Food Animal Drugs
Food Animal NSAIDs and Analgesics
Remember : Analgesics need to be given prior to the pain stimulus to prevent hyperalgesia and wind-up phenomenom. This preemptive analgesia decreases the amount of pain produced but does not prevent pain. Analgesics should also be used after the stimulus to control the resultant pain. Pain is generally related to the release of inflammatory mediators; this makes our NSAIDs pretty effective..
Our current practice “standards” are to 1) give nothing or 2) give it after the procedure. Neither of these make economic or physiological sense. It makes more sense to give the drug before the procedure, particularly if a single dose. The same dose given after the procedure has less effect. We have spent the same amount of money and effort for less result. Since our goal is generally production, avoiding drugs is also nonsensical. When drugs are given, production losses due to withholding are typically minimal and are offset by minimized drop in production of milk or meat related to pain.
Flunixin meglumine
Flunixin meglumine has been the primary NSAID approved for use in food animals in the US. In cattle, it needs to be given intravenously unless in the new topical formulation (below). Besides being off label, intramuscular injections are very irritating to tissues and can lead to Blackleg (clostridial myositis). Standard doses are 1.1 mg/kg iv BID (twice daily) or 2.2 mg/kg iv SID (once daily). You will find references for 2.2 mg/kg BID but that dose increases the risk of side effects. The topical formulation is not recommended for small ruminants.
FDA Approves First Medication for Pain Control in a Food-producing Animal
July 25, 2017
The U.S. Food and Drug Administration announces the approval of Banamine Transdermal (flunixin transdermal solution), an animal drug approved for the control of pain associated with foot rot and the control of pyrexia (fever) associated with bovine respiratory disease.
Flunixin is also a component of Resflor Gold – a combination of florfenicol and flunixin. This formulation of flunixin can be given SQ without causing irritation.
Ketoprofen
Ketoprofen is a NSAID compound that can be given IM or SQ. It has recently been combined with tulathromycin in Draxxin KP as an FDA approved food animal drug. Similar to Resflor Gold, this combination is approved for treatment of bovine respiratory disease and management of the associated fever. Draxxin KP is approved for SQ use.
In the process of labeling Draxxin KP, they also got ketoprofen approved! When ketoprofen was first introduced, the dosing was designed to be the same milliliters as flunxin meglumine; however, that dosage was not always effective.
Meloxicam
Meloxicam is an NSAID that has gained widespread popularity. It seems to have better analgesic properties than flunixin meglumine. It is being used under ELDU (extralabel drug use) regulations for its analgesic effects. This is permitted as flunixin is labeled for anti-pyrexia, not analgesia. Using meloxicam does require a VCPR (veterinarian-client-patient relationship).
Castration Guidelines– AABP.org
There are no approved pain drugs for use in cattle in the US. The AMDUCA allows extra label drug use (ELDU) provided a valid VCPR exists and the drug selection decision process is followed. Although flunixin meglumine is an NSAID labeled for use in cattle and has been shown to have short acting analgesic effects, long acting NSAID analgesics, such as meloxicam, are more desirable to mitigate the pain associated with castration and dehorning.
While most oral medications are not effective in ruminants and camelids due to passage through the forestomachs, meloxicam is effective when given orally to both cattle and camelids. It may also be effective in piglets if fed to the sow.
Impact of Transmammary-Delivered Meloxicam on Biomarkers of Pain and Distress in Piglets after Castration and Tail Docking–2014, PLoS One
The objectives of the study were to demonstrate meloxicam transfer from sows to piglets via milk and to describe the analgesic effects in piglets after processing through assessment of pain biomarkers and infrared thermography (IRT)… This study demonstrates the successful transfer of meloxicam from sows to piglets through milk and corresponding analgesia after processing, as evidenced by a decrease in cortisol and PGE2 levels and maintenance of cranial skin temperature.
FARAD suggests 21 days meat withholding after a single dose of 1mg/kg meloxicam po or 0.05 mg/kg im or iv: Considerations for extralabel drug use in calves, FARAD Digest, 2017
Poultry can also be given 1 mg/kg meloxicam. Contact FARAD for egg and meat withholding.
Narcotics
Narcotics are increasingly used for pain in ruminants and camelids. None are approved in food animals so AMDUCA guidelines must be followed. These are the most common choices:
Butorphanol
Used for acute pain, generally perioperatively. The short duration of action makes it expensive and challenging to use long term. Provides sedation when combined with other drugs.
Butorphanol is a partial agonist-antagonist so should not be used in combination with other narcotics (it will decrease their effectiveness).
Minimal side effects.
Dose at 0.05–0.2 mg/kg IM or IV, every 1-3 hours
Reversal: naloxone
Morphine
Commonly used in ruminants for pain. Inexpensive and lasts up to 8 hours. Does decrease GI motility and is a schedule II drug so requires careful monitoring of access to the drug.
Doses range from 0.05 – 0.1 mg/kg im or iv. Start with the lower dose to minimize side effects. If given iv, give slowly. The dose can be repeated in 4-6 hours.
Reversal: naloxone
Buprenorphine
Most commonly used for postoperative pain management in goats. Should be used with caution in sick animals due to side effects. Relatively expensive but a single dose is often effective.
Dose 0.0015–0.006 mg/kg IM or IV. Can be repeated in 4-6 hours but may last longer.
Reversal: naloxone
Fentanyl
Rarely used. May be used iv for perioperative pain control. The patches are more useful for control of camelid pain.
Try 150–225µg/kg/h.
Patches can take 4 hours to provide analgesia and last 36-48 hours.
Reversal: naloxone
Gabapentin
Cattle can be given 10-20 mg/kg orally twice daily.
Just for fun
One more transdermal option for poultry (warning – not serious):
Resources
Clinical Pharmacology of Analgesic Drugs in Cattle. Veterinary Clinics of North America: Food Animal Practice, March 2015, Vol.31(1), pp.113-138- bovine review with more pharmacology included
Assessment and Management of Pain in Small Ruminants and Camelids. Veterinary Clinics of North America: Food Animal Practice, March 2013, Vol.29(1), pp.185-208. Nice review with recommendations
A Review of Analgesic Compounds Used in Food Animals in the United States, 2013 VCNA Vol.29(1), pp.11-28
Approaching Pain in Cattle, AABP brochure
Current attitudes of veterinarians and producers regarding the use of local and systemic analgesia in beef and dairy cattle in the United States. J Am Vet Med Assoc 2021;258:197–209). Women do better than men and vets better than producers. May help vets get insights into hurdles.
Formulary – Wiley Library
