When Almera the cow suffers from twisted bowel or Avatar the llama shows signs of tuberculosis, Björn Seelig is on the scene. He is a veterinarian in the Taunus Mountains, north of Frankfurt, and one of Germany's best-known veterinarians. He demonstrates his dexterity in an afternoon television show on Germany's VOX channel.
The program, the name of which can be translated as "People, Animals and Doctors," depicts touchingly idyllic scenes of country veterinarians striding across springtime meadows in their rubber boots, hard at work next to grazing lambs. Strong medications are rarely used in this television world.
The idyllic scenes are deceptive. Many of Seelig's fellow veterinarians, with access to an entire battery of drugs on the shelves of their practices, take a completely different approach. In the past, veterinarians, including those in Seelig's practice, used these drugs in abundance and on a large scale. Indeed, a year and a half ago, three veterinarians in his practice were ordered to pay fines totalling €90,000 ($117,000).
They had sold huge quantities of drugs, some of which were not approved, and dispensed dozers of liters of medications to animals to which they should never have been administered. Investigators with the public prosecutor's office in the western city of Wiesbaden called the operation a "pharmacy on wheels." Antibiotics were allegedly stored on pallets. A former employee told investigators at the time that the veterinary clinic was essentially a mail-order operation for drugs, and that the pharmaceutical industry had expressed its gratitude by giving the clinic huge discounts.
The Taunus trio's operation was particularly shameless, but regulators have uncovered hundreds of similar cases in recent years. Most were treated as minor infractions and the offenders were ordered to pay small fines, if they were punished at all. The fault lies with prescription drug laws that have been relatively malleable until now, and with a system that rewards those who prescribe drugs in large quantities.
'Bigger Profits than Cocaine Dealers'
"Some veterinarians' profit margins are bigger than those of cocaine dealers," says Nicki Schirm, who has been a veterinarian in the state of Hesse for more than 25 years. When a veterinarian finds a sick chick among 20,000 other chicks, he treats the discovery as justification to preventively treat the entire flock with antibiotics, says Rupert Ebner, a veterinarian from the Bavarian city of Ingolstadt. "Nowadays, flock or herd health monitoring is the code name for the generous administration of drugs," says Ebner. In many cases, he adds, fake diagnoses are used to provide a justification for the use of antibiotics.
In large veterinary practices, profits from the sale of drugs can account for up to 80 percent of revenues. This is mainly due to the volume discounts offered by the pharmaceutical industry and the sweet privilege known as the right to dispense -- a special provision for the pharmaceutical monopoly. For more than 150 years, veterinarians have been allowed to both prescribe and sell medications -- with almost no supervision whatsoever.
But this could change. Veterinarians have come into the political firing line after testing of animal populations in the western states of Lower Saxony and North Rhine-Westphalia revealed the large-scale presence of antibiotics. In North Rhine-Westphalia, Green Party Environment Minister Johannes Remmel ordered the testing of 182 flocks on commercial chicken farms. More than 90 percent of the animals had been treated with antibiotics, many multiple times, so that they were essentially being fed a constant diet of drugs. Others were given the medications for only one or two days, which isn't long enough and is in violation of the conditions for licensing the drugs. Such results raise suspicions that the drugs were being used to guarantee the success of the poultry fattening operation rather than to fight disease.
Both farmers and veterinarians are now under suspicion, prompting Agriculture Minister Ilse Aigner to push for a tightening of Germany's Pharmaceutical Products Act and a "careful review" of veterinarians' right to dispense drugs.
The veterinarians' lobby has countered the effort with a petition to preserve the privilege. They speak of their professional honor and independence. But how independent are veterinarians who, for example, are members of the management of giant poultry marketers in Lower Saxony while at the same time monitoring poultry flocks?
There seems to be a great temptation to take laxer approach to dispensing lucrative antibiotics than professional standards would dictate. "In nine out of 10 cases in which a farmer asks for penicillin, he gets the drug right away, without an examination," says veterinarian Ebner, who was one of the top officials in his industry for years. Ebner is a former member of the conservative Christian Social Union (CSU) but now works for the Greens, writing draft legislation that goes beyond what Aigner, a member of the CSU, is calling for. Ebner proposes a ban on volume discounts for drugs in favor of fixed prices; he would also like a requirement that veterinary consulting services be billed separately from drugs.
The debate over the right to dispense is about more than cutting back a few professional privileges. The general effectiveness of antibiotics is on the line. There is only a limited number of agents and humans are dependant on them too. The more these drugs are used in livestock farming, the greater the risk that bacteria will develop new survival strategies, or greater resistance.
Although many of these drug-resistant pathogens originate in hospitals, factory farming also contains a risk of transmission. Animal rights activists with the organization Friends of the Earth Germany (BUND) recently discovered drug-resistant bugs, bacteria that could pose a threat to humans -- in chicken meat on supermarket shelves. Out of 20 samples of chicken meat from major producers like Wiesenhof, 10 contained strains of bacteria that could result in an infected patient no longer responding to certain antibiotics.
Wiesenhof noted that it conducts extensive hygiene testing of its own meat, and that it has cut antibiotic use in half in the last 20 years. The company did not provide any proof, however.
The BUND discoveries admittedly came from a random sample. But even before the discoveries were made, the Federal Institute for Risk Assessment (BfR) examined chickens in factory farms and found resistant bacteria in all of them. The normally restrained BfR scientists urgently recommended scrutinizing the overuse of drugs in animal husbandry.
