cbd oil reaction steroids for dogs

Steroids vs. CBD: A Topic of Truths and Transitions

Chances are that most humans and pets have been prescribed a steroid medication at some point in their life for treatment of one or more medical conditions. Whether it be for inflammation, allergies, or another type of illness, injectable and oral steroids have been applied by doctors and veterinarians for decades as a part of treatment plan due to their effectiveness in addressing numerous symptoms quickly and effectively. However, although the relatively fast effects felt by starting a steroid may be impressive, long-term use can and very often lead to serious side effects, both in humans and pets. Moreover, despite newer age doctors trying to move away from heavy use and dependence on steroids, this class of medications is still to this day used more than it should be, given that we know now what they likely lead to overtime.

In comparison, CBD and other cannabis-based therapies have recently been found to effectively address a majority of the same symptoms steroids remediate, but do not tend to cause any of the same adverse long-term side-effects steroids come with. Therefore, there is a huge potential promise in considering CBD as a legitimate therapeutic substitution for steroids when developing a safe and effective therapeutic treatment plan. Ultimately, when a life of longevity, health, and happiness is the long-term goal, understanding the ramifications and alternatives to steroid therapy is critical for the well-being of patients, including your pet.

Table of Contents

What are Steriods?

The term “steroid” simply describes a class of molecules that have a variety of influences and effects within an animal’s body. Specifically, there are “natural steroids” which our bodies make on their own, and “synthetic steroids” that are produced in laboratories which overlap with our internal bodily systems.

Steroids became widely popular in the 1940’s for inflammatory conditions . Corticosteroids in particular were and continue to be used to treat symptoms associated with arthritis and other degenerative musculoskeletal conditions. In fact, in 1950, the Nobel Prize for Physiology or Medicine went to Dr. Philip Hench, Edward Calvin Kendall, and Tadeus Reichstein for the discovery of cortisone and its applicable uses with rheumatoid arthritis.

Since their discovery and explosion onto the medical scene, steroids eventually became widely over-prescribed, as they were viewed as the “miracle drug” that could help with any and all conditions in conjunction with those initially known. However, as the repercussions of long-term use then began to surface as well, a shift towards healthier, long-term substitutions has slowly begun. Many doctors and veterinarians now only prescribe steroids for short-term applications and rely on multimodal therapies to promote long-term control of the underlying illness(es). However, many other medical professionals have not yet adopted this pattern, and still use steroids more often than is thought to be safe or required. T here are a small number of situations where steroids must be used for long-term immunosuppression (including some refractory autoimmune diseases and Addison’s Disease), but again, these are rather uncommon. Unless your pet has one of these conditions, steroids should be considered a short-term solution only.

The most common steroids prescribed by most veterinarians are prednisone, prednisolone, hydrocortisone topicals, and TEMARIL-P . Steroids do, in fact, reduce inflammation in the body, but not without a cost. The most common side effects of early steroid use include polyuria (excessive urination), polydipsia (excessive thirst), polyphagia (excessive signs of hunger despite not actually requiring more food), and panting. Steroids are also well-known for their serious, and sometimes dangerous, side effects including:

  • Weight gain
  • Salt and fluid retention
  • Diabetes
  • Cardiac Problems (Heart)
  • Increased secondary infection risk
  • Slower wound healing
  • Loss of muscle mass
  • Hepatic Problems (Liver)

If any of the following serious side effects occur, stop giving Temaril-P and seek emergency veterinary medical attention ; an allergic reaction ( difficulty breathing; swelling of the lips, tongue or face; hives ). Trimeprazine can cause drowsiness, tremors and muscle weakness . Prednisolone may cause symptoms of Cushing’s disease which include increased thirst, urination and hunger as well as vomiting and diarrhea . Other side effects may also occur. Talk to your veterinarian about any side effect that seems unusual or bothersome to your pet. Do not give any other over the counter or prescription medications, including herbal products, during treatment with Temaril-P without first talking to the veterinarian. Many other medications can interact with Temaril-P resulting in side effects or altered effectiveness. These include sedatives, anesthetics, pain medications, epinephrine and procaine.”

As stated above, there are few cases where lifetime use of steroids is necessary. But, in the majority of cases where it is not a necessity, the body will become susceptible to developing one or more of the many side-effects listed, and will also be subject to dependency and severe withdrawal effects if steroid therapies are discontinued too quickly. That’s why doctors generally advise a gradual tapering protocol off of steroids toward the end of a long-term treatment plan. Ultimately, if a steroid has been used for more than 7 days, then it is not advisable to stop this medication abruptly without the supervision of a medical professional, as this can prove detrimental to your pet’s health as well.

