Know Your CBDs

This hemp-sourced supplement is being touted as a miracle cure for almost anything that ails canines – and denounced as snake oil, too. What’s true?

46

It’s everywhere: CBD, the “miracle” drug. Each week, I probably have several clients inform me – their veterinarian – that they are giving this supplement to their dogs. Their intention and hope is that the supplement will cure their dogs of a vast array of disorders, including allergies, seizures, immune-mediated syndromes, and cancer. Despite the fact that the treatment was their idea, and that they found the product on their own – in a health food store, online, or made in a kitchen by someone they know – they often ask me, “What is it, exactly? Do you think it works?”

If you decide to administer products that contain CBD to your dog, you need to be aware that they are untested and unapproved, and that your veterinarian may not have any experience or reliable information about any adverse reactions your dog experiences.

The History of CBD Research and Discoveries

It’s hard to believe that a complex chemical signaling system that helps our bodies maintain homeostasis by sending protein messages between cells was only recently discovered – in the late 1980s, in fact – by researchers who were trying to learn why and how marijuana makes humans high. Weird, but true: The first piece of what has been named the endocannabinoid system (ECS) was discovered by researchers who were trying to figure out what part of the brain is affected by marijuana.

Actually, the word “marijuana” is a pejorative name, popularized in the 1920s, for dried parts of Cannabis plants. Marijuana became the commonly accepted name for the dried flowers and leaves of Cannabis plants,  just as tobacco has become the commonly accepted name of the dried leaves of Nicotiana plants. 

In 1964, scientists first isolated the chemical compound in Cannabis that causes psychoactive effects in humans and other mammals; it was named Delta-9 tetrahydrocannabinol (THC). This chemical, in both a version that is derived from Cannabis plants and synthetic, chemically reconstructed versions, have been widely studied because of their behavioral effects on humans.

In the late 1980s, still trying to figure out what is responsible for the psychoactive effect that THC has on mammals, researchers found, in the brain of rats, unequivocal evidence for the presence of a specific receptor that “takes up” (responds to) THC. Receptors are chemical structures that receive and transduce signals, and cause some form of cellular/tissue response. The receptor that responded to THC was named CB1 (cannabinoid 1).

The CB1 receptor was subsequently identified in other mammalian brains, including those of humans.

Once the receptor was identified in mammal brains, researchers began to realize that mammal brains contained a lot of these receptors. In fact, once they knew what to look for, they found CB1 to be present in a similar density to receptors for other critical neurotransmitters, including glutamate, GABA, and dopamine. Why on earth do mammals have such a wealth of receptors for chemicals found in Cannabis?

A second cannabinoid receptor, CB2, was discovered in 1993, in a surprising place: a rat spleen. In a very short time, researchers looking specifically for these receptors in humans found a wealth of them – and in a variety of places in the body! CB1 receptors are most plentiful in the brain and central nervous system; CB2 receptors are found widely in the immune system and peripheral organs. Both receptors are also found in the gut.

Of course, the presence of chemical receptors in the body suggests there are endogenous chemicals (chemicals produced in the body – “endo” means inside) that are interacting with those receptors. Molecules that bind to receptors are called ligands, and soon enough, scientists discovered the endogenous ligands for those receptors.

Research into the function of this signaling/responding system – what has been named the endocannabinoid system (ECS) – is current and ongoing. In recent years, scientists have learned that the ECS plays a role in regulating a number and variety of physiological functions, including appetite, temperature, motor control, fertility, mood, and pain, to name a few.  

When activated by a loss of homeostasis, the body produces  and releases endocannabinoid ligands (cannabinoids made inside the dog’s body), which bring the affected system back into normal balance. Once they are finished with their job, there are also enzymes that help break down the endocannabinoids.

According to “Review of the neurological benefits of phytocannabinoids,” published in Surgical Neurology International in 2018, “Manipulations of endocannabinoid degradative enzymes, CB1 and CB2 receptors, and their endogenous ligands have shown promise in modulating numerous processes associated with neurodegenerative diseases, cancer, epilepsy, and traumatic brain injury.”

We’re getting to CBD . . .

The ingestion of derivatives of Cannabis plants affect humans and other mammals (like our dogs) because they contain ligands that just happen to interact with CB1 and CB2 receptors in our bodies. These chemicals may be referred to as exogenous cannabinoids (“exo” means outside; exogenous means they were made outside the body) or phytocannabinoids (“phyto” means “of a plant”).

