client education materials

The endocannabinoid system (ECS) is a complex network of chemicals and receptors in our bodies and our animals’ bodies that help regulate various physiological functions and maintain balance known as homeostasis. Think of it as a team of messengers and receivers working together to ensure everything runs smoothly. The messengers, called endocannabinoids, are naturally produced by our own bodies. They travel around and bind to specific receptors, known as cannabinoid receptors, which are found throughout our body, including our brain, immune system, organs, and other tissues. Researchers have also discovered these endocannabinoids also bind to several other receptors.

When endocannabinoids bind to these receptors, they send signals that can affect things like pain sensation, mood, appetite, memory, sleep, immune function, and more. Essentially, the endocannabinoid system helps regulate these processes and keep our bodies in homeostasis.

In addition to the messengers and receptors, there are also enzymes that break down the endocannabinoids once their job is done. This ensures that the system remains balanced and doesn’t go into overdrive.

Interestingly, the endocannabinoid system can also interact with phytocannabinoids (also known as cannabinoids) found in the cannabis plant, such as THC (tetrahydrocannabinol) and CBD (cannabidiol). These cannabinoids can mimic the effects of our natural messengers – to an extent- or interact with the receptors in different ways, leading to various effects on the body and mind.

The endocannabinoid system itself can sometimes dysfunction which refers to a situation where the natural balance and functioning of the endocannabinoid system is disrupted or not working properly. Think of it like a miscommunication or a glitch in the system. Just like any other system in our body, the ECS can sometimes experience problems that can affect its ability to regulate different functions normally. This is where supporting the ECS with phytocannabinoids, things like CBD, come into play. By supporting the ECS with chemicals that are similar to the chemicals the body produces or offering more, we can supplement the ECS to hopefully create balance once again.

CBD has become popular in media as a useful supplement for many conditions including anxiety in animals. Unfortunately, there is little veterinary specific data to support CBD as a fix for chronic anxiety in animals without other interventions such as behavior modification and even other anti-anxiety medications. At Remedy we offer a unique opportunity to work with an internationally known cannabinoid researcher and practitioner that can give practical information on how to use cannabinoid containing products safely and effectively.

As mentioned in the seizure specific section (hyperlink), seizures are a complicated symptom of an upset brain. There is a ton of interest and science behind the use of administering phytocannabinoids to hopefully manage the frequency, severity, and length of seizures in animals. There is even an FDA approved CBD product for humans.

However, simply giving things such as CBD without proper guidance may be futile and even dangerous. So far, there are only two studies evaluating the efficacy of two different CBD products for managing seizure activity in dogs. Both studies were optimistic but not curative. Utilizing phytocannabinoids with conventional anti-seizure medications may be useful but should be done with the guidance of an experience cannabinoid practitioner to help find the right product, discuss possible side effects, possible drug interactions and assessing efficacy in your pet.

There are two broad categories of pain, adaptive pain (acute pain) and maladaptive pain (chronic pain). Adaptive pain is typical with tissue trauma such as a bite wound or surgery.

Maladaptive pain is a more difficult type of pain to manage, examples being osteoarthritis or nerve injury. Utilizing phytocannabinoids, like CBD, to help decrease pain is an emerging field of study for both animals and humans. To date there are multiple veterinary studies that have evaluated the efficacy of various formulas of CBD containing solutions to support the natural function of the endocannabinoid system to minimize pain specifically related to osteoarthritis in dogs. While there are no studies in dogs and cats for acute pain our clinical experience suggests supporting the ECS can also be advantageous for managing acute pain.

While it may seem like an easy option to administer CBD or other phytocannabinoids to our pets to decrease pain, there is a lot more to it than that. Each animal will respond differently to various phytocannabinoid containing products. We must also be mindful of potential drug interactions that may occur if your animal is already on other medications.

There is a lot of interest for the use of CBD or various other phytocannabinoids for a whole host of conditions. For somethings like irritable bowel syndrome (IBS), cancer, and dermatological conditions there is some scientific evidence. Others like canine and feline cognitive disorder, stomatitis in cats and immune system related disease there is less scientific evidence but an abundance of anecdote and successful clinical experience. At Remedy, we are one of a few veterinary hospitals in the world that are prepared to have these conversations.

Long-term monitoring

We may suggest liver enzyme monitoring for patients that will be on the product long-term, >3 months.

Common drugs where interactions may occur

Benzodiazepines- This is one of the most common drugs we see potentiating effects of even zero percent THC products. Animals may appear extremely lethargic or have symptoms similar to THC intoxication. While the idea of our animals being “high” may seem funny to some it is very stressful and potentially dangerous to animals.

Gabapentin, Acepromazine, Tramadol, Phenobarbital and Trazodone (or other behavioral drugs)- in some patients you may see lethargy, inappetence, abnormal behaviors and in severe cases urination. Dose de-escalating or escalating over time is usually warranted for the small percentage of animals that may experience these symptoms.

Product quality

How the product is produced and the ingredients are of the upmost concern when using these types of products. Please see the “Choosing a Product” page.

Broad Spectrum Products

Ideally, broad spectrum products are those that use a majority of the compounds found in the plant, whether that is from hemp or marijuana. During extraction, intentional or not, specific phytocannabinoids may be lost or removed. The same is true for terpenes. With broad spectrum products the entourage effect can occur. Manufacturers are attempting to define broad spectrum as “THC Free” or products that contain only a couple cannabinoids or terpenes.

While this could technically be true, we consider products with only a few compounds “limited spectrum” products.

Full Spectrum Products

A full spectrum product is one that contains all the phytocannabinoids and terpenes the plants have to offer- or spiked. Some purists define these as products that also use hemp seed oil as the carrier for the compounds. These are our preferred products to use not only because of their potential for a more pronounced entourage effect, but also often require lower dosing compared to broad or isolate products.

Isolate Products

Isolate products are heavily refined that contain only a single cannabinoid. Currently, the only FDA approved plant derived cannabinoid product is an isolate known as Epidiolex®.

What to Look for in a Cannabinoid Product

Many products, especially those high in CBD are readily available for the human market, many of them still contain levels of THC that may lead to toxicity in our patients (particularly dogs). This is especially true if a product is derived from marijuana, and not hemp. For this reason, products formulated specifically for veterinary species are better choices than those formulated for humans.

Because these products are not regulated by the FDA (just as human vitamins and supplements are unregulated), look for a company that adheres to current Good Manufacturing Practices, to ensure a clean supply chain and manufacturing environment.

Ask for a Certificate of Analysis (CoA) for any product you are thinking about purchasing. This is a third-party, independent laboratory analysis of the product. While there are issues with testing facilities and standardization, this is currently the best (only) way to evaluate the quality of a product.

The CoA should include:

• A breakdown of all cannabinoids present in the product

• We have good evidence that whole-plant (aka full-spectrum or broad-spectrum) products are more effective than products that contain ONLY CBD (such products are termed “isolates” and may require much higher doses to achieve the desired effect)

• The CBD:THC ratio in the product

• Terpene analysis

• Heavy Metal testing

• Herbicide / fungicide / insecticide testing

• Microbial testing

• Mycotoxin testing

• Residual solvent testing

  The company should also provide the following information:

• The amount of cannabinoids per mL

• A complete ingredient list

• Check for dangerous ingredients like xylitol or other flavoring

• Extraction method used

• A company should provide all the information listed above without hesitation and immediately upon request. As the market matures, purchasing a product that is backed by positive scientific studies using the product will be advisable.