Reflections on lambing with Fiona Lovatt and Emily Gascoigne

RCVS Knowledge:
Welcome to this VetTeamAMR Podcast from RCVS Knowledge. Leading responsible antimicrobial use in farm, companion and equine teams.

Fiona Lovatt:

Okay. So this Farm Vet Champion podcast, and I’m delighted to welcome my friend and colleague, Emily Gascoigne, and I think I’ll just, maybe I’ll start Emily by asking you to tell us about yourself. You’re working at Synergy Farm Vets, but how did you get to where you are now?

Emily Gascoigne:

So I graduated from vet school and went straight into an internship with practice, my CV said all over it that I was going to be a dairy cow vet, but spent my entire interview actually talking about sheep and sheep flock health. So very quickly the jig was up that I wanted to be a sheep vet and then working in practice have gradually built up the work that we’re doing here in what is very classically, a dairy area and eventually doing a diploma under your wisdom and guidance. So, and now I’m a specialist sheep vet. It is really just a cathartic journey for me. So sheep vet, sheep health, sheep care, sheep management is actually just my hobby, which I now do professionally. So yeah, self confessed sheepaholic.

Fiona Lovatt:

Brilliant. And you got married. Was that your last year or the year before?

Emily Gascoigne:

Yeah, nearly 12 months ago. So yeah, married a farmer, did the vet thing.

Fiona Lovatt:

And so, and now what’s your home flock of sheep?

Emily Gascoigne:

So it’s grown almost beyond exponentially, but we’ve got about 500 ewes at home now, which includes some Autumn lambing Poll Dorsets, a Spring Gramly flock and my beloved Hebrideans, which started off the whole journey. So yeah, sheep by day, sheep by night.
Fiona Lovatt: Brilliant. And then what about within the practice, what flock are you responsible for within the practice?

Emily Gascoigne:

Yeah, so very dairy area where we’re based, but there are a lot of sheet blocks as well. So across our practice, we’ve probably got about 400 registered flocks of all sorts of sizes and huge diversity. I work in a team of what’s now eight sheep vets or sheepaholics. I’m probably responsible for the health plan of about 60 sheep flocks, with support from some of my colleagues as well. But yeah, we think we’ve got somewhere between 60 and 70,000 in breeding ewes in the practice.

Fiona Lovatt:

Okay. And really you’ve got eight sheep fits in the practice.

Emily Gascoigne:

Yeah. I’m probably doing the greatest proportion as in, I’m probably about 80%, but yeah, across our geography, I think pretty sure there’s eight of us and we’ve got two sheep vet techs now as well. So it’s infectious this sheep thing when you start off.

Fiona Lovatt:

Excellent. Well, it just is a good indicator of the potential that’s there that yeah, gap in the market and know that you are really responsible for encouraging and bringing those sheep vets into the area. So that’s brilliant. Okay. And then, so Emily, you signed up as a Farm Vet Champion quite early on, I think when it first became available. And just so you’ve been through all the CPD, you’ve worked through that yourself.

Emily Gascoigne:

Yes.

Fiona Lovatt:

And so that was probably a few months ago now, can you think of any highlights, just things that jumped out at you?

Emily Gascoigne:

I actually, so there’s obviously the sheep, goat and small rearing and components of that, which were probably of the biggest topic interest to me. However, just the broad overview of the challenge that we’re faced there is as an industry, as a country, human health as well. I think I really valued that part of it as well. Just the global challenge and yeah, so the broad overview is really useful.

Fiona Lovatt:

Yes. And that would be fantastic to have your eight sheep vets setting goals, smart goals on how you’re going to progress. But I know the thing with how you’ve worked in the practice and that’s partly why we’re talking today, is because you’ve already made so many changes hadn’t you, before Farm Vet Champions came along. You were already on a pathway to realizing that you couldn’t use antibiotics in a way that maybe people had in the past. Would that be fair?

Emily Gascoigne:

Yeah. I think I thought about it a bit back to front in the sense of, rather than thinking about it, our target is to reduce antibiotics, approached it quite early on from if we improve animal health, the proxy for that is that we will reduce antibiotics. So it’s almost a hidden KPI or one that we’ve not intentionally been working on. So I think one of the things that we wanted to do was to, so it might sound totally unrelated, but it was to try and establish the number of sheet flock within the practice and a rough estimate hopefully quite accurate if we asked the farmer, but an idea of how big those flock were, it can be quite a laborious exercise because we’ve not got TB testing, thankfully, but it means that some of that data is a manual exercise.

So we tried to establish how big our flux were and what, by having that information, what that meant was we could identify quite early on. So things like oral antibiotics who wasn’t using any, who was using Pro rata quite a lot based on how many sheep that we thought we had and just wanted to start ensuring that those flocks were on our discussion list or the necessity to, what was leading to the need for that antibiotic and to focus it on problem solving.

