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I
believe there was a fundamental mistake made by the
US organic community when it rejected all antibiotics,
both sub-therapeutic and therapeutic. |
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May 11, 2007: I spend my life around livestock
and farmers, learning how to bring health to animals and greater
understanding to the people who care for them. What I see in organic
livestock systems encourages me in many ways, but I’m troubled
by the absolute prohibition against antibiotics in the system.
Organic standards must continue to focus farmer attention on wellness,
prevention and stress-reduction, but farmers need to consider a
definable but rare use of an antibiotic within organics when it’s
the humane thing to do.
The rise of antibiotics
Antibiotics, when first discovered, were truly miraculous. Age-old
infectious disease could be reversed and a person could become healthy
again. Life-threatening conditions such as bacterial pneumonia,
post-partum womb infections (puerperal fever), abdominal infections
(peritonitis) and generalized blood infections (septicemia) no longer
condemned people to premature death. Other conditions such as bone
infections could also be effectively treated without limb amputation.
Unfortunately, the miracle cures that made antibiotics rightfully
famous also made physicians less reliant on other methods of treatment.
Rather than integrating antibiotics into existing modes of therapy,
they became dependent upon them, and anti-infective/anti-bacterial
biologics and botanicals were discarded. Moreover, non-life-threatening
bacterial infections such as minor ear infections and skin conditions
became routinely treated with antibiotics.
Use of antibiotics, in both therapeutic (prescribed to respond
to appropriate symptoms) and sub-therapeutic situations also became
the norm for livestock agriculture, since antibiotics proved to
be useful in reducing disease prevalence as well as promoting growth.
This led to the intensification of livestock agriculture as we know
it today. The widespread use of antibiotics to treat non-life-threatening
conditions in both human and veterinary medicine may be the cause
of the resistance patterns seen in modern medicine.
Organic agriculture regulations in the United States explicitly
reject all applications of antibiotics for livestock. This is largely
due to early organic producers listening to the fears of organic
consumers regarding general over-reliance on antibiotics in agriculture.
Those fears are still present today.
US organic prohibition unique
I believe there was a fundamental mistake made by the US organic
community when it rejected all antibiotics, both sub-therapeutic
and therapeutic. It is very likely that the sub-therapeutic use
of antibiotics for undiagnosed disease control— as well as
growth promotion—is what organic consumers find so troublesome.
It is unlikely that an organic consumer (whether highly sensitive
to environmental or animal welfare concerns) would actually want
there to be punishment for treating an individual animal with a
therapeutic antibiotic for life-threatening infectious disease diagnosed
by a veterinarian. No other country than the United States has an
absolute ban (i.e. permanent removal from production) for the therapeutic
use of an antibiotic for an individual animal that is ill.
Proponents of the absolute ban quickly point to the regulation,
7CFR205.238(c)(7), that says:
“The producer of an organic livestock operation must
not withhold medical treatment from a sick animal in an effort
to preserve its organic status. All appropriate medications must
be used to restore an animal to health when methods acceptable
to organic production fail. Livestock treated with a prohibited
substance must be clearly identified and shall not be sold, labeled,
or represented as organically produced.”
While part of this statement certainly sounds good, there is a
penalty for carrying out such good will to the animals under our
care. Upon close inspection of this regulation, one can formulate
the following question: Who is to say what medication will be used
and when will it be started in the disease process?
In order to avoid the penalty associated with antibiotics, one’s
philosophy or comfort level of alternative medical treatment (including
herbs, homeopathy, acupuncture or other methods) will likely steer
the initial course of treatment. If treatment is successful with
the alternative treatments, great; but if not, then valuable time
may have been lost in order to “restore an animal to health”
as the regulation requires.
Anecdotes are not enough
Proponents of the complete ban often say (and rightly so) that
since organic farmers are getting paid premiums for their products,
they owe it to the animal to use whatever it takes to treat the
animal. Indeed, organic consumers expect a higher level of care
and compassion for the animals that produce the product they are
buying on the shelf.
