A look at CBD treatment for canine atopic dermatitis

Andrew Rosenberg, DVM, DACVD, began his presentation, “Cannabidiol (CBD) use for canine allergic skin disease”¹ by first explaining the basics of cannabidiol (CBD) and what it means to be used as a supplement. He told attendees at the 2022 New York Vet Show in New York, New York, “Cannabinoids are a unique group of chemical compounds found in the cannabis sativa plant. Very different than marijuana, same plant but different group. CBD is the predominant non-psychotropic cannabinoid found and the difference between marijuana and hemp is that hemp with CBD has a very low concentration percentage of THC [Tetrahydrocannabinol], a non-psychrotrophic amount. So, in order for something to be defined as hemp or CBD, it has to be less than or equal to 0.3% and marijuana typically has about 15% to 40%.”

Andrew Rosenberg, DVM, DACVD, received his DVM from the Cornell University College of Veterinary Medicine in 2009. Rosenberg completed his 3-year dermatology residency in 2013 and achieved Diplomate status with the American College of Veterinary Dermatology in the same year. Since 2015 he has been the practice owner of Animal Dermatology & Allergy Specialists with locations in Riverdale, NJ, White Plains, NY, Rockland County, NY and Long Island, NY.

Studying CBD treatment for canine atopic dermatitis

To see if CBD or cannabidiolic acid (CBDA) could help dogs with skin diseases, Rosenberg conducted his own study² alongside Daniel Bowden, DVM, DACVD; Melissa Loewinger, DVM, DACVD; Joseph J Wakshlag DVM, PhD, DACVN, DACVSMR; and Jeanine Peters-Kennedy, DVM, DACVP. The objective of this study was to determine if CBD/CBDA is an effective therapy for canine atopic dermatitis (cAD). The study was prospective, randomized, double-blinded, and placebo-controlled. Dogs were randomly assigned to receive either 2 mg/kg of an equal mix of CBD/CBDA or a placebo (sesame seed oil capsule) for 4 weeks. A total of 32 dogs were studied with 17 dogs in the treatment group and 15 dogs in the placebo group.²

Rosenberg explained that dogs included in this study had to have a certain score level of atopic dermatitis in order to see how the CBD/CBDA affected the patient. He stated, “They had to have a CADESI-4 score of greater than 10 and less than 60. What is the CADESI-4 score? CADESI stands for Canine Atopic Dermatitis Extent and Severity Index. Basically what it is, it's a validated scale for dermatology investigators to use to really quantify how severe atopic lesions on the skin are.”

In addition, the dogs, “also had to have a pVAS or Pruritic Visual Analog Scale of greater than or equal to 3 cm and less than 8 cm. What is pVAS? It is a validated score of itch level—owner perceived itch level. It's the itch level from 0 to 10 basis and we have owners just draw a line on how itchy your dog is.”

The results

At every examination of the patients, a CADESI-4 score was conducted by one of the veterinarians and the pVAS score was conducted by the owner.

“There was no significant difference in lesions or severity in any groups, at any time point for the CADESI-4. So, what I was seeing as an investigator with how bad their skin looked, [it] did not change,” Rosenberg said. “However, there was a significant difference in the pruritic scale from the baseline at week 2 and very, very close to the beginning of week 4.” In the treatment group, on average at week 2, dogs had shown a 1.9 cm improvement in the pVAS scale. At week 4, there was a 2.2 cm improvement from week 0. Compared to the placebo group there was only a difference of +0.1 cm.¹

“So, there was a difference in treatment groups and placebo groups when it came to how itchy their pets were. When we looked at cytokines, there was no difference between the placebo group and the treatment group.” Rosenberg also noted that in a survey after the study, 10 out 17 owners of dogs in the treatment group said it was effective in improving itch and 10 out 17 owners would use it again. Rosenberg concluded that CBD can decrease pruritis in some dogs with no severe adverse effects.¹

References

1. Rosenberg A. Cannabidiol (CBD) use for canine allergic skin disease. Presented at: New York Vet Show; New York, New York. November 2-4, 2022.
2. Loewinger M, Wakshlag JJ, Bowden D, Peters-Kennedy J, Rosenberg A. The effect of a mixed cannabidiol and cannabidiolic acid based oil on client-owned dogs with atopic dermatitis. Vet Dermatol. 2022;33(4):329-e77. doi:10.1111/vde.13077