Veterinary Cannabis & Legalities

DISCLAIMER: Veterinary cannabis is still a very fresh and constantly changing/developing aspect of veterinary medicine. If you ever have questions/concerns, or want to discuss the potential of adding CBD/cannabis to your pet’s medicine protocol and/or treatment plan we always stress to have an open and honest dialog with your veterinarian/specialist! We do not support nor condone veterinary cannabis but simply answering a question that a “President” Bifford supporter e-mailed us earlier in the week. We remove all responsibility for any effects (both positive & negative) that your pet may endure by trying veterinary cannabis!

Cannabis has important interactions with pharmaceutical drugs! If not managed carefully and properly, those interactions have the potential to be dangerous! Working together YOU and YOUR veterinarian can ensure that all medications & supplements work synergistically to reduce side effects and improve overall outcome while meeting your goals for your pet.

Your veterinarian should recommend periodic examination and laboratory evaluation (of both blood & urine) of your pet to ensure that all aspects of the treatment plan are supporting the positive goals that you and your veterinarian have established. We STRESS to have diagnostics accomplished PRIOR to starting veterinary cannabis as CBD has been noted to increase some liver enzymes, and at this time we do not know the significance of these changes. Regular monitoring and diagnostics are also an important part of caring for your pet!

Be aware that the “trial & error” period can take time and may need periodic changes and re-evaluation.

  1. As veterinarians, they are NOT authorized to prescribe any Schedule 1 drugs — including marijuana (products that contain more than 0.3% THC) or other types of cannabis. Since the DEA authorized cannabis as a scheduled 1 drug NO veterinarian can prescribe these products. Pet parents nee to choose a quality product and MUST have accurate information about the amount of THC and other cannabinoids it contains.
  2. With the passage of the 2018 Farm Bill, there is a clear distinction between marijuana (containing >0.3% THC) and hemp (containing <0.3% THC) types of cannabis & veterinarians may have more flexibility when working with hemp-based products. However, there still remain state-specific and even clinic-specific restrictions that the veterinary health care team and you as the pet parent must navigate together.
  3. Cannabis products derived from either hemp or marijuana (in certain states) may be legally obtained by a pet parent in accordance with their state and local laws.
  4. Once purchased, a cannabis product may be administered to an animal by a pet parent — that is YOUR right to decide as your pet’s guardian.
  5. Once you, as the pet parent, have decided to investigate the use of cannabis in your pet, you can then start the conversation with your veterinary health care team to seek guidance and education on product safety as well as administration and monitoring plans.

Starting The Conversation

  1. Make sure to mention the use of cannabis products when asked about your pet’s medical history and/or supplements. This may be something that you mention to the receptionist when first making the appointment or to the staff when checking in. Knowing if cannabis is being used at home helps the veterinarian make important decisions about other medications, supplements & treatment plans.
  2. Ask to work with a veterinarian/veterinary health care team that is “cannabis-knowledgeable”. Not every veterinarian is trained in cannabis topics or is comfortable providing guidance about the use of cannabis in your pet. To make sure that you’re working with the right veterinarian — just ask!
  3. If you already started your pet on a cannabis product prior to your clinic appointment, keep a journal that tracks trends such as appetite, sleep habits & energy levels. This journal can be extremely useful in identifying subtle trends, both positive & negative, associated with the use of cannabis in your pet.

What To Bring To The Appointment

  1. The cannabis product with as much original packaging as possible! The package label can provide essential information about product source and manufacturing, active & inactive ingredients and concentration or strength of the product. Since cannabis laws vary from state to state, make sure to ask your veterinary clinic if you should bring pictures of the packaging instead of the ACTUAL packaging material!
  2. A list of ALL medications & supplements currently being administered to your pet. The list should include all herbal supplements, over-the-counter medications and any special diets. DON’T FORGET about flea/tick & heartworm prevention!
  3. A list of goals for cannabis use. Take some time prior to the appointment to think about why you want to utilize cannabis in your pet- what are your short and long term goals for your pet that you hope to accomplish using cannabis?
  4. Journal — consider bringing pictures and/or videos in addition to your written journal to help explain symptoms observed at home that may not be evident during the appointment.