So if we’re using lots of antibiotics because we’ve got a lameness issue, well, if our initial discussion is not, we want to use less antibiotics, it’s how do we reduce your lameness issue using whatever is required to do that. And this… I think we tried to focus on trajectory of travel. So never put any targets on my sheep flocks, I’ve never said, this is what you’re using, and this is what you should be using, what I’ve been interested in or how we’ve tried to approach it is your lamb loss level for example, is X, we want to get it to Y, this is how we’re going to monitor it.

We may need to use antibiotics to achieve that in the short term, but how are we going to make sure that we’re not perpetually committed to needing to use it in that way. And the outcome of that is we have less lame sheep in that example. A system, which is hopefully a bit more robust, because we thought about the big picture. And that’s not a coincidence, is it? But the ultimate outcome of that is that we have less antibiotic usage. So try to approach it from a problem solving perspective rather than the target at the end. And that’s what we’re trying to do. And it applies to oral antibiotics. We’ve applied that to lameness, abortion, if it’s not been quite so relevant for us as a practice because of how we approach it, but any antibiotic consuming issue, what’s the problem? How can we solve that? And that’s our outcome.

Fiona Lovatt:

What your beautifully describing there is the mantra that we have right through Farm Vet Champions of plan ahead, prevent disease and protect the flock and herd, that sort of, it’s not talking about what to treat with, it’s talking about how to prevent them being in the first place. And I think that’s what you described really nicely there.

Emily Gascoigne:

Yeah, I think so. And I think we’ve got to… I think one of the reasons we found that method has been particularly effective is because ultimately we’re working with farmers who are custodians of their animals and it’s particularly brought home when you start having oral antibiotic based discussion, is our farmers want to do the best that they can for their animals. So if the conversation starts
with, “You are using this and we want you to use Y.” Then that’s what the focus of the discussion is. Rather than for example, you might feel that you need to use oral antibiotics at lambing because we have a watery mouth issue, but we might be having that because we’ve not got our feeding right or there’s something in our lambing shed, for example, that we need to tweak or think about.

And actually if we crack that, then actually our lambs will be healthier and they’ll probably grow quicker and there’ll be benefits for the ewes and all of these really positive things that will help your sheep flock. And we won’t need to use less antibiotics. So I think it’s this emphasis of just this big picture thinking rather than, I don’t want our farmers to feel picked on or that we’re not trying to support them or that we think that they’re doing something wrong, often the Mo the motives are totally correct. So I think by thinking about it in the three P direction, I think it’s just setting a culture of what we are trying to achieve.

Fiona Lovatt:

Okay. And so the way that you describe that in the first was to get a good idea of who all your sheep farmers are, how many sheep they’ve got? So that must all happen way, way before the start of lambing, when things are getting a bit stressful.

Emily Gascoigne:

Well, if I’m being really honest, it’s a process that I started frankly, years ago, and it’s actually an ongoing thing to do because flocks change all the time. So I suppose my question to the vets listening would be, do you know where all the sheep are in your practice? And it might be a case of actually sit down with a cup tea or some cake and thrash that information out, or the way that we tend to do it a bit now, because that’s quite a laborious exercise is, if you’ve got a named vet for a farm, they’re responsible for populating an Excel spreadsheet, for example.

Or when you’ve done a flock health plan, populate this central spread, it only has to be an Excel spreadsheet. And that just means that gradually you’re picking up that information. But if you’re starting from scratch and you’re doing that in one big hit, then yes, it needs to be well in advance of lambing, probably even topping time to be honest because we all know that once scanning happens, then it’s just a frantic race to lambing isn’t it? So yeah, well in advance and keep it updated because then you’re not reinventing the wheel every time you have to do it.

Fiona Lovatt:

Yeah. No, that’s really helpful advice. So I think people who maybe their sheep blocks are not the top priority in the practice. It’s lambing time when they’re having that contact with sheep farmers and quite frankly, we all know we are fire fighting then aren’t we? Because everyone’s under pressure and it’s a case of do whatever we can to keep these lambs alive. And actually it’s so much more relaxing. Isn’t it? If we’ve had all those conversations a couple of months beforehand and yeah.

Emily Gascoigne:

Just another top tip. As a general rule, if I’m going to start any major project or anything a little bit juicy and it applies to an exercise like this, I actually do it in the summer because once I’ve got eight week wait stuff out of the way and you’ll just get those lulls when everybody’s sowging. That’s a really good time to sit down with a brew in the office and do that project. So don’t leave it till March, if you want to embark on that exercise because it won’t happen.

