Preparing for Upcoming Changes to the Veterinary Feed Directive (VFD) R. TOM BASS, II, DVM, PHD RENAISSANCE NUTRITION, INC.

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Preparing for Upcoming Changes to the Veterinary Feed Directive (VFD) R. TOM BASS, II, DVM, PHD RENAISSANCE NUTRITION, INC. ELIZABETH SANTINI, DVM PA DEPT. OF AGRICULTURE

What is the Veterinary Feed Directive? Law Enforced by FDA to increase veterinary oversight of certain food animal medications ( VFD drugs ) and eliminate the use of these drugs for purposes other than treatment, control, or prevention of disease Written document Provided by veterinarians to legally purchase and use VFD drugs Drug ( VFD drug ) Administered in or on feed Medically important for humans

Why does FDA care about these drugs? Appropriate therapeutic use Toxicity Drug residues Antimicrobial resistance to drugs used in human medicine 2014 U. S. usage (sales) data: 62% of livestock antibiotic usage (sales) was medically important antimicrobials 70% of this 62% was tetracyclines

History of VFD Animal Drug Availability Act (ADAA amendment): 1996 Established a new category of animal drugs for use in feed as VFD drugs to be used under the supervision of a veterinarian First Rule: December 2000 Initial implementation of the VFD provisions of the ADAA Required written orders & cautionary labeling for VFD drugs First VFD drug was tilmicosin (Pulmotil ) for use in swine Guidance #209 (the Judicious Use Guidance)- April 2012 Outlines a plan for phasing out growth promotion uses and limiting medically important antimicrobials to therapeutic use Will require veterinary oversight for such use Only addresses antimicrobial use via feed and water

History of VFD Guidance #213- December 2013 Builds on GFI #209- intended to improve the efficiency & userfriendliness of the VFD rule Outlines an implementation timeline for the OTC to VFD conversion (per GFI #209) Second Rule (The Final Rule): June 2015 Further revisions to recommendations in Guidances #209 and #213 October 2015 Requires (NOW!) VFD from vet for drugs previously on the list January 2017 OTC to VFD conversion complete VFD will be required for all drugs on expanded list

What drugs presently require a VFD? 1) Florfenicol (Aquaflor, Nuflor ) 2) Avilamycin (Kavault, Inteprity ) 3) Tylvalosin (Aivlosin ) 4) Tilmicosin (Pulmotil, Tilmovet -swine approval only) This is the only feed grade antibiotic of the four labeled for use in cattle

What other cattle drugs will require a VFD as of January 1, 2017? Chlortetracycline (C) Neomycin (N) Tylosin (T) Oxytetracycline (O) Sulfamethazine (S) Virginiamycin (V) medically important antibiotics used in feed for the prevention, control, and/or treatment of disease

Affected brand name products labeled for cattle include: Aureomycin, Chloratet, ChlorMax, Pennchlor (C) Terramycin, Pennox (O) Neo-Oxy, Neo-Terramycin (N) Pennchlor S, Aureo S 700 (S) Tylan, Tylovet (T) V-Max (V) V-Max (V)

Which VFD medications does Renaissance sell? 1. Neomycin-Oxytetracyline ( Neo-Terra ) 22/20 AM NT 1600/1600 BioMOS Milk Replacer (#2576) : calf label Scours & Pneumonia Treatment Concentrate & Milk Replacer (#2927, #2925) : calf label Neo-Terra 10/10 (#9240) : swine, poultry labels Calf Enhancer Mixer TNT (#2750) 2. Chlortetracycline (Aureomycin ) Aureo 4G Crumbles (#9081) and Aureo 50G (#9082) : cattle, swine, poultry, and sheep labels Kickstarter Pig Pellets (#5818 and #5819) 12/31/2016

Which VFD medications does Renaissance sell? 3. Chlortetracycline-sulfamethazine Aureo S 700 (#9032) beef cattle label Aureomix S 10/10 (#9291) : swine label 4. Tylosin (Tylan ) Tylan 10 (#9310), Tylan 40 (#9321) : beef, swine, and chicken labels Tylan 10 Sulfa (#9320): swine label

