Veterinary Surgeon, Dr Alex Thomsett BVetMed(Hons), DPM, MRCVS, Director, George Veterinary Group shares with RUMA her antibiotic stewardship work with pig farmers. Alex devotes all of her time to pig health and production and was awarded the Royal College of Veterinary Surgeons Diploma in Pig Medicine in 2016.
Alex says: “The health and welfare of the pigs under our care is at the forefront of the work we do with our clients all year round. Intrinsically linked with this is the productivity and economic success of these businesses. All of these factors formulate the discussions that take place at each farm visit (the majority of our clients are seen a minimum of once per quarter). These discussions include:
- evaluating herd health status through diagnostic testing
- review of slaughter data and abattoir health monitoring
- reviewing antimicrobial usage through the evaluation of the eMB-Pigs data each farm generates and combining all these data to assess current vaccination strategies
“Some of the most recent significant successes have centred on deploying whole herd health improvement plans targeting specific pathogens such as Mycoplasma hyopneumoniae or PRRSv. Herds have seen significant reduction in clinical respiratory disease and associated secondary bacterial infections, which in turn has reduced mortality, abattoir condemnations and antimicrobial usage.
“We utilise a range of strategies including autogenous vaccination and multiple vaccination administration techniques, including oral and intra dermal to afford the best scope for our clients to utilise products effectively. We can monitor the success of health improvement schemes through abattoir health monitoring, herd performance figures and eMB-Pigs data.
“The biggest challenge that we have faced recently has been the impact of a steep rise in cost of production on the pig sector. When margins are tight projects that involve a greater capital investment are harder to get started; however we work closely with our clients to ensure they are achieving good return on investment whilst at the same time, improving health and welfare on their farms.”
Farmer/Vet Relationship
When asked by RUMA to discuss the importance of the farmer/vet relationship in addressing antibiotic stewardship, Alex says: “The farmer/vet relationship is crucial. There needs to be trust from both parties and an ability to challenge each other and be able to discuss key issues openly and honestly so that the best strategy for the herd and its antimicrobial usage can be adopted.
“Dialogue with most clients is not restricted to farm visits only as strategies identified at those meetings are further developed in between meetings and often require the input of other parties such as nutritionists, genetics companies and pharmaceutical companies to achieve the best outcomes.”
Celebrating the pig sector antibiotic reduction achievements
RUMA also asked Alex what she felt the key to success has been for the pig sector which has seen a 69% reduction in antibiotic use since 2015, and the use of the critically important antibiotics at negligible levels. She said: “ The willingness of the industry as a whole has played a huge part alongside having the right tools in place to tackle health challenges by means other than antimicrobials. And alongside that, the development of the electronic medicine book for pigs (eMB-Pigs) as a method of recording and tracking individual farm antimicrobial usage. Red Tractor Farm Assurance requiring eMB-Pigs recording of medicines usage has also helped aid data capture.
“When looking at antibiotic stewardship work right across UK livestock sectors, the overall reductions seen over the past decade have been very impressive – and all done voluntarily which should be applauded and celebrated. It demonstrates the UK livestock industry acknowledging and addressing its role in reducing AMR and preserving antimicrobials for use in the future. The UK has been on the “front foot” on this global issue rather than requiring legislation to achieve reductions as has been seen elsewhere. It was good to see in the recent Veterinary Medicines Regulation review consultation that voluntary submission of antimicrobial usage data is proposed to remain as the primary step rather than a drive to rigidly regulate, as voluntary submission has been largely successful to date.”
The importance of data
Commenting on the value of reliable data, Alex says: “As a scientist I am driven by information and research with a strong evidence base which is supported by good and reliable data. Understanding your starting point before setting targets for the future is critical in my opinion. Having a tool, such as eMB-Pigs, enables decisions on realistic reduction targets to be made from a position of knowledge rather than best estimates. This gives everyone more confidence and increases the chances of achieving those targets as has been demonstrated by the pig industry through the RUMA TTF 1 and TTF2.”
Responsible use, not zero use
“The health and welfare of the pigs under our care is our top priority as veterinary surgeons. I don’t believe that removing antimicrobials altogether is in the best health and welfare interests of the pigs we look after. I do however believe that when addressing health and welfare challenges all possible strategies for addressing those challenges should be explored, which may include targeted antimicrobial treatment as and when appropriate.”
The important role vets play in antimicrobial stewardship
Recognising the vital role vets play in the antimicrobial stewardship journey with clients, Alex says: “Our role as vets is very important in the antimicrobial stewardship process. We are responsible for the diagnosis and treatment of the health issues we are presented with. We have the responsibility of prescribing medication and ensuring correct use and administration is complied with by our clients. We have a role in shaping the protocols that manage the health of the pigs under our care and also in educating our clients in how to store and administer the medications we prescribe for those protocols. Regularly checking that medicines are being handled and administered correctly is part of my discussions at each farm visit that I carry out.”
Case report
Alex shares with RUMA a recent pig sector case study:
- Herd – 180 sows, farrow to finish, organic producer
- Health status – Good but challenged by Streptococcus suis type 2 and also lameness in grower and finisher pigs
- Antimicrobial usage, although low by national standards, was higher than the producer and I wanted it to be and the majority of the usage was targeting either meningitis cases or lame pigs. The Strep meningitis was also causing mortality and the lameness was resulting in condemnations at slaughter due to joint damage
Alex took the following actions:
- We used abattoir data to quantify the joint issues as well as records of reasons for antimicrobial use on farm and Real Welfare Outcomes assessments carried out at quarterly visits
- The Strep issue was quantified using treatment and mortality records
- The submitted eMB-Pigs data for the farm was used to quantify the start and end point antimicrobial usage and any changes in the types of antimicrobials used on the unit.
- We tackled the two problems with different strategies although by hitting both at a similar time, we had the greatest impact on the herd issues
- We introduced additional Vitamin E to the grower/finisher diet to target the lameness issue. For the Strep suis type 2 we identified the organism by bacteriology and then had an external lab utilise this isolate to develop an autogenous vaccination specific to the farm as there was not a commercial vaccine for Strep suis available at the time. This vaccine was administered to the weaned pigs rather than the sow herd as the clinical issues were occurring in the feeding herd rather than pre-weaning.
Outcomes:
- The eMB-Pigs data for the herd shows a clear spike in usage followed by a drop back to nearly pre challenge levels. This lower level has been maintained even after the farmer reduced the Vitamin E inclusion for economic reasons
- The Strep vaccination was maintained which potentially indicates a role of the Strep in the lameness cases as well as clinical meningitis