A farmer client, known to be sceptical of all things veterinary, requests a visit. Examination of a pregnant suckler cow reveals an infected, ulcerated growth on its third eyelid. You provisionally diagnose squamous cell carcinoma of the third eyelid, and suggest removal of the mass under local anaesthetic, with the caveat that by the time the cow had calved and reared its calf, the growth would probably have returned and culling would then be recommended. However, the client insists on palliative treatment with a time limit, without removal of the mass. A courtesy visit a week later reveals that the cow is showing signs of pain from the growth. On arrival at the farm, however, you notice several untagged dead calves and two dead sheep in a ditch on the farmer's land by the entrance. How do you approach the farmer to remind him of his responsibilities to both the cow's welfare and the dead animals?
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Mike Steele qualified from Bristol in 1999. After working in mixed practice for six years, he subsequently worked partly in practice but mainly in teaching for the following five years. He is currently a teaching fellow in farm animal science at Bristol, specialising in evidence-based veterinary medicine, as well as farm-related subjects.
Issues to consider
Both the eyelid mass and the dumped carcases present some difficult issues. The advice to remove the mass before eventual culling was obviously not initially acceptable to the owner of the cow. An evidence-based database search revealed that 86 per cent of squamous cell carcinomas in this area continue to grow without treatment (with consequent discomfort) if not removed (Stewart and others 2006). This justifies advising removal of the eyelid to prevent further welfare compromise. One trial revealed that treatment with interleukin-2 (IL-2), without removal of the eyelid, resulted in regression of the tumour in 50 to 55 per cent of cases (Stewart and others 2006). This may provide further justification to talk to the farmer about such treatment, but licensing restraints may rule out this intervention.
Then there is the more tricky issue of the dead animals in the stream. First, the animals are in a watercourse on the farmer's land, so irrespective of whether the animals belong to him, the problem is ultimately his. Secondly, the animals are not identifiable. This in itself may contravene the Rural Payment Agency's tagging rules, which state that calves must be tagged within 36 hours of birth (one tag) in dairy cattle and 20 days (both tags) in beef cattle. Therefore, depending on how old the calves are, this may or may not be breaking any laws.
The dumping of carcases in watercourses, however, would be treated very seriously by the authorities. Fallen stock must be collected, identified and transported without undue delay (EU 2009), and the responsibility for the disposal of the animals lies clearly with the farmer.
The Animal Health and Veterinary Laboratories Agency (AHVLA) advises sending dead animals under 48 months old to the hunt kennel or knacker's yard. Some farmers argue about the cost of doing this, but Defra requires reporting of carcases in watercourses and quick disposal in order to protect the public.
Possible way forward
If this is a trusted and long-term client of the practice, the vet may have some qualms about reminding him of his responsibilities with respect to both the welfare of the cow and the carcases in the watercourse, but this should be done there and then when the vet is on the farm.
One solution for the cow may be to decide to cull only if early signs of regrowth reveal themselves after removal, potentially allowing the cow to live longer. Consideration at all times should be given to providing the cow with sufficient analgesia throughout the treatment process. As the cow seemed to be unresponsive to the palliative approach in the intervening week, the recommendation to remove the mass would hopefully have gained more weight.
To avoid confrontation about the carcases, it is possible to anonymously report such cases to the local AHVLA office, which is obliged to follow this up with a visit within 24 hours of the call. However, further probing questions from you may address why the animals have been dumped, whether the farmer has sufficient money to call the knacker (and therefore does he have enough to feed his animals properly?), whether the animals are his, whether there is a disease outbreak causing such a problem that needs addressing, or whether there are movement restrictions meaning he cannot sell the calves and is therefore taking matters into his own hands regarding disposal in such difficult financial times.
Readers with views to contribute on ‘Regulation breach on farm’ should e-mail them toso that they can be considered for publication in the next issue, or fax comments to 020 7383 6418. The deadline for receipt of comments is Friday, August 19. Please limit contributions to 200 words.
THIS series gives readers the opportunity to consider and contribute to discussion of some of the ethical dilemmas that can arise in veterinary practice. Each month, a case scenario is presented, followed by discussion of some of the issues involved. In addition, a possible way forward is suggested; however, there is rarely a cut-anddried answer in such cases, and readers may wish to suggest an alternative approach. This month's dilemma, ‘Regulation breach on farm’, is presented and discussed by Mike Steele. Readers with comments to contribute are invited to send them as soon as possible, so that they can be considered for publication in the next issue. Discussion of the dilemma ‘Financially strapped owner with a suffering cat’, which was published in the June issue of In Practice, appears on page 363.
The series is being coordinated by Siobhan Mullan, of the University of Bristol. It is hoped it will provide a framework that will help practices find solutions when facing similar dilemmas.
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