Veterinary care is all about one thing above everything else: providing the best possible care for the animals in our charge. To do so, we as veterinarians need knowledge of the most effective options for treating various ailments, from advanced cancers to simple anxiety and stress. Sometimes, that means medications. Other times, physical therapy. And occasionally, it means more natural remedies.
Today, there's an ongoing trend in both human and animal medicine. That trend is a combination of distrust of modern medical practices, avoidance of them due to their expense, and a belief that older, more natural remedies may be as effective as medicines. The headliner for much of this is CBD.
There's a lot of nuance to this issue, and there's not necessarily even a single right answer. What should you know as a vet, and how can you navigate the situation? Let's discuss the myths, facts, and realities of CBD and its role in veterinary care.
What is CBD?
For a refresher, crash course, or simple clarification, it's worth discussing what CBD even is.
The cannabis plant is a useful plant. It grows quickly and produces strong fibers that can be woven into anything from rope to fabric. The leaves contain a variety of chemicals broadly known as cannabinoids, the two most important of which are CBD and THC.
THC, of course, is the psychoactive compound responsible for a variety of physiological effects when consumed and is the core reason why cannabis as a whole has been prohibited by law for so many years. It's only recently that studies proving the general safety of the compound have led to general legalization in parts of the country.
CBD, meanwhile, is a different compound with different effects. It's not psychoactive the way THC is, but it has effects of its own, both alone and in conjunction with THC. You can read more on the biology of the endocannabinoid system here.
CBD has long been more or less legal, but since the production of the compound required growing plants that could themselves be illegal, it existed in a sort of gray area for many years and has only recently been growing in popularity as both a natural medicine and a remedy.
Are Herbal Remedies Better than Medicines?
This is a tricky question to answer.
On the one hand, any time a plant or other molecule is found to have some form of therapeutic effect, you can bet that there will be some pharmaceutical company somewhere willing to buckle down and try to isolate and improve it. A huge array of modern medicines are essentially synthetic versions of existing plant compounds.
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This has a few added benefits. For one thing, by purifying and synthesizing the compounds, you have a more consistent idea of the purity and dosage of any given sample. With plants, each individual plant can have a huge variety of different compounds in it, some of which may be harmful or otherwise dangerous; moreover, different plants can have different concentrations of the helpful molecules you're seeking. These can vary based on soil conditions, sunlight, and much more.
Pure substances are also easier to test and control for unwanted variables, and they have both been evaluated in labs and validated by organizations like the Food and Drug Administration. Plant-based substances are generally too inconsistent to be qualified.
On the other hand, countless traditional herbal remedies and other medical practices developed hundreds of years ago have been broadly ignored as folklore and superstition. Yet many of them eventually, when tested, prove to have some basis in fact. Maybe they aren't necessarily as efficacious as modern medical equivalents, but they weren't nothing. It's difficult to dismiss herbal medicine out of hand.
Meanwhile, herbal options are often (though not always) less expensive and potentially more broadly available than pharmaceuticals. When one of the leading concerns in veterinary medicine is the cost of treatment, this is a benefit that should not be overlooked.
This brings us back to CBD. Is it effective? Can it be a useful treatment option, and if so, for what?
Myth: CBD Doesn't Have Medicinal Properties
Fact: CBD has a tangible effect on the bodies of both humans and animals.
Many people who don't otherwise know the biology of the endocannabinoid system may believe that THC is the active ingredient in cannabis and that CBD is little more than a plant oil extracted from it and marketed as a legal alternative before legalization was as widespread as it is now.
The truth is that CBD has been studied and has viable effects. In humans, it has only been approved for one purpose, which is the treatment of seizures caused by a handful of specific syndromes. Beyond that, though, proponents tout its effects for a variety of purposes, including pain management, nausea abatement, and as an antianxiety and antidepressant medication. Many people promote it as a solution to certain types of chronic pain, insomnia, and anxiety.
That's in humans, though. What about animals?
Myth: Animals are Different from Humans and Can't Use CBD
Fact: Many animals have endocannabinoid systems similar to humans.
The truth is that the endocannabinoid system is not unique to humans. In fact, it has been found to be pervasive throughout mammals. As veterinarians, of course, we're generally going to be concerned most with cats and dogs.
Though the biological expression of the endocannabinoid system remains largely similar across species, the actual way it affects the body will differ. CBD is most well-studied in dogs, and in a prime example, endogenous ligand binding is 30x less in dogs than in humans. Note that this doesn't necessarily mean that CBD is 30x less effective, just that this particular biological mechanism isn't as primed to operate the same way.
Cats also have the endocannabinoid system, but it's even less well-studied than the system in dogs.
A few studies have been showing promise in treating seizures in dogs using CBD, similar to how it's used in humans. However, the available studies are thin on the ground and small, so it will take significantly more study and investment to determine what the best options will be moving forward.
