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September 2024
CBD for Pets
CBD products for pets are all over the market and are being used by pet owners across the US, but professional and regulatory guidance on these products is hard to come by. This article presents a roundup of recent research and some insight into the future of this growing sub-field.
What’s New and What’s Not
When Trends published an article about the state of cannabis in veterinary medicine in 2020, I wrote, “By waiting for a definitive decree from national or state organizations or accepting prior statements as final, veterinarians may find themselves far behind in their knowledge of how cannabis-derived products such as cannabidiol (CBD) affect patients’ lives. Saying nothing may no longer be viable.”
Spoiler alert: All that remains true in 2024.
“There’s not much more clarity from the legal side or the organizational side,” said Casara Andre, DVM, founder of Veterinary Cannabis Education and Consulting. “Unfortunately, I think there has been enough [going on] in the wider cannabis industry that the veterinary industry has slid by without making comment.”
In part, that’s because cannabis derivatives are complicated constellations of potentially hundreds of molecules, terpenes, flavonoids, and entourage effects. It’s a lot to grasp, juggle, and adapt for different cases and patients. Plus, “Many states are still keeping veterinary practitioners in the dark with regard to legal protection for veterinarians who discuss or recommend cannabis or CBD,” said Trina Hazzah, DVM, DACVIM (Oncology), CVCH.
As cofounder and president of the Veterinary Cannabis Society (VCS) and also founder of Green Nile, Inc., a platform for cannabis-specific consultations, Hazzah encourages other practitioners to join the VCS and monitor its Legal Beagle Archive for news. While some states, including Nevada, Utah, California, and Michigan, passed cannabis or CBD-specific legislation, other states end up gutting various bills of cannabis- or hemp-related content before going to a vote.
Meanwhile, consumer demand keeps climbing. According to Packaged Fact’s US Pet Market Outlook 2024–2025, “CBD—cited as useful for everything from chronic pain to epilepsy—has become entrenched in the pet supplements space, posting high double-digit and even triple-digit growth in previous years, with pandemic-related anxieties giving the business an additional push.
Growth has moderated, however, with annual sales increases projected to be in the 6% range on a compound annual basis through 2028.” The outlook report also discusses the growing presence of direct-to-consumer distribution of CBD products for pets, leaving veterinary practitioners out of the equation entirely. “I definitely had more expectation from organized veterinary medicine bodies to have, by this time, a much stronger education-forward perspective of cannabis because it’s literally everywhere,” Andre says. “I’m shocked when I encounter a pet that has not been exposed. The need for us to understand it as practitioners just continues to grow.”
I definitely had more expectation from organized veterinary medicine bodies to have, by this time, a much stronger education forward perspective of cannabis because it’s literally everywhere.Casara Andre, DVM
Research Recaps
Thanks to work of veterinary professionals around the world, Andre says, “we’ve increased our cultural veterinary community understanding of what the endocannabinoid system (ECS) is, how it’s implicated in stress, and what we could actually be doing to support the ECS, plus or minus cannabis.” Veterinary researchers continue to explore both the safety and efficacy of CBD for specific conditions.
Many of them work with zoo animals in Latin America and publish in Spanish, so increasing translations of papers should allow for greater sharing worldwide. “We are still learning this information through more research that’s continuously being performed,” Hazzah says. “Based on several safety trials, we know that CBD and CBG are exceedingly safe at even high doses in dogs and cats, but the longest trial was only six months.”
Admittedly anecdotal, some of Hazzah’s dog and cat patients have been taking cannabis products for two to five years for “specific diseases such as cancer and seizures” with good tolerance and “minimal to no side effects.” That said, she explains, “A high dose of CBD may interfere with specific drug metabolism; it may be important to keep an eye out for any side effects noted. Also, high doses of CBD in both cats and dogs can increase liver enzymes and bone isoenzymes, so monitoring these values may be recommended in some patients, especially the ones that may already have mild liver dysfunction. Also, in pets with moderate to severe cardiac disease, monitoring heart function with a cardiologist a few weeks after starting is recommended.”
It’s important you know if all your patients already take cannabis-derived products. One recent pilot study found that full-spectrum cannabidiol-rich extract at 6 mg/kg reduced propofol dosages required for anesthetic induction by 23% in dogs. The authors explain, “The fsCBD-rich extract did not produce significant sedation within or between groups, although statistically significant differences in heart rate and systolic blood pressure were found.”
However, they also wrote, “Our findings indicate that phytocannabinoids could be an adjunct option in anesthesia, although further research is necessary to better confirm this data.
Additionally, further research is needed to determine the best dosage, delivery method, time for administration, ideal molecular profile for desired effects, safety, drug-drug interactions, and transurgical effects.” The typical trajectory for research goes from safety to efficacy for big things like pain before branching out into highly specialized uses for surgical recovery or even kidney disease, liver disease, and beyond. Andre says, “The interest in clinically applicable stuff is growing.”
Shared Vocabulary
Andre explains that California is the closest to creating “true cannabis recommendation powers for veterinarians” that might clear up confusion, including “what a medical card for an animal means.”
Yet, that’s just one state, and practitioners continue to dance around the appropriate vocabulary for discussions with clients, using words like these:
• Advise
• Educate
• Harm reduction
• Medical guidance
• Medical oversight
It’s a verbal challenge in a profession that recommends all kinds of things from probiotics to dental care to have a “CBD recommendation” suddenly mean something specific.
It “continues to be a point of confusion and fear for some veterinarians,” Andre said. Like the gastrointestinal microbiome, think of the endocannabinoidome. Andre says, “We’ve had to start thinking about the ECS in a bigger, broader environment because it interfaces with all these other receptors and systems . . . So, it really is challenging our prescriptive patterns, protocols, how much we’re journaling, how individualized we are with a patient, which I think is lovely, but sometimes that can be a little bit complicated.”
Looking Ahead
Those working in the veterinary cannabis space predict the creation of a vitality score that will help rank patients’ current ECS state and effects of cannabis interventions. The researchers use endocannabinoid assessments, but those aren’t yet clinically available in typical practice. Andre imagines an “amazing” future where exam-room or cage-side blood tests give practitioners actionable ECS information.