Which drugs have label approval(s) for use in dairy cattle? - Neomycin-Oxytetracyline In calves and non-lactating dairy cattle (replacement heifers and replacement bulls) - Chlortetracycline In calves and non-lactating dairy cattle (replacement heifers and replacement bulls) - Oxytetracycline In calves and non-lactating dairy cattle (replacement heifers and replacement bulls)

What about Aureo S 700 (#9032)? Animal Use Level Indication(s) for Use Beef cattle 350 mg/head/day chlortetracycline --AND 350 mg/head/day sulfamethazine As an aid in the maintenance of weight gains in the presence of respiratory disease such as shipping fever. WARNING: Discontinue use 7 days prior to slaughter. Do not use in calves to be processed for veal. LIMITATIONS FOR USE: Feed for 28 days. Source: 2016 Feed Additive Compendium, p. 179

FDA Cattle Terminology Beef Cattle: Cattle intended for meat production or to produce offspring intended for meat production. Excludes veal calves. Dairy Cattle: Cattle intended to produce milk for human food and/or offspring that will produce milk or meat for human food (including veal calves). Veal Calves: Immature cattle lacking a functional rumen and intended for meat production. They are recognized as a separate class from suckling calves because of their handling, housing, and proximity to slaughter. Reference: FDA-CVM GFI #121, May 2015

What is FDA s definition of non-lactating dairy cattle? - replacement dairy heifers, replacement dairy bulls, and dairy calves (those not to be processed for veal) DRY NON-LACTATING!! - Once a lactating cow, always a lactating cow.

Where can you find product label approvals? 1. Product labels (read the tag and/or the bag!!) 2. Drug manufacturers web sites 3. Feed Additive Compendium 4. Electronic Code of Federal Regulations www.ecfr.gov From the drop-down menu, choose: 1. Title 21 - Food and Drugs, 2. Volume 6, Browse Parts 500-599, 3. Part 558 (New Animal Drugs for Use in Animal Feeds), 4. Under Subpart B of the Contents, select the drug of interest by its generic name to find the label approvals

What are some products that will not require a VFD**? Ionophores: Rumensin, Bovatec, Cattlyst Other antimicrobials: Gainpro, BMD 60 Dewormers: Safe-Guard Coccidiostats: Deccox, Corid Others: HeifermaX, MGA, Optaflexx ** UNLESS used in a label-approved combination with one of the VFD antibiotics.

Rules and Regs of Feed-Grade Antibiotic Use NO extralabel use is permitted Drug dose/concentration must be approved Must be used for a labeled indication Must be fed for the prescribed time period Must be approved for use in the specie in question, and for the age/size/category of animal(s) in question CANNOT be fed concurrently with another feed-grade antibiotic, unless there is an approval for the combination These rules for disease treatment, prevention, and control will be maintained as medications shift to VFD status. All feed efficiency and growth promotion claims will be eliminated.

VFD drug labels will change... READ THE LABEL!! CAUTION: Federal Law restricts medicated feed containing this veterinary feed directive drug to use by or on the order of a licensed veterinarian. Note: Product labels do NOT typically include combination approvals, so other resources (e.g. Feed Additive Compendium, FDA Blue Bird label web site: http://www.fda.gov/animalveterinary/products/animalfoodfeeds/medica tedfeed/bluebirdlabels/default.htm ) may need to be reviewed if info on combination approvals is needed.

What are the requirements for obtaining a VFD? Veterinarian Licensed Veterinary Client Patient Relationship (VCPR) Written or electronic VFD document Delivered to the distributor of the VFD drug (feed mill, etc.) Licensed distributor Fills the order *IF* the VFD is correct and complete Source: FDA Draft Guidance for Industry #233 Veterinary Feed Directive Common Format Questions and Answers

What counts as a VCPR?

Information required on a VFD 1. Veterinarian s name, address, and telephone number; 2. Client s name, business or home address, and telephone number; 3. Premise(s) at which the animals specified in the VFD are located; 4. Date of VFD issuance (effective date); 5. Expiration date of the VFD; 6. Name of the VFD drug(s); 7. Species and production class of animals to be fed the VFD feed; 8. Approximate number of animals to be fed the VFD feed by the expiration date of the VFD; 9. Indication for which the VFD is issued; 10. Concentration of VFD drug in the feed and duration of use; 11. Withdrawal time, special instructions, and cautionary statements necessary for use of the drug in conformance with the approval; 12. Number of reorders (refills) authorized, if permitted by the drug approval, conditional approval, or index listing; 13. The statement Use of feed containing this Veterinary Feed Directive (VFD) drug in a manner other than as directed on the labeling (extra-label use), is not permitted; 14. Affirmation of intent for combination VFD drugs as described in 21 CFR 558.6(b)(6); and 15. Veterinarian s electronic or written signature.

