Commentary Commentaire Public veterinary medicine is a specialty V. Wayne Lees
I
t is with great interest that I read the recent commentary on public policy and veterinary medicine by Drs. Nielsen, Buntain, Stemshorn, and Evans (1). The authors are highly respected individuals who have done much in their respective careers to advance critical thinking in public veterinary medicine. As a recently retired provincial Chief Veterinary Officer, over the last several months I have had the opportunity to reflect on the role of public veterinary medicine, without having to face the daily issues and pressures of my former position. I agree wholeheartedly with the authors that, for too long, public veterinary practice has been overlooked, both as a recognized discipline and as a field for research. But why is that? My personal view is that the practice of public veterinary medicine has largely been viewed within the profession as government regulatory work, focussing on the details of learning the regulations and applying the rules. This largely misses the heart of public practice, which is to contribute to the development of policy that deals with significant real life issues — policy that makes sense and that takes a balanced approach to what are often competing interests. Getting policy right is the first step towards developing the strong regulatory framework which is essential to good public practice. Developing good policy is often not a simple task. How do we balance the rights and interests of the individual against the greater societal good? Or, how do we balance the rights of two interest groups with very different points of view? These are often difficult discussions which go beyond the realm of science, venturing into a competition between belief systems. Nowhere is this more evident than in discussions involving animal welfare. Sure, science does matter, but people’s feelings and moral views will hold much more sway in the discussion than will any scientific research paper. I suspect that some veterinarians and perhaps some producer associations have not yet realized that most of the public debate about animal welfare is centred on moral issues, not scientific ones. Good policy making is based on science, but it must also take into account these social mores. In the past, there has been only limited involvement of the academic community in studying how to formulate policy. Most of us who have had to develop public policy have done so by learning on the job, usually by taking on new positions with Box 471, Oak Lake, Manitoba R0M 1P0. Use of this article is limited to a single copy for personal study. Anyone interested in obtaining reprints should contact the CVMA office ([email protected]) for additional copies or permission to use this material elsewhere. CVJ / VOL 55 / JULY 2014
increased responsibilities within government. In the face of an emergency, public officials may consult with academic experts for technical advice, but often decisions must be made quickly and there is no time to conduct the research we might wish to have. It is in these times, where we draw on our previous experience with similar situations to make the best decision possible. The weight of this decision-making is significant, and I might argue especially far-reaching in animal health. For example, if a medical officer of health quarantines a school, then all of the students, teachers, and parents are affected. This is a substantial consequence, but one that is mainly confined to the local area. However, if a chief veterinary officer quarantines a farm, then international trade for the entire country could be stopped. We have seen examples in the past where some countries apply international sanctions to Canadian products even in in the case of diseases that are not officially reportable. Canada has successfully faced challenges with outbreaks of emerging diseases such as bovine spongiform encephalopathy (BSE), pandemic H1N1 influenza, food-borne listeriosis, and now porcine epidemic diarrhea. These have provided valuable lessons that should be reviewed and studied in an academic realm so that these lessons are not lost. I think what we will find most valuable from this exercise will be to outline, not so much the technical details, but rather the guiding principles that were used to arrive at major policy decisions during these challenging times. It is inevitable that some new disease in some species will arise in the not-too-distant future so it is critical that we learn from the past as to what principles worked and what did not, and under what context they were applied. This retrospective analysis is where the academic community can add real value to public policy-making. To formulate policy prospectively; however, we need to broaden the discussion to include not just government (federal, provincial, and territorial) and academic veterinarians, but also other stakeholders, such as non-government organizations, producer associations, and consumer groups. The National Farmed Animal Health and Welfare Council (www.ahwcouncil.ca) is comprised of senior policy advisors from federal/provincial/ territorial governments (such as the Council of Chief Veterinary Officers), producer industry associations, public health and academia (one member). The Council has commissioned a number of excellent policy advisory papers on topics such as national animal health surveillance, animal welfare, and antimicrobial use in food animals. This work is based on supporting the guiding principles outlined in the National Farmed Animal Health and Welfare Strategy. The strength of the Council is that it represents a broad range of stakeholders within its members. In addition, 695
C O M M E N TA I R E
the Council’s annual national animal health and welfare forum provides an opportunity for even broader input from interest groups. It is clear that no single agency, department or organization can manage the evermore complex challenges that we will face in the future. Having all the important players at the policy-formulating table just makes good sense. In conclusion, I wholeheartedly support the authors’ call for increased academic involvement in researching policy in animal health, animal welfare, veterinary public health and food safety by applying the principles of One Health. I also support the proposal to develop an organization of veterinarians interested
in public practice. Developing sound public policy within the realm of public veterinary medicine is a specialty in its own right. However, we need to go further and actively support a broadly based policy think tank, such as the National Farmed Animal Health and Welfare Council, where practical solutions can be developed.
