This question brings up 2 important ethical issues. The 1st issue concerns the ethics of veterinarians and producers having to rely on extra-label drug use to control even the most basic diseases. In most instances in food animal practice, veterinarians can easily limit all drug prescriptions to label claims only. There is no need to alter dose, frequency, route of administration, or duration from that listed on the label. This is particularly true with the control of internal parasite infections in cattle. But, in Canada, it is not true with small ruminants, particularly dairy goats. It is not that drugs currently on the market for cattle are not safe and effective for goats, but the companies that manufacture or distribute those drugs have not sought a label claim for this species. Why? Because Canada is a small market and there is no reciprocity with other countries to “share” label claims without (to the companies) a sizable expense.

So now the onus is on the veterinarian to seek out information on how to use these drugs from gFARAD or other scientific sources — which is not a problem as long as the information is not difficult to find, can be obtained quickly (at the latest the same day), and is accurate and not hearsay. If gFARAD is slow to respond, or the goat expert at an academic institution is not at his or her desk that day, the veterinarian is put in a position of best guess — and may guess wrong. With the example of anthelmintics, goats often metabolize this class of drugs faster than cattle or sheep, so a higher dose than that listed for those species may be required to achieve similar efficacy. If topical, the drug may be more poorly absorbed from caprine than from bovine skin. Goats suffer from different parasitic diseases than do cattle, which influences deworming program recommendations. Also, goats may be more at risk of an adverse reaction. So, because veterinarians in Canada are forced to use drugs in an extra-label fashion, who loses? The goats because the drug may not work or may be toxic, the producers because their goats are not getting the same quality of treatment as, for example, a dairy cow would, and the public because there may now be residue/food safety issues with that goat's milk or meat that would not exist in a country where drugs labeled for this species are readily available.

The 2nd ethical issue — what should the veterinarian's response be to the passing on of his or her treatment recommendations — is to me, a less important issue than the first. Here we are given an ideal situation where the veterinarian has taken the time to develop a safe and effective deworming program and communicated it well to his or her client. If all veterinarians could and did serve their small ruminant clients in this manner, there would be less need for a client to write a column for a local newsletter. Perhaps in response, the veterinarian could contact the editor of the newsletter and indicate his or her willingness to write a column about the principles of parasite control in dairy goats and, in particular, the dangers of anthelmintic resistance. It is also an opportunity to stress the importance of developing an appropriate veterinary-client-patient relationship when drugs are being used “extra-label,” and of the dangers of doing so without good quality veterinary advice from the herd veterinarian. My experience is that small ruminant producers are starved for good advice from interested veterinary practitioners. However, this is a time- consuming task with little monetary reward. Perhaps, if the 1st issue would be solved, there would be less need to fill the void created by the sparse availability of good quality information.

Paula Menzies, DVM, MPVM, Guelph, Ontario