Tag Archives: pneumonia

ADR…

Sometime in the later part of the 90’s, not too long after I moved to Nebraska and went to work at the feed yard, I asked my consulting veterinarian to come out to the farm and help me diagnose a calf.  I knew that something was wrong with it, but I was not experienced enough at the time to figure out exactly what ailed the animal.

When the vet arrived, he looked at the calf and said, “Anne, this calf is ADR”.

I replied, “Doc, what does ADR mean?”

He responded, “Well Anne, ADR means ‘ain’t doin right’.”

At this point in the conversation, I found myself getting a little bit frustrated as I knew that the animal was having difficulties — I was smart enough to figure that out on my own. What I needed was help figuring out specifically what was wrong so that I could enable the calf get better. We eventually got to that 🙂 And, I spent the next decade using his advice, along with my growing knowledge of the bovine animal and pyche, to become a intuitive animal care giver.

Over the years, Doc and I established a truly meaningful relationship and I think that we each got smarter as we traveled down the cattle care journey together. Much to my children’s chagrin, I started bringing home his interesting verbal lingo. Perhaps more importantly, I also developed an innately acute awareness of the concept of normal and healthy vs. abnormal and sick.

Anyone who has children recognizes that their good health will be interrupted with bouts of sickness. The key to being a good caregiver is recognizing the point that the pendulum shifts from healthy to ill, and acting appropriately to help diagnose and treat the challenge. We take our kids to the doctor when they get sick, but we still play a critical role on their diagnosis and care team. It’s really not very different from the relationship that I had with my veterinarian caring for my cattle.

The observations that we (as caregivers) can offer to the doctor, and the intuitive awareness of what level of support those that we care for need throughout the illness helps to aid in their recovery.

This past week my favorite brunette was challenged by a nasty viral respiratory infection. Despite a trip to the doctor and a round of tamiflu, she progressed past ADR to a level of illness that made my “caregiver’s instinct” uncomfortable. After almost 7 days with a fever and nasty cough, I sent her back to the doctor as I feared a secondary pneumonia infection. X rays showed pneumonia in the right lung and she began antibiotic treatment.

When she and her dad got home from the doctor, my favorite farmer looked at me and said: “Well, I guess you were right. I should know by now to trust your gut instinct.” I am glad to report that the pneumonia infection appears to be susceptible to the doctor’s choice of antibiotics. After 10 days of misery, she was able to swing back past ADR to a much better part of the health spectrum.

While I know that I sometimes drive my family nuts with my cowboy euphemisms and diagnoses, I think that the knowledge that I gained working with my vet made me a better caregiver — both toward my animals and toward my children. Awareness, intuition, education, and a practical team based common sense approach sets both our animals and our kids up for success.

It is good to have my baby on her way back to good health. While her recovery is slow, hopefully in the next week or so she will be back to answering the call of the track as she is going a bit stir-crazy being banned from running and exercise…

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The Conversationalist Take 2: Bovine Respiratory Antibiotic Use Relative to Human Antibiotic Resistance…

For my sixteenth birthday I went for a glider plane ride with one of my swimming teammates, Bill.  Bill’s birthday was just a few days away from mine, and we decided to do something “daring” to celebrate my 16th birthday and his 23rdbirthday.  Bill had graduated from college and was taking a year off to train for the Olympic Trials, and we became “training buddies”.  As “training buddies”, we spent about 30 hours a week together swimming and lifting weights.  In between training sessions, I went to high school and Bill worked as a lifeguard.

Here I am with our Coach, and Bill can be seen in the background. As part of our training, we competed in 1 mile ocean races. If my memory serves me right, this was right after Bill and I took 1st and 2nd places in the race...

I am not a naturally “daring” person, so my parents were pretty much astounded when I told them what Bill and I had planned.  In fact, I believe the looks shared by my parents when they heard our plan distinctly resembled the looks that they shared when I told them that I was getting married and moving to Nebraska to work at a cattle feed yard.

An aerial photo of my cattle feed yard...

Twenty years later and 2000 miles apart, Bill and I are still friends.  He is one of Feed Yard Foodie’s most loyal readers, and he left an interesting comment last week regarding the correlation between antibiotic use in humans and cattle relative to pneumonia infections.  I would like to take a moment to address the topic.  The information that I am going to share with you comes from Dr. Mike Apley DVM, PhD, DACVCP who teaches Pharmacology at Kansas State University’s College of Veterinary Medicine.  Dr. Apley is an expert on the topic of antibiotic use and resistance.