Want more information on this subject? Visit www.cannabismd.com

Veterinary Cannabis & CH Pets

DISCLAIMER: Veterinary cannabis is still a very fresh and constantly changing/developing aspect of veterinary medicine. If you ever have questions/concerns, or want to discuss the potential of adding CBD/cannabis to your pet’s medicine protocol and/or treatment plan we always stress to have an open and honest dialog with your veterinarian/specialist! We do not support nor condone veterinary cannabis but simply answering a question that a “President” Bifford supporter e-mailed us earlier in the week. We remove all responsibility for any effects (both positive & negative) that your pet may endure by trying veterinary cannabis!

Accessibility: Hemp and CBD-only products can be found in pet stores and online. Products with higher THC content can be found in a dispensary only. Make sure that you are familiar with and abide by ALL cannabis laws applicable in your area.

Manufacturer Reputation: Look for a company with high ethical standards that are open and honest about their manufacturing techniques, ingredients and resources.

The “entourage effect”: Products that utilize the 600+ compounds of the whole cannabis plan are safer and more therapeutic than those that utilize a single or few compounds.

Contaminant-Free: Look for products that are tested and confirmed to be free of contaminants such as pesticides and heavy metals as well as mold and bacteria.

Safe Extraction Technique: C02 and alcohol are the safest extraction techniques for the products used in animals. Other extraction methods may leave behind toxic residual chemicals in the product.

Tinctures (cannabis in liquid form): Tinctures are one of the safest & most accurate form of cannabis use in animals. The veterinary cannabis society recommends AGAINST the use of edibles (cookies, gummies, etc.,) made specifically for humans for use in animals.

Quality Ingredients: Animal tinctures should be formulated in a high-quality oil base and NOT alcohol. NOTE: alcohol is fine as an extraction method but NOT as a tincture base!

No Additives: Avoid products that have additives such as coloring, preservatives, or other herbs. Be especially careful to AVOID any product that contains xylitol which is extremely toxic to animals.

Ratio of CBD/THC: A combination of both CBD & THC has a greater therapeutic effect for most conditions than either one used alone. Work with your veterinarian to determine the right ratio for your pet & their condition(s).

Concentration: How many milligrams (mg) are in each drop or milliliter (ml)? Higher concentrations allow easier administration in bigger animals. Lower concentrations are safer for smaller animals because of their lower body weight.

Measured Dose: A marked dropper, syringe or easily calculated number of drops is required to provide accurate dosing.

Cautions: Although cannabis is remarkably safe, if your animal is taking other medications, please make sure to discuss your animal’s [potential] cannabis plan with your veterinarian. Do not use cannabis in immature or pregnant animals.

Go Slow: Always start with a low dose and slowly work up to your target dose. Gradually introduce any change in brand, CBD/THC ratio, or concentration. Re-evaluate your dosing if your animal’s health status changes.

Set Up For Success: Arrange the home environment so your animal feels safe & comfortable at ALL times. If an animal receives an inappropriate dose of cannabis, they may be overly sensitive to bright lights and loud sounds. ALWAYS contact your veterinarian if you feel your pet received an inappropriate dose!

Keep A Journal: Consider keeping a log of your animal’s cannabis dose and their reactions.

How CBD is thought to help dogs

Researchers are still learning CBD’s specific effects on dogs, but here’s how the compound is THOUGHT to work:

Dogs have an endocannabinoid system (ECS) just like humans.

The ECS is a network of cellular activators and receptors in the body that regulate physiological processes, including pain, mood, inflammation, stress & more.

CBD binds to and activates the vanilloid, adenosine & serotonin receptors in a dog’s ECS and helps to regulate pain perception, inflammation, temperature & more. It also boosts dopamine levels, helping to reduce anxiety & improve mood.

