The Moos Room™

Joe: Welcome to The Moos Room, everybody. The OG3 is here. We are going to talk about pain today. Talking to some people in the industry, had done some presentations, and this is a topic that came up lately. We've skirted around it a little bit. Brad has told us about studies he's doing with dehorning and everything related to pain around that, but we haven't really gotten into the topic in general with both cows and calves on the dairy side and the beef side. That's what we're going to talk about today. First, we need an update from Bradley about how excited he is to jump in a car with his whole family and drive to Florida.
Bradley: Ooh, it's going to be great. It's going to be fun. We're going to go on some R&R relaxing in Florida and trying to get my wife and kids to go to the University of Florida Dairy because we can't not do cow stuff, but nobody says they want to do cow stuff on vacation. I don't know. We'll see.
Emily: All the more reason to plan a trip for The Moos Room. We can do a little tour of the country.
Bradley: Hopefully, it doesn't turn into the Clark Griswold cross-country vacation, but we'll survive and it'll be good rest for us.
Joe: That sounds fun. Emily is also leaving me to go on vacation tomorrow. Where are you headed in?
Emily: I am going to Dallas, Texas to visit my sister. The weather is supposed to be very nice and sunny and warm and lovely and-
Joe: That's wonderful.
Emily: -not fluctuate every 12 hours like here.
Joe: I'll be here.
Bradley: You are visiting my favorite Kleberg in Texas, right?
Emily: Yes, I am. I know Monica's your favorite, Brad.
Joe: Okay, great. Then where are you headed?
Emily: Then I am headed to Las Vegas for the North American Agricultural Safety Summit [crosstalk]
Joe: That's a great place to have the conference at least.
Emily: Yes, weather there looks even better. It'll be fun. I'm presenting a poster on some of my work. It'll be good.
Joe: Awesome. All right. Well, let's get into the topic today. We're talking about pain. I was at a presentation not too long ago and this topic came up. What can we give calves, especially calves that are scouring, that are painful because we all know that scours are painful, especially crypto. If there's anybody out there who's personally had crypto like I have, it's painful. Pain relief is definitely a big part of getting them eating again, making them feel better. The answer really comes down to, "We don't have anything labeled for pain."
We have one drug in the US labeled for pain, but it's labeled for pain associated with foot rot and that's Transdermal Banamine. We just don't have very many options. That's why we want to talk about what can we do? What are our limitations around this? What are the things that people are working on when it comes to pain? Get into some of the stuff Bradley's doing up at Morris. Just what are the options out there and why aren't there more because it is a huge topic, it's a big thing.
We obviously want to take care of our animals and keep them from being in pain, especially when we know there's events that are going to cause some pain like calving, dehorning, castration, those kind of things. There are a lot of studies that show us that if we give an anti-inflammatory medication, like Meloxicam around the time of calving, we see a big increase in milk production, especially peak milk, and so there's a production benefit to doing that, and it's associated with the lack of inflammation or decreasing the inflammation around calving and decreasing the pain associated with calving.
The problem is the drugs that are most effective are not labeled for use in the US. It's extra-label use every time we use them, which means that there is zero tolerance when it comes to withholding in the meat and the milk, and that raises our biggest issue. We have to be super careful about what we give and why and when.
Emily: Before we dive into it, and Joe, you're already on your vet soapbox, so let's just continue that. Let's start with the why. Just from a veterinary perspective, why aren't there more drugs labeled for pain management in the US and especially for cattle?
Joe: Unfortunately, the answer doesn't make us look super great. It's just a fact though. The answer is that we haven't been thinking about pain control in cattle for a very long time. We have just relatively recently brought it to the front of what we think about. We didn't even used to think about it. When we dehorned or when we castrated, you just did those things and cattle are tough, which they are super tough. They didn't show a ton of signs of pain, so we didn't think about it.
It's just really in the last 20, 30 years that we've really started to think about it, and really in the last 10 to 15 years where we've really thought about it a lot. A lot of the things that we use are not labeled for pain. They're labeled for pyrexia or inflammation associated with something else, but they're not actually labeled for reduction in pain. Unfortunately, the answer for why we don't have a bunch of labeled products is that we just haven't been working on this topic for long enough to see those things come out and hit the market.