The Truths of Antibiotic Use and Resistance Relative to Respiratory Infections in Cattle and Humans:

  1. Respiratory pathogens (like pneumonia) in humans and cattle are different.  When we get ill, the “bugs” that cause the infection in humans are different from the “bugs” that cause the infection in cattle.  There is a species difference in pathogens causing respiratory illness.
  2. Cattle farmers (like me) use the Beef Producers Guide for Judicious Use of Antimicrobials in Cattle that were created by Dr. Apley and other veterinarians and animal scientists.  They are:
  • Prevent Problems: Emphasize appropriate husbandry and hygiene, routine health examinations, and vaccinations.
  • Select and Use Antibiotics Carefully: Consult with your veterinarian on the selection and use of antibiotics. Have a valid reason to use an antibiotic. Therapeutic alternatives should be considered prior to using antimicrobial therapy.
  • Avoid Using Antibiotics Important In Human Medicine As First Line Therapy: Avoid using as the first antibiotic those medications that are important to treating strategic human or animal infections.
  •  Use the Laboratory to Help You Select Antibiotics: Cultures and susceptibility test results should be used to aid in the selection of antimicrobials, whenever possible.
  •  Combination Antibiotic Therapy Is Discouraged Unless There Is Clear Evidence The Specific Practice Is Beneficial: select and dose an antibiotic to affect a cure.
  •  Avoid Inappropriate Antibiotic Use: Confine therapeutic antimicrobial use to proven clinical indications, avoiding inappropriate uses such as for viral infections without bacterial complication.
  • Treatment Programs Should Reflect Best Use Principles: Regimens for therapeutic antimicrobial use should be optimized using current pharmacological information and principles.
  • Treat the Fewest Number of Animals Possible: Limit antibiotic use to sick or at risk animals.
  • Treat for the Recommended Time Period: To minimize the potential for bacteria to become resistant to antimicrobials.
  • Avoid Environmental Contamination with Antibiotics: Steps should be taken to minimize antimicrobials reaching the environment through spillage, contaminated ground run off, or aerosolization.
  • Keep Records of Antibiotic Use: Accurate records of treatment and outcome should be used to evaluate therapeutic regimens and always follow proper withdrawal times.
  • Follow Label Directions: Follow label instructions and never use antibiotics other than as labeled without a valid veterinary prescription.
  • Extra label Antibiotic Use Must follow FDA Regulations: Prescriptions, including extra label use of medications must meet the Animal Medicinal Drug Use Clarification Act (AMDUCA) amendments to the Food, Drug, and Cosmetic Act and its regulations.  This includes having a valid Veterinary-Client-Relationship.
  • Sub therapeutic Antibiotic Use Is Discouraged: Antibiotic use should be limited to prevent or control disease and should not be used if the principle intent is to improve performance.

 3. In order for antibiotic resistance in human drugs to develop from antibiotic use in food animals ALL of the following steps must occur:

  • Bacterial populations in the bovine animal are exposed to antimicrobials (antibiotics) on the farm.   A bovine animals gets sick with a bacterial infection and is then treated with antibiotics on the farm.
  • Selection for resistant organisms due to the antimicrobial treatment occurs in the bovine animal. Instead of the antibiotic curing the infection and killing all of the bugs, some bugs are left and become resistant to the antibiotic.   (If the antibiotic is administered correctly according to veterinarian and drug label instructions, this should not occur.)
  • After selection occurs (which should not happen—see above), there must then be an increased incidence of resistant organisms in the bovine animal.  The number of resistant organisms must grow.
  • Then, a transfer of these resistant organisms must occur through the food chain or through direct transfer to a human.  In other words, the “bug” must make the jump from the bovine to a human.
  • Then, a presence of food animal derived resistant bacteria must occur in a human.  The resistant bug must survive the “jump” and grow in the new human host.
  • Then, the food animal derived resistant bacteria must contribute to a human disease infection. In other words, the resistant bovine respiratory “bug” must make the human sick. (Another unlikely occurrence because the respiratory “bugs” that affect humans and bovines are not the same).
  • Finally, treatment failure or prolonged disease must occur due to pathogen (infectious bug) resistance.

Completion of all seven of these steps is highly unlikely, and therefore, it is believed by experts (like Dr. Apley) that when I use a cephalosporin antibiotic to treat a bovine with a pneumonia infection that it is NOT contributing to antibiotic resistance in human pneumonia pathogens.  When I use a cephalosporin at the feed yard to treat respiratory illness, it is highly effective at treating the disease.  This demonstrates that step 2 (of the 7 steps) is not attained, and consequently steps 3-7 cannot occur.  This means that the use of antibiotics to fight respiratory infections in my cattle do not contribute to antibiotic resistance in the human population.

