Treatment refers to the application of nursing care, administration of therapeutic compound(s), or surgery. Nursing care refers to provision of separate or specialised care in a hospital pen or defined area including for example provision of shelter, bedding and good quality feed and water. Treatment is an option when the value of the animal exceeds the full cost of treatment, the prognosis with treatment is good and the time to recovery fits within the different stages of the export process. The full cost of treatments is easily underestimated.
A simple formula to gauge cost-effectiveness of treatment can assist the decision to treat or not to treat. The formula is C = V x P where C is cost-effective value of treatment, V is value of the animal and P is the probability of recovery with treatment.
For example, if a steer with pneumonia is worth $1,000 then spending up to, but not more than $1,000 on treatment is cost-effective. If the steer, based on clinical findings and experience, has a 30% chance of full recovery with treatment and therefore a 30% chance of resuming its value of $1,000, then it is cost-effective to spend up to $300 (30% x $1,000) on treatment.
This calculation can be useful to help make a decision although there is always uncertainty about the diagnosis, the effectiveness of treatment, the cost of treatment (mainly time) and the likelihood and time of full recovery. It should be used along with other considerations, but the animal’s welfare is paramount. Other prominent considerations include the time and resources available to treat, prognosis with and without treatment and whether the time and resources, if limited, might be better spent elsewhere.
Making a prognosis for a given case requires taking into account a range of uncertainties including accuracy of diagnosis, effectiveness of treatment, time to recovery, and level of recovery.
Making a prognosis in the export process can sometimes be difficult because time, facilities and diagnostic back up are often unavailable. In some cases the particular constraints associated with export (no access to laboratory support, no opportunity for salvage slaughter, limited treatment options) can make the decision process simpler.
It is important to monitor animals following any treatment, to determine the response and revisit the diagnosis, prognosis and management of the case. Rapid improvements over a few hours or days in demeanour, appetite and mobility usually indicate ongoing treatment will be rewarded. Little or no improvement may stimulate change of treatment or a decision to euthanise or slaughter for salvage value.
Decisions about whether to treat and which treatment to use are also influenced by the time remaining before the next phase of the export process. Animals treated at assembly points must be recovered in time for loading, animals treated at sea must be recovered in time for discharge, and animals treated at destination must be recovered sufficiently and be residue free at the time of slaughter.
It is important for veterinarians and stockpersons to have had a discussion with the exporter about how sick and injured animals aboard should be dealt with in the final stages of the voyage close to or at the destination port. Decisions on euthanasia and what is fit for unloading may be left to the professional judgment of the veterinarian or stockperson. However, making these decisions may be assisted by knowledge of previous experiences with importing inspectors and the importer, the opportunities for salvage slaughter or ongoing treatment at the destination feedlot, and other local factors.
Key considerations supporting a decision to implement treatment include:
- Pain and distress are controllable.
- The value of the animal is greater than the full cost of treatment including opportunity cost[5].
- There is a high likelihood of recovery with treatment.
- Risk of disease and injury to other animals and people is controllable.
- Skill, time and facilities are available to treat properly including at further stages along the export process.
- Sufficient time is available for recovery before discharge at destination.
- Sufficient time is available to meet drug withdrawal periods.
- The rate of response to treatment is encouraging.