Letters to the Editor Courrier des lecteurs Position of conflict and scripting an antibiotic — A reply to Dr. Radke’s comment (CVJ 2016;57:225) Dear Editor, The point of the commentary (CVJ 2015;56:1293) was to encourage clinicians to reflect seriously upon prescribing antibiotics each and every time — as physicians have been asked to. This topic has come to my attention as a result of professional experience in public health and as a clinician working both as a locum and practice owner. Physicians and veterinarians in practice of course must see the patient before writing scripts, a necessity quite apart from the financial conflict wherein the veterinarian accrues financial benefit from both selling and choosing to dispense medications. I could have been more explicit with respect to the risk that less-than-responsible dispensation of antibiotics to animals in close contact with humans represents to those families as well as the pets, but chose to focus on the need for an overall re-evaluation of antibiotic use in small animal practice. In various roles I have visited over 100 practices in Ontario. That experience provided insight into the widespread use of antibiotics including as noted “prophylactically” after an aseptic surgery, which was not recommended even when I graduated in 1986 or again “prophylactically” for a clean cut on a Labrador’s paw. More recently I have observed the inappropriate and routine, in one case, practice of dispensing doxycycline to clinically
healthy dogs for a minimum of 4 weeks strictly as a result of a positive antibody test for Lyme disease. This provided at least $100 profit to that practice with each large dog — I am not suggesting that this is common across practices but I observed this within the past year. The financial impact is an ethical issue and we must be transparent with respect to the extant conflict. Current clinical recommendations are contrary to management of Lyme disease as noted as is the practice of providing antibiotics generally for dental cases (there are rare exceptions) or even for blocked cats as cited. Those familiar with the extraordinarily diverse mechanisms of transmission of antimicrobial resistance will appreciate that transmission occurs with contact. Pets are in very close contact with owners and share microbes which in turn share antimicrobial resistance. While this risk has not been a focus of antibiotic use — rather the focus has been on use of antibiotics as growth promotants in livestock, the risk presented by broad use of antibiotics in pets is likely even more significant. This is an issue that we small animal practitioners can easily address while practicing according to current medical standards.
Kelly Butler, DVM
Treatment of Fish — A comment Dear Editor, Re: Diane Morrison’s Letter to the Editor (Can Vet J 2016;57:113) I stand by my comment on Treatment of Fish (Can Vet J 2016;57:12) that “intensive aquaculture practices can be even more harmful to the environment, to humans and to fish than intensive agriculture practices involving mammals and birds are. This is no more evident than in the sorry history of British Columbia’s salmon farms. But that is a topic for another day.” It is indeed another day. It is unclear who omitted Dr. Morrison’s affiliation as fish health and food safety director of Marine Harvest Canada, ostensibly the largest Atlantic salmon fish farming company in British Columbia, and thus an advocate for the farmed salmon fishing industry. Disclosure of vested interest is especially important, if not mandatory, when issues such as the humane treatment of animals are discussed. While harvest techniques such as those described by Dr. Morrison may not be in dispute, industry business models and practices have contributed materially to substantial degradation
of coastal habitat in BC, both land and sea, and have produced considerable if not irreparable harm to the farmed species and to other species inhabiting that environment. The latter concerns are poignantly raised by Alexandra Morton in her memoir on killer whales (1). For the sake of completeness, the following paper came to my attention only recently and not in time to be included in my references to “Treatment of fish — A comment” (Can Vet J 2016;57:12). It would also have buttressed Dr. Rollin’s commentary on November’s Ethical question of the month. Braithwaite VA, Huntingford F, van den Bos R. Variation in emotion and cognition among fishes. J Agric Environ Ethics 2013;26:7–23. John B. Delack, PhD, DVM
Reference 1. Morton A. Listening to Whales: What the Orcas Have Taught Us. New York: Ballantine Books, 2002.
Constructive and professional comments made in the spirit of intellectual debate are welcomed by the Editor. Writers are expected to be respectful of others and to ensure that letters are considerate and courteous. The Editor reserves the right to remove comments deemed to be inflammatory or disrespectful. CVJ / VOL 57 / APRIL 2016
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healthy dogs for a minimum of 4 weeks strictly as a result of a positive antibody test for Lyme disease. This provided at least $100 profit to that practice with each large dog — I am not suggesting that this is common across practices but I observed this within the past year. The financial impact is an ethical issue and we must be transparent with respect to the extant conflict. Current clinical recommendations are contrary to management of Lyme disease as noted as is the practice of providing antibiotics generally for dental cases (there are rare exceptions) or even for blocked cats as cited. Those familiar with the extraordinarily diverse mechanisms of transmission of antimicrobial resistance will appreciate that transmission occurs with contact. Pets are in very close contact with owners and share microbes which in turn share antimicrobial resistance. While this risk has not been a focus of antibiotic use — rather the focus has been on use of antibiotics as growth promotants in livestock, the risk presented by broad use of antibiotics in pets is likely even more significant. This is an issue that we small animal practitioners can easily address while practicing according to current medical standards.
Kelly Butler, DVM
Treatment of Fish — A comment Dear Editor, Re: Diane Morrison’s Letter to the Editor (Can Vet J 2016;57:113) I stand by my comment on Treatment of Fish (Can Vet J 2016;57:12) that “intensive aquaculture practices can be even more harmful to the environment, to humans and to fish than intensive agriculture practices involving mammals and birds are. This is no more evident than in the sorry history of British Columbia’s salmon farms. But that is a topic for another day.” It is indeed another day. It is unclear who omitted Dr. Morrison’s affiliation as fish health and food safety director of Marine Harvest Canada, ostensibly the largest Atlantic salmon fish farming company in British Columbia, and thus an advocate for the farmed salmon fishing industry. Disclosure of vested interest is especially important, if not mandatory, when issues such as the humane treatment of animals are discussed. While harvest techniques such as those described by Dr. Morrison may not be in dispute, industry business models and practices have contributed materially to substantial degradation
of coastal habitat in BC, both land and sea, and have produced considerable if not irreparable harm to the farmed species and to other species inhabiting that environment. The latter concerns are poignantly raised by Alexandra Morton in her memoir on killer whales (1). For the sake of completeness, the following paper came to my attention only recently and not in time to be included in my references to “Treatment of fish — A comment” (Can Vet J 2016;57:12). It would also have buttressed Dr. Rollin’s commentary on November’s Ethical question of the month. Braithwaite VA, Huntingford F, van den Bos R. Variation in emotion and cognition among fishes. J Agric Environ Ethics 2013;26:7–23. John B. Delack, PhD, DVM
Reference 1. Morton A. Listening to Whales: What the Orcas Have Taught Us. New York: Ballantine Books, 2002.
Constructive and professional comments made in the spirit of intellectual debate are welcomed by the Editor. Writers are expected to be respectful of others and to ensure that letters are considerate and courteous. The Editor reserves the right to remove comments deemed to be inflammatory or disrespectful. CVJ / VOL 57 / APRIL 2016
341
