October 26, 2015

(Dan) Hey folks, welcome to DocTalk, I’m Dr. Dan Thomson. I’m tickled to death that you joined us today. We’re gonna talk about the number one killer of beef cattle in the United States, bovine respiratory disease. And we’re gonna talk about how to treat cattle with bovine respiratory disease with Dr. Mike Apley from right here at Kansas State University. Stay tuned.

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(Dan) Well Mike, welcome to the show. Folks this is Dr. Mike Apley, he is a friend and colleague here at Kansas State University’s College of Veterinary Medicine. You know, we’ve done some things on the road with our cowboy college and do a lot of work directly with feedlots, directly with our veterinarians and our vet students. And BRD is one of the those things that has kind of been one of those things we’ve worked with a lot. (Mike) Main staple, yeah. (Dan) Yeah. So, we talk about bovine respiratory disease in beef cattle. The big thing, the first thing that we have to do is identify sick cattle out in the pen. And what are some of the things that you kind of coach on for picking up one that’s not doing right. (Mike) One of the things that I encourage people to do is they need a protocol anymore. I think the days of not having written plans are really behind us and it makes some people squirm, but it forces us to plan and really think about it. And I encourage people to write down what they’re looking for especially if you’re training the next generation or new help. And they may even use a scoring system, sometimes we use a zero to four, where zero is “hey there’s nothing wrong with this calf, four is it can’t get up.” And then we might argue a little bit about one, two or three in the middle. But that’s a training tool because by arguing about how ill the animal really is or depressed that forces us to talk about what we’re seeing. And then train and interchange about that. So, we call it a case definition in veterinary medicine about which ones we’ll actually treat and it shouldn’t be all of them in a pen situation obviously. We’re gonna you know, unless we’re applying treatment for control on arrival or something. But we’re going in to pick out certain animals. And let’s talk about the criteria that we’re gonna do, depression, how they move. And then we’ll have secondary criteria that we’re gonna do. Secondary criteria when we get to the chute and that includes maybe temperature or listening to ’em or a variety of different things. But that’s our main..those two things put together. (Dan) And so when we talk about out in the pen, let’s do our primary and then let’s go through our secondary. But let’s get in the pen. (Mike) Yes. (Dan) Protocol is pretty hard to beat, but what are some of the things that you’re having the cowboys, pen riders, farmer, feeders look for in identifying a calf that’s sick. (Mike) Sometimes you’ve got to adjust your dial on the way those cattle are behaving. Ones that are a little wilder might not allow you to see the illnesses, quick or as much. And so you have to be a little more tuned into them. Basically depression, hanging out from the others. It really draws my eye when I go up to a group of calves and every one moves away except one or two. Or some are slower so really heavily on depression, how well they’re eating. I’ll sure let a sunken flank make me look over a calf. But I won’t let a full belly talk me out of pulling one if I think they’re really sick. Respiration rate depends on the time of the day as all the listeners would know and how you evaluate that. But it’s one that really stands out as different from the others. And the way that they present to you may change and the way they do that is they become more used to you and more comfortable with you and not viewing you as a predator to them, so really standing out from others is one way. (Dan) Yeah. We’re gonna take a break but the big thing is cattle are kind of like people that have a hangnail and they miss work for two weeks, and you’ve got people that come to work every day with the Ebola virus and blood coming out of their eyes. And cattle they get sick and some of them you can identify real easy and some of them blend in and won’t let their guard down. But when we come back, we’re gonna talk more with Dr. Apley about bovine respiratory disease, how to pick out those cattle and how to treat them. You’re watching DocTalk and we’re sure glad you joined us.