Therefore, Dr. Apley reports that no scientific data exists to support the idea that a correlation exists between the uses of antibiotics in the treatment of respiratory illness in bovines with an emergence of an antibiotic resistant respiratory “super bug” in humans.

You can feel good about serving this to your family: it is safe and healthy and tastes great too!

Bill, I am sure that by now, you are wishing that Coach Andersen would give me a really long swimming work out so that I was forced to stop talking.  Some things never change, and I still am an opinionated female!  I have, however, done a lot of homework on this incredibly complex issue and hope that you find this post insightful…

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The Responsible User of Antibiotics…

I am a take charge person.  I am a person of action.  I am a planner.  It is very difficult for me to let things go and not be in the driver’s seat.  There is nothing that shakes my world up more than one of my children having a serious illness.  I can handle it when I am sick, but it shakes my foundation when it is one of my kids.

Like any parent, when my kids get sick I have an unrelenting desire to get them well as quickly as possible.  As an animal caregiver, I also have a great desire to obtain and maintain good health in my animals. Depending on what the source of the infection is when they become sick, sometimes that involves the use of antibiotics.

I will forever remember this smile---it came after two days of terrible sickness and struggle in the hospital. When I saw this smile, I knew that things were going to get better.

Karyn’s pneumonia infection was a tough one for me for a couple of reasons:  First, she got as sick as I have ever seen one of my children get.  During the five days that we spent in the hospital, we spent almost half that time getting Karyn’s infection stable so that she could begin the slow process of healing.  Secondly, I watched as the number of antibiotics and support drugs increased steadily in an attempt to get her well.  While all of these drugs were necessary to support her and help her body fight the infection, it was a lot to give to a little girl.

It took a combination of antibiotics to impact Karyn’s infection.  When the IV antibiotic did not cause any positive response in combating the infection, she was started on a second antibiotic orally that was from a different class of antibiotics.  The first antibiotic was a cephalosporin (B-Lactam antimicrobial), and the second was erythromycin (a macrolide antimicrobial).  I am familiar with both of these classes or families of antibiotics because I have antibiotics from those classes at the feed yard to use to treat my cattle if they develop an illness.

Healthy Cattle make Healthy Beef...

The issue of antibiotic resistance in bacterial infections is currently a very hot topic and, like many concerned people, I think about how my personal choices impact the balance of antibiotic use and efficacy.  We all play a role in the antibiotic resistance issue because we all use antibiotics.  Antibiotics (antimicrobials) are everywhere from prescription drugs to hand sanitizer.  I believe that the question that we must ask ourselves is:  Do the positives of using antibiotics out -weigh the subsequent possible impact on the bacterial organisms that live in our environment?  Because I am both a mother and a cattle farmer, I think about the issue of antibiotic resistance both from an animal use standpoint and from a human use standpoint.

Here I am treating a calf that has a respiratory infection with an antibiotic...This calf is clinically ill and will most likely die if I do not treat the infection...

When I use antibiotics at the feed yard, I use them very carefully and under the advice of my veterinarian using Beef Quality Assurance practices.  I diligently follow the “Judicious Use of Antimicrobials” protocol that has been developed by scientists and veterinarians.  I believe that healthy cattle make healthy beef, and sometimes I need to use antibiotics to help my cattle fight an illness.  In this instance, I believe that the positive results of antibiotic use to cure illnesses in food animals out-weighs the very slight risk that this use will impact the future efficacy of the antibiotics.  I am very careful to use the antibiotics according to the label directions which goes a long way in protecting the efficacy of the products for future use.

As a mom looking at the antibiotic resistance issue, I am also careful about how I use antibiotics with myself and my family.  I do not rush my kids to the doctor every time they have a cold because I know that antibiotics are not efficacious in fighting viral infections.  When prescription antibiotics are necessary, I am very careful to follow the directions and make sure that I use them for the prescribed period of time.  I also do not use anti-bacterial hand sanitizer, and only use anti-bacterial soaps when I feel that it is really necessary.  I want to be careful about how I use bacteria fighting products, because I know that I need them to work when we are faced with a crisis like Karyn’s pneumonia.

Getting up and around for the first time to try and starting building back some strength...

