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Numnuts investor backs injectable lidocaine change

Terry Sim, March 21, 2022

Boulia beef producer Rick Britton.

BOULIA beef producer Rick Britton doesn’t support Meat & Livestock Australia’s position on the rescheduling of NumOcaine, the active ingredient in the Numnuts pain relief system.

The Therapeutic Drugs Administration is considering an Australian Veterinary Association application to amend the TGA’s S5 scheduling of injectable lidocaine (NumOcaine’s active ingredient) which would allow its provision without veterinary prescription.

Sheep and wool industry bodies support NumOcaine’s S5 scheduling, but MLA has withdrawn its initial submission of support.

Rick and his wife Ann have invested $500,000 to help Senesino director Robin Smith fund Numnuts development.

“I am truly so proud that Rick and I have invested in the Numnuts venture and truly will be a good day when we are able to use it on our calves,” Mrs Britton said.

Up until 2006, the Brittons were sheep producers – with about 20,000 sheep — until wild dog attacks drove them into cattle. After seeing a Landline piece on Numnuts, they saw the potential for the pain relief tool in the beef industry, recognising that animal welfare is becoming part of all producers’ social license.

“I thought if you are in the game and not game to put your money in, you shouldn’t be in there.

“Their biggest issue was having cash to maintain supply to keep up with demand,” Mr Britton said.

MLA position is ‘hypocritical’ – Britton

However, Mr Britton is critical of MLA withdrawing its initial submission of support to the Therapeutic Goods Administration’s rescheduling of Lidocaine/NumOcaine from S4 to S5 on the Poisons Standard, after realising the NumOcaine quick change cartridge was not ‘tamper-proof’. The rescheduling would allow the sale of NumOcaine without veterinary prescription.

“I think it’s just hypocritical.”

“Here is our leading red meat lobby group which has put a lot of money into Numnuts and the lamb industry has run with it and now they are trying to put a handbrake on it?”

On 15 February, when asked his view on Numnuts, MLA managing director Jason Strong told Senate Estimates the product had been incredibly successful and had been a great solution for sheep producers to manage pain. But he said MLA had decided that the rescheduling of the product “was not something we should have a position on.”

Parts of Mr Strong’s evidence were indistinct; however, he told the Regional And Rural Affairs and Transport Committee it has been “misreported” that MLA did not support the rescheduling of NumOcaine from S4 to S5.

“That’s not the case at all; we absolutely support the development and use and broadscale use of that product in every way it possibly can be ….” he told Estimates.

Early last year, MLA’s then program manager for animal welfare and biosecurity, Johann Schröder gave his full support to NumOcaine’s rescheduling from S4 to S5 on the Poisons Standard, on a TGA feedback form.

However, Mr Strong later told Bendigo sheep vet Tristan Jubb that MLA’s submission to the TGA was made on the assumption that vials of NumOcaine are tamper-proof and that MLA intended to withdraw its submission to the TGA.

MLA’s group manager – productivity & animal wellbeing, David Beatty, subsequently confirmed to Sheep Central in January this year that MLA had withdrawn its initial TGA submission supporting the rescheduling and informed the APVMA’s chemicals and medicines scheduling secretariat team.

Numnuts outlay totals at least $5.57 million

Mr Strong’s evidence on MLA’s Numnuts investment amount was unclear at the Senate Estimates hearing; however, MLA recently submitted a full Numnuts funding breakdown to Sheep Central.

MLA said $5.57 million has been spent on the development and efficacy testing of Numnuts, comprising about $1.71 million in levy investment, and about $3.85 million funded through the MLA Donor Company (MDC), which is made up of $1.91 million from Senesino matched by the MDC. MLA said any further funds invested by Mr Smith’s team to support the development of Numnuts were not in partnership with MLA.

As a beef producer, Mr Britton said he is happy to see his levy spent on Numnuts.

“It doesn’t matter what husbandry practice you are in, if (Numnuts) takes off and goes forward it would give us our social license on animal welfare and pain relief.”

He believed MLA’s position on NumOcaine’s rescheduling would not be shared by its levy payers, who would support making the product more available.

“You can’t sit on the fence, you are the CEO of MLA, you don’t have the privilege of sitting on the fence, not after putting that amount of money in.

“You support it and then you withdraw it and don’t have an opinion – bull, have an opinion and stand up.”