Here is a fact that might surprise you: There are more than 100 different cannabinoids found in Cannabis plants. Again, because of its significant psychoactive effects on mammals, THC is the best-known. But the first cannabinoid compound that was identified in Cannabis was dubbed cannabidiol (CBD). Though it is quickly rising in the Cannabis-sourced cannabinoid popularity contest, when it was first identified (in 1940!), it was more or less dismissed by the chemists who mapped its chemical structure as having “no marihuana activity.” 

They were correct: CBD does not have psychoactive effects. But its growing population of fans in the medical community think it may have benefits in relieving pain, nausea, anxiety, depression, and seizure activity, among many other potential benefits in animals that have cannabinoid receptors in their bodies (humans and dogs among them).

Let’s talk about what is known about CBD, what is yet unproven, and why I can’t make any recommendations to my clients, pro or con, about CBD products.

Popularity Boom

The rapidly growing population of CBD fans in the medical community think it may relieve pain, nausea, anxiety, depression, and seizure activity. You may hear even more claims for its purported benefits, but these are the ones that, so far, have the most scientific evidence to support them.

Those claims sound amazing! So why isn’t the veterinary community jumping on the use of CBD for pets? Well, it’s complicated.

For the most part, the claims of CBD’s health benefits for pets are being made on the strength of pharmaceutical company research that has used synthetic analogues of cannabinoids; widespread anecdotal evidence; and very small, very recent studies of CBD on dogs.

The ability to study CBD in research labs was highly compromised until very recently. For many years, pharmaceutical companies that wanted to investigate cannabinoids have had to use synthetic versions. That’s because, in the United States, Cannabis was officially outlawed for any use (medical included) with the passage of the Controlled Substances Act of 1970.

However, in 2018, plants classified as “hemp” – Cannabis species with less than 0.3% dry weight of the psychoactive cannabinoid substance, Delta-9 tetrahydrocannabinol (THC) – were descheduled as controlled substances by the 2018 Farm Bill. This removed significant research barriers for both academic and commercial research into CBD, as well as legal barriers for growing and harvesting these plants, then refining and selling products that contain CBD to the public. In response, the market has been flooded with CBD-containing products for humans and – of particular interest to readers of this journal – dogs!

Supplemental Problems

While this might be a good thing, it does introduce new problems. First, these products are not subject to any regulatory oversight. Why? Because they have been classified as “supplements,” not “drugs.”

Any drug that makes therapeutic claims (prevents, cures, or manages disease) must be approved by the U.S. Food and Drug Administration (FDA). This ensures that the drug is safe and effective.

However, this process does not apply to products that are considered to be supplements, which is how most CBD products are currently treated. By virtue of the Dietary Supplement Health and Education Act of 1994 (DSHEA), supplements may not be labeled or marketed for the prevention, diagnosis, treatment, mitigation, or cure of disease.

Instead, supplement manufacturers can make only “structure or function” claims: They may only “describe the role of a nutrient or dietary ingredient intended to affect the structure or function in humans” (or pets) or “characterize the documented mechanism by which a nutrient or dietary ingredient acts to maintain such structure or function.”

Does that sound like gibberish? A 2018 article entitled “How to Market CBD Products in a Sea of Uncertainty,” published in Cannabis Business Executive (it’s an actual thing) clarified the difference and offered these tips to companies that aspire to produce and sell CBD-containing companies:

What are the Dos for a CBD vendor?

  • Do utilize cosmetic claims (“beautifies,” “improves”).
  • Do refer to emotions (“decreases irritability”).
  • Do use words like “wellness,” “supports,” “maintains.”
  • Do refer to general body parts including systems.
  • Do use qualifiers like “mild” and “occasional” to differentiate a temporary condition from the symptoms of the disease.
  • Do use FDA disclaimer but only with structure/function claims: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent disease.”

What are the Don’ts for a CBD vendor?

  • Don’t use words like “treat,” “cures,” “repairs,” “acute,” “disease,” “chronic.”
  • Don’t mention diseases like cancer, fibromyalgia, osteoarthritis.
  • Don’t refer to symptoms like fever, coughing, sneezing.
  • Don’t use disease claims.
  • Don’t recommend any product to augment another drug.
  • Don’t recommend a product as a substitution for another drug.

Further, since there is no legally required pre-sale testing or oversight of the production or labeling of supplements, it’s quite possible that there is no resemblance between what a label says and what is actually in the product. No tests are required to determine the purity or safety of any of these CBD supplements – or to confirm the reliability of any testing that a manufacturer may claim to have conducted.

It’s the wild, wild west out there! A study published in the Journal of the American Medical Association in 2015 found that CBD/hemp products were significantly mislabeled and often contained much more or less CBD than reported. Other concerns include purity and adulteration with substances possibly toxic to dogs, such as xylitol.

