When it comes to animal health and welfare, there are worse things than antibiotics
Healthy meat would be possible even if organic rules allowed a rare and well-defined use for treatment for a life-threatening infection.

By Hubert J. Karreman, VMD

I believe there was a fundamental mistake made by the US organic community when it rejected all antibiotics, both sub-therapeutic and therapeutic.

May 11, 2007: I spend my life around livestock and farmers, learning how to bring health to animals and greater understanding to the people who care for them. What I see in organic livestock systems encourages me in many ways, but I’m troubled by the absolute prohibition against antibiotics in the system.

Organic standards must continue to focus farmer attention on wellness, prevention and stress-reduction, but farmers need to consider a definable but rare use of an antibiotic within organics when it’s the humane thing to do.

The rise of antibiotics

Antibiotics, when first discovered, were truly miraculous. Age-old infectious disease could be reversed and a person could become healthy again. Life-threatening conditions such as bacterial pneumonia, post-partum womb infections (puerperal fever), abdominal infections (peritonitis) and generalized blood infections (septicemia) no longer condemned people to premature death. Other conditions such as bone infections could also be effectively treated without limb amputation.

Unfortunately, the miracle cures that made antibiotics rightfully famous also made physicians less reliant on other methods of treatment. Rather than integrating antibiotics into existing modes of therapy, they became dependent upon them, and anti-infective/anti-bacterial biologics and botanicals were discarded. Moreover, non-life-threatening bacterial infections such as minor ear infections and skin conditions became routinely treated with antibiotics.

Use of antibiotics, in both therapeutic (prescribed to respond to appropriate symptoms) and sub-therapeutic situations also became the norm for livestock agriculture, since antibiotics proved to be useful in reducing disease prevalence as well as promoting growth. This led to the intensification of livestock agriculture as we know it today. The widespread use of antibiotics to treat non-life-threatening conditions in both human and veterinary medicine may be the cause of the resistance patterns seen in modern medicine.

Organic agriculture regulations in the United States explicitly reject all applications of antibiotics for livestock. This is largely due to early organic producers listening to the fears of organic consumers regarding general over-reliance on antibiotics in agriculture. Those fears are still present today.

US organic prohibition unique

I believe there was a fundamental mistake made by the US organic community when it rejected all antibiotics, both sub-therapeutic and therapeutic. It is very likely that the sub-therapeutic use of antibiotics for undiagnosed disease control— as well as growth promotion—is what organic consumers find so troublesome. It is unlikely that an organic consumer (whether highly sensitive to environmental or animal welfare concerns) would actually want there to be punishment for treating an individual animal with a therapeutic antibiotic for life-threatening infectious disease diagnosed by a veterinarian. No other country than the United States has an absolute ban (i.e. permanent removal from production) for the therapeutic use of an antibiotic for an individual animal that is ill.

Proponents of the absolute ban quickly point to the regulation, 7CFR205.238(c)(7), that says:

“The producer of an organic livestock operation must not withhold medical treatment from a sick animal in an effort to preserve its organic status. All appropriate medications must be used to restore an animal to health when methods acceptable to organic production fail. Livestock treated with a prohibited substance must be clearly identified and shall not be sold, labeled, or represented as organically produced.”

While part of this statement certainly sounds good, there is a penalty for carrying out such good will to the animals under our care. Upon close inspection of this regulation, one can formulate the following question: Who is to say what medication will be used and when will it be started in the disease process?

In order to avoid the penalty associated with antibiotics, one’s philosophy or comfort level of alternative medical treatment (including herbs, homeopathy, acupuncture or other methods) will likely steer the initial course of treatment. If treatment is successful with the alternative treatments, great; but if not, then valuable time may have been lost in order to “restore an animal to health” as the regulation requires.

Anecdotes are not enough

Proponents of the complete ban often say (and rightly so) that since organic farmers are getting paid premiums for their products, they owe it to the animal to use whatever it takes to treat the animal. Indeed, organic consumers expect a higher level of care and compassion for the animals that produce the product they are buying on the shelf.

