More Good News on CBD and Canine Arthritis

I have been trying to keep up with the clinical trial literature evaluating cannabis (primarily CBD) in veterinary patients. There is a lot of research happening right now, so it is challenging to keep current even on this limited subset of studies, but fortunately I know some folks who are much more involved with CBD research and can pass along new evidence as it gets published. So far, clinical trials show promising results for treatment of arthritis pain in dogs and not so promising results in one study evaluating CBD for treatment of canine epilepsy. Another small study looking at treatment of arthritis in dogs (along with some lab animal and human effects) has recently been published which strengthens the case for use of CBD in these patients.

Verrico CD, Wesson S, Konduri V, et al. A randomized, double-blind, placebo-controlled study of daily cannabidiol for the treatment of canine osteoarthritis pain [published online ahead of print, 2020 Apr 24]. Pain. 2020;10.1097

This study included a relatively small number of dogs (20) divided into 4 groups: placebo, two different doses of plain CBD, and a type of CBD packaged chemically into little globules called liposomes, which can influence how some drugs are absorbed and distributed in the body. The study used subjective assessment of arthritis symptoms by both veterinarians and owners, and both groups were blinded to the treatment each dog received.

The study found statistically significant, and potentially clinically meaningful improvements in most measures for the high-dose and liposomal CBD and no improvement for the low-dose CBD or placebo. The lack of a placebo effect is always a bit of a concern since such an effect is usually seen in pain studies in dogs, and the absence of a caregiver placebo can be a sign of a methodological problem in a study. However, the apparent dose-response, with greater improvement seen at higher dose, is a good sign since this is commonly seen with most pharmaceutical effects. There were no signs of adverse effects or abnormal changes in blood tests.

The non-clinical measures in mice also showed some changes in modulators of inflammation which support a plausible mechanism for clinical effects, a necessary step in building an overall picture of the value of any drug therapy.

While this is a small study, and no single trial is sufficient to make a definitive judgment, this is good quality evidence which is consistent with other existing studies, and it strengthens the case for CBD as a potential treatment in dogs with arthritis. All of the usual caveats apply- this doesn’t support any of the hundreds of other claims for CBD; many over-the-counter CBD products have uncertain ingredients and poor quality control, so even if CBD has real benefits they may not be seen with poorly regulated products; there is stronger evidence for the benefits and potential risks of NSAIDs, and these are still a first-line treatment for arthritis in appropriate cases, along with weight management and other existing strategies. On the whole, though, the evidence is getting better and better, and the value of CBD for dogs with arthritis seems likely to be quite high.

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6 Responses to More Good News on CBD and Canine Arthritis

  1. Mason says:

    Hello,

    I have only read a few of your posts so far, but they have been very helpful. They are very informative and help me to think more clearly about things. Everyone seems to be trying to scare me into new methods of taking care of my dog… even though dogs have been around for a long time and have lived full lives before all of these new ideas about supplements and raw food diets…

    I had a friend who was a groomer, and she told me that purebred dogs have more genetic issues while mixed breeds have a better chance of escaping some of those genetic issues. Are there any reputable studies that support this?

    Also, Are there any proven ways to prevent joint problems in large dogs?

    Is there anything specifically known to cause cancer in dogs?

    If I buy cheaper dog food, will it be harmful for my dog?

    I apologize for all of my questions (for all I know, you’ve already answered them in other posts)… but, this is the first I’ve seen actual information in all my searching…
    People tend to say studies exist, but don’t reference any directly… I appreciate the work you put into your site. I’m sure you’ve helped many in my position. It shows that you truly do care about animals because you rely on the facts… rather than those who say they care yet rely on their imaginations…

  2. skeptvet says:

    Thanks for the questions and feedback.

    1) purebred vs iced breeds: It has long been believe that purebreds have more health problems due to inbreeding, but this has been hard to prove (and also this). Biology and genetics are complicated, and the answer depends on the breed, the condition, and other factors. Certain breeds have known health risks that other breeds and mixed breed dogs do not, but any individual mixed-breed dog can still have significant genetic or congenital health problems.

    2) Joint problems- The only thing you can do that will ABSOLUTELY reduce the risk of joint problems is not let your dog be overweight. A healthy body weight has huge benefits, for joint disease and other health problems. Beyond that, there is no good evidence that specific foods, supplements, activities, etc. make a difference.

    3) Cancer- Again, biology is complicated. Each specific cancer in an individual has a variety of factors leading to its development. These may be genetic or environmental or an interaction between the two. It is really more useful to think in terms of risk factors rather than causes, since any change is not going to absolutely causer absolutely prevent cancer, but specific factors can modify the risk. As already mentioned, obesity is a down risk factor for some cancers, so this is the most readily avoidable risk. Neutering can increase the risk of some cancers and lower the risk of others, so the impact will depend on the sex, breed, and age of the dog, which I have discussed elsewhere. Lots of environmental factors are known in humans (e.g. smoking, alcohol, red meat) that may or may not also be concerns in dogs, but the idea that specific “toxins” in food or the environment cause cancer and can be avoided or “superfoods,” supplements, and other magical. things prevent it is a gross oversimplification.

    4) Cost of food and nutritional value or not reliably related. A food that meets AAFCA standards and comes from a company with an established track record and with full-time veterinary nutritionists on staff is likely to be acceptable for most dogs. However, every dog is different, and there is some trial and error involved in finding a food that works for your dog. Here’s a great book on canine nutrition you might like.

  3. Jen Robinson says:

    I’m in New Zealand and CBD for human use is prescription only and difficult/expensive to get here. I don’t think it’s available at all for veterinary use. Is CBD use common in veterinary practices in the US? Are there well controlled formulations on the market (preferably at reasonable prices)? Are you seeing a lot of demand for it?

  4. skeptvet says:

    OMG, it is everywhere! I would guess half my clients are giving it in some form, usually for something there is zero evidence to support.

    The completely unregulated market, unfortunately, meat that almost none of the products have any quality control, so whether there is any CBD or how much, whether there is too much THC, and whether there are undisclosed contaminates is completely unknown. Lots of formulations that are likely worthless (e.g. cookies or water-based formulas when pharmacokinetics suggests only absorbed at effective levels in an oil base).

    I usually recommend using a brand that provides independent laboratory testing of each batch with a certificate of analysis. One of the clinical trials for DJD used the ElleVet product, so there is at least some direct evidence for that one.

  5. Dr. Joseph Frost says:

    I have yet to have any clients report any improvement for any disorder with CBD oil but….do you think simply an increase in anti-inflammatory fatty acids could be the mechanism of action for CBD and arthritis?

  6. skeptvet says:

    There is pretty good basic science behind the proposed mechanism for CBD and arthritis pain since the endocannabinoid system is a significant player in the mediation of nociception as well as inflammation. The vehicle in at least one of the studies was olive oil, which is higher in omega 6 than omega 3 EFAs, so I wouldn’t expect a major anti-inflammatory effect from that, though I admit it’s not my area of expertise.

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