Will pre-made VFD forms be available for use by veterinarians? Yes GlobalVetLINK ( www.globalvetlink.com ) RxExpress (by New Planet Technologies) Manufacturers (sponsors) of the VFD medications AABP, AVMA and other veterinary groups Possibly some feed mills FDA? (unlikely)

Q & A If a producer buys a bag of Aureomycin crumbles in September of 2016, can they legally feed it to their cattle in January of 2017 without a VFD? NOPE. Can a veterinarian write a VFD to add Aureomycin to a producer s free-choice mineral mix in the summer to help control pinkeye? NOPE.

Q & A Do these VFD rules apply to 4-H or other show animals? ABSOLUTELY. A producer has some pet goats that occasionally get treated for pneumonia with AS-700 crumbles. Can they continue to do that with a VFD? NOPE. A producer owns cattle both in PA and in MD. Can they treat both herds with the same VFD? MAYBE...

Q & A Does a veterinarian need to write a VFD if you treat animals with a medically important antibiotic in the water supply? NOPE, a prescription. A producer feeding a milk replacer medicated with Bovatec wants to treat some scouring calves by adding Neomycin- Oxytetracycline to it. Can their veterinarian write a VFD to facilitate that? NOPE.

Q & A What happens if a veterinarian submits an incomplete or inaccurate VFD? The VFD cannot be legally filled unless it is complete & correct. How long is a VFD good for? A maximum of 6 months, but potentially less, depending on product and indication. Will a staff veterinarian for a feed company be able to write VFDs? MAYBE

What do you need to do prepare? 1. Fill out your Notice to FDA of Distribution of VFD Feeds, sign and date it, and submit it to the FDA one-time deal, unless business ownership and/or address changes 2. Fill out your Distributor Acknowledgement Letter, sign and date it, and submit it to Renaissance five considerations for compliance 3. Ask questions if/when you have them! this will be a learning process for all involved

Distribution Limitations for VFD Feeds (from the Ren Distributor Acknowledgement Letter) (1) The distributor will not ship a VFD medication or feed to an animal production facility that does not have and has not provided said distributor with the required copy of a properly formulated, non-expired VFD order; (2) The distributor will not ship a VFD medication or feed to another distributor without first receiving a written acknowledgement letter similar to this one; (3) The distributor will comply with all necessary VFD-related record keeping; (4) The distributor has complied with the FDA s distributor notification requirements and forwarded a copy of their notification to Renaissance Nutrition (attn.: Caitlyn Massie); (5) The distributor has listened to one of the Pro-Start sessions on VFD training on either 07/15/16 or 11/18/16.

Comments on Distributor #12 Procedure (revised from original version mailed out in July) 1. affected products list (already covered) 2. V coding Will help with record keeping at Ren office Will be added to special mixes containing a VFD drug Will probably also be added at the end of the product codes for the VFD medications Example: #9081 Aureo 4G Crumbles will become #9081V 3. You can have VFD products in your inventory, but cannot sell and deliver them without receiving a copy of a valid VFD. - VFD required to be sent with the order for all special mixes and direct drops. Send these VFDs to Sherri Dilling. 4. You MUST send a copy of the VFD(s) in to Renaissance with your applicable sales tickets. Send these VFDs to Trona Leaper.

Record Keeping VETERINARIAN Paper or electronic copy of the VFD kept for 2 years DISTRIBUTOR (NUTRITIONIST, FEED STORE OR MILL) Paper or electronic copy of the VFD kept for 2 years PRODUCER Paper or electronic copy of the VFD kept for 2 years FDA can inspect or request VFD documentation from the veterinarian, distributor or producer at any time to verify compliance with VFD rules. You are legally obligated to produce records on demand.