Unfortunately, many organic farmers grasp at any treatment that
is promoted simply to avoid using antibiotics. Organic farmers who
are looking to use non-antibiotic approaches to heal infectious
disease need to be extremely careful about what they choose to use—or
to whom they listen. There are many anecdotal incidents of success
from individuals, but anecdotes are limited to the farm where they
were applied—usually with no thought to what other factors
may potentially have caused the animal to heal.
In essence, when it comes to an individual
animal needing truly prompt, effective treatment for a serious
infection on an organic farm, the US organic rule may compromise
animal welfare.
People just learning about organic agriculture often know that
antibiotics are not allowed, but then innocently ask how much extra
time the animals have to stay out of production if antibiotics are
used. The simple answer is: forever. Under the current USDA organic
rule, an animal must be immediately removed from any further involvement
in the organic system once it is treated with an antibiotic. This
rule applies to any age animal, not just adult animals, and renders
the animal of no value within the organic marketplace. (It can still
be used or sold in non-organic livestock channels, but at a greatly
discounted value.)
In essence, when it comes to an individual animal needing truly
prompt, effective treatment for a serious infection on an organic
farm, the US organic rule may compromise animal welfare. For instance,
an unborn calf can’t be certified organic if its mother is
treated with antibiotics during the last trimester of pregnancy.
Moreover, a calf delivered by Cesarean section is not even allowed
to drink its own mother’s milk if the mother has been treated
with an antibiotic, since animals must consume only organic feed
for their entire life. (To not use an antibiotic after a C-section
could be easily be construed as malpractice due to the very high
probability of an abdominal infection.)
“Just say No” doesn’t work
The absolute prohibition on antibiotic usage brings up many challenges—challenges
not only to the farmer managing the animals but also to the veterinarian
called in to treat a sick animal. While there tends to be less stress
on organic livestock (likely due to decreased production demands,
higher forage diets and grazing), there still can be the occasional
animal that, for any number of reasons, may become very ill due
to an infection. Reasons may include stressors on the immune system
such as calving or adding a new animal into an established group.
If the immune system is depressed, infectious problems can arise
more easily. Therefore preventing stress is very important in the
organic system if we are to avoid reaching for antibiotics.
Any health-compromising condition encountered
on a conventional farm can be encountered on an organic farm.
My experience shows, however, there will be dramatically less
occurrence of conditions needing veterinary attention on organic
farms.
The immune system functions optimally when animals are in robust
health resulting from sound nutrition, continual access to circulating
fresh air, dry bedding, shelter from the elements and grazing well-managed
pastures. It should be noted that even with somewhat less stress
on organic livestock, any health-compromising condition encountered
on a conventional farm can be encountered on an organic farm. My
experience shows, however, there will be dramatically less occurrence
of conditions needing veterinary attention on organic farms.
A major concept to understand is that not all infectious problems
require an antibiotic—and in actuality, only a few do. In
my experience, the following three conditions do need prompt antibiotic
treatment: peritonitis, bone infections and when there is infection
in two major organs (i.e. lungs and uterus, etc.). Withholding antibiotics
in these kinds of instances is not only blindly naïve but also
illegal according to 205.238(c)(7).
Other infectious problems, if attended to early in the process,
can respond to biological and botanical anti-infective agents. These
can include: mastitis, uncomplicated pneumonia, diarrhea, metritis,
pinkeye, foot rot, abscesses, kidney infections, fevers of unknown
origin, and so on. The key is early treatment. When farming organically,
it is imperative to be committed to jumping on problems as early
as possible. There is just no other way to handle problems with
livestock if antibiotics are to be avoided as first-line defense.
The real question is: Exactly when might antibiotics be the most
appropriate treatment?
