March 16, 2015

(Dan) Hey folks, welcome to Doc Talk, I’m excited about today’s show. We have Dr. Mike Apley back with us to talk about antibiotics and cattle. We’re gonna talk about a lot of things as far as our spectrum of activity, concentration versus duration dependent, why we give one shot and much more. Thanks for joining us here on Doc Talk. And we’ll see you right after these messages.

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(Dan) Hey folks, welcome to Doc Talk. Mike, welcome to the show. (Mike) Thanks. (Dan) It’s always good to have you. Folks, we have Dr. Mike Apley who is a professor here at the College of Veterinary Medicine. You have a new title? (Mike) Yea. Professor. (Dan) You’re the Frick Professor and you want to be careful how you say Frick when you say the professor. (Mike) Exactly. (Dan) But, anyway Dr. Apley, it is an honor to get a professorship. It’s due to your work that you’ve done nationally and internationally in the world of food animal pharmacology. And I know we joke around a lot on the show and things that we do teaching together here, but you’re one of those people that’s been a mentor for me and a mentor for a lot of people. And we’re gonna talk about that subject of antibiotics, which is not gonna get to be a smaller subject, is it? (Mike) No and it’s getting bigger and bigger. So, you know, the last time we did this we talked about some basics, about the drug groups and which groups are what. So today, thought we’d continue on with some more of the basics about how these things work and what’s behind the recommendations that producers get from their veterinarian. (Dan) Well, let’s just start out with the term spectrum, spectrum of activity and kind of what is that? (Mike) Spectrum of activity is the bacteria we expect an antibiotic to be able to be effective against. (Dan) OK. (Mike) And being effective against doesn’t necessarily mean killing it. It can mean just slowing the growth down enough that the body gets on top of it. So, it’s very important to remember that antibiotics help cure the animal, they don’t do all the work. (Dan) Right. They give the animal an opportunity to cure itself. So, let’s go down through this list because we had some topics that we’re gonna talk about. And we get into like bovine respiratory disease and you can have narrow spectrum, broad spectrum and when they’re narrow that means it’s going after a single class or a general class. And broad is many classes, right? (Mike) Yea, one of the favorite questions for the high level pharmacologists is just explain exactly what narrow and broad spectrum means to me. I knew it best when I got out of my PhD and it’s become less clear to me as I’ve gone through practice. But really for narrow spectrum the thought is it either gets primarily groups we call gram positive or gram negative which is based on how the cell wall stains. And so that separates them into two different groups with a lot of different characteristics, so it’s kind of a loose term. But for respiratory disease we’ve got quite a few label drugs that have the primary respiratory pathogens with inner spectrum. Now one of the ones that falls in and out of different antibiotics of their spectrum is mycoplasma bovis and one of the reasons is it doesn’t have a cell wall like the others do. And so drugs which require a cell wall to function on they don’t…it won’t work. (Dan) Right. (Mike) So the veterinarians can help if you are having a mycoplasma bovis problem in a group of cattle why there’s some antibiotics that get picked over others because of that. (Dan) What about foot rot? (Mike) Foot rot is an interesting drug problem. The pathogen, the bacteria that causes the disease like to live without oxygen, so it’s called an anaerobe. And we have some drugs that work well with anaerobes and some that don’t. But foot rot if you catch it early it’s really responsive. We make a big difference in all of them now if they’ve got club foot and they’re already swelling up and it’s hard and I think everyone listening that’s had one of those knows it’s not gonna work very well. But we have a lot of drugs that work well in that activity…or for that site. (Dan) Cool. I know we want to talk about pink eye, but we need to go take a break. When we come back we’ll talk more about antibiotics with Dr. Mike Apley. You’re watching Doc Talk and we’re glad you joined us.