The bottom line... 1. READ THE LABEL and VFD, and FOLLOW THE DIRECTIONS 2. EDUCATE YOURSELF AND YOUR CLIENTS, & COMMUNICATE W/VETERINARIANS 3. THIS MAY EVOLVE (SLIGHTLY) OVER TIME 4. DON T SHOOT THE MESSENGER

On-line resources www.feedstuffs.com/vfd.aspx www.togetherabx.com https://www.zoetisus.com/responsibleantibiotic-use/vfd.aspx www.fda.gov/animalveterinary/developmen tapprovalprocess/ucm071807.htm

Product label approvals: Chlortetracycline Animal Use Level Indication(s) for Use Beef Cattle 350 mg/head/day Control of bacterial pneumonia associated with shipping fever complex caused by Pasteurella spp. susceptible to chlortetracycline. WARNING: Withdrawal times vary by manufacturer. Read label for specific withdrawal times. Beef Cattle (under 700 lb.) 350 mg/head/day Control of active infection of anaplasmosis caused by Anaplasma marginale susceptible to chlortetracycline. WARNING: Withdrawal times vary by manufacturer. Read label for specific withdrawal times. Beef Cattle (over 700 lb.) 0.5 mg/lb. of body weight/day Control of active infection of anaplasmosis caused by Anaplasma marginale susceptible to chlortetracycline. WARNING: Withdrawal times vary by manufacturer. Read label for specific withdrawal times. Source: 2016 Feed Additive Compendium, p. 172

Product label approvals: Chlortetracycline Animal Use Level Indication(s) for Use Calves, beef, and non-lactating dairy cattle 10 mg/lb. of body weight/day Treatment of bacterial enteritis caused by Escherichia coli and bacterial pneumonia caused by Pasteurella multocida organisms susceptible to chlortetracycline. WARNING: Withdrawal times vary by manufacturer. Read label for specific withdrawal times. LIMITATIONS FOR USE: Feed for not more than 5 days. Feed approximately 400 g/ton varying with bodyweight and feed consumption to provide 10 mg/lb. per day. Beef and nonlactating dairy cattle 0.5-2.0 mg/lb. of bodyweight/day As an aid in the control of active infection of anaplasmosis caused by Anaplasma marginale susceptible to chlortetracycline. LIMITATIONS: In free-choice cattle feeds such as feed blocks or salt-mineral mixes; free-choice feed must be manufactured from Aureomycin Type A medicated articles using an FDA-approved formulation. Feed mill license not required if following free-choice loose mineral formulation published in 21 CFR 558.128. Source: 2016 Feed Additive Compendium, p. 172

Product label approvals: Chlortetracycline Animal Use Level Indication(s) for Use Calves, beef, and non-lactating dairy cattle 500-4,000 g/ton Treatment of bacterial enteritis caused by Escherichia coli and bacterial pneumonia caused by Pasteurella multocida organisms susceptible to chlortetracycline. LIMITATIONS: Hand feed continuously for not more than 5 days to provide 10 mg/lb. body weight per day; must be manufactured from Aureomycin Type A medicated articles manufactured by NADA sponsor No. 054771 (Zoetis). Calves, beef and non-lactating dairy cattle 4,000-20,000 g/ton Treatment of bacterial enteritis caused by Escherichia coli and bacterial pneumonia caused by Pasteurella multocida organisms susceptible to chlortetracycline. LIMITATIONS: As a top-dress, varying with bodyweight and feed consumption, to provide 10 mg/lb. bodyweight per day. Treat for not more than 5 days; must be manufactured from Aureomycin Type A medicated articles manufactured by NADA sponsor No. 054771 (Zoetis). Source: 2016 Feed Additive Compendium, p. 173

Product label approval: Chlortetracycline plus Sulfamethazine Animal Use Level Indication(s) for Use Beef cattle 350 mg/head/day chlortetracycline --AND 350 mg/head/day sulfamethazine WARNING: Discontinue use 7 days prior to slaughter. LIMITATIONS For Use: Feed for 28 days. As an aid in the maintenance of weight gains in the presence of respiratory disease such as shipping fever. Source: 2016 Feed Additive Compendium, p. 179