What has the scientists particularly concerned is that more and more pathogens, especially in poultry meat, are immune to several antibiotics, including fluoroquinolones, which, as so-called reserve antibiotics, are supposed to be used sparingly. But pharmaceutical companies have been anything but sparing in recent years when it comes to the use of antibiotics. In 2010, drug maker Bayer earned €166 million, an 11 percent increase over the previous year, with sales of the animal antibiotic Baytril, which is often used with turkeys when all else fails. Annual sales of veterinary drugs in Germany have climbed to €730 million.
Some 900 tons of antibiotics were fed to animals in Germany in 2010. This is 116 tons more than in 2005, and more than three times as much as the entire German population takes annually. Pharmaceutical producers were required to report their 2011 sales of veterinary drugs by the end of March. A number of companies did not comply, prompting the Federal Office of Consumer Protection and Food Safety to request the information in writing.
As factory farming has grown, so have veterinary practices, sometimes to enormous proportions. Some of these "animal clinics" now have staffs of 20 to 30 people. In some cases, their in-house pharmacies have grown large enough to fill large storage rooms, says a senior veterinarian with a state regulatory agency.
Heavy Reliance on Drugs
Sam de Snoek, a pig specialist, is part of the new generation of country veterinarians. The Dutch national recently gave a talk at a conference in the central German city of Göttingen titled "New Approaches to Pharmaceutical Treatment Strategies." In the Netherlands, antibiotic use was reduced by 32 percent in 2011 alone, says Snoek. It was high time, given that animals there were being pumped up with more substances than probably any other living creature in Europe. To ensure that his practice can continue to rake in revenues in the double-digit millions, Snoek and his colleagues are in the process of shifting the goalposts when it comes to sales. While they want to see antibiotic revenues, previously 60 percent of revenues, cut in half, consultations and preventive vaccinations are to be expanded.
The website of Snoek's company, Lintjeshof, offers a glimpse inside the modern veterinary market. It doesn't feel like the website of a veterinary practice, but like that of a small corporation instead. There are 24 veterinarians working in seven locations, and the company has two branches in Germany. Sometimes, it's even worthwhile to fly to Poland or Russia to visit customers there.
More and more critics are demanding that veterinarians should no longer be allowed to serve as both physicians and pharmacists. The dual role was banned long ago in Denmark and Sweden, where drug use is significantly lower than in German agriculture. At events sponsored by the Federal Association of Practicing Veterinarians (BPT), one gets the impression that the veterinary field in neighboring Denmark is on its last legs. In fact, however, the number of veterinarians there has remained relatively constant at about 1,000. And in 2011, antibiotic use in Denmark, which was already low, saw an additional decline of about 25 percent. One reason for the change is the new yellow-card system, which allows government officials to review the antibiotic use of individual farmers, to issue warnings and demand farm inspections as needed.
BPT officials want nothing of it. In fact, the organization has produced position papers urging members to continue upholding the old system of intensive livestock farming. "Limiting the size of operations," the BPT literature reads, "is not to be recommended from a professional standpoint."
Even factory-farming monolith Wiesenhof seems to be more progressive than that. Starting this summer, the company plans to test a new animal welfare label, as well as the use of longer fattening periods and smaller flocks.
Indeed, modern mass-farming methods may have run their course. The animals, which are bred to eat as much as possible, constantly stuffing themselves with high-fat and high-protein power feed, live in claustrophobically tight quarters, where they are practically guaranteed to get sick. For years, poultry farmers like Peter Bodmer (eds. note: not his real name) from the region near Vechta in northern Germany have been trying correct this defect in the system with drugs.
In the cold, wet months of January and February, conditions reached "alarm" levels once again in Bodmer's 10,000-unit turkey barns, and his veterinarian had to be called in. "The turkey," says Bodmer, is so susceptible to disease, "that it literally calls out for antibiotics." When his neighbor spreads liquid manure on his fields, it's a virtual guarantee that his animals will become infected by the resulting windborne bacteria. When Bodmer began his operation more than 20 years ago, a fattened turkey weighed about 16 kilograms (35 lbs.). "Today it's 23 kilos," he says, "but the heart and lungs are still the same size."
There are alternatives, including using breeds that don't grow as quickly. But this isn't good enough for the "people at Wiesenhof and the like," says Bodmer. "They want so much breast meat that the turkeys can no longer stand up in their last six weeks, because they're so overweight."
Return of the 'Autobahn Veterinarian'
Bodmer's logbooks are full of the records of antibiotic treatments. Even chicks from the hatchery seem to have problems. Despite meticulous inspections in the hatcheries -- there are even reports of eggs being sprayed with formaldehyde and dipped in antibiotic solutions -- some of the chicks Bodmer receives are not well. When that happens, and it usually does, he has to help them out with antibiotics. In fact, says Bodmer, he can't remember ever having had a flock that didn't need drugs to survive.
His logbook includes the records of several treatments with Aviapen, an antibiotic to treat diarrhea that apparently didn't work very well and, in some cases, wasn't used for the required duration. Penicillins were also used to treat colds. Later on, his veterinarian decided to switch to Baytril, says Bodmer. She left him with 12 liters of the medication and instructions to dispense it himself. All this drug use has its price. Bodmer spent €10,000 on medications in January alone.
The treatment was not entirely in keeping with professional standards. Nevertheless, Bodmer's veterinarian has a risk insurance policy of sorts. She is related to a senior government veterinarian, so that she is unlikely to run into any problems.
Things are going relatively smoothly again for another practitioner who became known years ago as the "Autobahn veterinarian." He had sold hormones and antibiotics, some of them banned, to hundreds of farmers -- usually in proximity to an autobahn exit and often without having examined a single animal. He was convicted in 2002 and banned from the profession for many years. The regional government of Upper Bavaria has just issued him a new license to practice veterinary medicine.