Letters to the Editor Courrier des lecteurs In memory of Mike Kaye Dear Editor, have been meaning for a long time to write a brief note about my best friend whose life ended in 1972. Michael Moxon Kaye was raised in British Columbia, obtained a BSc from the University of British Columbia, and was a graduate of the Ontario Veterinary College (OVC) in the Centennial class of 1962. After graduation he teamed with classmate Jerrold Niwa from Acadia Valley, Alberta, and together they bought Green Acres Animal Hospital in Lethbridge, Alberta. Mike was in mixed practice in Lethbridge till 1968 when he accepted an appointment in radiology at The Western College of Veterinary Medicine in Saskatoon. Mike married Gerarda Nanninga and had two daughters and a son. To advance his career he enrolled as an MSc candidate in the Graduate School at The University of Guelph and learned radiology from Dr. Paul Pennock. Mike’s Thesis was published in 1971 and dedicated to his family. During this time at OVC he was the only trainee in radiology and when Paul was on vacation he was the radiologist for the College and did his thesis work at night. Mike’s thesis is a 160-page document on arthrography and covers the stifle and hip joints of the dog. It is still pertinent
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today. Mike noted the lack of data on arthrography in veterinary published literature. The study was based on 48 dogs that were divided into 4 groups, each of which included dogs aged 8 weeks to maturity. The groups varied in the times they were studied from 2 days, 5 days, 10 days and 20 days with 1 side serving as controls and the opposite side were injected with a contrast agent (Renogravin-60). The 2-day trial dogs were first injected with contrast material then radiographed and had their joints aspirated for 2 days. The 5-day dogs were injected with contrast material and after a 5-day interval were again examined after an aspirate and arthrography. Each of the other groups was examined after 10 days and after 20 days and reexamined. At each examination slides were made of the aspirate and a total count was carried out. There are 49 plates of arthrography and of the cellular aspirates with extensive descriptions in the thesis. There are 16 tables of cell counts that are still of current value as are the descriptions of the cellular aspirates. The thesis is of interest to anyone with an interest in joints and in the interpretation of the cellular aspirates and the arthrography. V. E. [Ted] Valli, DVM
Utilisation prudente des antibiotiques Monsieur le Rédacteur en chef, L’utilisation des antibiotiques devrait toujours se faire, et être régie, en fonction de la santé animale et de la santé publique peu importe l’espèce et les secteurs de pratique. Il m’apparaît évident que nous ne pouvons pas défendre des restrictions qui visent à prévenir le développement de l’antibiorésistance chez le bétail tout en permettant ces usages pour les animaux de compagnie. Notre engagement envers la santé et le bien-être animal est vrai pour tous les animaux, mais aussi pour la santé publique par le concept «Un monde, Une santé». Il existe effectivement des restrictions afin d’éviter des conséquences (réactions adverses) sévères pour la santé humaine reliées à l’utilisation de produits chez les animaux destinés à la consommation (p. ex. chloramphénicol, phénylbutazone). Le phénomène de l’antibiorésistance devrait donc toujours être considéré lorsque vient le moment de prescrire l’utilisation d’un antibiotique, quel que soit l’animal. Bien que le lien entre l’utilisation des antibiotiques chez les animaux et le développement de l’antibiorésistance chez l’humain soit complexe et encore imparfaitement compris, tous les médecins
vétérinaires doivent favoriser l’utilisation la plus judicieuse possible des antibiotiques. L’affirmation qu’il pourrait être plus probable que l’usage des antibiotiques chez les animaux de compagnie transfère la bactérie de résistance aux antimicrobiens aux humains, par leur proximité avec leur maître, reste à démontrer et à ce moment-ci ne risque que d’entretenir la confusion et l’incompréhension sur ce phénomène. Le fait d’ajouter que des restrictions soulèveraient un tollé chez les propriétaires d’animaux de compagnie indique bien la nécessité de mieux faire connaître la problématique de l’antibiorésistance, tant aux propriétaires d’animaux qu’aux producteurs. Les producteurs sont tout aussi préoccupés par les interdictions et restrictions imposées, leurs impacts pour la santé et le bien-être de leurs animaux et les impacts économiques sur leur entreprise. En fait, les restrictions et précautions qui sont demandées quant à l’utilisation des antibiotiques concernent davantage la connaissance et le respect des classes d’antibiotiques d’importance en santé humaine (I à IV) telles que présentées par Santé Canada. C’est là que l’évaluation faite par les praticiens
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 55 / AUGUST 2014