Emily: Do you see a future where there are drugs on market labeled for that type of use?
Joe: I think it's possible. Now, the problem is that we also don't have great measures to show if cattle or calves are in pain. We don't have a good way to measure it most of the time. We can measure things that maybe are associated with pain or stress. Maybe Brad can talk to this a little more because he's doing pain studies right now, but the reason that we can get labels for pain associated with foot rot is that we can use pressure plates to see how much pressure a cow is actually putting on each foot so we can see before treatment, how much pressure was there and after.
There's a really definitive way to measure that but how do I measure the pain associated with dehorning or the pain associated with castration? There's things that we can do that kind of tell us or give us a clue to it, but they're not exact or exact enough. I think that we are moving in that direction but I think what's going to happen is we're going to have probably labels that are associated with inflammation and maybe not pain, but at least they'll be labeled for something that we can use that's connected to pain. That's what I think is coming in the future. Brad, do you have any insight?
Bradley: I agree. Pain is a tough one. I think about it from a consumer standpoint and that's one thing that consumers are starting to see too about pain and making sure we're treating animals humanely. I think about pain a lot and especially with our organic herd, there are some things we can use and can't use. Banamine, flunixin is one that we can use. You talked about Transdermal Banamine. That's not allowed in organics, but we can use the injectable kind.
We've been doing some studies here at Morris looking at trying to alleviate pain from disbudding of calves and how to measure pain. It's not easy. It can take a lot of blood samples. We have some sensors, heart monitors on calves where we can tell things. Of course, yes, I always use sensors.
Emily: Put a sensor in it.
Bradley: That's right. Put a sensor in. It's the mantra of the podcast. I agree. There's lots of things. We probably haven't thought a lot about it because we don't necessarily see that in calves. You just dehorned a calf without pain medication and you didn't see what happened to that calf three to four to five hours later that they were experiencing adverse behaviors or something was happening in them. We need to be thinking more about that in the future. I think about it from a disbudding pack, but there's pain from lameness, mastitis, there's pain from a lot of different health issues that are happening.
Joe: The topic is so big that it's hard to cover it all today. I think we're just really scratching the surface because, like Brad said, it's associated with so much more. We talk about calves a lot because we have predictable events that we influence, so we can plan our studies around them. Mastitis is one that's been studied extensively in Europe and we see wonderful benefits from using things meloxicam that are labeled for cattle in the EU. There's a lot of information out there that says there's a lot of benefits.
It's just what it comes down to is we have a lot of issues trying to figure out what should the milk withhold be on meloxicam and how long does it take to be eliminated and especially because we know that there's a lot of differences depending on where that cow is in her lactation. We know, especially in early lactation, postpartum cows take a much, much longer time to eliminate meloxicam than cows that are in mid-lactation. There's so many complicated factors to why we don't have a labeled product. The fact of the matter is though that we need one. We absolutely need one. Right now, we use meloxicam a ton, especially in the calf side and on the beef side as well. It's all an extra-label use, it's all prescription from your veterinarian to make those things happen, which is just another complication, another barrier to something that would be so beneficial to a lot of people. It's really tough. Then it gets even harder like Brad said, when you're working on the organic side, and you're really limited to just flunixin, and really flunixin needs to be given in the vein, it can't be given in the muscle, you're depending on an IV NSAID for pain reduction, and it has to be IVd.
It's just one another barrier to usage. I think we just have too many barriers up to preventing pain or helping treat pain in our animals, and really it's not acceptable at this point. We need to be moving faster towards a solution. There's lots of people working on this, I'm not saying we're not but there's a ton of people working on it, but it is a slow process.
Bradley: You have a good point about there's just not many opportunities for reducing pain. I'm not entirely sure why we in the veterinary animal science world have not necessarily focused on that, and have provided new products or things to look at to help reduce pain. It's one of those things that got pushed aside because-- and we get it. There's so many other things happening on farms, beef farms, dairy farms, that pain and pain medication becomes one of the least certain aspects.
I think as animal welfare becomes more important, in many different aspects, pain, and reducing pain, and increasing animal comfort, will become even more important. We need to be looking at things, researching things more to figure this out because it's not going to go away. We're on the national farm program as part of our dairy. There are a lot of questions about, if you read it about pain mitigation, and how to improve from disbudding, and other things to make sure that the animals are comfort.