CBD also blocks GPR55 signaling, which decreases cancer cell reproduction.

CBD can help improve:

  • Allergies
  • Anxiety & Fear
  • Appetite Loss & Digestive Problems
  • Arthritis, Joint & Mobility Issues
  • Cancer & Tumors
  • Skin Issues
  • Seizures & Epilepsy
  • Inflammation
  • Glaucoma
  • Spasms

Want more information on this subject? Visit www.cannabismd.com

ASA Status

Scoring System

This is where ASA classification can help. An ASA risk is a 1-to-5 score adapted for animals from human medicine’s American Society of Anesthesiologists. The system is based on the patient’s overall health, not the procedure being performed.

The ASA scoring system is NOT an assessment of total perianesthetic or perioperative risk, since many things, including the surgical procedure planned, the skill & training of the anesthetist and the surgeon, as well as the the resources at hand, contribute to the entirety of operative risk. If you EVER have any questions or concerns regarding your pet and any upcoming procedure they may be having talk to your veterinarian/veterinary support staff immediately!

The pre-anesthestic phase includes NOT only the choice of preanesthetic sedatives & analgesics but also a full preanesthetic evaluation & stabilization of the patient, if necessary. Categorization of patients using the American Society of Anesthesiologists (ASA) provides a framework for evaluation of patient health & determination of stabilization requirements prior to anesthesia.

STATUSASA CLASSIFICATIONEXAMPLES
IHealthy Pet, No DiseaseElective Spay/Neuter
IIMild systemic disease or localized diseaseHealthy geriatric pet, mild anemia or obesity
III (Fair)Moderate systemic disease limiting activity but NOT life-threateningMitral valve insufficiency, collapsing trachea, poorly controlled diabetes
IV (Poor)Severe systemic disease, incapacitating; life-threatening; not expected to live without surgeryHemoabdomen from splenic rupture, severe traumatic pneumothorax, organ failure
V (Grave)Moribound; not expected to live >24 hours, with or without surgeryMulti-organ failure, severe shock, terminal malignancy

Understanding the “FVRCP” vaccine & “modified live-virus” vaccines!

What is the “FVRCP” vaccine?

The FVRCP vaccination is an important part of your cat’s routine.

It prevents three potentially deadly airborne viruses:

  1. rhinotracheitis
  2. calicivirus
  3. panleukopenia 
  1. Rhinotracheitis is triggered by the common feline herpes virus. Symptoms include sneezing, a runny nose and drooling. Your cat’s eyes may become crusted with mucous, and he or she may sleep much more and eat much less than normal. If left untreated this disease causes dehydration, starvation, and eventually, death.
  2. Calicivirus has similar symptoms, affecting the respiratory system and also causing ulcers in the mouth. It can result in pneumonia if left untreated—kittens and senior cats are especially vulnerable.
  3. Panleukopenia is also known as distemper and is easily spread from one cat to another. Distemper is so common that nearly all cats—regardless of breed or living conditions—will be exposed to it in their lifetime. It’s especially common in kittens who have not yet been vaccinated against it, and symptoms include fever, vomiting and bloody diarrhea. This disease progresses rapidly and requires immediate medical attention. Without intervention, a cat can die within 12 hours of contracting the disease.

These three viruses can be contracted by cats at any age.

Kittens should receive their first FVRCP vaccination at 6 to 8 weeks of age, followed by three booster shots once a month. Adult cats should receive a booster once every year or two, according to your veterinarian’s recommendation.

Adult cats with unknown vaccination records should receive a FVRCP vaccination, plus a booster in 3-4 weeks from the time they initially received the first FVRCP vaccine.

Because FVRCP is a live vaccine, it should not be given to pregnant cats. If a live-vaccine is administered to a pregnant cat then the unborn kittens may develop cerebellar hypoplasia.
 

What is a “modified- live” vaccine?

Modified live vaccines (MLV) contain a small quantity. of virus or bacteria that has been altered so that it no longer. is capable of causing clinical disease but is still capable of. infection and multiplying in the animal.

