Probable cutaneous adverse drug reaction due to a cannabidiol‐containing hemp oil product in a dog

Abstract

Background Cannabidiol (CBD) in hemp oil has become a widely used product in veterinary medicine. To date, there have been no reports of cutaneous adverse events associated with CBD‐containing oil in the veterinary literature. Clinical summary A 4‐year‐old castrated male Labrador retriever presented with pad sloughing and rapidly progressive cutaneous and mucosal ulceration within five days of administering an oral CBD oil product. Histopathological findings in combination with cutaneous signs were consistent with Stevens–Johnson syndrome. All lesions completely resolved after discontinuation of the hemp oil in addition to a 12 day course of cephalexin and prednisone. Given the lack of alternative causes including other medications, an adverse drug event was deemed probable according to the Naranjo algorithm. Conclusions and clinical importance To the best of the authors’ knowledge, this is the first report of suspected cutaneous adverse drug reaction to a CBD‐containing hemp oil product.

Pharmacokinetics, efficacy, and safety of cannabidiol in dogs: an update of current knowledge

“…It is interesting to note that a particular adverse sign, i.e., erythematous pinnae, which may be observed during treatment with CBD compounded in a transdermal cream, is likely to occur also during oral administration of doses over 10 mg/kg (93). Furthermore, it is also noteworthy a case report (95) where a dog manifested widespread cutaneous erythema and ulceration associated with anorexia and diarrhea 5 days after receiving an oral hemp oil formulation (CBD 0.3 mg/kg, once daily) for anxiety. The absence of a history of cutaneous or systemic disease, the histopathological findings, and the remission after symptomatic treatment and discontinuation of the CBD product allowed the Authors to consider a possible CADR (cutaneous adverse reaction to drugs) to CBD, as described in men (96), or to additional substances in the vehicle.…”

Hemp – Its Use in Prevention and Treatment of Diseases of Companion Animals

“…Histopathological findings combined with skin manifestations were consistent with Stevens-Johnson syndrome. All changes completely resolved upon discontinuation of hemp oil in combination with cephalexin and prednisone therapy [Simpson et al 2020].…”

Erosive and ulcerative stomatitis in dogs and cats: which immune-mediated diseases to consider?

“…14,15 The mortality rate is high and correlates with the percentage of epithelial detachment; shock and sepsis are common causes of death. 13 Various drugs have been implicated (ie, trimethoprim-potentiated sulphonamides, cephalosporins, penicillin, levamisole, diethylcarbamazine, phenobarbital, flea dips, cannabidiol-containing hemp oil product) 13,14,[16][17][18] , although the causality was not always well documented. Infectious triggers are rare.…”