What are Steriods Used for?

Oral steroids are the most commonly prescribed medication for dogs (and us). These medications again are synthetic steroids, meaning they are not naturally produced by our body . They are most often prescribed to treat inflammatory conditions, skin conditions, non-infectious respiratory diseases, and degenerative neuromusculoskeletal conditions.

According to Dr. Gary Richter , “ steroids are some of the most powerful anti-inflammatory medications available .” Because of this, they tend to be a commonplace treatment for pets with skin and respiratory conditions. Dr. Richter continued to state, “ despite steroids’ ability to reduce inflammation, their long term side effects far outweigh their benefits .”

Steroid-Sparing Methods

CBD is being researched as a ‘steroid sparing option.’ A study published in Current Neuropharmacology indicated CBD has therapeutic benefits for both people and pets who suffer with chronic pain. There is an abundance of compounds found to reduce inflammation in both us and our pets. The most common phytocannabinoids found in the Cannabis plant, THC and CBD, both possess anti-inflammatory properties. Other minor cannabinoids, including CBG, CBC, and THCV were also found to provide anti-inflammatory properties as well.

According to Future Medicinal Chemistry , “ cannabinoids have exhibited significant potential to be used as novel anti-inflammatory agents and specific targeting of CB2 receptors holds the promise of mediating immunosuppressive effects without exerting psychotropic side effects.”

The University of Pennsylvania’s School of Veterinary Medicine is currently (and has been) conducting research to better understand the effects of cannabis on dogs with osteoarthritis. The study, once published, will have a sample size of about 60 dogs who are suffering from inflammation. The dogs have been separated into three groups. The first group is receiving some type of mobility support supplement. The second group is receiving CBD. The final group is receiving a placebo. Research will be released later this year.

According to a veterinarian named Steven Katz , who is one of only a few doctors applying CBD-based therapies in practice, “our experience in my clinic has shown cannabidiol (CBD) is an effective treatment in reducing inflammatory response . We have a passion for improving dogs’ quality of life, and we look forward to learning all we can about therapeutic methods to achieve this.”

The Ultimate Question: Steriods vs. CBD

First things first: If you are reading this and your dog is already taking steroids, it’s absolutely critical the regimen is not stopped immediately. Never attempt to taper this medication without the supervision of a licensed veterinarian.

Taking a full-spectrum CBD-based product in combination with a steroid, like prednisone, will most likely (not guaranteed) not result in any detrimental adverse effects. Although both compounds are broken down by the liver, taking both at the same time is unlikely to cause “liver overload” unless the liver is already unhealthy (which would have been or can only be determined by submitting bloodwork with your veterinarian). If the liver is already “sick” then there may be hypothetical concerns regarding administering both at the same time, even though research up to this point has not proven such statements. The reason for this is because research indicates that CBD and other cannabis-based molecules are broken down by the “cytochrome p450 enzyme” group located in the liver, and that CBD specifically inhibits a component of the activity of a particular enzyme (CYP3A4) which is used by the body to break down numerous other molecules. The effects of this are still not entirely known, but with an unhealthy liver, it is highly advised to be more careful when considering any extra stress it may cause on this organ. We do know that Prednisone does cause liver “induction” resulting in numerous secondary effects, both on the liver’s functioning ability and its ability to handle other molecules simultaneously, such as CBD and the other active compounds in a full-spectrum product. Again though, each animal is an individual, and therefore, each case must be addressed individually before making any decisions or conclusions.

Of course, given what we know about steroids and CBD, we should all desire to get more pets off of long-term steroid use, and if appropriate, using a properly-vetted CBD-based therapy to address the conditions steroids were originally applied for. But, this transition must be done responsibly. The overall goal is and should always be to promote a lifestyle of optimum healthiness and happiness. With the proper diet, natural supplements, and safe remedies in times of illness like a properly vetted full-spectrum CBD-based product, there is an opportunity to enhance and maintain your pet’s overall well-being without abusing and over-using pharmaceuticals, in an age where pharmaceuticals still seem to be king.

If you are seriously interested in discussing and formulating a completely new, natural, and customized lifestyle for your beloved pet, it starts with scheduling a personalized consultation. You can book a consultation by clicking here . This exclusive team of responsible pet advocates will help you design a life of longevity for your pet, discuss safe ways of transitioning away from conventional pharmaceutical medicine, advise on how and why to consider full-spectrum CBD-based therapies if appropriate, and help you to make educated, informed decisions for your pet as time goes on. So don’t wait, and book your personalized consultation with our team today!