Current Studies

Those of us who like our supplements to be served along with a healthy dose of scientific data supporting their use are holding off on trying out these products for a bit longer. Other than a handful of small-scale studies looking at the use of CBD oil in dogs, there is no data on veterinary usage. Most available information is individual case studies and/or anecdotal.

So far, there have been only three studies that have evaluated the use of CBD in dogs.

It’s big business: This is just one of more than 40 booths at the 2019 Global Pet Expo pet products trade show for a company that is marketing CBD supplements for dogs.

 

The earliest was published in January 2018 in Frontiers in Veterinary Medicine and evaluated the oral pharmacokinetics, safety, and efficacy of CBD oil. The results showed that CBD in the concentrations used appeared safe, well-tolerated, and to decrease pain associated with osteoarthritis. Serum alkaline phosphatase, a liver value (SAP or ALP) was noted to increase, but this is not uncommon with many drugs, including phenobarbital and prednisone. This is called liver induction and can occur with drugs that rely heavily on liver metabolism. The significance of this finding is not known.

A second study, published in September 2018, evaluated adverse effects when CBD oil was given to a group of 30 healthy research dogs. Several different formulations were used, and despite the differences, all the dogs in the study developed diarrhea. Some also developed elevations in SAP, as in the first study. Overall, the CBD was considered to be well-tolerated but more research is needed on the significance of the associated diarrhea, as well as the liver enzyme increases.

A random sample: CBD supplements for dogs come in oils, tinctures, chews, cookies, and more.

 

Very recently (June 2019), a study was released evaluating CBD oil used in combination with antiseizure medications in dogs with intractable epilepsy. One group received CBD-infused oil, and the other received a placebo. The seizure frequency did decrease in the CBD oil group, but the results need further study. As in previous studies, SAP was increased in many of the patients.

The American Veterinary Medical Association is actively encouraging well-controlled studies into the uses of cannabinoids at this time. It is also working with the FDA to encourage the development of veterinary-specific products. State veterinary associates are making strides, as well, in addressing the sudden abundance of products and claims.

Veterinary Constraints

Veterinarians and “Legal” CBD Products

There is not a single medication containing CBD that is approved by the United States Food & Drug Administration (FDA) for animals.

In 1994, the FDA introduced the Animal Medicinal Drug Use Clarification Act (AMDUCA), which allows veterinarians to use medications in patients “off-label”  – using the drug in a manner that is not in accordance with the approved label directions. Using a drug in this manner can include using a drug in a dose, frequency, or route of administration that is not on the label or in a species for which it is not labeled. So, for example, we may use drugs that are FDA-approved for humans on our animal patients. This must be done within the bounds of a valid veterinary-client-patient relationship.

There is only one Cannabis-derived medication containing CBD that is FDA-approved, and so could conceivably be prescribed or recommended legally “off-label” by a veterinarian for a dog. That drug is Epidiolex, and it is used for the management of seizures in humans with specific types of abnormalities. But the estimated annual cost of this medication is $32,500, making it prohibitively expensive for the majority of dog owners.

One more thing you must know: By law, veterinarians are currently prohibited in every state from dispensing or administering cannabis or cannabis products to an animal patient. It doesn’t matter if your dog suffers a chronic, painful condition or seizures. It doesn’t matter if the product is a supplement (rather than a drug), and you were able to buy it in a pet supply store.

Except for veterinarians licensed in California, Colorado, and Oregon, we can’t even legally discuss CBD products with our clients. Why are veterinarians in those states allowed to talk about it?

In late 2018, California became the first state to pass veterinary-specific legislation that amended the state’s Business and Professions code to allow veterinarians to discuss Cannabis and its derivatives. It also requires that the California Veterinary Medical Board develop guidelines for these discussions by the year 2020. Like every other state, however, California’s code also specifically “prohibits a licensed veterinarian from dispensing or administering Cannabis or Cannabis products to an animal patient.”

The Colorado Veterinary Medical Association’s position statement on what it calls “marijuana and marijuana-derived products” says that the state “recognizes the interest of companion animal lovers and veterinarians regarding the potential benefits of marijuana therapies for a variety of animal medical conditions. Similar to human medicine, there is extremely limited data on the medical benefits and side effects of marijuana products in companion animals.”

Further, the Colorado position statement clarifies that veterinarians licensed in that state “have an obligation to provide companion animal owners with complete education in regard to the potential risks and benefits of marijuana products in animals. . . . Any discussion regarding a specific marijuana product as part of a companion animal’s therapeutic regimen should be consistent with a valid veterinarian-client-patient (VCP) relationship.”

