I had the opportunity to sit down and read an article in your publication (“Pain relief for cattle is finally available” Feb. 19). I have a few points of concern.
Your article implies that pain control has never been available and gives the impression that Merck has saved the day by delivering a product that we have not had access to. The reality is, this molecule has been available for quite some time. It has a new administration and use label. That is all. But it is a double-edged sword. We now have a product that is “on label” for foot rot pain, which makes us feel all warm and fuzzy, but no medication for other pain.
Now, because of this label and clearance, in the instance where banamine is not enough, we have no other options without being “off label” and illegal. This molecule performs no differently now than it has before. However, real pain control in animals has been hindered.
We have all been in a situation where “Tylenol” or “Advil” was not enough. Now we are forced to turn a blind eye and convince ourselves, our clients, and our patients that it is enough, as that is all that we can do. Pain control has been on our radar far longer than what your article implies. It is not a novel topic. Additionally, because of this label, now flexibility in selecting the most effective medication for pain control has now been hindered as banamine is all we legally have.
My point rests in the understanding of AMDUCA (the Animal Medicinal Drug Use Clarification Act of 1994). As explained to me by a representative of the Nebraska Veterinary Medical Association, now that there is a label claim and clearance for banamine as foot rot pain control, we can no longer exercise the use of extra label products for foot rot pain, even if banamine is not enough.
Prior to this new banamine formulation, there were no label claims for foot rot. Therefore, AMDUCA gave veterinarians the liberty to use banamine or another product if more appropriate. It is my understanding that since a labeled product exists, that the liberties of AMDUCA no longer exist for the veterinarian, thus limiting pain control in this animal when a simple NSAID (nonsteroidal anti-inflammatory drug) is not enough.
There are several other points of concern with having only banamine available for foot rot pain. Because of the short half-life of the molecule, multiple dosing is required for extended period of pain control. Because of that, human and animal safety are also a concern because of the need for repetitive dosing. Every trip through a chute is increased stress and increased risk for further injury. And every interaction between human and injured/painful animal increases risk to human safety, even in the best of facilities. — Cody Gulbrandson DVM, Nebraska
[Editor’s note: This letter is a combination of a pair of Dr. Gulbrandson’s emails sent to WLJ in what has become an ongoing conversation about AMDUCA and on-label pain control claims. It has been slightly edited for flow as a result of the combination.]
