As of December 1, 2018, all livestock producers will need a prescription from a licensed veterinarian, before they can buy a medically important antibiotic (MIA) for therapeutic use in livestock production. This applies to all beef cattle sectors using antibiotics — cow-calf operators, feedlots and feedmills (and really all sectors of animal agriculture including beef, dairy, hogs, sheep, horses, fish and even bees). The new policy doesn’t just apply to injectable products, but also includes some boluses and calf scour treatments, and Component and Compudose implants. At the same time, the new policy does not apply to certain antimicrobials such as the ionophores, which are not considered to be medically important in managing disease in humans.

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The underlying issue that has brought about these Health Canada changes is the increasing concern in recent years about development of antimicrobial resistance (AMR) in bacteria in animals as well as in humans. Anyone who has grown annual crops in the past 25 years is well aware of efforts to prevent and reduce development of herbicide resistance in weeds. Well, it is a very similar issue at play when it comes to the use of antibiotics used in animal agriculture — a concern over AMR.

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Research indicates that AMR is developing in beef cattle; some antimicrobials used on the farm or in the feedlot are not working as well as they once did. Antimicrobial resistance is also developing in human patients, though there is no compelling evidence that antimicrobial use in Canadian livestock production is contributing to AMR in human medicine.

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The veterinarian-client-patient relationship (VCPR) is the basis for interaction among veterinarians, their clients, and their patients and is critical to the health of your animal. 

 

A VCPR means that all of the following are required:

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1. The veterinarian has assumed the responsibility for making clinical judgments regarding the health of the patient and the client has agreed to follow the veterinarians’ instructions.  

2. The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of the medical condition of the patient.  This means that the veterinarian is personally acquainted with the keeping and care of  the patient by virtue of a timely examination of the patient by the veterinarian, or medically appropriate and timely visits by the veterinarian to the operation where the patient is managed.

3. The veterinarian is readily available for follow-up evaluation or has arranged for the following: veterinary emergency coverage, and continuing care and treatment.

4. The veterinarian provides oversight of treatment, compliance, and outcome.

5. Patient records are maintained.

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Veterinarian-Client-Patient-Relationship 

(VCPR) FAQ

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Q: What is a Veterinarian-Client-Patient Relationship (VCPR)?

A: A Veterinarian-Client-Patient Relationship, or VCPR for short, exists when your veterinarian knows your pet well enough to be able to diagnose and treat any medical conditions your animal develops. Your part of the VCPR is allowing your veterinarian to take responsibility for making clinical judgments about your pet's health, asking questions to make sure you understand, and following your veterinarian's instructions. Your veterinarian's part of the VCPR involves making those judgments; accepting the responsibility for providing your pet with medical care; keeping a written record of your pet's medical care; advising you about the benefits and risks of different treatment options; providing oversight of treatment, compliance (your follow-through on their recommendations) and outcome; and helping you know how to get emergency care for your pet if the need should arise.

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Q: How is a VCPR established and maintained?

A: A VCPR is established only when your veterinarian examines your animal in person, and is maintained by regular veterinary visits as needed to monitor your animal's health. If a VCPR is established but your veterinarian does not regularly see your pet afterward, the VCPR is no longer valid and it would be illegal and unethical for your veterinarian to dispense or prescribe medications or recommend treatment without recently examining your pet.
A valid VCPR cannot be established online, via email, or over the phone. However, once a VCPR is established, it may be able to be maintained between medically necessary examinations via telephone or other types of consultations; but it’s up to your veterinarian’s discretion to determine if this is appropriate and in the best interests of your animals’ health.

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Case In Point: 

If a producer discovers on a Saturday afternoon a case of pink eye in an animal that needs to be treated, for example, they won’t have the option to run to a local farm supply outlet and pick up a bottle of penicillin. It also means, a producer can’t just stop in at a veterinary clinic and pick up an antibiotic from staff if there is no veterinarian on duty.

A VCPR doesn’t usually involve a formal written agreement.

But it means the veterinarian knows the operator, visits the farm or ranch to get an understanding of the operation, sees how animals are cared for, and is confident the producer will be responsible in following medical advice and properly use any products as directed. Establishing a VCPR starts with a producer sitting down with a vet to discuss his or her livestock operation and provide some record of animal health treatment protocols. It may or may not involve a farm visit.

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