(Dan) Hey folks welcome back to DocTalk. We’re back with one of our regular guest, Dr. Mike Apley. And we’re always tickled to death to have him break free from his busy schedule to come talk to us. Generally it’s about antibiotics or feedlot operations and every once in a while we might let you talk about a pig, but… (Mike) Not today. (Dan) Not today. Today we’re gonna talk about bovine respiratory disease and we’ve got the calf, found the sick one out in the pen, and now we’ve got him in the chute. You know you have a secondary criteria that doctors or cattle feeders are gonna look at and let’s go through those. (Mike) Well, I’d say we found one in the pen, might be sick. That’s the attitude we want to have to come in. Now some places will say if they come out of the pen, they’re gonna get treated, I prefer to apply some secondary criteria and we can use temperature, rectal temperature. And one of the things to do is make sure you’ve got a decent thermometer, that’s actually reading right. And we sometimes use water baths along with a cattle breeder thermometer, which may be beyond some of our producers watching to do that. But a good, high quality thermometer. Invest in a good thermometer. (Dan) And our normal rectal temp is 101.5 to 103.5 in these feeder cattle. (Mike) Most of the time. And of course yeah, a hot afternoon it’s gonna be higher but usually we use at least a 103.5 to 104 cutoff. And yeah, there’s gonna be some exceptions to that but if we just make a lot of exceptions sometimes we end up treating a bunch that don’t need to be treated. Another way that people are looking at is listening to the lungs. (Dan) Yeah when you said it earlier we’re gonna listen to the cattle, I was like listen to them talk to ya? (Dan) Hear these little voices? (Mike) That’s only late at night. So, it’s called auscultation, but listening to their lungs and seeing if there’s some sounds there that would direct us one way or the other with ’em. So there’s some secondary criteria to apply in the chute. And you put that together with the fact they came out of the pen and now you make the decision to treat or not treat. (Dan) Right. And sometimes you can adjust. I see some veterinarians adjust their treatment protocol based on primary and secondary criteria. If one’s sick I pretty much use a criteria that this is what they’re gonna get. Just trying to simplify things. Once you’ve made that decision you know, we’ve looked in the pen, we’ve identified the sick calves, we’ve brought ’em up, we’ve confirmed that the pull was running a high fever and the lungs don’t sound very…we don’t have good lung sounds. You know, what… we’ve got to make a choice on an antibiotic. And you know we’ve got about a minute until we go to the break, so if we need to we can go into the segment and talk about this as well. But when it gets down to antibiotics, what are some of the big things you’re thinking about? (Mike) I’m thinking about probably giving it to them just once. And then the big thing that’s in my mind when I give an antibiotic is when am I gonna decide whether this animal has responded or not. After I’ve given this antibiotic what’s the period I’m gonna allow for recovery? And then I’ll have a plan to for yes, no on that. But that’s the main thing in my brain. (Dan) So, I’ve read your myths. So, is there any good combination of antibiotics. (Mike) No. Just give one. (Dan) Just give one antibiotic and give it at the higher dose once, rather than the lower doses, consecutive days. (Mike) Yeah, and then I would go for the antibiotics that are single administration. Which is the majority of them we have now for respiratory disease. (Dan) Well, we’re gonna have to pick this up. Let’s take a break and we’ll come back. We’re gonna come back. We’re gonna talk a little bit more about antibiotics and then we’ll jump into some of the ancillary therapies. Which might be an even shorter conversation with the good Dr. Apley. Thanks for joining us. See you here in a minute.

(Dan) Hey folks, welcome back to Doc Talk. Dr. Dan Thomson here with my friend and colleague Dr. Mike Apley who is a veterinarian who specializes in feedlot medicine. He specializes in clinical pharmacology and Mike I’m just gonna bolt with some things. (Mike) OK. We can do that. (Dan) And the first one is is I’ve heard people want to use combination therapies, two antibiotics versus one. If one is good three’s better. And what’s your thoughts? (Mike) Two issues with that. Well several actually more than two. One is you know, can we justify the added cost and the added injection sites, etc? Two, is there anything at least publicly available I can access? Which would suggest that this improves response to therapy and there just isn’t. So I know we can increase costs, we can complicate things. I don’t have evidence it increases efficacy. And the fourth is, if you pick the wrong combination you can inactivate some of those. So, for example the beta lactams, which include penicillins, like penicillin G… (Dan) Cephalosporin. (Mike) Cephalosporins, like ceftiofur, which we have three versions of. Those work with the cell wall dividing, so the cell wall has to be clicking along and dividing. So, for example when we have step throat those things are dividing every 20 minutes. So they’re having to build new cell walls and those are like slipping a fake brick in there and they get built and they just crumble, so they die. But if you put in a drug that slows down the growth like a tetracycline, then those can’t work as well because it isn’t growing as fast. So sometimes putting two things together isn’t best. (Dan) And you’ve even shown me some of the papers in some to the pediatric pneumonia cases where we have decreased treatment response when we use combinations versus using the drugs individually. (Mike) And you avoid all that by picking one drug. And the other thing is thinking you have to put something with it to get quicker action and that’s just not true either. So many of these things are peak concentration by three to six hours. When it’s a six hour peak concentration by three it’s really close to it because it’s a big gradual arch. (Dan) So how about IV versus Sub Q, intravenous injection, veining it. (Mike) Veining it. (Dan) Getting it in there quick. (Mike) Any more that’s kind of more for show. I think that our drugs we have today, even though they’re single injection, they get to a pretty rapid concentration gradient, they get pretty quick. (Dan) And then the other one is single versus multiple treatments of an antibiotic. (Mike) I really like the single injections. (Dan) And the example is given, let’s just use Baytril as an example, one big dose of Baytril the 6ml per 100 one day versus three cc’s per hundred three days in a row. (Mike) Right, right. And you know we learned something years ago. And back then it was the long acting oxytetracycline versus daily injections. And so they would get a total of nine milligrams per pound once with the single injection of the long acting over three days. Or they got five milligrams per pound every day for three days. So they got a total of 15 split up daily. And the nine milligrams once beat the 15 giving it every day. Part of that’s just quit messing with ’em, give ’em the single injection, let ’em recover. (Dan) I always say, which one would you rather have? Going to the doctors office three days in a row for a treatment or get one dose? We’re gonna take a break. When we come back, we’re gonna wrap with BRD with Dr. Mike Apley. We’re gonna talk about ancillary therapy and some of things on recovery. You’re watching Doc Talk and we’re sure glad you joined us.