What is the difference between the various types of vaccines?

There are three major types of vaccine:

1.  Modified live vaccines. These vaccines contain live organisms that are weakened or genetically modified so that they will not produce disease but will multiply in the cat’s body. Live vaccines induce a stronger, longer lasting immunity than inactivated vaccines. It is not advisable to use modified live vaccines in pregnant queens or cats whose immune system is not working properly (e.g., cats infected by feline immunodeficiency virus (FIV), or other diseases).

2.  Killed (inactivated) vaccines. These vaccines are prepared using actual organisms or genetically modified organisms that have been killed by various treatments. On their own, they do not give as high a level of protection as the live, replicating type of vaccine, so killed vaccines may have an adjuvant (an added ingredient) to make the immune response stronger.

3.  Subunit vaccines. These are more commonly called recombinant-DNA vaccines. These are vaccines in which the infectious organism has been broken apart and only certain parts are included in the vaccine.

How do vaccines work exactly?

Vaccines work by stimulating the body’s immune system to recognize and fight a particular microorganism such as a virus, bacteria, or other infectious organism. Once vaccinated, the animal’s immune system is then primed, or prepared to react to a future infection with that microorganism. In other words, the vaccine mimics a true infection so that the immune system can better protect the body in the future. Depending on the disease, the vaccine will help the body prevent infection or lessen the severity of infection and promote rapid recovery.

Which particular brand of the FVRCP vaccine is considered “modified-live”?

FELOCELL 3 by Zoetis is a “modified-live” virus vaccine
  1. FELOCELL (Zoetis)
    1. FELOCELL 3 is a non-adjuvanted* modified-live virus (MLV) vaccine.
    2. Contains attenuated strains of feline rhinotracheitis virus, calicivirus, and panleukopenia virus (Johnson Snow Leopard strain), propagated on established cell lines.
    3. Safety of FELOCELL 3 was demonstrated in field trials involving 2,288 cats. No serious post-vaccination reactions attributable to the vaccine were reported.
    4. Packaged in freeze-dried form with inert gas in place of vacuum.
    5. Customer-friendly packaging includes peel-off labels for faster and more accurate record-keeping, a color-coded organizing system, and an easy-open safety band.
    6. FELOCELL 3 is supported by our Companion Animal Immunization Support Guarantee (ISG).

* Non-Adjuvanted : An adjuvant is a substance that is added to a vaccine to enhance the body’s immune response to the vaccine. Studies have shown that adjuvants have been associated with injection site reaction, injection site granuloma, and chronic inflammation in cats. (purevax.com)

The AAFP vaccination guidelines recommend that low-risk adult cats be vaccinated every three years for the core vaccines, and then as determined by your veterinarian for any non-core vaccines. Some vaccine manufacturers have developed approved three-year vaccines for many of the core vaccines. It is important to note that feline leukemia virus (FeLV) vaccine is recommended by some AAFP members as a core vaccine, while other experts classify it as a non-core vaccine. Your veterinarian is the ultimate authority on how your cat should be vaccinated. Please always consult your cat’s veterinarian about the vaccine schedule/process, types of vaccines, side effects & more!

Eight Common Myths about Surgery & Cats

Dr. Phil Zeltzman, brought to you by IDEXX & Pet Health Network


There are many urban legends surrounding surgery and cats. Here I take a rational look at 8 stubborn myths I encounter regularly.

1. Myth: “My cat is too old for anesthesia”
You should think twice when your friend or the internet tells you that your cat is too old or sick for anesthesia, and don’t be afraid to seek out an expert about this concern. If your cat is that old, surgery is probably not being recommended just for fun. Your veterinarian is probably talking about performing surgery because of a serious reason or even a life or death situation.

A complete physical exam and blood work should always be performed before anesthesia. In older cats, it may be wise to also take chest and belly radiographs, as well as an ECG to be thorough. Some patients may need to be stabilized before anesthesia, which may mean correcting blood work imbalances, giving IV fluids or giving a blood transfusion prior to anesthesia and surgery.