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devient essentielle pour le choix de l’antibiothérapie la plus judicieuse. C’est sur un processus de réflexion rigoureux, basé sur les connaissances actuelles de la science et sur les conséquences potentielles (incluant le développement de souches résistantes), que le médecin vétérinaire doit baser sa réflexion et prendre sa décision. Heureusement, nous n’en sommes plus à l’étape du questionnement éthique mais bien à l’étape cruciale de la réalité
scientifique et de l’application d’une rigueur professionnelle dans l’usage judicieux des antibiotiques et de toute médication pour la santé et le bien-être de tous. Dr Joël Bergeron, d.m.v. Président Ordre des médecins vétérinaires du Québec Saint-Hyacinthe (Québec)
Prudent use of antibiotics Dear Editor, Antibiotics should always be used and managed in relation to animal health and public health, regardless of the species and area of practice. It seems obvious that we cannot defend restrictions that are aimed at preventing the development of antimicrobial resistance in cattle, while allowing uses for companion animals. Our commitment to animal health and welfare is real for all animals, but also for public health within the concept of “One Health.” There are in fact restrictions aimed at avoiding severe consequences (adverse reactions) for human health linked to the use of products in food animals (e.g., chloramphenicol, phenylbutazone). The antimicrobial resistance factor should always be considered when the time comes to prescribe the use of an antibiotic, regardless of the animal. Although the link between the use of antibiotics in animals and the development of antimicrobial resistance in humans is complex and not yet well understood, all veterinarians must promote the most prudent use possible of antibiotics. The notion that it would be more likely that the use of antibiotics in companion animals would transfer the resistance bacterium to humans, through their proximity to their master, still has to be demonstrated and, at this time, this may only support the confusion and misunderstanding surrounding this phenomenon. Arguing that these restrictions would create a strong
714
opposition on the part of companion animal owners clearly indicates the need to better explain the issue of antimicrobial resistance to owners of companion animals as well as producers. Producers are worried about bans and restrictions that have been imposed, their impact on the health and welfare of their animals as well as their economic impacts on their businesses. In fact, the restrictions and precautions that are requested with regard to the use of antibiotics have more to do with the knowledge and respect of the categories of importance in human medicine (I to IV) for antibiotics as presented by Health Canada. This is where the assessment of practitioners is essential for the choice of the most prudent antimicrobial therapy. The veterinarian must make a decision based on a rigorous decision process, which is supported by current scientific knowledge and awareness of potential consequences (including the development of resistant strains). Fortunately, we are not at the stage of ethical considerations but more at the crucial step of scientific reality and the application of professional rigour in the prudent use of antibiotics and of all medications for the health and welfare of all. Dr. Joël Bergeron, D.M.V. President Ordre des médecins vétérinaires du Québec Saint-Hyacinthe (Quebec)
CVJ / VOL 55 / AUGUST 2014
I
today. Mike noted the lack of data on arthrography in veterinary published literature. The study was based on 48 dogs that were divided into 4 groups, each of which included dogs aged 8 weeks to maturity. The groups varied in the times they were studied from 2 days, 5 days, 10 days and 20 days with 1 side serving as controls and the opposite side were injected with a contrast agent (Renogravin-60). The 2-day trial dogs were first injected with contrast material then radiographed and had their joints aspirated for 2 days. The 5-day dogs were injected with contrast material and after a 5-day interval were again examined after an aspirate and arthrography. Each of the other groups was examined after 10 days and after 20 days and reexamined. At each examination slides were made of the aspirate and a total count was carried out. There are 49 plates of arthrography and of the cellular aspirates with extensive descriptions in the thesis. There are 16 tables of cell counts that are still of current value as are the descriptions of the cellular aspirates. The thesis is of interest to anyone with an interest in joints and in the interpretation of the cellular aspirates and the arthrography. V. E. [Ted] Valli, DVM
Utilisation prudente des antibiotiques Monsieur le Rédacteur en chef, L’utilisation des antibiotiques devrait toujours se faire, et être régie, en fonction de la santé animale et de la santé publique peu importe l’espèce et les secteurs de pratique. Il m’apparaît évident que nous ne pouvons pas défendre des restrictions qui visent à prévenir le développement de l’antibiorésistance chez le bétail tout en permettant ces usages pour les animaux de compagnie. Notre engagement envers la santé et le bien-être animal est vrai pour tous les animaux, mais aussi pour la santé publique par le concept «Un monde, Une santé». Il existe effectivement des restrictions afin d’éviter des conséquences (réactions adverses) sévères pour la santé humaine reliées à l’utilisation de produits chez les animaux destinés à la consommation (p. ex. chloramphénicol, phénylbutazone). Le phénomène de l’antibiorésistance devrait donc toujours être considéré lorsque vient le moment de prescrire l’utilisation d’un antibiotique, quel que soit l’animal. Bien que le lien entre l’utilisation des antibiotiques chez les animaux et le développement de l’antibiorésistance chez l’humain soit complexe et encore imparfaitement compris, tous les médecins
