While research is still in its infancy, there is a growing understanding of medicinal cannabinoids as an efficacious treatment option for animals, especially when we talk about pain, inflammation, oncology, stress, anxiety... and epilepsy!
Dr. Marta Calvo Blanco, Head of Veterinary Operations and Education at eCS Vet (Endocannabinoid System Veterinary Centre) explains what medicinal cannabis is, what is CBD and how it can help epileptic dogs.
Medicinal cannabis contains hundreds of different compounds called cannabinoids. These cannabinoids are part of a complex system found inside all animals, including humans, called Endocannabinoid System (ECS), that helps us maintain a stable internal environment for many of our body systems.
It is involved in the regulation of sleep, pain, temperature, metabolism, appetite, digestion, inflammation, cardiovascular and immune function, emotions, stress response, memory, cognition, neuroprotection and neural development.
It is important to understand that there are 3 types of cannabinoids:
1. Endocannabinoids are natural substances produced in the body of the animals, involved in the regulation of many physiological processes.
2. Phytocannabinoids are molecules (including THC and CBD) produced naturally in the Cannabis plant that are capable to behave and interact in the same way as the endocannabinoids.
3. Synthetic cannabinoids are human-made chemicals used in the production of both legal pharmaceuticals and illegal substances.
CBD - derived from the Cannabis Sativa plant - has been historically used for a number of neurological disorders, with several anecdotal descriptions starting to appear since 2013 about therapeutic effects in children with treatment-resistant epilepsies. It was in 2017 when the first CBD-based product was registered for the successful treatment of treatment-resistant epilepsies in humans.
In the last few years, several studies examining CBD benefits in dogs have been published. One of them, from 2019, examined the ability of CBD to decrease seizures in epileptic dogs that were already receiving anticonvulsant medications.
“The results of this study were really rewarding since a significant reduction in seizure frequency was achieved, and it helped to support what vets are seeing in their practices on a daily basis” said Dr. Calvo Blanco.
In McGrath S. et al (2019) research, 67% percent (6/9) of the dogs in the treatment group experienced a greater than 40% reduction in average monthly seizures during the study, whereas only 29% (2/7) of the dogs in the control group had a greater than 40% reduction in average monthly seizures.
Epilepsy in dogs
Epilepsy is the most common chronic neurological condition seen in dogs, in which the brain activity becomes abnormal, causing seizures or periods of unusual behaviour. Any involuntary or uncontrolled muscular contractions in dogs may represent a seizure.
Not all seizures are related with epilepsy, since they might be caused by situations outside the brain like:
✔️ severe dehydration or electrolyte disbalance
✔️ high or low blood sugar
✔️ circulating metabolic toxins due to liver issues
✔️ external poisons…
When there is no external cause for the seizures, and there is a recurrence of them (one single seizure does not reveal any abnormality), especially on animals between 1-5 years old, the term canine epilepsy or idiopathic epilepsy can be applied.
Some of these dogs might display most of their seizures at night-time, early in the morning or when they are comfortably resting. While others might be triggered by stressful situations. It is usually a sudden loss of voluntary control, with muscle twitching, shaking convulsions and salivation. This may last a few seconds or minutes and the animals usually regain consciousness between seizures.
These attacks might be very similar each time and have repetitive pattern in which the dog might previously seem altered, maybe hiding, looking nervous or seeking for the owner.
Most of the dogs will be set on medication and veterinary control if:
✔️ There are two or more generalised seizures occurring within 24 hours
✔️ A seizure lasts more than 5 minutes
✔️ If the recovery from a seizure takes very long or they do not return to 'normal' and regain full consciousness between two seizures
✔️ More than two seizures in 6 months
Missy's Story
Sally Muscat from Northern Territory has a gorgeous apricot Chihuahua, who just turned 10 last month, whom she’s had since she was four months old.
“She is a little dog with a big personality,” said Sally. “Missy started having seizures at 3 years old, and after a full set of tests (with the limitations on equipment we have here in the NT) it was put down to epilepsy.”
Current medication for epilepsy
Idiopathic epilepsy in dogs cannot be cured, so the goal is to maintain the number of seizures and the duration of the episodes as low as possible without causing unacceptable side effects. Some anti-epileptic drugs can cause significant adverse effects as liver toxicity, therefore titrating the medication and performing blood controls is necessarily throughout the entire life of the patient.