Dr. Zac Pilossoph

Dr. Zac Pilossoph, a Long Island, NY born, nationally recognized veterinary medical professional, a top graduate of Tufts University Veterinary School of Medicine with post-graduate focused training in E/CC and Neurology/Neurosurgery at two of the most recognized programs in the country, and a young multidimensional serial entrepreneur, has rapidly and collaboratively helped promote a new wave of global evolution and individual empowerment in more ways than one. In addition to developing and launching several novel platforms in the veterinary and mental health fields, he is now quickly joining some of the most reputable leaders in the cannabis education and innovation space. Dr. Pilossoph is determined to synergize with colleagues, allowing evidence-based information to fuel a rapidly expanding industry. As one of the world’s most proactive cannabis-focused experts in his respective industry, Dr. Pilossoph provides tremendous value by delivering non-bias, harm reduction education, via both large-scale speaking engagements and individualized consultations, to the global cannabis pet and vet industry. Further, he is a Certified CBD Professional Educator through the CBD Training Academy and has started a nationally influential multi-tiered cannabis brokerage firm titled Excelsior Honour Associates. Lastly, he acts as a consultant for the CBD product space in order to impart as much quality, control, and consistency across the industry as much as possible.

Use of Prednisolone, CBD and Behavior Modification as a Treatment for Atopic Dermatitis in a Canine: A Case Report

1 Department Of Animal Health Technology, Yamazaki University Of Animal Health Technology, Tokyo, Japan 2 Tokyo Animal Allergy Center, Tokyo, Japan 3 Nagoya Animal Allergy Center, Aichi, Japan 4 Department Of Gastroenterology And Gastroenterological Oncology, Fujita Health University, Aichi, Japan

* Corresponding Author(s):

Abstract

Introduction: Canine Atopic Dermatitis (CAD) is a chronic, pruritic skin disease. Although Cannabidiol (CBD) has neuroprotective, analgesic, anxiolytic, and anti-inflammatory effects, few studies have examined its use in dogs with CAD. This study aimed to evaluate the efficacy of CBD-containing hemp oil in combination with behavior modification therapy in the treatment of CAD.

Case presentation: A 48-month-old castrated male Maltese dog with a history of Canine Atopic Dermatitis (CAD) and adverse food reaction presented with genital licking behaviors that began approximately two years prior to presentation. The patient had received dermatological treatment two years prior to presentation, but the licking behavior continued. During the visit, the patient was diagnosed with stereotypical genital licking. The behavior was temporarily interrupted when the dog’s owner intervened verbally but would continue shortly thereafter. A diagnosis of obsessive compulsive disorder was made and behavior modification therapy was initiated. An elimination diet was prescribed and topical steroids were administered. These treatments alleviated the pruritis in the extremities but did not alter the frequency of genital licking. Therefore, Cannabidiol (CBD) was administered for 21 days after the initiation of the behavior modification therapy. Twenty-seven days later, the genital licking behavior decreased and could be stopped via verbal intervention from the dog’s owner.

Conclusion: In this patient, the stereotypical behavior was treated with CBD. Factors that contribute to stereotypic behavior are frustration and conflict. It is likely that the behavior began due to lack of care and unsatisfied motor drive. To date, potential efficacy has been reported in human dermatology; however, there have been no reports of CBD being used to treat CAD in dogs. These results highlight the importance of careful medical evaluations and treatment of a primary illness even when behavioral issues are prominent, as well as the potential use of CBD to treat stereotypical behaviors.

Keywords

Atopic dermatitis; Behavior therapy; Cannabidiol; Canine; Steroids

Introduction

Canine Atopic Dermatitis (CAD) is a chronic, pruritic skin disease that is seen with high frequency in veterinary clinics [1]. In atopic dermatitis, there is an excessive immune response in the skin, abnormalities in epidermal barrier function and scratching behavior [2]. Generalized pruritis is present in more than 40% of cases. Behaviors such as scratching, rubbing, and excessive grooming are seen due to the intense pruritis [3]. Acral lick dermatitis is a common skin disease in dogs caused by stereotypical licking of localized areas of the skin, such as the lower legs and armpits, and is believed to be caused by inadequate housing conditions and lack of social interaction and care. This behavior can be treated with serotonin modulators, suggesting an association with serotonin dysregulation [4].

