I work as a vet. I have a particular interest in companion animal pain management and rehabilitation, and over the past few years, I’ve narrowed down my work to mainly focus on just that. On a normal day to day basis, I look at medication protocols and do massage, acupuncture and laser therapy. The bulk of my work is with arthritic dogs.
But recently I have struggled with one of my patients. Luna, an elderly husky, had severe arthritis of the elbows and hips, as well as liver, heart and kidney failure. Unfortunately, that means she couldn’t have any pain medications.
That’s how I began to learn about CBD oil for dog arthritis. Her owners had been using it on her to good effect. It’s now gaining more recognition in the veterinary world, and I’m excited to start being able to recommend it for certain patients when options are running thin.
Understanding Canine Joint Pain and Arthritis
Arthritis is extremely prevalent, and a silent cause of discomfort in many older animals. In fact, one in five animals older than the age of eight, has underlying arthritis. In humans, it is well known that arthritis causes pain long before it causes limping, which means we can only assume the same in our canine friends. That means, by the time you notice that your dog is limping, the arthritis is already moderate or severe. To understand how we can improve the joint comfort, we must first understand the joint itself.
The moving joint comprises of six components; the joint capsule, the cartilage, the subchondral bone (under the cartilage), the ligaments and tendons, the nerves and blood vessels, and the synovial fluid filling the joint. All six components are involved in arthritis.
The joint capsule comprises of two layers. The outer layer is dense and fibrous, and its purpose is to protect the inner layer. The inner layer membrane produces a substance called hyaluronic acid which makes up the synovial fluid. It is richly supplied with blood vessels, and has plenty of nerve endings. This means it detects pain very well.
The cartilage is composed of cells called chondrocytes, molecules called glycosaminoglycans, and collagen fibers. It hasn’t got many blood vessels or nerves, and therefore its nutrients come from the synovial fluid and subchondral bone. Its function is as a shock absorber for the joint, due to the great amount of water it holds. It also provides a smooth surface to allow the joint to glide. Unfortunately, cartilage cannot regenerate well when it becomes damaged.
The synovial fluid is a transparent or pale-yellow protein-rich fluid, comprising of hyaluronic acid. The functions of the synovial fluid are to allow for constant load bearing, efficient heat conductivity and lubrication.
When a joint has arthritis, the cartilage gradually deteriorates and the subchondral bone becomes thick, reducing the shock absorbing capacity of the joint. In addition, the inner membrane becomes thickened, and the surrounding areas become devitalized because of the reduction in blood supply. The thick inner membrane grows into the joint space and starts to becomes stuck to the cartilage. As a result, the synovial fluid can no longer flow normally into the pores of the cartilage, leading to deceased nutrition and degeneration.
In a nutshell, the joint becomes very sore, and loses a great amount of function.
What Are the Symptoms of Arthritis in Dogs?
When people think of arthritis, they think of limping. And that certainly is the main symptom which is seen. However, as mentioned earlier, by the time a dog is limping, they already have moderate or severe arthritis, so it is vital to look out for early indications of pain.
There are some tell-tale signs to look out for, which even stoic dogs will demonstrate if they are in pain.
- A change in breathing. Dogs in pain generally breathe at a faster rate. This can be shallow, or it can be panting. People often mistake it for their dog feeling hot or worn out, but it should not be forgotten that pain often causes this symptom.
- Behavior changes. These can be changes such as increased aggression, avoiding affection, reacting when picked up, or generally being quieter than usual.
- Poor coat quality. Sometimes when a dog is in pain or unwell, their coat becomes duller and greasier. This is because of a lack of grooming as they cannot turn around and reach parts of their body easily.
- Struggling to settle. Lying down in a comfortable position can be a struggle for a dog in pain. You are likely to see him circle round and round before lying down, and once he’s down, it won’t be long before he’s up again.
- Licking. One of the most common indications that somewhere is sore, is obsessive licking of the area. Dogs find comfort in licking areas of pain. You may not see him actively licking, but orange or brown saliva stains over the joints are an indication that he is secretly doing it.
- Difficulty passing stools. If your dog suffers from either back or hip pain, squatting to pass stools can be very uncomfortable. They may avoid passing a motion because of the pain, and as a result become constipated, or they may get themselves into an awkward position to do their business.
Traditional Arthritis Treatments
Arthritis can be treated in many different ways, and there is not one way which is best or most effective. In fact, treating arthritis in a number of different ways concurrently, will give the best results. It is thought that each individual arthritis treatment accentuates the effect of the other arthritis treatments, and so each one works better in conjunction with others, rather than by itself.
The following are ways in which arthritis is traditionally treated, some of which are not suitable for every dog:
- Pain relief medications – The main type of pain relief is a drug class called non-steroidal anti-inflammatory drugs (NSAIDs). These are drugs, such as meloxicam and carprofen, that work similar to ibuprofen in humans (although you should NEVER give your dog ibuprofen, as it is toxic to them). NSAIDs are metabolized by the liver and excreted out of the body via the kidneys, and so they are unsuitable for any dogs which suffer from liver or kidney disease, or that are very young. There are other types of pain relief available, such as opioids and gabapentin, however these can also have a toll on the liver, and they cause drowsiness.