Fiona Lovatt:

Yes, yes, absolutely. So actually, so this year and we all know nationwide, we know that people have been very stressed this year because withdrawal of certain products that people have used commonly in the lambing shed. Has that been a big thing for you at Synergy or have you dealt with that in a calm way?

Emily Gascoigne:

Yeah. I think what we as a practice, I think we’ve probably been quite comfortable with how we’ve managed it, but for individual farmers, sometimes that discussion is still very stressful and they’ve needed a resolve. To be honest how we, we were already on a bit of a journey with regards to our oral antibiotic usage. So we had seen a significant reduction over the last three or four years and it was slightly because of a changing policy about how we discussed oral antibiotics with our clients. So just having the policy that it was on a year by year basis, IE, every year you needed to have a phone call with a vet in order to access that medicine, rather in it just being a rolling thing in your health plan.

And what that had meant was that our farmers had already been on the route of, or a lot of them had already been on this selective approach anyway. And so we had minimal flocks who were probably blanket users of oral antibiotics. And what that meant was that for the… It’s all about confidence building, I think. And I think one of the difficulties, if you haven’t had an advanced conversation, is the perception that your sheep, your lambing is the success of it, is totally reliant on an individual product. And by having those discussions where we’ve effectively said, “Well, just do your high risk.” It’s actually given a lot of our farmers, the confidence in that situation, that all the other good stuff that they do, like getting their feeding right, appropriate culling of ewes, vaccination for the relevant diseases that, abortion, just getting all of that stuff probably has a bigger impact.

So when we got to the point this year, where in December or whenever it was the earliest, we were aware of it, there was an issue. We started our communication then, that’s saying, forage needs to be analyzed now, you need to be getting your health funds in now, this is not a five o’clock on a Friday afternoon discussion because we’ve got a watery mouth outbreak, this needs to be proactive. And because there had been that dialogue, I think it probably made it a little bit easier. But certainly, I don’t want anyone listening to think I’m in an ivory tower.

We do have flocks that we needed to have some of those difficult discussions with. And how we approached that is because we had the numbers, because we had the sales data, in January we approached them. So in January we went to those flocks and said, “We know that you have required oral antibiotics before, and we know how many ewes you’ve got, we guess how many lambs you’ve got. We think it might have been quite a proportion. Let’s start talking about it now in January.”

So quite a proactive approach. I think what I will just say, because I’m conscious that, so to think about the geography we work with, I’ve got a lot of outdoor lambers in our practice, a lot of lake lambers. So of those 400 flocks, actually quite a small proportion of them would be using or would be housed, would be even having discussions about oral antibiotics. I’m very mindful, there’ll be vets listening to this where their client portfolio maybe looks very, very different. But I think we’ve just got to recognize that having that really difficult discussion when the proverbials hitting the fan, they’ve got lambs on the ground, they’ve got clinical disease and issue, it’s not the best of anybody in that discussion. Your farmer is not going to be as receptive because you wouldn’t be, if you had that clinical challenge.

You are not going to be the best version of your communicating self in that scenario because you’ve got, ultimately, you’ve now got sick lambs on the ground. You need to provide a solution for that. So having these really thoughtful discussions, you’ve got to do that in an appropriate time. And just recognizing that if you leave it too late is difficult. I’ve got a lot of support, both from colleagues and from the management structure, which means that this was prioritized and there’ll be other practices for whom their sheep flock work. It’s not that it’s not important to them. It’s just the hot potato needs dealing with first doesn’t it?

Which is why trying to capitalize, recognizing who the right person is in your practice to do that. And it may be support staff actually that can help articulate some of this data, but doing it at a time of year or where you’ve all got the head space to do it, being thoughtful in that respect really probably makes quite a big difference rather than when it’s all getting a bit exciting in spring.

Fiona Lovatt:

Yes. And absolutely. And when we’re faced with a clinical situation, none of us are saying we don’t want to use an antibiotic when we need to, in a clinical situation, are we? But we really, we all feel that pressure when we’ve got sick lambs or dying animals and it’s horrible for us, it’s really horrible for the farmer isn’t it? So no, I’m with you there, that the planned stage of planned prevent, protect and that’s as much for us as a practice, isn’t it? And with our colleagues. Yeah, no, that’s really helpful, Emily thank you. If you have, and I know you have got or more intensive flocks or flocks where they would have really relied on antibiotics and you’ve gone through that journey, would you say, or do you have the data to show that they’ve managed to do that without it affecting lamb survivability?

