Changing farmer behaviour: how vets can challenge treatment loyalty and influence choices

Some people welcome change while others find it very difficult to manage. Remember when selective dry cow therapy was introduced, restrictions were put on the use of critically important antibiotics (CIAs) and when a key member of the practice retired? Many people might have had real concerns about these changes and yet we managed them all with ease. Change can be good and very positive.

This article is all about changing farmer behaviour and their choices concerning treatments. Maybe we should look at our own house before we start looking at what our clients are doing?

I remember a farmer asking me why I used one antibiotic to treat a cow with retained faecal membranes when another member of the practice used a different one. He also asked why different members of the practice used different doses of the same antibiotic in cows.

He commented one of us must be right and others wrong. It certainly made me feel very uncomfortable and got me thinking about the importance of agreeing and following practice protocol of commonly encountered conditions. The practice should decide on the most appropriate treatments for common conditions.

Farmers understand medicine use is changing significantly. Many farmers have accepted selective dry cow therapy better than some vets. Some farmers were carrying out selective dry cow therapy without practices even being aware of it.

Many on supermarket contracts stopped using third and fourth generation cephalosporins sometime ago. Farmers realise use of CIAs are going to be severely restricted or will be stopped altogether and want to know what other treatments should be used.

Practice guidelines

Most practices dispense all antibiotics. The reality is most clients ring up and talk to lay staff, who do the dispensing and follow practice guidelines for individual clients. In the UK, farmers are trusted to keep stocks of medicines on farm and use these appropriately.

We must always remember the Responsible Use of Medicines in Agriculture (RUMA) guidelines, as they are very apt: as much as necessary and as little as possible. We don’t always know how farmers are using medicines when treating their animals.

An ideal time to have this conversation is when reviewing the herd health plan. Unfortunately, many farmers regard herd health plans as more of a paper exercise to get through farm assurance. They don’t always see the value of sitting down and spending time reviewing their herd health practices, including use of preventive medicines and treatments.

We need to choose the correct time and place to have an engaging conversation. Just think about an important conversation you might have had. It might be a proposal of marriage, asking for a pay rise or asking your parents for a loan to help purchase your first house. You don’t just ask the question at a random time, you prepare for this and choose your timing carefully.

We need to do the same when we are talking to farmers on important topics. You want them to be fully engaged. You might invite the farmer in for lunch at the practice, so you can go through this without distraction. Often when these conversations take place on farm the farmer is interrupted, so you don’t get his full attention.

I can think of two farmers I work with regularly. They are both lovely people, but one of them, let’s call him James, refuses to turn his phone off, so our work is constantly interrupted. This means the work is generally very unproductive. Bob is different, though, and turns his phone off until we are finished. Bob points out there is no point in him paying me to advise him unless he gives his total focus and attention.

Find out about current treatments

It’s relatively easy to find out what treatments are used. Ask the owner and his staff (who often will give different answers), look in the medicine book and have a look through his medicine purchases. Many of the practice software programs can give you a breakdown of products and this can be invaluable.

You must find out what a farm is currently doing. You could set up a checklist of common treatments, such as clinical mastitis, calf pneumonia, navel ill and retained faecal membranes. Go through treatments for these conditions. You must go through this process when carrying out Milksure training and this is another way to engage farmers in this discussion.

An Icelandic vet once asked me whether it was true UK farmers could keep a stock of antibiotics to treat their own animals. When I told him this was true, he asked how a farmer was able to make a correct diagnosis and decide the most suitable treatment for that animal and condition.

It gets you thinking. Did I really waste time bothering to go through veterinary school? For most conditions farmers can make a basic diagnosis, but we are all aware there are times when they get this very wrong.

Many farmers use treatments out of habit. They might change treatments after talking to their vet or fellow farmers, or something they have read in the press.

Some medicines become attractive due to unique properties. The use of ceftiofur became highly popular because of its zero-milk withdrawal, not because it was the superior antibiotic. Choice of intramammary products might be due to a short milk withdrawal period to maximise milk sales. Often there is little logic in which treatments are used.

You need to find out about routine and preventive treatments, for example, blanket or selective dry cow therapy. If it is selective, what criteria are they using to decide if a cow should get antibiotics? And which antibiotics and why?

Anything else?

You can then move to vaccinations, anthelmintic use, fly control and anything else you feel is appropriate. This should then give you a very good indication of what is happening.

This is the easy part. The challenging part is to agree the most appropriate treatments the farmer should be using. When I qualified, we did not have CIAs or NSAIDs, and vets still managed to cure sick animals. There is nothing to fear – it’s just a question of how you manage this change.

Japan operates a state-subsidised veterinary service called the NOSAI system. It has a technical board of vets that recommends the most appropriate treatments for all common conditions. All vets must follow this guidance.

When vets see a calf with pneumonia, they must start off with treatment number one. If the calf does not respond to this, they move on to treatment two. If that fails, they move to treatment three. Under the NOSAI system, you are not allowed to start with the most potent antibiotics.

Often, we make dangerous assumptions. We assume a farmer will not pay for a service or advice, they will not be interested in a new vaccine and we should always offer the cheapest option. Actually, most farmers want the best treatment and price is secondary.

I dealt with an outbreak of pneumonia in a group of 40 yearlings owned by Geoff many years ago. I talked to him about the benefits of NSAIDs in addition to discussing antibiotic treatment. I explained one antibiotic would be significantly more expensive than the other. Geoff asked if these were my animals what treatment would I use? I said I would use the more expensive antibiotic and NSAIDs. He then asked why I bothered giving a choice when I knew which treatment would give the best success. He just wanted the best treatment and cost was secondary. An invaluable lesson.

Coming to a consensus

When you come to drawing up an appropriate treatment and preventive medicine plan, you want the farmer to come to a consensus, rather than trying to impose a decision. If the current treatment success is poor, then it becomes easy to make change.

Ask the right questions to evaluate treatment success. Find out how the farmer feels about selective dry cow therapy and use of CIAs. He might already be a convert and wants to engage in this review. It is quite likely you might find something he is doing that has little benefit, in which case you will be saving him money.

Farmers want solutions. They want to do a good job and ensure all treatments they are using will be successful. Most want to prevent disease.

We know uptake in vaccination has increased significantly, as have other preventive measures in the past few years. Use of selective dry cow therapy and restrictions on CIA use should be driven by vets. Vets should ensure animal welfare and treatment success are maximised by using the most suitable medicines.

Updated Red Tractor rules from 1 June 2018 (https://bit.ly/2KOnGaQ) mean vets must be engaging in use of CIAs and certify any use on farm, so this is an excellent opportunity to start these discussions.