It's in a lot of things, and I think of BQA certification and National Dairy Farm Program, it's all there, and we need to be doing a better job at mitigating those issues.
Joe: The cool thing is that the research out there and the way people are trying to go about this shows the benefit, not just from the lack of pain, but in production. When we look at weight gain after disbudding, or weight gain after castration, or like I said, already, milk production, or peak milk yield after dystocia, or even just normal parturition. We have data that says that it's not just about animal welfare, which is the most important thing that we have, but it's also beneficial to production.
To me, we have all the information there, and it's ready to go, the only thing that we are trying to figure out is really the pharmacokinetics of everything, and how things are moving around in the animal's body. Depending on where they are in their production stage, and how can we make sure that it's safe for the products, the end product on the other end for people?
Bradley: I think it's interesting because, in the organic world, I think about pain, and the thing that we run to all the time is flunixin because we're allowed to use that. We've had some veterinary aspects out here, where we utilize the animals to inject them and see what actually some of these compounds can do to animals if you don't utilize them right. That's another aspect to this being able to utilize them correctly. It actually mitigates the pain and doesn't cause other issues with beef quality issues and flunixin can be quite nasty on meat quality.
If we are using that-- and we do use it out here in our dairy, we use it very sparingly, only on animals that really need it under veterinary supervision. I think sometimes people can abuse it and just use it for everything, and that's not the intent. We need to be using these compounds correctly for whatever we may be doing.
Emily: I think that's another important note to somewhat on the piece of why we don't have products like this already available and approved in the US. Part of that is yes, we need to be doing the testing and the trials and making sure that people are using them correctly, which we know doesn't always happen. We need to remember that all of this comes back to the health of the animal. Yes, there are production benefits potentially and other things and welfare concerns, but for me, it's a health issue for cattle. We need to be mindful of that as we're thinking about this.
Bradley, I'm really excited to dive in a little bit to what you've been looking at in your research, specifically with disbudding in calves. I know that there's some different non-traditional methods and things that you've been looking at and have tried. Can you just give us the little overview of what you've been looking at and what you've been using as a part of this disbudding study?
Bradley: We've been looking at alternatives from an organic standpoint to what we can utilize. We did an early study looking at Salix or Salix extract, which is predominantly, it's in aspirin, looking at how that can be used to reduce pain. We also looked at flunixin. From the first study flunixin works great, it reduces inflammation. We know that. It reduces it quite rapidly, but there's many other aspects that go along with it. Salix, it may have worked, it probably needs to be at a much higher level than we were using it at.
We were a bolusing calves with Salix so probably be we need to bolus it at a higher level. Although if you bolus too much you have gut aches and things like that. Then some more recent ones, we've been looking at lidocaine and along with Salix extract, and some other products with apple cider vinegar and St John's wort and Salix and those to try and reduce pain in disbudding. I think it comes down to lidocaine works, it works well at the time of dehorning to reduce pain, but three to five hours later, it has this effect where it causes behavioral aspects in animals.
There might be some pain happening four to five hours later, once the lidocaine works off. We've all been to the dentist before, we've had that novocaine and it feels funny and stuff, so there's something going on there with calves. I think with the Salix, we just can't dose it at a high level enough to reduce the pain. I can't put 3 lbs of Salix in a calf's gut to be able to make it work. In a nutshell, that's what we found. Salix by itself probably is not the magic bullet.
Joe: Especially when we know there's pain, whether we're treating or if we have a procedure that we know is going to be painful. It's a way to prevent problems in the future and try to decrease the risk of there being an issue associated with the stress that comes from pain. The industry managing pain is trying to be preventative, they're trying to get ahead of issues and use safe products instead of having to turn to more serious drugs or surgeries or other things that might happen or complications that might happen because of just ignoring this issue.
It is a super responsible thing to do for the industry to be worried about these things, and there's just not very many options. There's a lot of things we use, but there's nothing that's labeled for most of the things that we run into. Before we get out of here, we should really run down the major list of things that are available just so everyone's on the same page. Banamine or flunixin is one of them. It's an injectable product, needs to be given in the vein. It does have both a milk and meat withdrawal.
