On November 21, 2016, I underwent full knee replacement surgery on my right knee. The surgery went fine as did the subsequent physical therapy. I was up, moving, and bearing weight without crutches in a matter of days. I was fully confident that this was a piece of cake and I had it whipped! Then on December 4th, I experienced a persistent, sharp pain in the rear of my chest and then severe shortness of breath. A quick trip to the local emergency room revealed multiple pulmonary emboli in both lungs originating from a deep vein thrombosis in my right leg. A couple more days in the hospital, several rounds of warfarin injections and I was back on my way to recovery, albeit a bit weaker and feeling very mortal, perhaps even a bit more reflective, both personally and professionally.
All I will say from a personal note is that surviving a life-threatening condition certainly makes you appreciate who you love and cherish the most: family, friends, and colleagues. It does help to focus your attention on how you wish to spend your remaining time on what is important. It also helps to highlight what is really the small stuff that should not be sweated.
On a professional level, my reflection began with how thankful I am to have had the privilege to be a veterinarian for the last 36 years. Even more than that, I am so thankful to have been associated with the AASP-AASV for that entire 36 years, first as a member and then as staff. I am now entering my 24th year as an AASV employee. Over that time I have watched the pork industry and the AASV evolve and change. I believe that both will continue to evolve and change with the future. There are some issues and challenges I think will continue to develop over the course of the next few years.
The use of antibiotics will continue to draw attention from many different segments. Beginning on January 1, 2017, we have experienced an unprecedented removal of feed-grade antibiotics from the market and a reclassification of antibiotics used as water medications. The scrutiny from regulators, media, consumers, and activists will not stop here. Animal agriculture has become a popular scapegoat for the issue of antimicrobial resistance and this will be true for the future.
Veterinarians will play an integral role in ensuring the responsible use of the remaining antibiotics. We cannot allow responsible use to be defined as no use. Part of our role is to constantly review and consider any routine uses that occur on the farm. It is up to us as the medical professionals to not become complacent with the status quo, but to question every routine use as well as every assumption. If we fail to act as the medical professional on the farm, then we abdicate that role to others with less knowledge and experience.
My recent experience with pain mitigation leads me to believe that as a profession we need to do more to understand the relief of pain in pigs. I know there are legal limitations on pain medications in food animals. Let’s look at solutions with the regulatory body (United States Food and Drug Administration) as well as interested companies with resources to research and develop products. We need to advocate for the pigs in our care and assert ourselves as animal welfare professionals. Too often we leave the high ground to be occupied by others whose so-called concern for animal welfare is just another marketing tool to sell more of their products.
The last few years have seen the consolidation of a number of veterinary practices. These have stretched across state lines and represent a trend that I believe will continue. Efficient and effective delivery of veterinary services to an increasingly consolidated production system is important for pig health and welfare. Practices and veterinarians will look for creative and sustainable ways to provide the best care to clients and patients. As we see multi-state, regional practices develop, the question arises whether or not we will see true “national” practices develop with time.
The porcine epidemic diarrhea (PED) epidemic of 2013-2014 taught us valuable lessons about the illusions of biosecurity. As these lessons fade with time, it worries me that our diligence on controlling what goes onto a farm is also fading. Feed is the commodity that goes onto a farm in the largest quantity and highest frequency. Our understanding of the pathogens that can survive in feed, even from overseas, has improved. It still remains to be seen how much better we are doing in ensuring that the feed going to farms is not carrying some pathogen much worse than PED.
This is just my view from the hospital pen. While I do not recommend a hospital stay to others, I truly benefitted from having the experience, especially since I lived to tell the tale. Each of you has your own insights about veterinary medicine and raising pigs. I would love to hear each and every one!
Tom Burkgren, DVM Executive Director