Other Chlortetracycline combination label approvals 1. Chlortetracycline and decoquinate (Deccox ) approvals for calves, beef, and non-lactating dairy cattle 2. Chlortetracycline and laidlomycin (Cattlyst ) approvals for beef cattle in confinement 3. Chlortetracycline and lasalocid (Bovatec ) approvals for multiple cattle production classes Source: 2014 Feed Additive Compendium, pp. 209-212

Product label approvals: Neomycin/Oxytetracycline Animal Use Level Indication(s) for Use Calves, beef, and non-lactating dairy cattle Calves (up to 250 lb) To provide 10 mg/lb. of body weight/day (of each drug) To provide 10 mg/lb. of body weight/day (of each drug) For treatment of bacterial enteritis caused by Escherichia coli and bacterial pneumonia (shipping fever complex) caused by Pasteurella multocida susceptible to oxytetracycline; treatment and control of colibacillosis (bacterial enteritis) caused by Escherichia coli susceptible to neomycin. For treatment of bacterial enteritis caused by Escherichia coli susceptible to oxytetracycline; treatment and control of colibacillosis (bacterial enteritis) caused by Escherichia coli susceptible to neomycin. WARNING: Withdraw 5 days before slaughter. LIMITATIONS FOR USE: Feed continuously for 7-14 days in feed or milk replacers. If symptoms persist after using for 2-3 days, consult a veterinarian. Treatment should continue 24-48 hours beyond remission of disease symptoms. A withdrawal period has not been established for use in preruminating calves. Do not use in calves to be processed for veal. A milk discard time has not been established for use in lactating dairy cattle. Do not use in female dairy cattle 20 months of age or older. Source: 2016 Feed Additive Compendium, p. 276

Product label approvals: Neomycin/Oxytetracycline Animal Use Level Indication(s) for Use Cattle To provide 0.5-2.0 g/head/day (of each drug) For prevention and treatment of the early stages of shipping fever complex. LIMITATIONS FOR USE: Feed 3-5 days before and after arrival in feedlots. A withdrawal period has not been established for use in preruminating calves. Do not use in calves to be processed for veal. A milk discard time has not been established for use in lactating dairy cattle. Do not use in female dairy cattle 20 months of age or older. Source: 2016 Feed Additive Compendium, p. 276

Product label approval: Tylosin Animal Use Level Indication(s) for Use Cattle (beef) 8-10 g/ton* to provide 60-90 mg/head/day. (Feed continuously.) *90% dry matter basis. For reduction of incidence of liver abscesses in beef cattle caused by Fusobacterium necrophorum and Arcanobacterium (Actinomyces) pyogenes. NOTICE: Do not use in any finished feed (supplement, concentrate, or complete feed) containing in excess of 2% bentonite. LIMITATIONS FOR LIQUID FEEDS: Liquid Type B feeds must be maintained at ph 4.5-6.0. Recirculate or agitate immediately prior to use for not less than 10 minutes, moving not less than 1% of the tank contents per minute from the bottom of the tank to the top or creating a turbulence at the bottom of the tank that is visible at the top. Recirculate or agitate daily, even when not in use. Liquid Type B feeds shall bear an expiration date of 31 days after its date of manufacture. Source: 2016 Feed Additive Compendium, p. 331

Other Tylosin combination label approvals 1. Tylosin and decoquinate (Deccox ) and monensin (Rumensin ) approval for cattle fed in confinement for slaughter 2. Tylosin and lasalocid (Bovatec ) and melengestrol acetate (MGA or HeifermaX ) approvals for heifers fed in confinement for slaughter 3. Tylosin and melengestrol acetate approval for heifers fed in confinement for slaughter 4. Tylosin and melengestrol acetate and monensin approval for heifers fed in confinement for slaughter 5. #4 above and ractopamine hydrochloride approval for heifers fed in confinement for slaughter Source: 2014 Feed Additive Compendium, pp. 425-429

What s Next? Undefined duration of use Indication/disease Ingredient(s) Anaplasmosis Bacterial enteritis Liver Abscesses Pneumonia Chlortetracycline. Chlortetracycline. Oxytetracycline. Chlortetracycline. Tylosin. Oxytetracycline. Neomycin & Oxytet. Virginiamycin. Chlortetracycline. Source: FDA