Something that you need to be working with your veterinarian is prescription, something that you need to be working with them to give. That is, as far as I know, the only thing labeled for organics, right, Brad?
Bradley: Yes.
Joe: Then we have Transdermal Banamine, something that we pour on our cows, it avoids the use of a needle, but not for use in lactating dairy cattle. That limits where we can use it. It's also quite a bit more expensive than our injectable form. Then we have a product that we haven't really brought it up, but it is making more headlines now which is called ketoprofen. Ketoprofen is making headlines because it's now in a new product combined with an antibiotic that's out there. Again, expensive, not labeled for pain, it's labeled for pyrexia, which is a fever reduction of pyrexia.
Again, not really labeled for pain, quite a bit more expensive. Again, that's a needle as well, injectable. Then we mentioned aspirin or Bradley mentioned something similar to aspirin. Aspirin in a monogastric animal, so in our calves, definitely could be of some use but like Bradley said, maybe we can't get enough into the calf safely to make it work for pain reduction. Then in our ruminants or adult cattle, it's just not bioavailable, very much. It just isn't. We can give a bunch and we have to give a huge dose for it to have a significant effect, so at the label dose, maybe not effective. Also has a 24-hour milk withhold, so that's important to note as well. Then we're finally to meloxicam, which I think we're all in agreement is the best option for pain in calves, especially and then in cows, you just have to be careful because the withdrawal is not really well established. In closing, my argument is that we need to be focusing on meloxicam because it's inexpensive and it works, and I would love to see it approved for organic use because of how well it works and how safe it is for the animals, and because it doesn't involve a needle, it's dosed orally as a pill.
That would be my push. Let's try to get meloxicam approved and maybe just getting it approved for organic use might be the first step. What do you think, Brad?
Brad: I agree, I agree. We need some alternatives for pain mitigation and we need more in our toolbox. We can't just rely on flunixin, it's not sustainable.
Emily: I'd also like to add, and I'm surprised I'm the one adding this and not the vets here, but also just being mindful of the type of drug that it is, right? A lot of these ones we're talking about flunixin, meloxicam, et cetera are NSAIDs, they're anti-inflammatories. We can also manage pain. Brad mentioned lidocaine and that's a local anesthetic. Also, just want to note that we need to be mindful of what these actual drug types are and what is their mode of action. How do they actually work? That's a really important consideration to make as well.
Joe: I totally agree with that, Em, because there are some other things in the toolbox that we just don't use very frequently because they're quite either incredibly expensive or they're something that we can't dispense as a veterinarian but we might have available to us in the truck, things like that. Then there's all sorts of other options too like you said with lidocaine at least temporary relief to the procedure itself is really beneficial and then combined with an NSAID is even better.
Then the one thing that we haven't mentioned yet and then we'll wrap it up, the length of action is really what matters because when we look at the studies comparing meloxicam and flunixin or Banamine, we just see that once-a-day dosing with flunixin is not enough to control pain. If it's not enough to control pain with once a day dose, that means you're putting a needle into that animal, multiple times a day to effectively control pain and you got to hit the vein every time. It's just not a great option and I always feel for the organic farmers.
I say, "This is really all we got right now," and so hopefully that can change. I think we've talked enough about pain, we've just scratched the surface. We can definitely get into more of this if people want. It's time to wrap it up.
Emily: Questions, comments, or scathing rebuttals you can email us at themoosroom@umn.edu.
Joe: That's T-H-E M-O-O-S R-O-O-M@umn.edu.
Emily: You can also leave us a voicemail by calling 612-624-3610 and we may answer your question on an episode of the podcast. You can also follow us on Twitter @UMNmoosroom and @UMNFarmSafety. You can find out more by visiting our website extension.umn.edu. No promos for Bradley. Bye.
Brad: All right.
Emily: Oh, is that my cue?
Joe: That's you. You're the wrap-up person.
Emily: Not always, I don't know. Anyway--
Joe: You always are now because you keep telling me that you're way better at it and I was fine like, "Yes, you're right. Do it every time."
Emily: I am better at it so with that said, if you have questions, comments, or scathing--

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