Emily Gascoigne:

Yes. And its not just in this last 12 months, so really interestingly for us. So at the practice we do a lamb loss survey every year where we just, some crude benchmarking figures and we’ve been doing it for quite a few years now. And I don’t know if you remember the beast from the east year, so that year as a practice was the year that we started our reducing oral antibiotic year campaign. And we’d put a lot of farmers on essentially a selective program at that point. And I remember the snow hitting thinking, “Oh no.” Well, no, I should have had more confidence, but thinking, “Oh everybody’s going to be up against it.”

Fiona Lovatt:

Of all the years to start. That was a challenging one. I remember it well.

Emily Gascoigne:

Yeah. Of all the years to get clever, this wasn’t the year to do it. And we got to our end of year lamb loss survey. And I know some of the clients that are in that, who would’ve been on this oral antibiotic reduction journey and it had been the beast from the east and their lamb losses had not deteriorated. And in fact, our practice average, excuse me, median lamb mortality that year had reduced. So I think what I took away from that, and it is probably only a few anecdotal farmers that were in that particular data set, but actually the plan bit is the gift that keeps on giving. It’s not just the watery mouth thing that it benefits. And I think I don’t know, I think one of the key themes that used quite early on with the oral antibiotic discussion was, if your feeding’s not right, where your ewes are in good condition.

Okay, you’re going to get water mouth. And that’s the thing in this discussion you are worried about right now, and that’ll affect lamb mortality and lamb health, but actually if the ewes aren’t fit and the feeding’s not right, they’re not going to milk, their growth rates are going to be compromised. They’re not going to get off farm quicker.

They’re going to cost you more money. So actually by having this discussion and thinking about your business overall, rather than just this 48 hour window and putting a sticking plaster in there, why don’t we crack it? If we crack it, we could make the whole thing better and-

Fiona Lovatt:

Yeah, it’s going to reduce labor and make it a much more enjoyable experience at the same time.

Emily Gascoigne:

And that starts getting really exciting quite quickly doesn’t it? So, I think it’s just, I don’t know, I’m a carrot sheep there. I think that’s my approach. I like highlighting where the carrots are and where we can go find-

Fiona Lovatt:

No, well, I find that really, really helpful because when people were fearful, because I thought, this product that we’ve used a lot is not going to be available, what are we going to do? That’s a very negative way of looking at it, isn’t it? And actually we have seen so many positive stories that, and it is about building confidence, isn’t it? So, and to hear your positive stories and to share them with others all over the country. We’ve got farmers who have actually realized that they don’t need to be using their antibiotic on a routine basis. Yeah. And it’s giving them the confidence and it’s giving their vets confidence as well. That actually we can… Yeah, brilliant.

Emily Gascoigne:

But sometimes, just one little anecdote, I don’t know if this farmer are listens to this, but a client of mine, who will totally remain anonymous. I wanted to give them the confidence that I knew that their lambing shed was really as brilliant as it was. And they couldn’t see that it was as brilliant as it was. And it was a, so it’s confidence thing. It was a totally confidence thing. And I shouldn’t say this out loud because I’d lent the [inaudible] I think, I don’t think I ever took it back. A Brix Refractometer and said, this was when oral antibiotics was still available in the way that they historically were. So I said, “Have the Brix Refractometer, have a play with that. And tell me what, come back to me, let me know. And then if we’re still not happy, then we can… Maybe we don’t have to change anything in terms of how we use oral antibiotics.” And the results were phenomenal.

The colostrum was awesome. They just needed somebody else to give them a tool to just highlight. And I know it’s not all reliant on one Brix, there’s a lot of other things that have to be correct, but sometimes it’s just highlighting the stuff that’s going really well. And the the flock I’m thinking of, was not a flock I had to have a discussion this year with regards to oral antibiotics at all. So sometimes it’s just highlighting the good stuff as well. So I think that they have the potential to be very positive discussions, but not at the last minute, not in an unprepared capacity, not when… And crucially in that scenario, you’re actually quite powerless to change but the week before lambing.

Fiona Lovatt:

Just have to do what you have to do then don’t you? Yes. Absolutely. Oh, Emily, that is so fantastic and really encouraging. And it’s really struck me that as we are talking about this now in May, as maybe vet’s listening are thinking actually maybe I could do something. Maybe I could start to get a plan on where my sheep flocks are and those things would be great smart goals to put in place in time for lambing next year, having meetings, talking to farmers, one to one discussions, all of that would be really good, smart goals for people to set and then track their progress and encourage each other. So I’m really delighted we’ve spoken to you Emily. Thank you very much. Always encouraging, always great to hear how it’s going from your mouth. So thank you really. Thank you.

RCVS Knowledge

Thank you for listening to this VetTeamAMR Podcast from RCVS Knowledge, visit rcvsknowledge.org/amr for free CPD benchmarking and audit tools to improve your antimicrobial use.