ECC Suggested Readings
March 2025
Bobbi Conner DVM, DACVECC
I'm currently faculty at Virginia Tech (at the Virginia-Maryland College of Veterinary Medicine) and I'm also a student at Virginia Tech - I'm pursing a part-time Master's in Educational Psychology. I'm so grateful to have the opportunity to continue learning and growing professionally and personally. I think more people should go "back" to school later in life if they can!
A paper that I recently liked…
Analysis of cannabinoids in plasma from 38 cases of suspected cannabinoid intoxication in dogs
Loewen JM, Munn-Patterson ML, McEwen KE, Vuong S, Alcorn J, Chicoine AL.
J Vet Emerg Crit Care (San Antonio). 2024 Nov-Dec;34(6):545-553. doi: 10.1111/vec.13428
Paper Commentary
The study design
This study is a semi-prospective observational study of dogs that were presented with suspected cannabinoid intoxication. Because there are no reliable bedside tests for cannabinoids in dogs, the researchers aimed to determine the accuracy of making a clinical diagnosis based on history and compatible physical examination findings but using reliable (but not readily available) liquid chromatography. I love the practical applicability of studies like this that can support real-world emergency practice!
The study background
Exposure to marijuana is definitely on the rise, and clients aren't always forthcoming or don't always know what their pet has gotten into (or even that they got into something!). Anecdotally, I think many of us have felt pretty comfortable and confident in our assessments of these cases without confirmatory tests. I think it's great to support our belief with evidence - this is also really helpful for newer graduates who maybe don't feel as confident in their own clinical judgment yet. Useful research doesn't always have to be super fancy, or in-depth, or even super expensive! Sometimes the simplest studies can offer really beneficial information.
Study considerations
I think the researchers did a great job of keeping this study very practical. They essentially used a type of convenience sampling (dogs with clinically suspected cannabinoid intoxication with client consent). There are, of course, limitations with this approach. This study does a nice job of confirming that "typical" cases of marijuana intoxication based on history and classic exam findings is a reasonable method for making a presumptive diagnosis. We are left wondering about cases that aren't so classic and whether we are missing those patients. It would have been helpful to include cases for which the clinicians didn't suspect cannabinoid intoxication - perhaps two different control groups: 1) dogs with suspected intoxication with something other than cannabinoids (ie, maybe they only had gastrointestinal signs) and 2) dogs with acute neurological signs not suspected to be neurotoxin/cannabinoids (ie, brain tumor or vascular event was suspected). Comparing results of liquid chromatography in dogs suspected as not ingesting cannabinoids, to confirm the negative predictive value of our clinical assessment, would have strengthened this paper. There's always room for a follow-up study!
Takeaways
This study confirms my approach to suspected marijuana intoxication cases - if it walks like a duck... This will also help me when I'm mentoring early-career veterinarians that they can trust their judgement, too! A wide variety of clinicians, with varying degrees of experience, were part of the study sample - this is another reminder that in many cases we can and should trust our own expertise and don't always have to run a test to confirm what we already know - and this is backed up by evidence in the case of cannabinoid intoxication!
