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. 2023 Nov-Dec;37(6):2291-2300.
doi: 10.1111/jvim.16912. Epub 2023 Oct 27.

The efficacy and safety of cannabidiol as adjunct treatment for drug-resistant idiopathic epilepsy in 51 dogs: A double-blinded crossover study

Aaron J Rozental  1 , Brooke G Weisbeck  1 , Isabella Corsato Alvarenga  1 , Daniel L Gustafson  1 , Breonna R Kusick  1 , Sangeeta Rao  1 , Lisa R Bartner  1 , Stephanie McGrath  1
Affiliations

The efficacy and safety of cannabidiol as adjunct treatment for drug-resistant idiopathic epilepsy in 51 dogs: A double-blinded crossover study

Aaron J Rozental et al. J Vet Intern Med. 2023 Nov-Dec.

Abstract

Background: Approximately 30% of dogs with idiopathic epilepsy (IE) are drug-resistant. Recent studies have suggested cannabidiol (CBD) may be an effective anticonvulsant in dogs with IE.

Objective: To evaluate the addition of CBD to antiseizure drugs (ASDs) on seizure frequency and to report adverse events in dogs with drug-resistant IE.

Animals: Fifty-one dogs. Dogs having at least 2 seizures per month while receiving at least 1 ASD were included in the trial.

Methods: Double-blinded placebo-controlled crossover study. The 5 mg/kg/day dosage met futility requirements after 12 dogs, and a dosage of 9 mg/kg/day was used in the next 39 dogs. Dogs were randomly assigned to receive CBD or placebo for 3 months, with a 1-month washout period between oils. Total numbers of seizures and seizure days were recorded. Diagnostic testing was performed periodically throughout the trial.

Results: At the 9 mg/kg/day dose, the decrease in total seizure frequency was significant compared with placebo. A 24.1% decrease in seizure days occurred in dogs receiving CBD and a 5.8% increase occurred in dogs receiving placebo (P ≤ .05). No significant difference was found in the number of responders (≥50% decrease in total seizures or seizure days). Liver enzyme activities increased at both dosages. Decreased appetite and vomiting were more common in the CBD phase (P ≤ .05).

Conclusions and clinical importance: Cannabidiol decreased total seizures and seizure days compared to placebo when administered to dogs PO at 9 mg/kg/day. Liver enzymes should be monitored with administration of CBD in dogs.

Keywords: CBD; canine; cannabis; epileptic; seizures.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Means and SD of percent change of total seizures from baseline averaged over the course of 3 months while taking 9 mg/kg/day of CBD oil versus placebo, along with conventional ASD treatment (n = 39). Treatment P = .04. CBD, cannabidiol.
FIGURE 2
FIGURE 2
Means and SD of percent change of seizure days from baseline averaged over the course of 3 months while taking 9 mg/kg/day of CBD oil versus placebo, along with conventional ASD treatment (n = 39). Treatment P = .002. CBD, cannabidiol.
FIGURE 3
FIGURE 3
Box and whisker plot comparing serum ALP activity from baseline over the course of 3 months while taking 9.0 mg/kg/day of CBD oil versus placebo, along with conventional ASD treatment (n = 39). There was a significant difference between CBD treatment and baseline in all months (asterisks) (P ≤ .0001). There was no difference between placebo and baseline in any month (P ≥ .88). ALP, alkaline phosphatase; CBD, cannabidiol.
FIGURE 4
FIGURE 4
Box and whisker plot comparing serum ALT activity from baseline over the course of 3 months while taking 9 mg/kg/day of CBD oil versus placebo, along with conventional ASD treatment (N = 39). There was a statistically significant increase in ALT with CBD treatment when compared to baseline (asterisks) (P ≤ .003). There was no difference between placebo and changes in ALT. ALT, alanine transaminase; CBD, cannabidiol.
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