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MedicalI'm Dr. Tim Shu, I make medical cannabis for animals. Pets can also benefit from cannabis, AMA!

Mar 13th 2018 by tim_shu • 6 Questions • 124 Points

EDIT: Time to sign off! Thanks for all the great questions. Happy International Women's Day and I hope everyone has some great adventures lined up in your future. Hi my name is Hilaree Nelson O’Neill. For nearly two decades, I’ve been a professional ski mountaineer and alpine climber. My first ski expedition to a remote area in the Indian Himalaya ignited a passion for adventure that has taken me to some of the most remote corners of the globe. In all that time India, and more specifically an obscure peak by the name of Papsura, aka the Peak of Evil, remained one of my most beloved places. I recently was selected as one of National Geographic’s 2018 Adventurers of the Year for completing a climb and ski descent of that same Peak of Evil. I’ve been on upwards of 40 expeditions, and I was the first woman to climb two 8000 meter peaks in 24 hours, Everest and Lhotse.

Check out my climbing adventures: - http://on.natgeo.com/2oPPMWc - http://on.natgeo.com/2tpKzcs

Proof: https://i.redd.it/p6gc1fqcndk01.jpg https://twitter.com/NatGeo/status/971810302785478656

Q:

What are some long term side effects if any?

A:

How did everything start?


Q:

Great question. CBD is the primary component of products made for animals. There have been a number of studies observing animal models being administered CBD at varying doses, using various routes of administration at short and long term intervals and the conclusion is that CBD has a wide margin of safety. Our experience reflects the same conclusion. However more pharmacokinetic and clinical studies are warranted to fully elucidate the interaction of cannabinoids within various species. We're starting to get a good understanding of the endocannabinoid system and we need more studies to better understand it, as we're just scratching the surface.

A:

It all started for me when I moved to Chamonix, France at 23 years old. I've skied my entire life but didn't start climbing until I was 19. In Chamonix I learned how to put all of it together, the glaciers, ice climbing, rock climbing, route-finding skiing etc. I lived there for 6 years. It was like a second university.


Q:

What makes cannabis more effective than other drugs (with regards to pets)? Why does it prove an advantage over drug company prescriptions? Negative side effects?

A:

Was there a point you ever just wanted to give up?


Q:

Cannabinoid therapy can be very safe with minimal side effects when formulated and dosed properly. Although not common, potential side effects of diarrhea or sedation are possible. When it comes to treating pain, especially chronic pain, such as arthritis in cats, we don't have many good options and opioids are not good options for chronic pain. This is where cannabis has been a life-saver for many pets. It's also important to understand that many disease processes require multimodal therapy, and cannabis may be just one component of treatment.

A:

Wow- yes! Many times in my life I have wanted to give up. It's a lot to juggle a family and a career involving so much travel and risk. The hardest time for me was after a Nat Geo expedition to Myanmar where I experienced a lot of difficulty with our team dynamics and incredibly difficult climbing. I came home feeling inadequate and frustrated. I missed my kids terribly. Ironically, it was their influence, and my own passion for the mountains that brought me back.


Q:

Thanks for the response! How does it compare to NSAIDs as far as arthritis goes?

A:

On this International Women's Day can you talk about how you've been influenced by female mountaineers like Stacy Allison (first US woman to summit Everest)?


Q:

Thanks for the question! The concern many owners have with NSAIDs is the potential for serious adverse effects, especially when used long term, as is the case for conditions with chronic pain like arthritis. Kidney damage, liver damage, or GI ulceration are possibilities when it comes to NSAIDs and long term treatment.

A:

I must say that I was not influenced by Stacy Allison. I think her career in climbing has been amazing but I was just never familiar with her story. My roots were in skiing and I was originally influenced by the likes of Kristen Ulmer and Wendy Fisher. As I got into climbing, I greatly admired Lynn Hill, Catherine Destival and Arlene Blum.


Q:

Okay. I've got to ask.

How on earth did you get into this profession? And what were family/friend's opinions on it? Personally think it's a fantastic idea but I can't imagine "I'm making animal weed" went down well! :D

A:

How even? did you have a team?


Q:

The way medicine is practiced today is not the same as it was 50 years ago, or even 10 years ago. The reason is because it's improving, and better options and therapies are available. The way medicine is practiced tomorrow will not be the way it's practiced today, it will improve. It is up to us to push for those improvements. If cannabis has therapeutic potential, we have a moral and ethical obligation to our patients and clients to thoroughly evaluate that potential.

Edit: When I first started the company, many people thought it was a crazy idea, some still do. But we as humans didn't get to where we are now by being content with the status quo.

A:

In regards to Papsura, it took me nearly two decades from when I first saw the mountain to actually successfully climbing the peak and skiing the west face. I had years of gathering experience and the skillset to undertake that expedition. I tried in 2013 with a larger team and we were not able to get far on the mountain. In 2017, I was able to learn from the earlier failed attempt and went with a smaller team, a different time of year and climbed via a different approach.


Q:

Does it effect various species differently ?

A:

When, if ever, did you feel like you were in the most danger, and how did you handle it?


