory disease, beginning with high fever (up to 106°), coughing, nasal discharge, and occasionally mild swelling of submandibular lymph nodes. Secondary bacterial infections may develop. Healthy adult horses will typically recover within one to three weeks,
although there may be a persistent cough.
Diagnosis: Can be presumed based on history, clinical presentation, and ruling out other causes of fever
• HDOA’s Veterinary Laboratory does not perform diagnostic testing for Equine Influenza.
• A number of mainland veterinary diagnostic laboratories can test for Equine Influenza and other infectious etiologies which can cause similar clinical signs. Contact the mainland laboratory of your preference for specific guidance regarding sample collection, preservation, and submission.
What has been observed in this event:
• Infection has been self-limiting, lasting approximately two to three weeks.
• Vaccinated horses were less likely to develop clinical signs than unvaccinated horses.
• Clusters of ill horses have been observed associated with equine events.
• Practicing good biosecurity reduces the likelihood of spread.

For more information, visit the website of the Hawaii Dept. of Agriculture, Animal Disease Control Branch at http://hdoa.hawaii.gov/ai/main/eiv/ or contact the Animal Industry Division at (808) 483-7106.

Thanks to Jenee Odani, DVM, DACVP and Dr. Travis Heskett, DVM, DACVP who contributed technical information for this article. [3/7/18]

2018 Legislative Update

HVMA Opposes SB2260

SB2260 requires veterinarians, upon request of the owner of an animal, to make available a copy of any prescription that the veterinarian has previously prescribed the animal free of charge. This bill will have a public hearing on Tuesday February 20, 2018 at 9:00AM at the Hawaii State Capitol conference room 229 by the Senate Committee on Commerce, Consumer Protection, and Health. Read the complete bill text (brief) here.

Please send in written testimony opposing this bill via the Hawaii State Legislature website (steps detailed below) by Monday Feb 19th 9am and consider testifying in person at Tuesday’s hearing.

HVMA opposes SB2260 because it places unnecessary legislative burden on veterinarians and is of questionable value to the public. According to Hawaii Revised Statutes 471-10, licensed veterinarians in Hawaii are required to practice by “the recognized principles of medical ethics of the veterinary profession as adopted by the Hawaii Veterinary Medical Association and the American Veterinary Medical Association”. According to the AVMA Principles of Veterinary Medical Ethics Section V.b.iii., “Veterinarians are obligated to provide copies or summaries of medical records when requested by the client.” Prior prescription information is already contained within a patient’s medical record and available upon request by the client (owner of the animal). In regards to current prescriptions, Section VII.f.iii. states: “Veterinarians are entitled to charge fees for their professional services: A veterinarian shall honor a client’s request for a prescription or veterinary feed directive in lieu of dispensing, but may charge a fee for this service.” AVMA’s Policy on Client Requests for Prescriptions states: “Veterinarians shall honor client requests to prescribe rather than dispense a drug (AVMA Principles of Veterinary Medical Ethics). The client has the option of filling a prescription at any pharmacy.”

Please make the voice of veterinarians heard and submit your testimony today:
1. Go to the Hawaii State Legislature website.
2. In the upper right hand corner, either “Sign In” to your account or “Register” if you do not have an account.
3. Once signed in, click on “Submit Testimony” (first orange button in the middle of the page).
4. Under “Enter Bill or Measure” enter SB2260 and click “Get Hearing”.
5. Complete your testimony submission (you may upload a document or enter your testimony directly on the webpage) and click “Submit”.
6. Feel good about participating in the legislative process and shaping the practice of veterinary medicine in Hawaii!

The Hawaii State Capitol is located at 415 South Beretania Street in downtown Honolulu. If you have never testified in person before and have questions about the process, please feel free to email us at contact@hawaiivetmed.org.

Other Current Pending Legislation

HB2498 – Establishes and appropriates funds for one full-time equivalent permanent veterinary medical officer position within the Department of Health. HVMA SUPPORTS.


HB1823 – Defines emotional support animals and makes it a misdemeanor to knowingly make a misrepresentation regarding a service dog or emotional support animal.


HB2060 – Removes the word “Examiners” from the names of the State Board of Chiropractic Examiners, Board of Dental Examiners, Board of Examiners in Optometry, and Board of Veterinary Examiners. Renames the boards with titles that more accurately reflect their scope and duties. HVMA defers to BVE stance.


HB2072 – Prohibits certain restraints and tethers that endanger or deny sustenance to a dog. Specifies penalties.


HB2081/SB2566 – Appropriates funds to the Department of Land and Natural Resources to provide assistance and supplemental funding to the National Wildlife Research Center of the U.S. Department of Agriculture to conduct pilot field studies to evaluate control tools and develop a management plan to reduce the rose-ringed parakeet population on Kauai.


HB2270/SB2501 – Requires the Department of Human Services to establish ohana zones where homeless persons may reside. Appropriates funds.


SB2014 – Requires persons convicted of animal cruelty to register with the attorney general. Requires animal shelters, animal breeders, and pet stores to check whether an individual has been convicted of animal abuse when the individual applies to work or volunteer, or purchases or adopts an animal. Establishes penalties. Prevents persons convicted of animal cruelty from possessing, owning, or working in close proximity to animals. Requires police officers to be trained in identifying and investigating animal abuse.


SB2289 – Establishes the offense of sexual assault of an animal. Provides for impoundment and forfeiture of a sexually assaulted animal.


SB2435 – Requires the Department of Health to contract with a nonprofit animal rescue group to oversee caretakers of feral cats. Exempts registered caretakers of feral cats from state laws and county ordinances relating to the feeding and confinement of cats. Establishes a trap-sterilize-return process.


SB2461 – Establishes the offense of “misrepresentation of a service animal”. Changes the term “service dog” to “service animal” and amends the definition of that term to conform with the Americans with Disabilities Act of 1990


SB2929 – Establishes the Hawaii spay/neuter council to be administratively attached to the department of Commerce and Consumer Affairs. Establishes the Hawaii spay/neuter special fund. Imposes a fee on pet food to support the Hawaii spay/neuter grant program to spay and neuter dogs and cats. Makes an appropriation.

Participate in Our Membership Survey

Help improve the HVMA to better serve you! We are surveying both current and non-HVMA members. Each survey participant may enter to win our drawing for free HVMA membership in 2018. We will hold the drawing during our Annual Conference Social on Saturday Oct 28th from 6-8:30pm at the Hilton Waikiki Beach Hotel. You will not need to be present to win. Take the survey here!

Animal Welfare Symposium

CABI and UC Davis are offering 6 hours of CE credits for a one day animal welfare symposium on June 27, 2017. The symposium will be held at UC Davis, but remote attendance is also possible in webinar form. Topics will focus on the subject of animal behaviour problems and veterinary approaches to dealing with them. Further information available here: http://www.cabi.org/vetmedresource/animals-behaving-badly/