(Dan) Hey folks welcome back to Doc Talk, Dr. Mike Apley here at Kansas State University’s College of Veterinary Medicine. Talking about BRD treatment and we kind of hammered on work with your veterinarian, identify cattle early, set up criteria on when you’re gonna treat them, on antibiotic, single dose, Sub Q, and then we get to the question, what else do we give them? (Mike) Time. (Dan) Time’s a good answer. (Mike) But it did remind me of one thing. The post treatment interval when you give that single injection, really gotta have a plan for when how long it’s gonna be till you say, are they better or do they need another treatment? And the data is just starting to look like that week to ten days is pretty much the magical spot. (Dan) And when I was in practice, and I still do some consulting, our treatment interval from first treatment to an animal that is gonna need a second one is 11 to 14 days on average. And that’s looking at millions of cattle. So, when you’re looking at that seven to 10, even regardless of a 48 hour or…the ones I treat day one, day three, day five, I don’t buy a big bag of feed for those. (Mike) No. (Dan) Those are checking out. (Mike) You can tell where they are. (Dan) Yep. So good treatment interval, seven to 10 days depending on the types of drugs when we’re gonna reevaluate, but do it consistently. (Mike) Yes. So, back to your original question. (Dan) What else are we gonna do? (Mike) I still struggle for any evidence every year. You know we talk about thinking about this fall and what’s gonna happen, I’m still struggling for evidence that putting anything with the antibiotic helps us. Helps us in long term recovery and getting that calf back to being a productive animal. (Dan) And so we’re talking about B vitamins. And folks were talking about, when we say ancillary therapy, it means we’re going to give the calf an antibiotic but we’re also going to treat them with something else at that point in time. And I’m with you, I haven’t seen anything yet that says that treating with B vitamins, IBR vaccination, Vitamin C, banamine or flunixin and meglumine and dexamethasone helps. (Mike) Dexamethasone especially. I think there is some very clear evidence we can do some harm with that one. Definitely some harm besides just not making an outcome difference. (Dan) Because of the immuno suppressive actions? (Mike) Yeah, and as a matter of fact, dexamethasone in cattle is used as a research model to shut down their white cell function. (Dan) I think the big thing is and we’ve got to wrap up, but, closing comments BRD? (Mike) It’s pretty straight forward, case definition, do it consistently, so you can have some records, you can evaluate. Pick one antibiotic, get with it. (Dan) Work with your vet. (Mike) Work with your vet. (Dan) Well, thanks for being here. It’s always great to have Dr. Mike Apley from Kansas University’s College of Veterinary Medicine. And thank you for watching Doc Talk. Remember always work with your local veterinarian and if you want to find out more about what we do at K-State, you can find us on the web at www.vet.ksu.edu. Thanks for watching Doc Talk. I appreciate all that you do. And I’ll see you down the road.

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