Reference 1. Nielsen NO, Buntain B, Stemshorn B, Evans B. Public policy and veterinary medicine. Can Vet J 2014;55:389–390.
Book Review Compte rendu de livre Color Atlas of Diseases and Disorders of Cattle, 3rd edition Blowey RW, Weaver AD. Mosby Elsevier, London, UK, 2012. 267 pp. ISBN: 978-07234-3778-9. $165.00.
T
he third edition of this book is a wonderful visual romp through diseases and disorders of cattle throughout the world, and would be a useful addition to any bovine practitioner’s library. The book is organized into 13 chapters by body systems (with the exception of Congenital and Neonatal Disorders that start the book, and Infectious Diseases and Toxicological Disorders that end it). This makes for a very organized flow of information. Each chapter is divided into specifically grouped diseases, but each also has unique divisions. For example, Ocular Disorders are grouped into congenital, acquired and neoplastic conditions, while Alimentary Disorders are grouped anatomically. Most of the chapters have infectious and non-infectious divisions, whereas the Infectious Diseases chapter is subdivided into viral, bacterial, tick-borne and miscellaneous components. It may sound confusing, but it is actually very logical as one reads through the book. There is an exceptionally detailed index indicating the page of the pictures as well as the text, and also a page for the clarification of acronyms. There are 848 color photographs; concise written overviews with at least one, to as many as four, photos that comprise each named condition. There is about a quarter of a page of script per disease, which is broken into 4 subheadings: definition, clinical features, differential diagnosis, and management; the text is impressively succinct. The differential diagnosis sections are comprised of a list of conditions with reference to appropriate figures found elsewhere in the book. The management sections are brief, yet relatively complete, synopses of treatment. As stated in the preface, the aim is not to provide in-depth discussion on treatment, but to provide the basic premise. There is no mention of specific drug therapy, but types of drugs, e.g., NSAIDs, antibiotics, anti-parasitics, etc., are suggested where
696
necessary, and there are tips on how to avoid the problem, such as a feed or housing change, vaccination, surgery, etc. The book’s panoply of content is remarkably complete and covers the most common of diseases to the relatively obscure. There is even a small section on dystocia, which, practically speaking, is fairly useless, but in the essence of completeness, does round out the chapter titled Urinogenital Diseases. The chapter on Locomotor Disorders is especially thorough. There are 22 pages dedicated to the lower limb and digit with numerous high quality photos of hooves showing a myriad of conditions. Each photo is well-described and cross-referenced to other pictures, if indicated. It is interesting that there are 30 named conditions of the bovine foot — definitely the most detailed chapter in the book. While there is an obvious dairy cow bent, the common causes of beef cow lameness are wellcovered. The second part of this chapter is on the upper limb and spine. This can be a particularly frustrating area of bovine medicine as there are many causes of downer/crippled cows that are difficult to differentiate. The chapter covers many disorders, and the excellent photos include radiographs and postmortem specimens; some of the photos exhibit pathognomonic presentations — always useful to show when communicating with producers. In general, I think this book is a wonderful addition to any veterinary library. It is attractively laid out and the cross-referencing is excellent. The atlas will have international appeal due to the attention it affords to tropical diseases. Many of these are names that just linger as vague memories of veterinary school for the average Canadian bovine practitioner, so it is worthwhile to be reminded that these serious diseases are still present in many parts of the world. I would recommend this book to anybody involved in cattle production. Moderately priced, it is suited to students and veterinarians as a quick and easy reference in everyday practice.