Mr Britton did not accept the Australian Veterinary Association’s argument that making NumOcaine more available through resellers without veterinary prescription might lead to off-label use.

“I buy a lot of other chemicals through my livestock agent … it’s just making an excuse that this could be detrimental or someone could use it for ill gain.

“There is a lot of other stuff that people can use for ill gain,” Mr Britton said.

He believed as vets are trained in animal welfare they should support the wider uptake of Numnuts.

Mr Britton said it would be easier to get products like NumOcaine via his stock agent rather than through a vet in Longreach or Mt Isa.

“We don’t have vets running around everywhere, but we have a lot of livestock agents.”

Mr Britton also queried why the TGA is considering AVA’s application for it to reverse its initial decision to approve lidocaine/NumOcaine’s rescheduling to S5 status.

“They should stick to it — they’ve already made the decision nothing has changed.”

The TGA’s Advisory Committee on Medicines Scheduling (ACMS) and the Advisory Committee on Chemicals Scheduling (ACCS) joint session on 15 March 2022 discussed the AVA’s application on lidocaine/NumOcaine. It is anticipated that the interim decisions will be published on the TGA website in June 2022.

“This is followed by a period of public consultation on the interim decision before the Delegate makes their final decision, which is published on the TGA website.

“The final decisions of the March meetings are planned for August 2022,” the TGA said.

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Comments

  1. Tristan Jubb, Bendigo Sheep Vets, March 25, 2022

    Regardless of scheduling status, use of the Numnuts rubber ring system is inconsistent with the current Australian Welfare Standards & Guidelines for Cattle if it was used in calves older than two weeks.
    G6.16 states “Calves more than two weeks old should be castrated by the cutting method in preference to the rubber-ring and tension-band methods.”

  2. Tracy Sullivan, March 24, 2022

    As president of the Australian Cattle Vets, I stand by AVA’s assessment that the risk of potential abuse increases by making lignocaine more available through resellers. But this is not the only reason that I believe that NumOcaine should retain its S4 classification.

    The Australian Animal Welfare Standards and Guidelines for Cattle include the following guidelines: G6.15 – Calves less than two weeks old should be castrated by the rubber ring method in preference to the cutting method and G6.16 – Calves more than two weeks old should be castrated by the cutting method in preference to the rubber ring and tension band methods.

    These guidelines are based on conclusions from extensive reviews of scientific studies of routine husbandry procedures in cattle. These reviews found that surgical castration produces more rapid healing, fewer complications and reduced chronic pain compared to rings and bands, and that rings used in calves older than two weeks give the highest level of inflammation, infection and chronic pain.

    Simply put, pain is caused by the tissue death in the strangulated testes. This occurs over a period of days to weeks, and the amount and duration of pain experienced increases with the size of the testes.

    The application of local anaesthetic prior to ring application may provide some short-term pain relief (for up to an hour) at the site of the ring application, but this rapidly wears off and provides no relief for the extended period of pain following ring use. Relatively new, non-steroidal anti-inflammatory drugs such as meloxicam, on the other hand, provide generalised pain relief for up to 48 hours, but this is still insufficient for the duration of pain expected following ring application. However, these drugs are useful in combination with Tri-Solfen for surgical castration.

    Research has also shown that the metabolites resulting from injected lignocaine breakdown may be different in cattle than sheep and we know that overseas markets can be sensitive to these metabolites. Further research is warranted to establish withholding periods before widespread increase in lignocaine use occurs outside of its current use in individual animals undergoing surgical veterinary procedures.

    Another important consideration when applying rings to calves is that the reduction of blood flow to the testes creates a thriving environment for the bacteria Clostridum tetani, that can result in tetanus outbreaks with serious animal welfare considerations. So it is a good idea to discuss the timing of the Clostridial vaccination to the calf or its dam with your vet, when deciding on which husbandry procedure and pain relief option best suits your enterprise.

    NumOcaine is promoted for use by vets and available from vets, but it comes with veterinary advice and is only available to bonafide clients who own cattle or sheep.

    The Australian Cattle Vets recognises that regular on farm veterinary visits are not feasible for some remote properties. We encourage our members to offer teleconsultation services to dispense drugs for pain relief for routine cattle husbandry procedures for remote properties, within the vet’s professional guidelines and state legislations.

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