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Veterinary practices and antibiotic milk failures

The MilkSure programme aims to reduce the number of milk samples failing antibiotic tests through vet and farmer collaboration

14 October 2018, at 2:48pm

At the BCVA Congress, 18 to 20 October 2018, a workshop session will enable veterinary surgeons to discuss what has been achieved to date with the industry-driven MilkSure programme and the lessons learned. Delegates are encouraged to consider how they and their clients have engaged with the training. Owen Atkinson, who developed the veterinary surgeon and farmer manuals, has received formal assessments from participants and direct comments from individuals. His observation is that from slow beginnings, the uptake is “taking off”.

Owen Atkinson will continue to develop the MilkSure manuals for veterinary surgeons and farmers
Owen Atkinson will continue to develop the MilkSure manuals for veterinary surgeons and farmers

At the heart of the MilkSure initiative is the farmer’s own veterinary practice. Approximately 140 veterinary surgeons, from over 70 practices, have completed the veterinary module, but that is only part of the picture. The farmer client is dependent on their veterinary surgeon to deliver the training through to certification, but the client’s selected vet does not have to have taken part in the MilkSure veterinary training module. The three-hour involvement includes technical essentials, a specific herd risk assessment and a certifying online test. It is up to the farmer to nominate a vet and to pay the vet’s fees – typically £250. By the close of 2018, 1,000 farmers are expected to be certified.

In the past 12 months to June 2018, 1,364 samples failed the antibiotic tests on the content of their bulk tank. Tim Hampton, chairman of the Dairy UK Antibiotics Working Group, advises that 581,873 tanks were tested from a total of some 2.3 million bulk tank collections. Some milk purchasers test daily, others weekly and the smaller buyers test monthly.

An important part of the forthcoming discussion is the source of antibiotic failures and the reality that the tests are becoming more effective, the frequency of testing for many producers is likely to increase and that when the antibiotic is detected, the milk has already entered the food chain.

Approximately 12 percent of herds had one or more failures and one in four herds had repeated failures in the year. It is in the interests of veterinary practices to know which of their farmer clients have antibiotics in their milk because, apart from the heavy penalties for the farmer (including the potential loss of their milk sales contract), the prescribing veterinary practice is likely to appear in a little black book, somewhere.

Involvement of the milk purchaser

The milk purchasers, for example Mueller and Arla, are advising all farmers who have an antibiotic failure to engage with MilkSure, involve their veterinary surgeon and complete the certification within three months. Two other smaller buyers with a total of 100 producers have already had all their producers certified, and another dairy is asking their producers to certify within the coming months. It is expected that all milk producers will be encouraged to engage in due course.

The various buyers are promoting involvement in different ways. For example, Arla has purchased 500 registrations at £65 and local agricultural managers are contacting farmers to encourage involvement. The uptake is widespread with clusters of veterinary practices and farmers participating in the intensive dairying areas, but geographically no locale is dragging its feet. An interactive map showing participating veterinary practices is available at milksure.co.uk. The number of blue ticks is expected to increase throughout 2018.

Course structure and developments

Owen Atkinson is very aware of the need to update the course as participants engage. A point of detail is that the workbook and manual are only printed in batches of 100. Each batch can therefore be “tweaked” as required for ongoing accuracy and understanding. Technical developments continue and need to be reviewed and incorporated.

The online test has 10 questions, and eight have to be answered correctly. The 10 questions are selected at random from a pool of 40. The farmer can repeat the test but the next batch of questions is likely to be different. It is this test that has received some negative comments; some herdsmen have found some of the questions difficult to understand. Veterinary terminology may not equate to herdsmen and farmer speak. For some people milking cows, English may not be their first language and although they manage perfectly well on the farm, viewing and understanding the on-screen questions presents difficulties. However, the test may be conducted with the farm vet so that any problems can be identified and rectified at the time.

Veterinary surgeons have commented that sitting next to the candidate to complete the test has led to other discussions related to diagnosis and treatment as well as responsible use of medicines. On larger farms, several people involved have worked together with the vet to understand the reasons for antibiotic failures and to carry out a risk assessment for the herd that they milk.

Looking through the MilkSure workbook, it is striking just how much detail is contained for the farmer to be aware of and the laying out of responsibilities. For example, “Vets are the people who should always decide the exact treatment regimes. Ideally, these are set out in written protocols. On some farms, there has been a drift towards farmers increasingly devising their own treatment regimes using medicines available to them. Honestly, how does your farm use treatment protocols? Mark where you believe your farm’s culture lies on the scale below. Low to high vet involvement: we devise our own treatments and ask the vet for the medicines we want; we generally follow the vets protocols but these are not always written down and we sometimes use our own discretion; we always only ever follow treatment protocols devised by the vet and written down.”

The producer’s certificate of participation is signed by the milk producer who has completed the MilkSure training and their veterinary surgeon. The veterinary declaration states: “I certify that the above named person has completed the MilkSure training workbook to safeguard the production of residue-free milk. A management plan to reduce the risk of residues in milk has been agreed for this farm.” The milk industry is looking for an increase in veterinary involvement. For there to be an effective reduction in the annual bulk tank antibiotic failure rate, it is the farmers who do not routinely engage with veterinary protocols who need to be approached.

The industry local managers are actively contacting the farmers who have bulk tank failures and veterinary surgeons are expected to respond enthusiastically to any enquiries from farmers and herdsmen. Studies have indicated that many failures are due to inadequate animal identification and misuse of products. Recent studies have identified that there is a wide range of medicines in the drug cupboards of dairy farms. Early indications, from the veterinary surgeons and farmers who have engaged with MilkSure to date, are that there is confusion about the use of medicines and that greater control will benefit the farmer, the vet and the industry.

Engaging with the MilkSure programme is not a particularly easy task for many veterinary surgeons. Some of the technical content, including the interpretation of Beta Star, Charm, Idexx, Snap, Delvo SP NT, Charm Cowside, liquid chromatography mass spectrometry, antibiotic loading and combination therapy, may rely on detailed analysis when problems arise, and specific contamination sources need to be identified. Technical help is on hand and engagement with farmers to achieve lower disease levels, less treatment, more consultancy and fewer panics appears worthwhile.

Following a 16-year apprenticeship with Beecham, Richard established a project management and development consultancy and writes regular contributions for the veterinary press.

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