Making it real
In order to appreciate the complexity of addressing an infectious
problem, a real-life scenario is helpful. Pneumonia is a good example
because its illustration can include ways of prevention but also
treatment in case it does occur. Pneumonia can be a major concern
for farmers transitioning to organics, as well as for the veterinarians
assisting them. Additionally, pneumonia can easily become a life-threatening
situation if not addressed early and properly.
Pneumonia can occur in picture-perfect, fresh heifers that have
been outside until just prior to calving and then brought inside
to join the milking string, especially in tie-stall situations.
The rapid mixing with older animals in housing with poorly circulating
air can give rise to respiratory problems. Risk of infection in
this scenario is often elevated since the animal’s immune
system becomes suppressed from the internal hormonal changes that
occur near calving time. Additionally, abrupt feed changes and ensiled
feeds with invisible molds or mycotoxins may upset her digestive
system and disrupt normal homeostasis (dynamic wellness), increasing
the chances of not being able to withstand infectious challenges.
Young calves can also be afflicted with respiratory problems. Pneumonia
is common in young pre-weaned and just-weaned calves which are housed
indoors, especially when they share poorly circulating airspace
with nearby older animals. Outdoor hutches or age-group housing
offer continuous fresh air to animals. Along with dry bedding, outdoor
venues are excellent in preventing pneumonia.
I like to remind farmers that it is better
to have a live cow than a dead organic one.
However, respiratory problems can also happen soon after older
calves—having been outside all summer on pasture during their
first year of life—are brought back into a barn in late autumn.
In this case, the calves may be parasitized with stomach worms (strongyles)
which will draw down their defenses, making it likely they will
succumb to respiratory problems when placed back into a barn shared
by other animals. Less commonly, other species (like pigs) that
are allowed to freely wander around barns can track germs from one
area to another.
Obviously, preventing animals from experiencing poorly circulating
air, ensiled feeds with molds or mycotoxins or becoming parasitized
is critical to prevent many problems in general. Even if vaccinated,
an animal can still become ill for reasons never to be fully understood.
Recognizing symptoms to scale response
The cardinal signs of pneumonia are fever (above 102.5° F),
increased respiratory rate, cough, slowness to eat and a somewhat-distant
stare. If the fever is high (~106° F), it may be viral at the
time and respond well to non-antibiotic treatments to stimulate,
as well as support, its immune system. When listening to the lungs:
- If there are raspy or rough sounds, a non-antibiotic approach
can be considered.
- If abscesses are detected by stethoscope or the animal is “belly
breathing” (more belly than chest movement), go immediately
to antibiotics.
- If there is another infection somewhere in the body (udder,
uterus, etc.), go to the antibiotic.
Always be prepared to use an antibiotic if no improvement occurs
within 48 hours of using natural approaches. I like to remind farmers
that it is better to have a live cow than a dead organic one.
Various botanicals have been proven to make the immune system more
robust in overcoming infection—garlic, goldenseal and ginseng
immediately come to mind. Biologics (therapies derived from living
organisms) can actively stimulate the non-specific arm of the immune
system and also supply the animal with antibodies while vitamins,
minerals and botanicals support the animal in general. Animals with
pneumonia need to be watched closely. If a further decline is noticed,
antibiotics need to be started.
In groups of coughing calves that are bright and alert and still
eating (the earliest stage of a respiratory problem), natural treatments
can work quite well as long as the other basic management tools
of fresh air, dry bedding and sound nutrition are practiced. However,
it is usually the one calf that caught the farmer’s attention
that is depressed, laying down and coughing that should receive
antibiotic treatment.
Animals treated by natural means tend to recover more slowly but
should be improving continuously.
So, once an animal displays symptoms that indicate infection, how
exactly is a farmer to know when to choose between natural treatment
methods and an antibiotic? The farmer actually doesn’t need
to know—this should only be done in consultation with the
local veterinarian who has personally examined the animals.
What the farmer needs to know is when to call in the veterinarian.
For the sake of animals on organic farms, sooner is better.
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