Veterinary Medical Ethics

Ethical question of the month — May 2022

Pregnant Mare Serum Gonadotropin (PMSG) is used in farmed animal agriculture for the induction and synchronization of ovulation in cattle, pigs and sheep, superovulation in cattle, and increased fertility rates. This hormone is produced by collecting a substantial volume of blood from early pregnant mares once or twice a week for 11 to 12 wk. The mares are then aborted and re-bred for another collection cycle. There have been numerous accounts of serious acts of horse abuse and neglect on these so-called “blood farms” located in South America and Iceland. Animal welfare advocates have had little success in improving the conditions on these farms or ending this practice as the source of PMSG. However, PMSG products are used in North America routinely in farmed animal practice. How do veterinarians resolve the ethical conflict of using drugs produced in such a manner? Is the productivity gained using by PMSG worth the risk of damage to public trust in modern agriculture?

Ethicists’ commentary on obtaining hormones from pregnant mares

This case concerns veterinarians’ responsibility towards pregnant mares, whose blood is used to produce the hormone originally called Pregnant Mare Serum Gonadotropin (PMSG) and more recently called Equine Chorionic Gonadotropin (eCG). There is no doubt that production of PMSG can, and sometimes does, result in poor welfare for the mares concerned. Based on the literature, however, this doesn’t seem to be necessary; that is, it appears possible to produce the hormone in a way that does not violate widely accepted standards for animal use.

In the first of 2 questions raised, we are asked how veterinarians resolve the ethical conflict of using a drug produced like this. This seems to be an issue both for individual veterinarians and for the veterinary profession.

We conclude that individual veterinarians may reasonably take different ethical stances on prescribing this drug. They may, with good justification, decide that they will not prescribe PMSG. After all, the hormone is normally used to make farm animal breeding more efficient. Increased efficiency may benefit the owners but not necessarily the animals which are under the veterinarian’s care. Indeed, some animals at least are better off with a longer rest period between births. However, there are also reasons to think carefully about taking such a path. It requires a balancing of duties to the paying client versus animal patient, and an awareness of the limited effect of uncoordinated individual actions (a veterinarian can choose to stop prescribing, but who does this help if colleagues in the profession simply step in and take these clients?).

Veterinarians can help address the issue by working towards a strategy for collective action. An important model is provided by the pregnant mare urine (PMU) industry, the product of which is used to manufacture the drug Premarin used in human medicine. When this industry grew in the 1990s it encountered criticism associated with several welfare concerns including lack of exercise, thirst, indoor housing conditions, urine collection methods, and the fate of the resulting foals. Industry stakeholders including ranchers, veterinarians, the pharmaceutical buyers, and government officials worked together to produce a set of standards that sought to mitigate many of these concerns (as specified in the Recommended Code of Practice for the Care and Handling of Horses on PMU Ranches); the pharmaceutical company that purchases the urine inspects all farms and requires adherence to this code.

Veterinarians should consider working collectively via their professional bodies to urge companies producing PMSG to adopt a similar model. As a first step, the CVMA and AVMA could join forces to create a North American commitment similar to the existing Federation of Veterinarians of Europe and Federation of European Equine Veterinary Associations’ statement to “stop both the import and European production of PMSG and other related products if blood collection procedures in horses do not live up to animal welfare standards.” Already many major pharmaceutical companies have an official policy of responsible animal use and are likely to be affected by such a commitment.

Drs. Clare Palmer, Peter Sandøe, and Dan Weary

Ethical question of the month — August 2022

Your client purchases a young large-breed stallion that must be castrated on short notice. You are unable to do the surgery, so ask the client to find a colleague that can accommodate their needs. The surgery is performed with injectable general anesthesia on-farm. Within an hour, the client calls in a panic. The horse is down, groaning, and flank watching. You advise that the client call the veterinarian who performed the surgery. She refuses, saying that she asked 3 times about pain control and was told that “it is better to have them sober so we can see how they are doing.” You advise giving an NSAID and an hour later the horse is up and grazing.

You contact the veterinarian to tactfully discuss interoperative, regional, and post-surgical pain control. The response is along the lines of “I’ve been doing it this way for decades…” You hope that there will be an exploration of some of the suggested options.

Recently you are contacted by a client that had the same veterinarian repair an eyelid laceration with an accompanying corneal ulcer. She is satisfied with the repair but asks you about pain control, as none was administered or dispensed beyond the local aesthetic. What do you do?

Responses to the case presented are welcome. Please limit your reply to approximately 50 words and forward along with your name and address to: Ethical Choices, c/o Dr. Bettina Bobsien, 4353 Yellowpoint Road, Ladysmith, British Columbia V9G 1G5; email; bettinadvm@gmail.com

Suggested ethical questions of the month are also welcome! All ethical questions or scenarios in the ethics column are based on actual events, which are changed, including names, locations, species, etc., to protect the confidentiality of the parties involved.