Q:

There are differences among species in regards to how the endocannabinoid system is mapped out. For example in dogs they have the highest concentration of CB1 receptors in their cerebellum, so they can be more sensitive to CB1 agonists like THC. However that's not to say that THC can't be utilized for therapeutic benefit. It can, it just has to be using the proper formulation and dose.

A:

Most recently would be on the ski descent of Papsura in India. Our ascent took much longer than we'd hoped, the weather was a terrible white-out and we were exhausted. I handled it by trusting my teammates, behaving an internal focus to stay in the moment. I chose not to look down whenever possible to quell the fear of the exposure, and I forced my mind to compartmentalize and break up the descent into small pieces so as not to be overwhelmed. Breathing helps a lot as well. I find it keeps the panic at bay.


Q:

Hello and thank you for your continued work in this somewhat burgeoning field. My question is this: What is the difference in medical cannabis for animals versus humans? Does it come down to weight being proportional to dosage?

A:

Hi Hilaree. Congrats on being named a Nat Geo Adventurer of the Year! You have done some amazing expeditions, but what mountain is still left on your bucket list?


Q:

The biggest differences are formulation and dosing. Animals are much more sensitive to THC, so the primary component of cannabis products made for animals is CBD. THC can still be safely utilized therapeutically but needs to be done so at specific ratios of CBD:THC to prevent psychoactivity and adverse effects associated with THC. Dosing is the other crucial element, as their sizes can vary greatly, so the dose must be tailored to their size and need.

A:

I would really love to still go to the antarctic. For me to ski on the peninsula and to climb and ski around the vinson massif has been a dream of mine for years.


Q:

My boxer has cancer, and apparently it flew under the radar for years. He's almost 12 do surgery isn't an option. The cancer gives him upset tummy...and the vet suggested Prednisone but I would have to take him back for blood work every 6 months due to the effects it could have on major organs. the CBD oil helps so much. Helps him eat and it's liquid so it's not difficult to get down him when he doesn't want to eat.

The only downfall is the cost. It can be pretty expensive for a 70 pound dog.

A:

I'm sorry to hear about your pup's cancer diagnosis. Were they able to determine the type of cancer? More and more owners are approaching their veterinarians about the use of cannabis and CBD, and many have changed their stance on it after seeing the results in their clients' animals. I know several veterinarians who have changed their stance on cannabis after seeing positive results with their own pets. Have you discussed CBD with your veterinarian?


Q:

I have. They said it's worth a shot and it won't do any harm, but they said don't expect a lot from it. Most the the veterinarians in our area are pretty conventional when it comes to cannabis. They said he has a mast cell tumor, so it causes allergic/anaphylaxic reactions. He has has been taken to the vet for years for situations where he suddenly can't breathe. The emergency vets and my vet never suspected cancer. They finally got to the point where they said just give him Benadryl when it happens. Now that the tumor finally showed itself ( it grew between two flaps in his ear where it went unnoticed) all the dots finally connected. The CBD oil helps his acid reflux, and he's able to eat better. Most days he gets around great, he's been a great pup and we cherish these days we have left.

A:

I'm glad to hear that CBD has been providing him some relief. It's all about improving quality of life, every day is important. Please give him a hug for me :)

It's good to hear the vets in your area have an open mindset about cannabis. If you don't mind me asking, what part of the country are you in (PM me if you don't want to post publicly)? After speaking to hundreds of vets from around the country, a lot of the vets in legalized states have a very open mindset about it, but even in a lot of the more conservative states vets are wanting to learn more. I was just at Western Veterinary Conference, one of the largest gatherings of veterinary professionals in the world, and there were multiple lectures on cannabis use in animals. Each lecture was filled to capacity and had to use overflow rooms to accommodate all the attendees. It's pretty amazing to watch history unfold.


Q:

Have you or anyone in your field researched the effect of a "tolerance" buildup to CBD's in response to repeated dosing (e.g. "overuse" for many seizures in a short amount of time)? Does the body (human or animal) reach a "saturation" point at which more CBD's becomes useless?

A:

That's a great question and one that needs more study. We know in humans that chronic THC consumption leads to downregulation of CB1 receptors and causes tolerance. CBD tolerance is less clear. There are some anecdotal reports of CBD tolerance, but for many humans and pet owners tolerance using CBD has not been an issue. Many of our clients' pets have been using it for years without issue. One thing to consider is disease progression. Sometimes disease progression can be confused for tolerance. Nonetheless it's an area that needs further study.

Edit: wording.


Q:

Is there an additional benefit to THC vs using just CBD’s? I use HempRx for my dog with arthritis along with other supplements. What is your opinion of the hempRx? Thanks for doing this ama!

A:

The theory behind the synergistic effects of using multiple cannabinoids has been gaining traction. Dr. Ethan Russo has done a lot of work and research in this area. It's important to remember that animals are more sensitive to THC, so proper formulation and dosing are key to avoiding potential side effects.

Although I don't have personal experience with HempRx, it's formulated by Dr. Rob Silver who is a leading researcher and advocate for cannabinoid therapy in animals, so you have the added assurance that they are formulated by a well-respected veterinarian.


