How high is your hound?

Now that recreational marijuana use is legal in some states and medical marijuana is legal in many states, marijuana exposure and intoxication in pets is on the rise. A 2013 study reports that the number of marijuana cases at two Colorado veterinary hospitals quadrupled in the five years after marijuana was legalized for medical use there. Dogs are inquisitive by nature and like to think that the world is edible unless proven otherwise, so someday sooner or later someone’s Schnauzer is going to snarf up their stash. Cats usually just sit there and laugh at all the goings-on while they plan total world domination and, besides – they already have catnip. Why would they need another vice? It also looks undignified to be caught holding a bong.

I have treated a few pot toxicities in my years as an ER vet, and most of them played out the same way. Droopy-looking dog comes in, usually dribbling urine (I’m not sure where this symptom comes from, as people don’t do this…so I am told). Owners swear up and down that they have no idea what the dog could have come into contact with, until I mention that I won’t call the cops (unless it was a willful exposure, like they got the dog high on purpose). Once they know they I’m not a narc, usually some variant of “well, my friend did leave a bag of pot lying around” or “actually, doc, my step-cousin was over and he’s a big pothead” is cast about, while they look sheepishly through red-rimmed eyes, staring at my lab coat pockets to see if they might contain a bag of Doritos or a stray burrito.

Most stoned dog cases pass uneventfully with a little time and perhaps some IV fluids, and without the medical pyrotechnics reserved for more serious toxins. I remember one of my first cases, in the pre-OSHA days, when we were treating a pot dog in ICU and the staff ordered some pizza for a meeting, also held in ICU. The poor dog tried to squeeze himself between the cage bars to get at the pizza. Apparently pups get the munchies, too.

Brownies, bongs, and butter

Pot used to be a pretty benign intoxication for pets – when compared to baddies like rat poison, antifreeze, and acetaminophen, a little pot intoxication is a milk run. That may be changing, though, as pot evolves and people find ever more creative ways to distill out the THC (the active ingredient that produces the "high") and concentrate it. Today’s pot is most definitely not the same pot we…uh, they…smoked in college. Different strains of pot have differing levels of THC, and there is always the specter of pot being laced with more nefarious substances like PCP or methamphetamine. THC is fat soluble, which is why ‘pot butter’ is a thing now. The fat in the butter is able to leech out and concentrate the THC from the pot leaves, and guess who loves butter? Well, really, everyone, (especially French chefs) but dogs for sure. The only dog fatalities that are thought to be related to marijuana come from dogs ingesting the highly concentrated THC in pot butter. I think pot bacon may be just around the corner – and remember, you read it here first. (Hello, Patent Office? Get me the Pork Products Division!)

Harnessing the power of fat?

One thing that’s been recently making the rounds of veterinary ERs is using a concentrated fat solution to treat cases of severe pot intoxication in dogs. Just as the THC gloms onto the butter in pot brownies, injecting a high fat lipid solution IV will suck all the THC up and allow the body to break it down slowly. I personally think eating a couple packs of bacon might have the same effect, but no one’s asked me yet. I also think that the High-fat-sucking-up-toxins Effect (another call to the Patent Office, I guess) explains my magically disappearing hangover after a Denny’s Two Moons Over My Hammy®.

Toxicologists differ on the effectiveness of this therapy, and some are concerned that if we are using it for veterinary patients, the lipid medication (which goes by the brand name Intralipid®) may not be available for use in human hospitals, especially human neonatal units where it is a core component of intravenous nutritional mixtures.

So, starve a baby to treat a stoner dog? Lifesaving treatment or needless expense? No one really knows. I have used Intralipid® several times to treat other poisonings with some success, but never for severe pot toxicity. If I was called to do it for a bad case of marijuana intoxication, I would probably try and find some if it was available, but only if I thought the benefit was justified.

Paging Dr. Stoner

And all of this doesn’t even touch on whether using marijuana for pets as a treatment will ever see the mainstream light of day. Some are suggesting its use already for afflictions like cancer and neurological conditions (consequently a few veterinary product companies are ramping up production), while others see it as just another anthropomorphic profiteering scheme. It is being used on pets, and both pet owners and doctors feel they are seeing results. But the data on just how scientifically it helps pets is as hazy as the backstage lounge at a Phish concert.

It could all be wishful thinking and the placebo effect, or maybe it’s just a bunch of stoned pet owners thinking their pets are better. Or there could be something in that little plant that people love to love and love to hate. Aspirin came from willow bark, periwinkles give us mainstream anticancer drugs, and foxglove gifts us with the powerful heart medication digitalis…so why can’t the humble little Cannabis sativa provide pets with relief, too? I am certainly open to the idea that it may help pets, and I don’t really see too much downside, but I’d like to see some data before I could write a prescription with a straight face.

Hashing it all out

It’s not likely to be resolved soon, as it’s a thorny topic with legal, moral, and political ramifications. Both in medical use for pets and in inadvertent pet intoxications, there’s currently more unknown than known, and the usual response to a knowledge void is to call for more studies, more experiments, and more information. Until we have that, the way forward is unclear. For now, I’m sticking with the traditional, both in terms of treating pot dogs and non-pot therapies for other conditions. But the winds of change are blowing, and there’s a faint smell of smoke on them.