13 Jun Winter is here – it’s colder, a season to support pets getting older…
The Expanding Evidence for CBD in Canine OA and Pain Relief
Veterinarians are increasingly introducing CBD earlier into their management protocols – even compared to just a year ago. With a growing body of evidence supporting its safety and efficacy, and fewer adverse effects than traditional options, CBD is becoming a valued part of multimodal pain management in dogs.
Since our previous blog, Exploring CBD: A Hopeful Alternative for Pets with Osteoarthritis, several new studies have deepened our understanding of how CBD interacts with osteoarthritic pain pathways and its potential to enhance quality of life. Mobility remains a critical factor, with the inability to stand or ambulate continuing to be one of the most common reasons for euthanasia in particularly large dogs with musculoskeletal disease. Supporting mobility can quite literally extend and improve life.
Quick Review of what we have previously explored:
1. Pharmacokinetics and Efficacy at Standard Doses
A foundational study (Pharmacokinetics, Safety and Clinical Efficacy of Cannabidiol Treatment in Osteoarthritic Dogs) demonstrated that dosing at 2 mg/kg twice daily significantly improved both pain scores and activity levels (p < 0.01). Veterinary assessments also recorded reduced pain during treatment (p < 0.02).
2. Synovial Endocannabinoid Mapping
Characterisation of Endocannabinoids and Related Acylethanolamides in the Synovial Fluid of Dogs with Osteoarthritis was the first study to quantify endocannabinoids and related compounds in canine synovial fluid — offering molecular evidence for targeting the endocannabinoid system (ECS) in OA.
3. Real-World Efficacy and Gabapentin Reduction
A pilot study using CBD oil reported effective doses ranging from 0.3–4.1 mg/kg BID. Most dogs responded well at 1–2 mg/kg BID. Notably, of 23 dogs on gabapentin, over 90% were able to discontinue (10) or significantly reduce (11) their dose following CBD introduction. Only two dogs in this study failed to respond to CBD at 2 mg/kg BID.
What’s New? Recent Data
While NSAIDs remain a first-line therapy for OA, they’re not suitable for every patient — particularly those with renal compromise or gastrointestinal sensitivity. CBD offers a compelling adjunct or alternative, with anti-inflammatory, analgesic, and quality-of-life benefits now well-supported by clinical evidence.
CBD acts via both CB1 and CB2 receptors. CB1 affects central and peripheral nociceptive pathways, while CB2 — upregulated in inflamed tissues — helps reduce cytokine production, leukocyte infiltration, and bone degradation, all contributing to pain relief in OA joints.
CBD and NSAIDs: Combined Use and Monitoring
A recent placebo-controlled, double-blind crossover study (Evaluation of the Effect of Cannabidiol Administration With and Without NSAIDs in Dogs with Mobility Disorders) followed 42 dogs (38 completed). CBD alone resulted in significantly improved veterinary assessments, accelerometer data, pain scores, and client-reported outcomes, compared to placebo.
However, when co-administered with NSAIDs, elevations in liver enzymes (ALT, ALP) were noted. While these changes were not accompanied by clinical or diagnostic signs of hepatic damage, they do warrant monitoring — particularly at higher doses or when using CBD alongside other medications.
Meta-Analysis: Consensus on Efficacy
A recent systematic review and meta-analysis (Efficacy and Safety of Cannabidiol for the Treatment of Canine Osteoarthritis) aggregated results from five studies involving 117 dogs. The findings reinforced statistically significant improvements in both pain and function, aligning with what many clinicians are seeing in practice.
Consistently it is noted that CBD absorption is enhanced when given with food — a small adjustment that may improve clinical outcomes.
Future Directions and Potential: New Delivery Routes and Long-Acting Formulations
While oral formulations remain the only widely available option for veterinary use, research is rapidly expanding. One study (Therapeutic Efficacy and Pharmacokinetics of Liposomal-Cannabidiol Injection) explored a single subcutaneous liposomal-CBD injection, showing sustained plasma levels and analgesia over several weeks — a potential game-changer for chronic pain management.
Other routes (rectal, transdermal, nasal) have shown limited absorption and are not currently recommended due to poor efficacy, though some compounding is occurring on a trial basis in practice.
Conclusion
As the evidence continues to grow, CBD has moved beyond a novel therapy and is becoming a mainstream adjunct — particularly for dogs with osteoarthritis where NSAIDs may be contraindicated or poorly tolerated. While dosing and monitoring guidelines continue evolving, the consistency in clinical outcomes — particularly in reducing pain and improving mobility — is promising. As we move into the colder months, consider CBD not just as an alternative, but as a proactive addition to your treatment toolkit. Beyond osteoarthritis, CBD also shows potential benefits in managing common geriatric comorbidities, including cognitive decline, anxiety, and appetite changes.
References:
Scientific Validation of Cannabidiol for Management of Dog and Cat Diseases – PubMed