Veterinarians and “Legal” CBD Products

There is not a single medication containing CBD that is approved by the United States Food & Drug Administration (FDA) for animals.

In 1994, the FDA introduced the Animal Medicinal Drug Use Clarification Act (AMDUCA), which allows veterinarians to use medications in patients “off-label”  – using the drug in a manner that is not in accordance with the approved label directions. Using a drug in this manner can include using a drug in a dose, frequency, or route of administration that is not on the label or in a species for which it is not labeled. So, for example, we may use drugs that are FDA-approved for humans on our animal patients. This must be done within the bounds of a valid veterinary-client-patient relationship.

There is only one Cannabis-derived medication containing CBD that is FDA-approved, and so could conceivably be prescribed or recommended legally “off-label” by a veterinarian for a dog. That drug is Epidiolex, and it is used for the management of seizures in humans with specific types of abnormalities. But the estimated annual cost of this medication is $32,500, making it prohibitively expensive for the majority of dog owners.

Oregon’s Veterinary Medical Examining Board emailed its members a memo in August 2016 stating, “Veterinarians may discuss veterinary use of Cannabis with clients, and are advised to inform clients about published data on toxicity in animals, as well as lack of scientific data on benefits. Please be aware that a client’s written consent is needed for any unorthodox treatment.”

The states’ legislation and veterinary medical board rulings will likely change quickly, as the landscape of Cannabis use is rapidly evolving. But at the moment, with many veterinarians fearing that they could face legal repercussions for violating their state regulations, few pet owners have much recourse for discussion about CBD with veterinarians.

You Are On Your Own

I’ll repeat this: If you decide to administer products that contain CBD to your dog, you need to be aware that they are untested and unapproved, and that your veterinarian may not have any experience or reliable information about any adverse reactions your dog experiences.

If you are taking your dog to a veterinarian for treatment, tests, or advice and your dog is receiving CBD products of any kind, make sure that the veterinarian is aware of this; ideally, she can alert you to the dangers of any potential adverse drug interactions between the CBD and any prescription drugs (or other supplements) that you may be giving your dog.

Your veterinarian also should be alerted to help you be the lookout for side effects – or perhaps, one would hope, to recognize any signs of improvement in your dog’s health and/or comfort.

46 COMMENTS

  1. As Trump’s Secretary of Agriculture has virtually , as of 7/19/19, Dismembered the FDA, the Po premier Research Lab in the World, it’s Highly Unlikely ANY New Studies on ANYTHING will be done! 100% of Researchers were ORDERED to Move to St. Louis, where NO Facility even exists, given only One Month’s Notice to Do So, @ their Own expense, or be Fired! Not even extensions for Severe Medical reasons were granted! This has been “masked”, so the public won’t know, but truly Concerned And Resoected Journakists Have Teoorted it!!!

      • You know. Pamela is correct and this is something to think about. Furthermore, the “new” FDA is in the pockets of Big Pharma and big AG. Why do you suppose, with people using CBD and pets they haven’t focused in on getting doing research and doing studies on products with CBD oil? Smart people SHOULD be concerned. I haven’t had the need so far to use CBD oil on my dogs. But many friends of mine have and other breedeers, primarily for anxiety issues use it, and IT WORKS for that. No sides effects. Should I need it for any of my dogs, I will feel much more comfortable with this natural product than with the chemical based products that our vets may prescribe, with many potentially harmful side effects. It’s sold, over the counter, in health food/dog food stores for people and dogs. Anecdotally, it’s a safe product as products go. So when are studies, testing and approval going to be done? Probably with a new administration that promots science again, so yes, politics need to be mentioned.

        • Well said, Pamela and Randi! The current occupant of the White House and the current administration are anti-science and not to be trusted regarding the welfare of our pets, citizens, and environment! Unbelievable what they are trying to do to the scientists and employees in the FDA! I hope Congress puts a stop to the exodus, i.e., brain drain!

        • I agree with Susan. We can’t ignore the negative impact of this administration on our pets’ health. We need to be aware and try to fix this problem. But we need a different administration as this one is trying to erase science from the dictionary. And it is a fact, that this is harming our pets.

        • Interesting that I found this thread Randi. I met with a doctor only yesterday for lunch. He is launching a line of CBD products for dogs and he is in the process of doing extensive research on his products which are organically grown. He will be lab testing for strength and shelf life and will be marketing a high quality product with studies to back it up. We talked about market saturation with all types of products and what will set him apart is the extensive quality controls and lab testing of his product. He has extensive background with use CBD oil on humans. He is currently setting up blind studies for dogs. Will be most interesting to see where this goes and what his results reveal.