Cannabidiol (CBD) is a non-psychoactive component of cannabis that has many beneficial effects on the body. CBD does not have a direct effect on the CB1 and CB2 receptors of the endogenous cannabinoid system, but has been reported to have neuroprotective, analgesic, anxiolytic, and anti-inflammatory effects. CBD and other hemp-derived natural constituents are expected to improve atopic dermatitis due to their involvement in the regulation of the endogenous cannabinoid system [5].

However, few studies have been conducted on the use of CBD in dogs with CAD [6]. The purpose of this study was to evaluate the efficacy of CBD-containing hemp oil in combination with behavior modification therapy in the treatment of CAD.

Case Presentation

A 48-month-old castrated male Maltese (2.5 kg) dog with a history of atopic dermatitis presented with stereotypical genital licking. The patient was obtained from a pet shop at the age of 2 months. From that time, frequent vomiting and diarrhea occurred and were effectively treated using an antidiarrheal drug. The patient was also noted to frequently have a decreased appetite. While the patient was walked outdoors for approximately 20 minutes per day, he did not urinate or defecate as he was focused on smelling the surroundings and scavenging for food. He swallowed anything he could put in his mouth. The patient played with toys with his owner twice a day and did not bark to make demands. The patient was kept within an enclosed area of the home with a place to urinate and defecate and an area to sleep when his owners were not home and overnight. Throughout the day, he independently went to his bed to lick his genitals or sleep.

At the age of 24 months, the patient’s hair began to change color as a result of licking his hind legs. He was treated with steroids, though the licking behavior would restart once the medication was discontinued. At 44 months of age, allergen identification and a lymphocyte reaction test were performed. The patient was identified as reactive to beef, pork, chicken, eggs, sheep, horse, turkey, duck, and salmon. He was diagnosed with Canine Atopic Dermatitis (CAD) and Adverse Food Reaction (AFR). A wheat-based diet resulted in normalized stools and appetite.

The patient also had a history of growling and was diagnosed with a learned behavior of defensive aggression for self-protection. Growling was observed during the consultation when the veterinarian attempted to palpate the patient and was reported to occur when the owners attempted to remove items from the patient’s mouth, stop the patient from licking his genitals, or take away toys or snacks. The patient was also diagnosed with pica based on reports of his behaviors during outdoor walks. The owner stated that the patient would put garbage and stones into his mouth that the owner was unable to remove.

The patient was treated with prednisolone (1.25 mg every 3 days), oclacitinib (0.9 mg/ day on days he did not take prednisolone), paracasei (lactic acid bacterium Lactobacillus paracasei: approximately 20 billion (live bacteria)/capsule, one capsule per day), and kestose (400 mg/day). On treatment day 35, CBD treatments were initiated. The patient was administered Sweet Potato Soft Chewables (3 mg CBD) (Treatibles; AD Remedies, Inc., TN, USA) three times daily. On treatment day 91, the CBD chewables were decreased to twice daily. On treatment day 94, the oclacitinib was discontinued. On treatment day 150, the prednisolone was adjusted to 1.25 mg every four days.

The patient was maintained on a wheat-based food (pure protein wheat), allergen-restricted diet with gluten-free quinoa biscuits as needed. Erythritol mist, an epithelial moisturizing bacteriostatic mist, was sprayed on the locations that the patient licked. On treatment day 53, the patient’s diet was changed from pure protein wheat to cod (Figures 1 & 2).

Figure 1: Schematic diagram of the treatment process. Changes in PVAS and the drug and CBD doses during treatment and at follow-up.BW, body weight; CBD, Cannabidiol; PVAS, Pruritus Visual Analog Score.

Figure 2: The axilla and forelimb after treatment. Discoloration of the coat has faded. The arrows show the lesion sites before and after treatment. The number of days corresponds to the time that has elapsed since the behavioral treatment was initiated.

Behavior modification methods

The patient’s strict diet was increased as needed when the patient’s desire to eat increased. The owner was instructed to make the patient walk faster so that he could not put foreign objects in his mouth while walking. When the dog tried to sniff the ground during the walk, she gave him a cue to “sit” and rewarded him if he sat down without sniffing. The owner was also instructed to hold the patient during outdoor walks, as needed. Due to the increased walking speed, the patient was allowed additional sleep time throughout the day.

To inhibit genital licking behavior, the patient was trained to obey the commands “sit,” “down,” and “wait” using positive reinforcement methods by rewarding with highly palatable, hypoallergenic treats. Treats were also used for counter conditioning to the licking behavior. In other words, the owner cued him to “come” when he tried to lick and rewarded him if he approached the owner without licking. During the follow-up period after behavioral modification began, aggressive growling and biting behaviors were no longer observed when the owner reached out while the patient was licking.