Pain Relief Guidance - Angora GoatsThursday, 27th August 2020
By Dr Mackie Hobson
There are situations on Angora goat farms when pain relief is required. This may be due to injury, wounds or certain disease conditions. There are also certain management practices such as castration when pain relief may be required as per the RESPONSIBLE MOHAIR STANDARD (RMS)
Providing pain relief is unfortunately not as simple as one would think due to rules and regulations pertaining to medicines in South Africa.
To simplify matters:
- There are ‘suitable’ but no ‘available’ drugs currently in South Africa which means pain relief medicines can only be used ‘off label’ on advice from your veterinary surgeon.
- Mohair SA and SAMGA however recommend producers provide pain relief for their Angora goats when applicable through involvement of their vet.
To explain the above statement:
The Responsible Mohair Standard (RMS) requires that for all methods of castration and serious shearing injuries pain relief must be used when suitable pain relief products are available.
What does a “suitable” product mean?
A suitable product is defined as one that has a pain relieving effect for the method of castration that is used. Some pain relieving products act quickly for acute pain, others take longer to show an effect, but last for a greater time period. Methods of castration will give acute pain at the time of the procedure (e.g. burdizzo); others may give rise to chronic pain post-operatively (e.g. rubber ring castration).
What does “available” mean?
Following on from defining whether a product is suitable, the next point is whether it is available. Veterinary pharmaceuticals, including pain relieving drugs, have to be licensed for use in individual countries by the companies that produce these.
In the absence of a suitable licensed product, a veterinary surgeon can use their country’s “off-label” or “extra-label” procedure to prescribe a product that is licensed for another species or another therapeutic indication. Depending on the licensing rules, such products may only be used by the vet or under the control of the vet.
For the purposes of these standards “available” is defined as a product that is licensed for use by the farmer, in the relevant country, for the relevant species, for pain relief.
This definition does not require the farm’s vet to make a judgement call regarding the use of off-label drugs, and the farmer does not have a reason not to get access to the appropriate product.
What types of pain relieving drugs are there?
The two main groups of pain relieving drugs that would be used by producers in South Africa are:
- Local anaesthetic
A local anaesthetic is a drug that, when injected or given topically (on the skin), produces a state of local anaesthesia by reversibly blocking the nerve conductors that transmit the feeling of pain from the point of administration to the brain. They are designed not to distribute widely in the body – hence the name “local”. They are easily broken down and excreted by the body. This means that the duration of action is limited. Local anaesthetics are the ideal class of drug for reducing acute pain, but will not persist long enough to have an effect on long lasting or chronic pain.
There are off label Schedule (S) 1 Prescription Only Medicines (POM) available from your vet that can be dispensed for topical local anaesthesia that can be used. SEE TABLE BELOW
- Non-steroidal anti-inflammatory drugs (NSAIDS)
NSAIDs are a group of drugs that all have an anti-inflammatory mode of action as well as antipyretic (fever reducing) and analgesic (pain relieving) effects.
NSAIDs are slower to act than local anaesthetics but have a longer lasting effect – up to 72 hours in some cases. These NSAIDS are S3 or S4 so can only be used by the producer after a Veterinary consultation and diagnosis. SEE TABLE BELOW
What is expected from RMS certified farmers for castration?
If farmers are in countries where pain relieving products are licensed for use; and the methods used by the farmer for castration match the pain relieving products that are available pain relief must be used.
Pain relief for shearing injuries
The Standard requires that pain relief is applied to severe shearing injuries (cut larger than 10cm, depth to muscle layer, teats, vulva or prepuce) when a suitable pain relief product is available.
WHAT PAIN RELIEF IS AVAILABLE WITHOUT A VET EXAMINATION IN SOUTH AFRICA?
The Medicines and Related Substances Control Act, 1965 (Act No. 101 of 1965) describes various levels of control, which is intended to ensure the safe supply of medicines to the public but also to restrict the supply of substances, or drugs, which are dangerous or harmful.
For the veterinarians there are restrictions enforced by the rules to the Veterinary Act.
SCHEDULE 1 (see Table Below)
- Schedule 1 medicines are substantially safe. Dispensing does not require medical diagnoses or monitoring.
Purpose: To allow effective medicines to be available without a prescription - professional advice or counselling may be supplied if required by the consumer.
WHAT PAIN RELIEF IS AVAILABLE AFTER GOATS HAS BEEN EXAMINED BY A VET
SCHEDULE 3 (See Table Below)
- Description Schedule 3 medicines are indicated for use in disease or conditions that require veterinary diagnoses and management but do not require close medical monitoring after treatment has been initiated.
The substances are often indicated for chronic use and the long-term safety and efficacy of the substances are well established. Supply should be on prescription only, but may be repeated at the discretion of the veterinarian.
A chronic prescription may be repeated by the Vet but the animal must be examined at 6 month intervals
SCHEDULE 4 (See table below)
- Description Schedule 4 medicines require a veterinary diagnoses, management and monitoring. The safety and efficacy of the substances may require further evaluation. The drugs have serious side effects that require further evaluation and serious contra indications.
A prescription may be repeated by your Vet for Schedule 3 and 4 drugs but the goats must be examined at 6 month intervals to maintain the ‘veterinarian-client-patient relationship’
The closest is the definition of the "veterinarian-client-patient relationship" contained in the veterinary rules, as quoted below:
- the veterinary professional has assumed the responsibility of making professional judgment and/or treatment regimens regarding the health of a patient or improvement in the production of the animal or animals, at the request of the client;
- The veterinary professional has sufficient personal knowledge to initiate or at least a general or preliminary assessment of the condition of the patient by virtue of a consultation with the client; and
- Clinical records are maintained." That definition must be read with section 34 of the Veterinary and Para-Veterinary Professions Act, Act 19 of 1982' quoted below and which refers to an animal under the "professional care" of a veterinarian, which is interpreted to mean within a veterinarian-client-patient relationship