Reviewed by Cathy Patterson, DVM, Large Animal Practitioner, Box 192, Gladstone, Manitoba R0J 0T0. CVJ / VOL 55 / JULY 2014
I
t is with great interest that I read the recent commentary on public policy and veterinary medicine by Drs. Nielsen, Buntain, Stemshorn, and Evans (1). The authors are highly respected individuals who have done much in their respective careers to advance critical thinking in public veterinary medicine. As a recently retired provincial Chief Veterinary Officer, over the last several months I have had the opportunity to reflect on the role of public veterinary medicine, without having to face the daily issues and pressures of my former position. I agree wholeheartedly with the authors that, for too long, public veterinary practice has been overlooked, both as a recognized discipline and as a field for research. But why is that? My personal view is that the practice of public veterinary medicine has largely been viewed within the profession as government regulatory work, focussing on the details of learning the regulations and applying the rules. This largely misses the heart of public practice, which is to contribute to the development of policy that deals with significant real life issues — policy that makes sense and that takes a balanced approach to what are often competing interests. Getting policy right is the first step towards developing the strong regulatory framework which is essential to good public practice. Developing good policy is often not a simple task. How do we balance the rights and interests of the individual against the greater societal good? Or, how do we balance the rights of two interest groups with very different points of view? These are often difficult discussions which go beyond the realm of science, venturing into a competition between belief systems. Nowhere is this more evident than in discussions involving animal welfare. Sure, science does matter, but people’s feelings and moral views will hold much more sway in the discussion than will any scientific research paper. I suspect that some veterinarians and perhaps some producer associations have not yet realized that most of the public debate about animal welfare is centred on moral issues, not scientific ones. Good policy making is based on science, but it must also take into account these social mores. In the past, there has been only limited involvement of the academic community in studying how to formulate policy. Most of us who have had to develop public policy have done so by learning on the job, usually by taking on new positions with Box 471, Oak Lake, Manitoba R0M 1P0. Use of this article is limited to a single copy for personal study. Anyone interested in obtaining reprints should contact the CVMA office ([email protected]) for additional copies or permission to use this material elsewhere. CVJ / VOL 55 / JULY 2014
increased responsibilities within government. In the face of an emergency, public officials may consult with academic experts for technical advice, but often decisions must be made quickly and there is no time to conduct the research we might wish to have. It is in these times, where we draw on our previous experience with similar situations to make the best decision possible. The weight of this decision-making is significant, and I might argue especially far-reaching in animal health. For example, if a medical officer of health quarantines a school, then all of the students, teachers, and parents are affected. This is a substantial consequence, but one that is mainly confined to the local area. However, if a chief veterinary officer quarantines a farm, then international trade for the entire country could be stopped. We have seen examples in the past where some countries apply international sanctions to Canadian products even in in the case of diseases that are not officially reportable. Canada has successfully faced challenges with outbreaks of emerging diseases such as bovine spongiform encephalopathy (BSE), pandemic H1N1 influenza, food-borne listeriosis, and now porcine epidemic diarrhea. These have provided valuable lessons that should be reviewed and studied in an academic realm so that these lessons are not lost. I think what we will find most valuable from this exercise will be to outline, not so much the technical details, but rather the guiding principles that were used to arrive at major policy decisions during these challenging times. It is inevitable that some new disease in some species will arise in the not-too-distant future so it is critical that we learn from the past as to what principles worked and what did not, and under what context they were applied. This retrospective analysis is where the academic community can add real value to public policy-making. To formulate policy prospectively; however, we need to broaden the discussion to include not just government (federal, provincial, and territorial) and academic veterinarians, but also other stakeholders, such as non-government organizations, producer associations, and consumer groups. The National Farmed Animal Health and Welfare Council (www.ahwcouncil.ca) is comprised of senior policy advisors from federal/provincial/ territorial governments (such as the Council of Chief Veterinary Officers), producer industry associations, public health and academia (one member). The Council has commissioned a number of excellent policy advisory papers on topics such as national animal health surveillance, animal welfare, and antimicrobial use in food animals. This work is based on supporting the guiding principles outlined in the National Farmed Animal Health and Welfare Strategy. The strength of the Council is that it represents a broad range of stakeholders within its members. In addition, 695
C O M M E N TA I R E
the Council’s annual national animal health and welfare forum provides an opportunity for even broader input from interest groups. It is clear that no single agency, department or organization can manage the evermore complex challenges that we will face in the future. Having all the important players at the policy-formulating table just makes good sense. In conclusion, I wholeheartedly support the authors’ call for increased academic involvement in researching policy in animal health, animal welfare, veterinary public health and food safety by applying the principles of One Health. I also support the proposal to develop an organization of veterinarians interested
in public practice. Developing sound public policy within the realm of public veterinary medicine is a specialty in its own right. However, we need to go further and actively support a broadly based policy think tank, such as the National Farmed Animal Health and Welfare Council, where practical solutions can be developed.