(Dan) Folks, welcome back to Doc Talk. Dr. Dan Thomson here with Dr. Mike Apley who is the Frick Professor here at Kansas State University’s College of Veterinary Medicine and he is a boarded clinical pharmacologist. And Mike when we left we’d already talked about BRD and foot rot, let’s talk a little bit about spectrum or types of antibiotics you pick for pink eye. (Mike) The thing about pink eye that will a lot of our listeners may have seen is seeing the vet put a shot of an antibiotic up under the eyelid and actually some of our newer research casts doubt on exactly how effective that is. Probably a lot of the good is from draining out from that injection site over the eye with penicillin. But there are others that are labeled for pink eye that have systemic administration where you give ’em under the skin. And the thing to remember about any drug and especially antibiotics is it goes everywhere in the body. So, it’s not necessarily better to put the drug right above the eye or at the eye for pink eye, you can get really good treatment response, studies have shown by putting something systemically just like you would for foot rot or respiratory disease. (Dan) I can still remember getting… having tonsillitis or strep throat as a kid and they’d give you the shot of penicillin, they didn’t necessarily put it in your throat. (Mike) No, no. (Dan) So, alright let’s get on because there are some of the things that I want to get to like the term I hear this all the time, concentration versus duration dependent drugs. (Mike) So concentration dependent means that the drug is most effective when it gets a quick high peak and then it can leave and you can still wait a long time for the animal to respond after it leaves, but the effect on the pathogen happened from a very, very high concentration. So, drugs they know by the trade names Baytril or Advocin which are fluoroquinolones, those are peak dependent, they are really dependent on concentration. And then we have other drugs that they know as LA-200, Liquamycin, those drugs… (Dan) BioMycin. (Mike) All the long acting oxytetracylines and those work by having a long time… in the plasma or the serum, the part of the blood that’s liquid, a long time it is above the concentration it takes to inhibit that organism. They don’t necessarily have to kill it, they just hold it down. (Dan) So, some of ’em… and that’s the reason why you can retreat at 48 hours with some versus 10 days with others is whether or not they are concentration dependent which you put in there and you get a big dose, so… Here’s the thing I see people say I’m gonna take a concentration dependent drug and you use Baytril and Advocin as examples of those. Given those at lower doses over multiple days would probably not be as effective as a high dose once. (Mike) Yeah, the I was involved in the initial work for one of those where they had it initially were gonna with the label as giving it multiple days. And the first time they said well instead of doing that, we’re gonna give it all one day and watch to see what happened, and I was nervous too. And sure enough it works just as well if not better, but it’s essentially the same results from doing it once. So, we’ve got drugs out there, some of them are dependent on the slow prolonged release and some one big hit. (Dan) OK. Well that’s concentration versus dependent. We’re gonna take a break. When we come back after the messages we’re gonna talk about why you can give one shot and then wait until the animal gets better. Thanks for watching Doc Talk. More with Dr. Mike Apley right after these messages.

(Dan) Folks, welcome back to Doc Talk, Dr. Dan Thomson here with Dr. Mike Apley who’s the Frick Professor at the College of Veterinarian Medicine at Kansas State University where he serves not only as a veterinarian and professor but he is also a boarded clinical pharmacologist that is internationally renowned and speaks at may different venues for producers for veterinarians, for dietitians, people who want to know more about food. And Mike we’re gonna talk a little bit more about the antibiotics and we’ve got this segment titled, “One Shot.” So, why can we just give one shot? (Mike) There’s two reasons, one is, some drugs last a long time, give better coverage, longer coverage. Some like we just talked about work with one big thump. But even after that one big thump on the bacteria, you can clear the body, but that animal isn’t gonna look better right away. So, everyone listening has had the flu and even when the flu virus is beat, and you can go back to work, the really severe signs have stopped. But still when you go back to work you’re not ready to go out and run two miles or… you feel punk for a few days. So, one of the things that long duration antibiotics did force I think, is give us the courage to wait a little longer and allow those animals to respond. And as more and more research data comes out probably for a lot of the drugs, no matter how they work given a little more time for that animal to respond is a good thing. And so we look for respiratory disease five to seven days for a lot of drugs and everyone should talk to their veterinarian on how they feel about what we call the post treatment interval and how you deal with animals during that interval that maybe looked especially tough. But one of the things that I think we’ve really come a long ways on in the last five to ten years is understanding that giving them some time to respond can help the animals have a better response rate and also stop us from maybe giving more antibiotics than are needed. (Dan) And I keep using the example that if you’re sick and the Dr. says you need to be treated once and go away for a week, or I’m gonna treat you three days, Monday, Wednesday, Friday and in the case of entirety rate doesn’t improve, which treatment do you want? (Mike) Yea, I’d like the single. And it wasn’t that long ago that we were introduced to the first drugs that allowed us to do that because long-acting oxytetracyline came around like ’80? (Dan) Yep. (Mike) Around ’80 and then we got the first other one was still mycosin, which we know as Micotil, that was ’92. So, when those came out where you could give one shot and then wait 48 to 72 hours, it was really tough for people because they felt like, we gotta get ’em in the chute the next day at least to touch ’em. So, we continue to evolve along that. (Dan) And so we got about a minute. So, one of the thing while we’re on this topic because what about…what happens when give two drugs at once? Or what can happen? What can be some of the negative consequences? (Mike) In some cases, at least theoretically it can interfere with the activity. Some need the bacteria to be rapidly growing. And some slow down the growth. There are cases where it’s been documented that two together help. But before I put two together I want to have documentation that they actually help. So, more isn’t always better with antibiotics. And if I don’t know different I always go with just one. (Dan) I never recommend two. We’re gonna take a break here and when we come back from the break, we’ll wrap up with antibiotics and we’re gonna talk about root, volume, needle, all that type of stuff on making your treatments effective. You’re watching Doc Talk. We’ll see you here after these messages.