- Nutraceuticals – Otherwise known as supplements, nutraceuticals are very popular. The most common ones which are used for arthritis are glucosamine and chondroitin. They make up the building blocks of cartilage and therefore improve cartilage health. Unfortunately, they are not able to rebuild cartilage. Other supplements which are sometimes used are MSM, green lipped mussel and hyaluronic acid. Nutraceuticals have a fundamental problem that they have to be given by mouth. They have variable bioavailability, and therefore it is difficult to judge how much is truly absorbed. As a result, they have variable effects.
- Polysulfated glycosaminoglycans (PSGAGs) – Weekly and monthly injections can be given which contain PSGAGs. As mentioned earlier, these are components of cartilage, and therefore injections of PSGAGs can help improve cartilage health. This is fairly effective, however with most treatments, there are some down-sides. Many owners are not confident at giving their dogs injections, which means that they have to bring their dog frequently to the vets. This can build up cost over the lifetime of the dog, given that arthritis is a non-curable condition.
- Weight control – All arthritic animals should be put on a diet if they are overweight. Increased gravitational force on the joints will only make things worse. This is not easy to do, as arthritic dogs will not want to exercise more, however, there are some ways in which dogs can lose weight without added pressure on the joints. Hydrotherapy, firstly, is an excellent way of increasing a dog’s exercise, without stressing the joints. There are also diet foods available, which are either low in calories, or are high in fiber, meaning the dog feels fuller for longer.
- Omega oils – These go hand in hand with nutraceuticals, and are commonly given at the same time. The use of omega oils, however, are more scientifically solid compared to other supplements, and their mechanism of action is better documented in scientific research. When an area is inflamed, a hormone called PGE2 is released. This attracts more inflammatory cells to the area. When omega oils are given, PGE3 is produced instead of PGE2. This is significantly less inflammatory than PGE2, and therefore reduces the inflammation in the area. Unfortunately, omega oils are not effective enough to be used alone in the treatment of painful conditions.
So, as you can see, there are many ways arthritis can be addressed, but no one way is perfect. Selecting multiple approaches will be beneficial, but sometimes that is still not enough. That’s where CBD oil comes in. CBD oil is not a traditional arthritis treatment, and is only starting to gain recognition in the veterinary community recently, however, it is proving to be an effective way of managing pain safely, without many side effects.
What is CBD oil?
There’s a lot of hype around hemp products, and it is easy to get confused about all the different ones. There’s a lot of false information floating around the internet, getting people confused between hemp oil, CBD oil, cannabis oil and medical cannabis. The two most similar are hemp oil and CBD oil. Both hemp oil and CBD (cannabidiol) oil are derived from the hemp plant Cannabis sativa, but they are quite different from the cannabis drug. Neither oil contains the psychoactive substance, tetrahydrocannabinol (THC), and therefore they have all the health benefits with no side effects.
The difference between CBD oil and hemp oil is that CBD oil comes from the stalks, leaves and buds of the plant, whereas hemp oil comes from the seeds alone. They are quite different in medical uses and so it is important to know what you are buying.
There are a huge number of CBD oil products available, and the amount of CBD in each will vary. Therefore, it is important to buy one of very high quality from a reputable source. Here are a
Few tips to ensure that you buy a quality CBD oil product:
- Ensure it’s organic. That way it will not contain traces of pesticides, fungicides or additives.
- Don’t buy the cheapest. If it’s high quality and high in purity, it is not going to be cheap.
- Look for the certificate of analysis. All CBD oil products should be sold with a certificate of analysis, detailing how much CBD and THC is in it. There should be a high amount of CBD, and no, or just traces, of THC.
- Buy a tincture rather than a capsule or tablet. This is much easier to administer and adjust the dose of.
CBD For Pain
CBD oil is becoming more popular in treating seizures, arthritis, nausea, anxiety, stress and symptoms of cancer. But CBD is particularly excellent for treating pain, and is a popular adjunctive treatment for managing arthritis. The sensation of pain is a complicated neurological pathway. In essence, there are lots of types of receptors, which are triggered when a painful stimulus arises. These are all different for deep pain, sharp pain, chronic pain, sudden pain etc. The signal is then sent to the spinal cord, and then up to the brain for processing, and the body then responds accordingly through a number of ways, such as physically reacting, sending inflammatory cells to that area, feeling emotional etc. A study in 2011, showed that CBD reduced inflammatory pathways in rats, through working at the basic level of the pain receptors. This changed how the receptors responded to stimuli so that less nerves were triggered with the painful signal.
Later on, in 2014, a scientific review of the published research on animals, concluded positively that CBD can be used in the management of arthritis in animals. It emphasized there was still not a lot of published data on its use, however preclinical data was promising.
Will my dog feel high or funny?
The great thing about CBD oil is that it has none of the psychoactive substance, THC. Therefore, it has all the medicinal effects of hemp, but none of the psychological side effects.
