Use of medicinal cannabis in animals

Purpose

This position statement is intended to guide veterinarians in their decisions about potential use of CBD in animals.

Position statement

The AVA supports use of evidence-based principles when choosing treatments for animals. As such, veterinarians should use medications that are effective, safe, and of proven quality.  If there is a registered veterinary product available that will achieve the desired therapeutic result, then this should be used in preference to an unproven therapy.

The use of medicinal cannabis in animals is an emerging area of veterinary medicine and continued research into its use is recommended.

Background

Current regulatory framework

In Australia, veterinary products containing cannabinoids must be registered as veterinary medicines. To date the APVMA has not approved any medicinal cannabis products for use in animals.

Medicinal cannabis products with levels of the psychoactive tetrahydrocannabinols (THC) above 2% of the total cannabinoids in the formulation are Schedule 8 in the Poisons Standard and can only be prescribed by human health practitioners who are Authorised Prescribers, or by doctors under the SAS-B program for use in humans.

Products containing the non-psychoactive cannabinoid, cannabidiol (CBD) as the only cannabinoid are listed in the Poisons Standard under Schedule 4. To satisfy Schedule 4 the product must be 98% or more CBD and contain no more than 2% of other cannabinoids including THC.

Recently, CBD has been additionally allocated to Schedule 3 for human therapeutic use only (over the counter medicine available from a pharmacy), however as yet there are currently no CBD products registered for use in humans that are Schedule 3.

Supply and control of medicinal cannabis for animals

Veterinarians may legally prescribe medicinal cannabinoids for animals which satisfy the requirements for CBD under Schedule 4 (i.e. the product contains 98% or more CBD and less than 2% of total other cannabinoids).

Veterinarians should ensure that any CBD products prescribed for veterinary use in Australia have not been produced from domestically cultivated sources. It may be permissible for veterinarians to prescribe CBD products formulated in Australia providing the active pharmaceutical ingredient (cannabidiol) was cultivated outside of Australia and imported with the requisite import licence/permit from the Office of Drug Control.

Locally compounded CBD formulations are also permissible (provided the cannabidiol is imported under permit as described above) and should be sourced through reputable, licenced compounding pharmacies.

Schedule 8 and Schedule 3 cannabinoid products are not allowed for animals.

Recommendations

There is increasing interest in the potential benefits of medicinal cannabinoids in animals, such as use in pain relief, inflammation, neoplasia, anxiety, epilepsy, and appetite stimulation. However, there are conflicting reports around the efficacy of medicinal cannabinoids in treating these conditions,^1,2 and there are a range of registered veterinary medicines already approved for these purposes. There should be demonstrable benefits to justify choosing medicinal cannabinoids over the available registered medicines. Reasons may include the presence of multiple comorbidities needing management, the presence of contraindications to conventional medications or based on the veterinarian’s clinical experience and judgement.

Early indications suggest CBD is likely to be relatively safe in animals, however there is insufficient data on the risks associated with THC in animals. We know that animals can be psychoactively affected by THC and can suffer severe complications which may be fatal. Thus, until there is a body of evidence based on controlled clinical trials to establish safe dose rates and definite therapeutic benefits of THC in animals, the use of THC cannot be recommended. Cautious prescription of CBD for animals should follow AVA policy on the prescription of S4 medications based on the individual clinician's clinical expertise and judgement.

While it is recognised that under a veterinarian’s right to prescribe, CBD may be used under certain conditions, the AVA believes that proponents of medicinal cannabinoids should apply for registration of their product(s) as veterinary medicines through the APVMA process, so that evidence of safety, efficacy and product quality can be demonstrated. This should occur prior to these products becoming available for animal use.

Related AVA policies and position statements

Complementary and alternative veterinary medicines

References

1. De Briyne, N.; Holmes, D.; Sandler, I.; Stiles, E.; Szymanski, D.; Moody, S.; Neumann, S.; Anadón, A. Cannabis, Cannabidiol Oils and Tetrahydrocannabinol—What Do Veterinarians Need to Know? Animals2021, 11, 892. https://doi.org/10.3390/ani11030892
2. Use of cannabidiol (CBD) in dogs and cats | BSAVA Library – Scientific Information Document

Further reading

APVMA Position Statement: Cannabis in veterinary chemical products: https://apvma.gov.au/node/116471

Landa, L.; Sulcova, A.; Gbelec, P. (2016). The use of cannabinoids in animals and therapeutic implications for veterinary medicine: A review. Veterinární Medicína. 61. 111-122. 10.17221/8762-VETMED.

Vaughn, D.; Kulpa, J.; Paulionis L. Preliminary Investigation of the Safety of Escalating Cannabinoid Doses in Healthy Dogs.  Frontiers in Veterinary Science 2020, 7 https://www.frontiersin.org/articles/10.3389/fvets.2020.00051 

Trina H.; Casara A.; Gary R.; Stephanie M. Cannabis in Veterinary Medicine: A Critical Review. AHVMA  2020; 61:17-41