Some of the observed side effects include:
✔️ sleepiness or sedation
✔️ increased appetite and thirst
✔️ drooling and vomiting.
1. Phenobarbital: is the first drug choice because it is usually effective, relatively inexpensive and well-tolerated. It is a long-acting barbiturate capable of suppressing seizure activity in the brain, but needs to be blood tested to adjust the doses. It can induce liver toxicity, develop tolerance over time and have withdrawal effects.
2. Potassium bromide: next step for refractory cases. It is usually combined with phenobarbital. Still over 25% of dogs might be not completely controlled. The animals might display several side effects.
3. Levetiracetam: is considered to be a particularly safe treatment option with a wide range of dosages, however, its efficacy remains unclear and its price is quite high.
However, a combination of phenobarbital and potassium bromide is not enough to control seizures in approximately 20% to 30% of dogs.
She said, “I was hesitant to agree to this due to the effect it would have on her liver and possible suppression of personality, but I was told this was the best option for her and due to the fear of damage that seizures could cause her brain I felt there was no other option.”
In her experience, “It was difficult to get the dose right and we had to do blood tests every 3-6 months to check her therapeutic levels and her liver function. Missy was definitely still having seizures here and there and the blood tests were stressful for her and very expensive,” she said.
Dr. Calvo Blanco said many owners feel like there is no other option.
“They don’t know that CBD is a real option for their animals, either as a single or as an adjuvant medication, with far less side effects than some of the current medications.”
Fortunately, many veterinarians are starting to realise how much CBD can improve the quality of life of their epileptic patients.”
How CBD can help your dog
CBD is a fascinating molecule that works in a myriad ways related to the nervous system. It is capable to interact and somehow control the release and activity of many other neurotransmitters.
In the particular case of epilepsy, CBD is capable of addressing many of the issues related to this illness in a more complete or holistic way.
2. Neuroprotection: cannabinoids have been shown to have neuroprotective qualities and the ability to attenuate neuroinflammation and promote neurogenesis. Which is particularly important and interesting in idiopathic epilepsy affecting the neurological system and the brain.
3. Anxiolytic effects: CBD has been proved to have anxiolytic effects both in animal and humans comparable to Diazepam. This is very important to reduce the chance to trigger an epileptic seizure due to stress.
4. Anticonvulsive properties: It has been proved to reduce the number and strength of epileptic seizures both in humans and in animals, both as a single treatment or as and adjuvant of the phenobarbital allowing to reduce its dose at very low, safer levels.
For little Missy, there has been a lot of trial and error to try and get the CBD dose correct. She hasn’t been able to get off the phenobarbitone completely, but she is now on an extremely low dose twice a day. More important, her liver enzymes, that had lately increased, are now back to normal.
“Missy’s dad and I immediately noticed a change in her when we reduced her phenobarbital levels; she is much more bright and bubbly and very playful. She is like a puppy again and she was not like this whilst on the phenobarbital, so it’s great to see,” said Sally. “Missy is also storm phobic and we go through 4 months of storms here in the wet season so it’s great to have CBD on hand when needed for calming.”
CBD is the great unknown treatment that can really make a difference in the quality of life of epileptic dogs.
To find an eCS Vet in your State, please visit ecsvet.com
written by Dr. Marta Calvo Blanco, April 2022 for Australian Dog Lover (all rights reserved)
About the writer
Dr. Marta Calvo Blanco received her Veterinary Degree with Honours in Spain over 25 years ago and ran her own practice with her veterinary surgeon husband for 15 years. Marta worked for highly recognised international small animal nutrition companies and pursued further education in Homeopathy, Flower Essences, Essential oils, Food Supplements and Animal Communication. Marta is also a Certified Veterinary Acupuncturist since 2012 (IVAS). After coming to Australia in 2015, Marta worked as an Animal Naturopath and Vet Technician and founded her own company “Holistic Animal Naturopath”, while learning and improving her knowledge on the use of medicinal cannabis.
She joined CANNect Veterinary (now eCS Vet) in 2019 to help educate veterinary professionals about using cannabinoid medications with animals. Marta is currently the Head of Veterinary Operations and Education at eCS Vet.
Learn more at www.ecsvet.com and follow their Facebook page at www.facebook.com/ecsvet
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