Unfortunately, many organic farmers grasp at any treatment that is promoted simply to avoid using antibiotics. Organic farmers who are looking to use non-antibiotic approaches to heal infectious disease need to be extremely careful about what they choose to use—or to whom they listen. There are many anecdotal incidents of success from individuals, but anecdotes are limited to the farm where they were applied—usually with no thought to what other factors may potentially have caused the animal to heal.

In essence, when it comes to an individual animal needing truly prompt, effective treatment for a serious infection on an organic farm, the US organic rule may compromise animal welfare.

People just learning about organic agriculture often know that antibiotics are not allowed, but then innocently ask how much extra time the animals have to stay out of production if antibiotics are used. The simple answer is: forever. Under the current USDA organic rule, an animal must be immediately removed from any further involvement in the organic system once it is treated with an antibiotic. This rule applies to any age animal, not just adult animals, and renders the animal of no value within the organic marketplace. (It can still be used or sold in non-organic livestock channels, but at a greatly discounted value.)

In essence, when it comes to an individual animal needing truly prompt, effective treatment for a serious infection on an organic farm, the US organic rule may compromise animal welfare. For instance, an unborn calf can’t be certified organic if its mother is treated with antibiotics during the last trimester of pregnancy. Moreover, a calf delivered by Cesarean section is not even allowed to drink its own mother’s milk if the mother has been treated with an antibiotic, since animals must consume only organic feed for their entire life. (To not use an antibiotic after a C-section could be easily be construed as malpractice due to the very high probability of an abdominal infection.)

“Just say No” doesn’t work

The absolute prohibition on antibiotic usage brings up many challenges—challenges not only to the farmer managing the animals but also to the veterinarian called in to treat a sick animal. While there tends to be less stress on organic livestock (likely due to decreased production demands, higher forage diets and grazing), there still can be the occasional animal that, for any number of reasons, may become very ill due to an infection. Reasons may include stressors on the immune system such as calving or adding a new animal into an established group. If the immune system is depressed, infectious problems can arise more easily. Therefore preventing stress is very important in the organic system if we are to avoid reaching for antibiotics.

Any health-compromising condition encountered on a conventional farm can be encountered on an organic farm. My experience shows, however, there will be dramatically less occurrence of conditions needing veterinary attention on organic farms.

The immune system functions optimally when animals are in robust health resulting from sound nutrition, continual access to circulating fresh air, dry bedding, shelter from the elements and grazing well-managed pastures. It should be noted that even with somewhat less stress on organic livestock, any health-compromising condition encountered on a conventional farm can be encountered on an organic farm. My experience shows, however, there will be dramatically less occurrence of conditions needing veterinary attention on organic farms.

A major concept to understand is that not all infectious problems require an antibiotic—and in actuality, only a few do. In my experience, the following three conditions do need prompt antibiotic treatment: peritonitis, bone infections and when there is infection in two major organs (i.e. lungs and uterus, etc.). Withholding antibiotics in these kinds of instances is not only blindly naïve but also illegal according to 205.238(c)(7).

Other infectious problems, if attended to early in the process, can respond to biological and botanical anti-infective agents. These can include: mastitis, uncomplicated pneumonia, diarrhea, metritis, pinkeye, foot rot, abscesses, kidney infections, fevers of unknown origin, and so on. The key is early treatment. When farming organically, it is imperative to be committed to jumping on problems as early as possible. There is just no other way to handle problems with livestock if antibiotics are to be avoided as first-line defense. The real question is: Exactly when might antibiotics be the most appropriate treatment?

Making it real

In order to appreciate the complexity of addressing an infectious problem, a real-life scenario is helpful. Pneumonia is a good example because its illustration can include ways of prevention but also treatment in case it does occur. Pneumonia can be a major concern for farmers transitioning to organics, as well as for the veterinarians assisting them. Additionally, pneumonia can easily become a life-threatening situation if not addressed early and properly.