Q:

With the lack of FDA oversight and approval, what measures do you take to ensure your product meets certain quality standards? Is it produced in a facility compliant with CGMP or NSF standards? How do customers verify claimed CBD content?

A:

The states have taken the lead in those areas. Third party lab testing is key. Here in California's cannabis industry, every batch of product must be tested for potency, pesticides, residual solvents, and microbials.

Producers and manufacturers are licensed by the state and must abide by the standards set by the California Bureau of Cannabis Control.


Q:

Hi Dr Shu, I am a veterinarian working in SA ER/ICU on the east coast. I would be interested in trying your product specifically for treating hospital anxiety, especially for post operative orthopedic procedures, separation anxiety, and young GSDs (lol). Do you have any anecdotal experience on how the effect compares to trazodone? This is currently our go-to anxietolytic of choice.

My second question would be what effect, if any does your product have on appetite? Current appetite stimulants like mirtazapine, cyproheptadine, and even Entyce have an unpredictable and unreliable response. If your product could be incorporated into a multi-modal analgesia protocol and stimulate appetite there is definitely a huge market in the ICU (pancreatitis, trauma, post operative nausea and pain, etc)!

If you are ever in need of a east coast or Midwest representative, DM me.

A:

Hey doctor, thanks for doing what you do. I worked ER/ICU for 3 years and it gets brutal at times. Although there were also plenty of slow nights spent refreshing the front page of reddit :) Our anecdotal experience when it comes to trazodone vs cannabis is just that - anecdotal. We've had owners report that they switched to cannabis because it lacked the side effects their pet was experiencing compared to trazodone. However we don't hear about the owners that successfully use it without issue.

We do use it for nausea control and have clients that successfully use it for appetite stimulation, primarily in renal failure patients that don't respond to traditional appetite stimulants like the ones you mentioned. I do agree with you that cannabinoid therapeutics will play a large role in multi-modal treatment protocols in veterinary medicine very soon.


Q:

Question:

What about livestock (i.e. poultry, cattle, porcine, etc,) Would it be safe to use on farm animals?

A:

Great question, there is a lot of potential in that area, but we need to do more R&D with farm animals. We do have some clients that use it for their pet birds and pet pigs, but cattle, goats, sheep, etc are an area that we'll be looking into soon.


Q:

Would cannabis be effective in helping a cat with breast cancer?

A:

There's potential, but the truth is we don't know how much. More studies need to be done when it comes to cannabis and cancer. We know that it can help with pain and nausea associated with cancer, and some preclinical studies have shown cannabinoids inducing tumor cell death. But it's important to keep in mind that different cancers will respond differently to therapy. What's the best ratio of CBD:THC and at what dose? How much of a role do minor cannabinoids and terpenes play in cancer therapy? We don't know yet.

Having said that, we've seen some interesting results when it comes to cancer and cannabis. I've seen tumor reduction and remission in a number of cases and some of our clients' pets have lived well beyond their vet's expectations. Many of my associates in the industry have reported very promising results, but this is all anecdotal evidence, and we need more clinical trials to better establish guidelines.


Q:

Whenever I sit down to smoke pot, my 13 year old dog will wobble up to me and plop down at my feet and play with his ears. He sniffs and sneezes when it's the good stuff. Can he just breath in my exhales and get the weed effect?

A:

That is very much not recommended as smoke inhalation can be harmful to their lungs and airways. Additionally, if the cannabis you're smoking is THC dominant and not CBD dominant, he may get adverse effects from the THC. Proper formulation using CBD as the primary component and proper dosing are key!


Q:

Do you own and cultivate the farm your flower is grown on? Are there any plans on expanding outside of the California market?

A:

We partner with farms to source our flower. We will eventually look to markets outside of California.


Q:

Hi Dr. Shu!

Our dog does very well with CBD pet products, but I have to say that yours is BY FAR the best on our local market (Sacramento).

Our little guy has luxating patellas and severe anxiety. Your product has been amazing!

My question:

How do you deal with the stigma and reluctance from pet owners and convince them to give it a try? My in-laws have geriatric dogs and one of them is getting pretty senile. They gave her melatonin and it made things worse. They refuse to even try your product because they think it will freak her out.

Thanks!

A:

I'm glad we've been able to help your pup! I was just in Sacramento a few weeks ago, great city and great vibe, looks a lot different from when I was last there a few years ago.

Education is the biggest factor when it comes to tackling the myths and biases surrounding cannabis. When it comes to any treatment modality, the evaluation of risk vs benefit is key. When properly formulated and dosed, cannabis can have great therapeutic potential with minimal potential side effects, and should be evaluated in that regard, independent of stereotypes or biases.

One of my dogs is 16, and I use it for her arthritis and senility. When she's not receiving her daily dose she will get up in the middle of the night and aimlessly pace. More studies are coming out showing the therapeutic potential of cannabis and cognitive dysfunction, so it's something that can be considered as cognitive dysfunction/dementia is not an uncommon finding in senior dogs.