vétérinaires doivent favoriser l’utilisation la plus judicieuse possible des antibiotiques. L’affirmation qu’il pourrait être plus probable que l’usage des antibiotiques chez les animaux de compagnie transfère la bactérie de résistance aux antimicrobiens aux humains, par leur proximité avec leur maître, reste à démontrer et à ce moment-ci ne risque que d’entretenir la confusion et l’incompréhension sur ce phénomène. Le fait d’ajouter que des restrictions soulèveraient un tollé chez les propriétaires d’animaux de compagnie indique bien la nécessité de mieux faire connaître la problématique de l’antibiorésistance, tant aux propriétaires d’animaux qu’aux producteurs. Les producteurs sont tout aussi préoccupés par les interdictions et restrictions imposées, leurs impacts pour la santé et le bien-être de leurs animaux et les impacts économiques sur leur entreprise. En fait, les restrictions et précautions qui sont demandées quant à l’utilisation des antibiotiques concernent davantage la connaissance et le respect des classes d’antibiotiques d’importance en santé humaine (I à IV) telles que présentées par Santé Canada. C’est là que l’évaluation faite par les praticiens
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 55 / AUGUST 2014
713
C O U R R I E R D E S LE CT E U R S
devient essentielle pour le choix de l’antibiothérapie la plus judicieuse. C’est sur un processus de réflexion rigoureux, basé sur les connaissances actuelles de la science et sur les conséquences potentielles (incluant le développement de souches résistantes), que le médecin vétérinaire doit baser sa réflexion et prendre sa décision. Heureusement, nous n’en sommes plus à l’étape du questionnement éthique mais bien à l’étape cruciale de la réalité
scientifique et de l’application d’une rigueur professionnelle dans l’usage judicieux des antibiotiques et de toute médication pour la santé et le bien-être de tous. Dr Joël Bergeron, d.m.v. Président Ordre des médecins vétérinaires du Québec Saint-Hyacinthe (Québec)
Prudent use of antibiotics Dear Editor, Antibiotics should always be used and managed in relation to animal health and public health, regardless of the species and area of practice. It seems obvious that we cannot defend restrictions that are aimed at preventing the development of antimicrobial resistance in cattle, while allowing uses for companion animals. Our commitment to animal health and welfare is real for all animals, but also for public health within the concept of “One Health.” There are in fact restrictions aimed at avoiding severe consequences (adverse reactions) for human health linked to the use of products in food animals (e.g., chloramphenicol, phenylbutazone). The antimicrobial resistance factor should always be considered when the time comes to prescribe the use of an antibiotic, regardless of the animal. Although the link between the use of antibiotics in animals and the development of antimicrobial resistance in humans is complex and not yet well understood, all veterinarians must promote the most prudent use possible of antibiotics. The notion that it would be more likely that the use of antibiotics in companion animals would transfer the resistance bacterium to humans, through their proximity to their master, still has to be demonstrated and, at this time, this may only support the confusion and misunderstanding surrounding this phenomenon. Arguing that these restrictions would create a strong
714
opposition on the part of companion animal owners clearly indicates the need to better explain the issue of antimicrobial resistance to owners of companion animals as well as producers. Producers are worried about bans and restrictions that have been imposed, their impact on the health and welfare of their animals as well as their economic impacts on their businesses. In fact, the restrictions and precautions that are requested with regard to the use of antibiotics have more to do with the knowledge and respect of the categories of importance in human medicine (I to IV) for antibiotics as presented by Health Canada. This is where the assessment of practitioners is essential for the choice of the most prudent antimicrobial therapy. The veterinarian must make a decision based on a rigorous decision process, which is supported by current scientific knowledge and awareness of potential consequences (including the development of resistant strains). Fortunately, we are not at the stage of ethical considerations but more at the crucial step of scientific reality and the application of professional rigour in the prudent use of antibiotics and of all medications for the health and welfare of all. Dr. Joël Bergeron, D.M.V. President Ordre des médecins vétérinaires du Québec Saint-Hyacinthe (Quebec)
CVJ / VOL 55 / AUGUST 2014