There has been no research to indicate exactly what the side effects are on dogs, however based on humans, here is an indication of how your dog might feel or what he might experience:
- Dry mouth or increased thirst: CBD can decrease the production of saliva.
- Decreased blood pressure: This might create a feeling of being light headed.
- Drowsy: While your dog won’t be feeling high, he may feel drowsy or more sedate. This is because of the anti-anxiety effects of CBD.
What does the law say?
Given that CBD oil comes from the cannabis plant, it’s understandable that some people, even some veterinarians, are hesitant to give CBD oil to their dogs. However, the law in the USA allows for hemp to be produced as long as the THC levels remain under 0.3%. This means that the CBD oil has not been produced from illegal cannabis plants, but rather industrial hemp, which is grown widely.
The American Veterinary Medical Association has been hesitant to approve the use of CBD oil in dogs. They claim that all therapeutic agents given to pets should be licensed by the FDA, which few CBD oils have been. As a result, they advise veterinarians to be cautious in their recommendations, as products can be labelled inaccurately and vary in their active ingredient if not FDA licensed.
The Veterinary Medicines Directorate in the UK have also been hesitant to sing the praises of CBD oil. They claim that CBD products fulfil the definition of a ‘veterinary medicine’ and therefore should be regulated and treated as one. As a result, CBD products for use in animals require a marketing authorization before they can be supplied in the UK, and none have been granted this so far. Off license use of human CBD products is allowed if approached with caution.
How to Give CBD Oil to Your Arthritic Dog ?
CBD oil is usually given orally to dogs, which means via the mouth. If you are giving capsules, the gelatin exterior can be pierced, and you can pour the contents on the food, if your dog does not take a whole capsule willingly. Tablets can usually be broken up into smaller pieces and hidden in treats.
Luckily, CBD oil often comes in a tincture or mixed with another oil, and therefore with the pipette you can drop it directly into your dog’s mouth or on his food.
However, a study in 2016 suggested that CBD has poor oral bioavailability, and therefore to avoid the gastrointestinal system, CBD can be effectively applied to the skin. It can be rubbed directly into the site which is sore, however, remember to wear gloves when applying it.
CBD Oil Dosages for Dogs
If you decide to purchase a CBD oil specifically made for dogs, the manufacturers will have had to clearly detail on the data sheet how much should be given to your dog. This is the safest guideline for that particular product, and therefore you should follow that. Unfortunately, there are very few products on the market available specifically marketed for dogs.
However, if you buy a generic CBD oil, you may not know how much to give. Unfortunately, some CBD oil manufacturers deliberately don’t give a dose on their product, to avoid getting into trouble with the FDA over promises of results at a specific dose.
Cornell is a leading institution in the research of CBD oil in dogs, and a research project which was submitted to the American College of Veterinary Surgeons Summit in 2017, demonstrated that 0.9mg/lb of CBD oil twice daily will increase the comfort and activity of dogs which suffer from arthritis. This dose, however, is very generous, and most dogs will be able to be managed on a tiny fraction of this dose. It is recommended to start on a dose of 0.02mg/lb twice daily, and gradually work up to the most effective dose.
To convert this into how many millilitres to give your dog, you can do a simple equation:
For example, if your dog weighs 25lb, 0.02mg/lb will equate to 0.5mg. Now, if the CBD oil comes at a strength of 5mg/cc, then you simply divide 0.5 by 5, which gives you the answer 0.1cc. Therefore, you would need to give your dog 0.1cc twice daily, as a starting dose. This can gradually be increased to the most effective dose.
This becomes a little more complicated when the CBD oil doesn’t come in a liquid form. Capsules and tablets are common, but most come in sizes of 5-20mg, and so once you’ve figured out how many milligrams your dog needs, then you should just give the closest dose possible with the capsules or tablets, by splitting them up if necessary.
The main thing which should be taken from this, is that CBD oil has a massive dose range, which means that it is safe at many different doses, so the dose should be tailored to each individual.
Talk with Your Vet
As with starting any treatment for an ailment, you should ensure that your vet is on board. It is important that they are aware of your dog’s health, and how he responds to recommended treatments, to ensure he gets the best care possible.
If they are against use of CBD oil, it is most likely from either lack of knowledge, or just being cautious of the potential pitfalls of buying CBD oil. Nevertheless, it is important not to dismiss their concerns, as they are professionals in the field of animal health, and will be able to recommend the best way to treat your dog’s arthritis.
CBD oil is a potentially exciting treatment option for painful health issues, such as arthritis. However, you must be cautious when buying CBD oil. It is easy to buy one which contains additives or very little amounts of CBD oil, and therefore may have variable effects. Nevertheless, it can potentially provide a profound pain relief for dogs which are suffering from arthritis or painful conditions, especially if there are reasons why conventional treatment cannot be used.
One request from Speedy
Dr. Joanna De Klerk put so much effort writing this blog post to provide value to the dog parent community. It’ll be very helpful for me, if you consider sharing it on social media networks.
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