Cannabis, Cannabidiol Oils and Tetrahydrocannabinol—What Do Veterinarians Need to Know?
3. The History of Cannabis Use in Veterinary Medicine
4. The Cannabis Industry in the EU and North America
4.2. North America: US
4.3. North America: Canada
5. Regulatory Framework in the EU and North America
5.1.1. Human and Veterinary Medicinal Products
Authorisation as Food Ingredient or Additive
5.1.2. Animal Feed
5.1.3. Pet and Equine Supplements
5.2. North America: US
5.2.1. Human and Veterinary Medicinal Products
5.2.2. Authorisation as Food Ingredient or Additive
5.3. North America: Canada
6.1. Mechanism of Action
7. Use in Human and Veterinary Medicine
7.1. Use in Human Medicine
7.2. Use in Veterinary Medicine
8. Concerns Regarding Illegal Product Claims and Unknown Composition
9. Cannabis Toxicosis in Veterinary Medicine
9.1. Clinical Signs
9.3. Treatment and Prognosis
- If less than 30 min have passed since consumption, the animal should be decontaminated by inducing emesis and administering activated charcoal and cathartic. Repeated dosing with activated charcoal and cathartic may reduce the elimination half-life of THC by interrupting enterohepatic recirculation.
- If clinical signs have started, inducing emesis might be difficult (due to the psychoactive properties of THC) and could be dangerous if the patient is heavily sedated, as vomit could be inhaled and lead to aspiration pneumonia.
- Fluid support and keeping the patient warm may also be needed due to hypothermia. The patient should be rotated frequently to prevent dependent oedema or decubital ulceration.
- Diazepam can be given for sedation or to control seizures.
- Administer oxygen to assist respiration or relieve respiratory depression, if needed.
- Treat central nervous system depression, if needed.
- If the patient has lost consciousness, intense observation and support are needed. The chance of fatality is statistically small but possible.
- Recovery may take 24 to 72 h, or longer (up to 5 days), depending on the ingested dose.
10. Conclusions and Recommendations
- Well-controlled clinical trials (double-blinded, placebo controlled) and pursuit of EU/North American approval or approval at the national level by manufacturers of cannabis-derived products should be conducted, so that high-quality products of known safety and efficacy can be made available for veterinarians and their patients.
- Clinical trial studies should be encouraged to investigate the potential therapeutic value and safety of hemp-derived products for companion animals.
- Harmonize the analytical procedure of the determination of the THC level in serum and oral fluids and set up harmonised tolerable limits of cannabinoids in different products.
- Use of hemp-derived products for animals should require a veterinary prescription.
- Prohibition on producing pet food with cannabis-derived products without known safety and efficacy and without the knowledge of the intended purpose of the included cannabis-derived products as specified by the pet food manufacturers.
- The prohibition on producing feed supplements or beddings for food producing animals with CBD/Cannabis without known safety and efficacy and without knowledge of the intended purpose of the included cannabis-derived products as specified by manufacturers, and data on any residue in the food derived from these animals.
- We encourage veterinarians to act cautiously, as there may be risks associated with having such products in their possession if the product(s) were subsequently shown to contain illegal levels of THC. Any suspected breaches should be reported to Competent Authorities in the EU Member State where the event occurred.
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
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|Brand Name||Pharmaceutical Form||Active Substance||Clinical Indication||Approved In|
|Sativex (Nabiximols)||Oromucosal Spray||δ-9 THC and CBD from Cannabis sativa L.||Multiple sclerosis||Canada, EU|
|Marinol (Dronabinol)||Gelatin capsule||Synthetic δ-9-THC||Nausea with cancer treatment, anorexia with AIDS, multiple sclerosis||EU, US|
|Cesamet (Nabilone)||Capsule||Synthetic cannabinoid similar to THC||Cancer treatment||Canada, EU, US|
|Epidyolex/Epidiolex||Liquid to be taken orally||CBD||Against epilepsy||EU, US|
|Species (Number of Animals)||Dose/Time of Exposure||Objective||Result/Conclusion||Reference|
|Dogs (37)||CBD oil product at a dose of 0.25 mg/kg delivered in food, once a day for 3 days and then morning and night (approximately every 12 h).||To assess the impact of a full-spectrum product containing hemp extract and hemp seed oil on dogs with chronic maladaptive pain.||Thirty of the 32 dogs showed a significant improvement in pain reduction. The addition of a hemp-derived CBD oil appears to positively affect dogs with chronic maladaptive pain (decreasing their pain and improving their mobility and quality of life).||Kogan et al., (2020) |
|Dogs (16)||CBD oil (2 and 8 mg/kg) or placebo oil every 12 h.||To determine basic oral pharmacokinetics and assess safety and analgesic efficacy of CBD-based oil in dogs with osteoarthritis.||Pharmacokinetics revealed an elimination half-life (T1/2) of 4.2 h. at doses of 2 and 8 mg/kg. The peak serum concentrations of CBD oil 102.3 ng/mL and 590.8 ng/mL occurred at 1.5 and 2 h, respectively, for 2 and 8 mg/kg doses. CBD produced a significant decrease in pain and an increase in activity in the group treated with CBD||Gamble et al., (2018) |
|Dogs (23)||CBD treatment for 6 week (2.5 mg/kg per dog every 12 h).||To provide preliminary data describing the safety and effect of CBD for clinical signs relief of canine osteoarthritis associated.||Baseline data were acquired for 4 weeks, followed by the random allocation to the placebo group or CBD treatment group for 6 weeks, followed by 6 weeks with the opposite treatment. No differences were found between groups at any time point for any of the recorded outcome measures. Adverse effects associated with CBD administration included enzymes liver elevations and vomiting signs.||Mejia et al., (2021) |
|Dogs (20)||Four groups: placebo, 20 mg/day (0.5 mg/kg) naked CBD, 50 mg/day (1.2 mg/kg) naked CBD, or 20 mg/day liposomal CBD.||To support the safety and therapeutic potential of hemp-derived CBC for relieving arthritic pain.||CBD significantly decreased pain and increased mobility. Liposomal CBD (20 mg/day) was as effective as the highest dose of non-liposomal CBD (50 mg/day) in improving clinical outcome. It was demonstrated that the widely available supplement CBD exerts robust and quantifiable anti-inflammatory properties in experimental systems.||Verrico et al. 2020 |
|Wobbling, pacing and agitation|
|Others||Sound or light sensitivity|
|Fast or slow heart rates|
|Low body temperature|
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De Briyne, N.; Holmes, D.; Sandler, I.; Stiles, E.; Szymanski, D.; Moody, S.; Neumann, S.; Anadón, A. Cannabis, Cannabidiol Oils and Tetrahydrocannabinol—What Do Veterinarians Need to Know? Animals 2021, 11, 892. https://doi.org/10.3390/ani11030892
De Briyne N, Holmes D, Sandler I, Stiles E, Szymanski D, Moody S, Neumann S, Anadón A. Cannabis, Cannabidiol Oils and Tetrahydrocannabinol—What Do Veterinarians Need to Know? Animals. 2021; 11(3):892. https://doi.org/10.3390/ani11030892Chicago/Turabian Style
De Briyne, Nancy, Danny Holmes, Ian Sandler, Enid Stiles, Dharati Szymanski, Sarah Moody, Stephan Neumann, and Arturo Anadón. 2021. "Cannabis, Cannabidiol Oils and Tetrahydrocannabinol—What Do Veterinarians Need to Know?" Animals 11, no. 3: 892. https://doi.org/10.3390/ani11030892