The issue of antibiotic resistance is incredibly complex and I do not even begin to understand the many complexities that go into the equation, but I have always believed that a little bit of common sense goes a long way.  If we all do our part to wisely use the tools that science discovers to combat infection, then those tools will remain as effective as the naturally evolving environment allows them to be.  We all play an important role as there is no easy fix to this challenge.  My experience with Karyn’s recent illness has caused me to do some serious soul searching to ensure that I am doing my part to be a responsible user of antibiotics both as a mom and as a food animal caregiver.

Are you doing your part?

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The Balancer…

I define success as the ability to maintain balance while moving forward in a positive way.  Complete balance involves physical, mental and emotional components.  Whether you are managing yourself, your family, running a business, or caring for animals; maintaining balance is both an art and a skill.

I mentioned in a previous post that my life is a juggling act, and that I am both a planner and a creature of habit because this helps me to be a more successful juggler (https://feedyardfoodie.wordpress.com/2011/10/04/a-two-legged-creature-of-habit%E2%80%A6/).  Despite my quest for balance and my dedicated attempt to plan and run both my life and my feed yard with a regimen based on HAACP (Hazard Analysis Critical Control Points), being a mother of three (in addition to being a caregiver to thousands of animals) has also taught me to “go with the flow”.

HACCP is a critical part of BQA. At a basic level, it means "Figure out what can challenge you before you are challenged so that you can deal with the situation effectively and efficiently."

Although both Matt and I had to work off and on all weekend (me at the feed yard and Matt at the alfalfa dehydration plant loading railroad cars with alfalfa dehy pellets and corn destined for the west coast), we had plans to spend time as a family cutting down a Christmas tree, riding horses, and watching college football (in addition to the traditional over-eating that generally occurs Thanksgiving weekend).

"Horse time" with my girls is a very special time for me. Here I am "ponying" Karyn as she learns to develop good balance and feel in the saddle...

Instead, we spent the weekend at the hospital with our youngest daughter.  Karyn was diagnosed with pneumonia the day before Thanksgiving and we kept her at home on oral antibiotics until Friday when it became apparent that it was going to take more intensive care for her to get better.

After the blood work and IV were put in, but before the need for extra oxygen...It's hard work to "cowgirl up" when you are sick...

My life is consumed by the desire to keep my kids and my animals healthy…It is sobering when I fail…

I believe in the proactive power of:

  1. A Balanced Diet
  2. Being well rested with adequate sleep.
  3. Maintaining up to date vaccinations.
  4. Having time to play and learn.
  5. Being active and getting sufficient exercise.

 Sometimes, however, even the highest dedication to a good proactive health plan is not successful at keeping illness at bay…

 Sometimes the best laid plans change and challenges occur—that is life…It is how we deal with those challenges that define us as individuals…

So, instead of Christmas trees and relaxing horse rides, we got: IV antibiotics, breathing treatments, additional oxygen, and worries about our sick little girl.  All of this on top of reading bunks (the process of determining how much each bovine will be feed for the day) and making sure that the cattle were fed on schedule (they are creatures of habit just like I am and expect to be fed at the same time every day).  A special thanks to my crew for filling in for me as much as they could so that I could spend most of the weekend at the hospital.

I am looking forward to getting my littlest cowgirl back to good health!

Challenges allow for learning and the development of personal strength.  If we are never thrown off balance then we never learn how to obtain it.  Unfortunately, my seven year old had a hard time believing that being stuck with a needle, an IV, and enduring little plastic pokey things sticking up her nose to increase her oxygen levels would make her a better and stronger person (all of these on top of a fever, cough, nausea, and a rash)…But, I know that learning to deal with crisis and being tough enough to do what it takes to improve is an important  life lesson.   It is my job as a parent to teach her to deal with challenges because no matter how much I would like to be able to solve all of her problems for her, I know that I cannot.

Our children mirror us and our behavior.  They look to us for leadership and guidance.  We fail them when we do not deliver it.  It is so hard to stay strong when your child is lying lethargically on a hospital bed and you want to move mountains to make her better, yet really all you can do is help her professional caregivers and pray that God will make her better.  Although Karyn does not really understand why she has to endure all of the medical procedures that go along with fighting a pneumonia infection, my support and quiet strength show her how important it is for her to be tough and to cooperate with the hospital staff.  We had a couple of bouts of tears over the blood work and the IV, but she “cowgirled up” and rose to the occasion.  She is a fighter and gets better each day.  She also is learning to balance herself when faced with adversity, and that is a lesson that she will carry with her long after the pneumonia infection is gone.

Although my little cowgirl is improving, she is still a  sick little girl.  Please pray for her speedy recovery—we are hoping to have her home from the hospital soon.

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