Pneumonia can occur in picture-perfect, fresh heifers that have been outside until just prior to calving and then brought inside to join the milking string, especially in tie-stall situations. The rapid mixing with older animals in housing with poorly circulating air can give rise to respiratory problems. Risk of infection in this scenario is often elevated since the animal’s immune system becomes suppressed from the internal hormonal changes that occur near calving time. Additionally, abrupt feed changes and ensiled feeds with invisible molds or mycotoxins may upset her digestive system and disrupt normal homeostasis (dynamic wellness), increasing the chances of not being able to withstand infectious challenges.

Young calves can also be afflicted with respiratory problems. Pneumonia is common in young pre-weaned and just-weaned calves which are housed indoors, especially when they share poorly circulating airspace with nearby older animals. Outdoor hutches or age-group housing offer continuous fresh air to animals. Along with dry bedding, outdoor venues are excellent in preventing pneumonia.

I like to remind farmers that it is better to have a live cow than a dead organic one.

However, respiratory problems can also happen soon after older calves—having been outside all summer on pasture during their first year of life—are brought back into a barn in late autumn. In this case, the calves may be parasitized with stomach worms (strongyles) which will draw down their defenses, making it likely they will succumb to respiratory problems when placed back into a barn shared by other animals. Less commonly, other species (like pigs) that are allowed to freely wander around barns can track germs from one area to another.

Obviously, preventing animals from experiencing poorly circulating air, ensiled feeds with molds or mycotoxins or becoming parasitized is critical to prevent many problems in general. Even if vaccinated, an animal can still become ill for reasons never to be fully understood.

Recognizing symptoms to scale response

The cardinal signs of pneumonia are fever (above 102.5° F), increased respiratory rate, cough, slowness to eat and a somewhat-distant stare. If the fever is high (~106° F), it may be viral at the time and respond well to non-antibiotic treatments to stimulate, as well as support, its immune system. When listening to the lungs:

• If there are raspy or rough sounds, a non-antibiotic approach can be considered.
• If abscesses are detected by stethoscope or the animal is “belly breathing” (more belly than chest movement), go immediately to antibiotics.
• If there is another infection somewhere in the body (udder, uterus, etc.), go to the antibiotic.

Always be prepared to use an antibiotic if no improvement occurs within 48 hours of using natural approaches. I like to remind farmers that it is better to have a live cow than a dead organic one.

Various botanicals have been proven to make the immune system more robust in overcoming infection—garlic, goldenseal and ginseng immediately come to mind. Biologics (therapies derived from living organisms) can actively stimulate the non-specific arm of the immune system and also supply the animal with antibodies while vitamins, minerals and botanicals support the animal in general. Animals with pneumonia need to be watched closely. If a further decline is noticed, antibiotics need to be started.

In groups of coughing calves that are bright and alert and still eating (the earliest stage of a respiratory problem), natural treatments can work quite well as long as the other basic management tools of fresh air, dry bedding and sound nutrition are practiced. However, it is usually the one calf that caught the farmer’s attention that is depressed, laying down and coughing that should receive antibiotic treatment.

Animals treated by natural means tend to recover more slowly but should be improving continuously.

So, once an animal displays symptoms that indicate infection, how exactly is a farmer to know when to choose between natural treatment methods and an antibiotic? The farmer actually doesn’t need to know—this should only be done in consultation with the local veterinarian who has personally examined the animals.

What the farmer needs to know is when to call in the veterinarian. For the sake of animals on organic farms, sooner is better.

Hubert Karreman, VMD, is a solo dairy practitioner who predominantly works with organic herds in Lancaster County, Pennsylvania. He relies heavily on botanicals, biologics and homeopathy to treat dairy cows and only rarely reaches for an antibiotic. He is on the USDA National Organic Standards Board (NOSB) and chairs its livestock committee.