Cat got your tongue when it comes to cannabis?
Veterinarians can add a new item to the growing list of cringeworthy client communication topics: cannabis-based treatments.
"The vet looks nervous. My, how the tables have turned." (Shutterstock.com)The exam room can be an awkward conversation minefield.
“Actually, Mr. Martin, your cat's just plain fat, not fluffy.”
“Good news, Mrs. Pratt! We were able to successfully remove the panties your dog swallowed.”
And while cannabis consumption has long been an uncomfortable subject, the legalization of marijuana in a few states and the passage of medical marijuana laws in several states have altered the stigma and thus the veterinarian-client dynamic. Whereas before, it was the clients who were embarrassed to bring up or admit to marijuana use, veterinary professionals are now faced with the possibility of mentioning-perhaps even recommending-cannibidiol (CBD).
A need for weed?
Though actual research may still be slim, more and more anecdotal evidence suggests that CBD can have positive medical effects in pets in the areas of pain relief and seizure control (and there's certainly a need to take a long look at potential oncological benefits as well).
My own anecdotal evidence started rolling in a few years ago when I diagnosed lymphoma in a technician's dog. She elected to treat her dog with prednisone, adding CBD oils on her own, and the dog had a good quality of life for another eight months-more than double the life expectancy on prednisone alone.
Over the past year, I've had clients seek CBD treatments through various sources to help control their pets' seizures when the traditional anti-epileptic medications I was prescribing simply weren't getting the job done. I eventually had to ask myself if I was underserving my clients.
Cannabis client communication
In case finding a credible website isn't an easy part for you …
I refer my clients to peakvets.com because it provides the CBD concentration (making it easier to dose), and I tell them that CBD oils made via carbon dioxide extraction are best. The dosage I use for both dogs and cats is 0.02 to 0.1 mg/kg orally, twice a day. Other good websites that just give a dosage based on whether the pet is small or large are canna-pet.com, cannacompanionusa.com, treatibles.com, rxvitamins.com and vetcbd.com.
(Note: I admittedly got a lot of this information from listening to fellow Fetch dvm360 conference speaker Michael Petty, DVM, CVPP, CVMA, CCRT, CAAPM.)
Finding credible CBD websites to refer clients to and determining indications and ballpark dosing was the easy part. The real challenge, at least for me, is knowing how and when to bring up CBD treatments.
My first attempts at bringing up cannabis with clients were over the phone. Out of the blue, I called the owner of a pet with chronic arthritis and the owner of a pet with uncontrolled seizures to let them know we may have something worth a shot at improving their pets' quality of life. One politely declined. The other was downright confused.
Since that initial experiment, I've learned it's better to broach the subject face-to-face in the exam room. When discussing treatment options for an appropriate candidate, I may say, “There's some evidence that cannabinoids without the hallucinogenic effects can help with Louie's arthritis,” or, “The attitudes toward cannabinoids are changing, and we may be able to gain better control of Spot's seizures.”
After that, it's all about eye contact. If the client's nonverbal communication screams disinterest or discomfort, I keep moving and focus on traditional treatments or the weather, if necessary. But if I see the client's eyes widen and ears perk up, I have the encouragement I need to continue with a CBD conversation.
Dr. Andrew Rollo is a Veterinary Economics Editorial Advisory Board member and an associate at Madison Veterinary Hospital in Michigan.