Myth: CBD is Illegal to Use, Even for Animals
Fact: CBD used to be illegal but has been made legal by the 2018 Farm Bill.
Years ago, anything cannabis or cannabis-derived was illegal across the board. There are many reasons for this, from puritanical anti-drug morality to cotton lobbies wanting to fight back against hemp, but all of that is beyond the scope of our discussion.
In 2018, the farm bill broadly legalized cannabis as long as whatever plant or product grown or created contains less than 0.3% THC. At this low level, the psychoactive effects are considered negligible. CBD, however, has enough of an impact on its own that, now legalized, it can be used.
That said, it once again applies to humans. Animal medicine is another story. According to the American Veterinary Medical Association, vets currently aren't allowed to prescribe, administer, dispense, or even recommend CBD for the treatment of animals. It's broadly illegal under both state and federal law, and being caught doing so can lead to a variety of penalties.
This may or may not be true for long. THC and CBD are receiving an increasing amount of study, along with public pressure to legalize them across the board; in the coming decade, it might not be out of the question for broad legalization. Of course, medical studies take time, and the FDA approval process is rigorous, so it will likely be quite some time before either is truly considered medicine.
Myth: CBD Has No Real Side Effects on Cats or Dogs
Fact: CBD, while generally mild, can still have real side effects.
Despite being illegal for vets to prescribe or recommend, nothing stops individuals from purchasing CBD tinctures and using them on their own. As such, it's important for vets to know what the side effects might be. Even if you can't recommend CBD, you can still discuss it with your clients if they ask. So, what are the side effects of CBD?
In dogs, known side effects of CBD can include:
Dry mouth. For dogs, this tends to directly correlate with increased thirst.
Low blood pressure. Generally, this drop is very minimal, so unless a huge dose is given, most dogs won't even notice. That said, if a dog already has low blood pressure issues, CBD can be an added danger.
Drowsiness. While one of the main potential benefits of CBD is calming anxiety and helping with insomnia, that does mean it has the effect of promoting drowsiness. Dogs on CBD may be more lethargic and sleep more.
While CBD isn't known to be toxic to dogs, there's also very little study into it. It's possible that it could be dangerous in high doses. Moreover, since concentration and purity aren't regulated, clients will need to be cautious with where they get the CBD and how they administer it. Dosing charts are typically based on weight, which, while fairly standard, still requires some interpretation.
Myth: CBD is Unsafe to Purchase Because it's Unregulated
Fact: While there are certainly challenges to buying CBD, it's generally safe in most cases.
Since legalization, there are a lot of producers of CBD springing up across the country. More importantly, since FDA regulation and enforcement aren't available, a variety of third-party labs have started offering services to verify the purity, quality, and concentration of batches of CBD. In fact, common advice for purchasing CBD – for humans or for animals – is to seek a lab report and never buy from a company that doesn't offer one.
Generally, clients should be advised that if they plan to purchase CBD, they should make sure it's in liquid form so they can adequately adjust dosages. CBD-infused treats and other items aren't as well governed, and dosing is much harder, especially for smaller dogs.
It's also important to consider quality over price. Since costs are a main driver of turning to herbal alternatives over modern medicine, it can be tempting for clients to seek the cheapest supply they can get. Unfortunately, the cheaper the CBD, the more likely it is to have things like pesticides or heavy metals in it, which are much more dangerous than the CBD itself.
Should You Advocate for CBD Legalization for Vets?
Part of the ongoing debate over THC and CBD in general is the medicinal properties, which most believe deserve more study, even if you don't support full legalization. CBD has promising medical effects in humans, and anecdotal evidence suggests that dogs can benefit from it as well. Cats are a trickier subject; fewer people buy CBD for their cats, the effects are more difficult to notice, the endocannabinoid system of a feline differs from that of dogs, and overall, less study has been performed.
At the end of the day, what it comes down to is your personal stance on the matter. As a vet, your goal is to provide the best possible care. That may mean pushing for the further exploration of additional options, particularly organic, readily available options like CBD. On the other hand, you can't do your patients any good if, through violating the law, your ability to practice is revoked. In general, it's best to answer questions as factually as you can, avoid recommending the substance until it's fully legalized, and keep an eye on developing science to determine whether or not it's something you should advocate for.
How else can you advocate for your patients? One option is to make sure you're getting a robust perspective on the more complex issues you handle from day to day. While you're perfectly suited to the common issues you normally see, there are always going to be outliers and unusual cases that don't present with typical, easily diagnosed symptoms.
That's where we come in. At Hope Vet, we're a consulting group with decades of veterinary experience. We're more than happy to offer second opinions, thoughts, and other advice for complex cases, ranging from oncology to internal medicine and more. It's simple to get started, too; just click the "request a consult" button above.