(Dan) Welcome back to Doc Talk with my friend and colleague Dr. Mike Apley and we teach and work and do research at the College of Veterinary Medicine at Kansas State University where Mike is the Frick Professor and is a boarded clinical pharmacologist besides being a veterinarian. Let’s talk about, cause I know you want to get into this, about giving these injections properly. (Mike) So, on the label there’s a regimen, which includes the dose and how much you give per hundred pounds. The route subcutaneous, under the skin, inter muscular. We prefer subcutaneous under the skin, Sub Q, and duration so how often you give, for how long and frequency. So, those two go together, how often for how long. One of the things I’ve seen that concerns me is some attitudes about where you can give these things. And of course beef quality assurance is something that anyone who works with cattle and anyone who works with pigs should be pork quality assurance trained, certified. (Dan) Yep. (Mike) They’re two great programs. But there’s one drug out there that’s labeled for giving at the base of the ear and that’s Exceed. (Dan) Yep. (Mike) And it’s a good antibiotic, one of the many good antibiotics out there, but people have started taking short cuts and putting that under that skin in the neck. And there’s just no real reason to do that other than not wanting to do it properly and restrain ’em and get ’em around and get to the base of the ear. And the thing that everyone needs to understand is if they do that we’re not sure what happens to efficacy. But we know one thing that the slaughter withdrawal time is drastically, drastically extended above what it is at the base of the ear. (Dan) Cause they’re putting it next to the edible tissue. (Mike) Yea, so they need ro have a real discussion with their veterinarian and if their veterinarian is recommending that, they need to have a discussion with the veterinarian who isn’t about why they’re not. because that’s a residue issue. It’s a legality issue because for that drug any use other than specified on the label as far as where it’s given and how much is given is illegal. So, not only is that a bad idea for residues but it’s also an illegal act to do that and we don’t need that in the cattle industry. (Dan) And that’s one of those drugs that is critically important to human medicine as well. So, if we want to keep these tools and we want to keep using these tools, we’ll use ’em appropriately. (Mike) Yea, and we have to. And transparency is increasing and we need to understand that everything we do with our animals is open to scrutiny and we want to be doing those things right. So, that’s one of the things that bother me out there and I think we could do a lot better. (Dan) Cool. Well thanks for being on the show today. Appreciate you taking the time. Folks, beef quality assurance, proper antimicrobial usage, all these are important things that we need to do to keep the tools around so we can keep our animals healthy and keep the food supply safe. Work with your local veterinarian and if you would like to know more about what Dr. Apley and I do here at the Veterinary College you can find us on the web at Thanks for watching Doc Talk today. I’m Dr. Dan Thomson signing off from Kansas State University’s College of Veterinary Medicine and I’ll see you down the road.

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