2. Myth: “Surgery is painful”
This is actually a true statement. However, surgical pain should not be ignored in 2015. We have many safe pain medications to choose from to treat pain before, during and after surgery. We should also remember that depending on what your cat’s condition is, she is most likely already in pain, which will continue to stay the same or worsen without surgery. The goal of surgery is often to decrease pain.

3. Myth: “There is no point if there is no cure”
This mostly relates to cats with a tumor. It is a matter of opinion and expectations. And it’s a very personal decision.

Without the benefit of a biopsy, we don’t know whether a mass is cancerous or benign until it is removed and analyzed. Even when a mass is cancerous, it doesn’t necessarily mean that it’s the end of the road.

Ultimately, your decision should not be based only on quantity of life (or survival), but mostly on quality of life.

Ironically, sometimes, the situation doesn’t depend on whether a mass is benign or cancerous, but on where it is located. A perfectly benign mass blocking the windpipe, the esophagus (the tube between the mouth and the stomach) or the urethra (the tube between the bladder and the outside world) will have life-threatening consequences.

4. Myth: “My cat will not survive confinement”
Confinement is often required after surgery. The time required depends on the procedure. Confinement may be in a crate, an upside down baby/puppy play pen, a “cat tent,” a small room or part of a room. It may seem cruel to some, yet preventing jumping and running is critical to allow proper healing. Cats don’t know what is best for them. You should.
 
Interestingly, most cat guardians I deal with regularly tell me that in the end, confinement was easier than they expected.

5. Myth:  “I can’t keep a plastic cone on my cat”
Sure, a plastic cone can be a royal pain depending on how stubborn your cat is. But this “necessary evil,” worn for two weeks, is not nearly as bad as another surgery to stitch up a chewed incision. And it sure is cheaper than paying for this second surgery!

There are a few alternatives to the standard “lamp shade” or Elizabethan collar such as neck braces or inflatable “donuts.” Not all of these options will work, depending on where the incision is located, so alternative options must be discussed with your surgeon or family veterinarian.

6. Myth: “There’s always a cheaper way”
Sure, you can get to work in a beat-up truck or in a Ferrari. You can go to work in worn-up, second-hand clothes or in a tailor-made suit. But when it comes to surgery, the choices are suddenly much more important. Seeking the cheaper surgery may not be in your cat’s best interest. Which corner do you want to cut? Not give pain medications? Not give antibiotics? Not use sterile equipment? Unfortunately, good equipment, good staff and good skills cost money. And this is reflected in the cost of surgery. The good news is you can get an insurance plan for your dog to avoid this financial dilemma.

7. Myth: “I can just use medication instead”
I am very sorry to say that I have met cats with megacolon (a painful condition due to many months of severe constipation) and other long-term conditions that had been treated “medically” (i.e. with medications) for months to years. These cats suffer on medications, while surgery could have provided much better results. Initially, the medications only address the signs, until they don’t. Surgery addresses the cause of the condition.

As I always say, “the disease is the enemy. Surgery is your friend.”

8. Myth: “Things will get better on their own”
The difficulty is that you cannot tell if vomiting is a sign of something benign or something serious. Sometimes, vomiting is due to eating a bit too much or a bit too fast. And sometimes, vomiting is due to a foreign body which requires surgery to be removed. So don’t procrastinate; seek help from your family vet sooner rather than later. Waiting too long can have devastating consequences on your cat’s health.

These 8 myths are not meant to offend anyone. They are based on observations made over years of practice. Sure, there are complications, expected or not, during and after surgery. Fortunately, most of the time, surgery can make a world of difference for your cat.

Questions to ask your veterinarian about surgery:

  • What are the goals of the surgery you recommend?
  • What would happen if we didn’t do the surgery?
  • What can I do to ensure my cat’s comfort after surgery?

If you have any questions or concerns, you should always visit or call your veterinarian — they are your best resource to ensure the health and well-being of your pets.