Reference 1. Nielsen NO, Buntain B, Stemshorn B, Evans B. Public policy and veterinary medicine. Can Vet J 2014;55:389–390.
Book Review Compte rendu de livre Color Atlas of Diseases and Disorders of Cattle, 3rd edition Blowey RW, Weaver AD. Mosby Elsevier, London, UK, 2012. 267 pp. ISBN: 978-07234-3778-9. $165.00.
T
he third edition of this book is a wonderful visual romp through diseases and disorders of cattle throughout the world, and would be a useful addition to any bovine practitioner’s library. The book is organized into 13 chapters by body systems (with the exception of Congenital and Neonatal Disorders that start the book, and Infectious Diseases and Toxicological Disorders that end it). This makes for a very organized flow of information. Each chapter is divided into specifically grouped diseases, but each also has unique divisions. For example, Ocular Disorders are grouped into congenital, acquired and neoplastic conditions, while Alimentary Disorders are grouped anatomically. Most of the chapters have infectious and non-infectious divisions, whereas the Infectious Diseases chapter is subdivided into viral, bacterial, tick-borne and miscellaneous components. It may sound confusing, but it is actually very logical as one reads through the book. There is an exceptionally detailed index indicating the page of the pictures as well as the text, and also a page for the clarification of acronyms. There are 848 color photographs; concise written overviews with at least one, to as many as four, photos that comprise each named condition. There is about a quarter of a page of script per disease, which is broken into 4 subheadings: definition, clinical features, differential diagnosis, and management; the text is impressively succinct. The differential diagnosis sections are comprised of a list of conditions with reference to appropriate figures found elsewhere in the book. The management sections are brief, yet relatively complete, synopses of treatment. As stated in the preface, the aim is not to provide in-depth discussion on treatment, but to provide the basic premise. There is no mention of specific drug therapy, but types of drugs, e.g., NSAIDs, antibiotics, anti-parasitics, etc., are suggested where
696
necessary, and there are tips on how to avoid the problem, such as a feed or housing change, vaccination, surgery, etc. The book’s panoply of content is remarkably complete and covers the most common of diseases to the relatively obscure. There is even a small section on dystocia, which, practically speaking, is fairly useless, but in the essence of completeness, does round out the chapter titled Urinogenital Diseases. The chapter on Locomotor Disorders is especially thorough. There are 22 pages dedicated to the lower limb and digit with numerous high quality photos of hooves showing a myriad of conditions. Each photo is well-described and cross-referenced to other pictures, if indicated. It is interesting that there are 30 named conditions of the bovine foot — definitely the most detailed chapter in the book. While there is an obvious dairy cow bent, the common causes of beef cow lameness are wellcovered. The second part of this chapter is on the upper limb and spine. This can be a particularly frustrating area of bovine medicine as there are many causes of downer/crippled cows that are difficult to differentiate. The chapter covers many disorders, and the excellent photos include radiographs and postmortem specimens; some of the photos exhibit pathognomonic presentations — always useful to show when communicating with producers. In general, I think this book is a wonderful addition to any veterinary library. It is attractively laid out and the cross-referencing is excellent. The atlas will have international appeal due to the attention it affords to tropical diseases. Many of these are names that just linger as vague memories of veterinary school for the average Canadian bovine practitioner, so it is worthwhile to be reminded that these serious diseases are still present in many parts of the world. I would recommend this book to anybody involved in cattle production. Moderately priced, it is suited to students and veterinarians as a quick and easy reference in everyday practice.
Reviewed by Cathy Patterson, DVM, Large Animal Practitioner, Box 192, Gladstone, Manitoba R0J 0T0. CVJ / VOL 55 / JULY 2014