          • My dog has been diagnosed with Valley Fever and suffers from periodic seizures from the disease. The medication they have her on makes her lethargic, dizzy and confused. CBD has been shown to reduce seizures in children with epilepsy, why can’t it help dogs? I am willing to put my dog in the clinical trial for the use of CBD to treat animals. Not sure where to look. I can’t see myself spending $300 month on pills that are slowly killing her and most definitely her spirit. Any information you have on this study would be much appreciated. Thanks

        • I have read most of what is on this thread. Seems as if Facts as you say are pretty limited as of now. So this isn’t a political sight, I understand. I have come to realise however, every aspect of my life including caring for my pet is profoundly impacted by the political scene

      • I have several friends at Gov labs in EPA, FDA, and NOAA whose taxpayer paid for data is now hidden from them, but is available to the lobbyists running their departments and their businesses. Some managed to back it up on the cloud so research can continue if things ever go back to normal.

    • Pamela Taylor, you are correct! This is an important point. Until we have a new Administration that believes and promotes science again, much research will be on hold, which is a reply to this WDJ article and simply the truth. The political climate now is a road block and this needs to be said. I’m glad I live in Colorado and don’t buy my head in the sand.

  2. Whole Dog Journal,
    Let me say this, I absolutely LOVE your article and all the research you are doing!!! AWESOME, AWESOME!!
    Nobody actually researches anything anymore, but thats this new culture, just take someones word,NOT! I spread the word with every moment I get about Whole Dog Journal, the best information anywhere for You & Your Dog!!

    Keep up the great work.
    Scott

    • ElleVet Sciences and Dr. Joe Wakshlag of Cornell have completed 1 clinical trial and have a published paper, and have 5 more clinical trials in the works right now! The most researched and tested product available is ElleVet and the results with one product cannot be attributed to another CBD product because they are not all the same. Make sure anything you use is the actual product that has been tested.

  3. Colorado State University Vet Teaching Hospital is doing their second canine CBD trial right now. They researched it previously in dogs with arthritis; now are doing it for dogs with uncontrollable epilepsy. Our dog is in this trial and I am very impressed by their professionalism/science/dedication. (I work in the clinical trial field; we drove 4200 miles round-trip to enroll him – well worth it!)
    For more info go to: csuvth.colostate.edu and scroll down to ‘Ongoing Clinical Trials’ on the right side of the page

  4. There is a difference between CBD oil derived from hemp and CBD oil derived from marijuana. The hemp version is available online and OTC. Until the laws changed (in California), the marijuana version was only available with a medical card at a dispensary. I had a dog with epilepsy. He was on a lot of drugs…phenobarbital, levetiracetam, zonisamide, many others. My dog’s seizures were very erratic and impossible to predict so it’s hard to know if CBD oil helped, but I belonged to a canine epilepsy list and the marijuana CBD oil was widely recommended. This was in 2016-2017, so fairly recently. Anecdotal, yes, but the list had hundreds of members, many with extensive knowledge of epilepsy and medications, and CBD oil was very widely used to great effect. But only the marijuana version, not hemp.

  5. This is such an important article and mirrors conversations I’ve been having with friends. I believe there likely
    are therapeutic applications from CBD & THC, but right now we just don’t know. Except in the 3 states listed, you can get plenty of CBD oil advise from the teenager working at your local pet store, but not from your vet. I recently attended a health fair and easily half the products there had some CBD oil connection……everything from honey to lube. So many folks trying to make a buck on the CBD oil wave. Without testing and appropriate regulation all we’ve got is snake oil.

  6. First, I’d like to say “thank you for the great article”. I would also like to point out studies are being done elsewhere such as universities and abroad so I think more info will be coming but like everyone, we wish it were here now. I have found companies that manufacture cbd products that are organic and some that manufacture without using chemicals. One interesting note I learned in my extensive research is that labeling is inconsistent right now but that is starting to change. You see, if the label says 1500mg of cbd (at least with hemp versions) then that usually means the whole bottle contains 1500 mg not each dose. Many manufacturers are now adding or changing labels to include actual amt of cbd per dose.
    Lastly, I would like to say that I avoid politics at all costs on public forums and in general but I often disagree with certain pieces of legislation introduced or passed by both parties presently and past but that doesn’t make me a “Trump/Obama/Bush/Clinton/Bush/etc hater or lover. So, pls lets not get so offended or nasty if someone doesn’t agree with a move any administration makes (as they all have made some mistakes) AND lets not use this forum to further political divide.
    Thx again for your thoughts.