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"He believed his license gave him wide latitude to make judgments and recommendations for patients as long as client-informed consent accompanied his medical recommendations ... and his ethical responsibility required that he act in the best interests of his patient."

Before buying his small hospital on the East Coast, Dr. Lou Knox had owned a progressive small animal practice in Southern California. He prided himself for years on practicing cutting-edge medicine and giving patients and his clients every option the 21st century had made available: laser therapy, acupuncture and physical and massage therapy. He also discusses and recommends, where indicated, medical cannabis use for pet patients. Use of these therapies and medical marijuana therapy discussions in the practice of veterinary medicine in California is an acceptable part of the veterinary landscape (CA AB 2215).

Practicing in his new hospital far from California, Dr. Knox kept up-to-date on the impact of cannabis on canine patients. In the area of pain management, certain forms of renal disease and anti-inflammatory properties, Dr. Knox had seen great therapeutic potential. So, his waiting-room display included a number of nonprescription, non-FDA-approved, holistic products-everything from glucosamine to melatonin-that included some perfectly legal low-TCH cannabis supplements.

Due to the fact there have been many articles in the news and legislation in various states about legalizing cannabis, Dr. Knox was frequently asked questions on this subject by his clients. He responded to the best of his professional and ethical ability-in short, honestly. When asked if he thought cannabis could help certain pets, he replied yes. When asked if he could prescribe the medication, he said no. He explained to clients that there were over-the-counter options they could pursue to assist their pets. He also said he thought that cannabis, in the not-too-distant future, would be an available therapeutic option for pets in most states.

Unfortunately, it didn't take long for the rumor mill to report that Dr. Knox was recommending and prescribing marijuana for pet patients. Some of his fellow vets heard the rumors and reported him to the board.

... [H]is ethical responsibility required that he act in the best interests of his patient. As a result, he honestly gave his professional opinion about the use of cannabis derivatives in pets.

Dr. Knox always prided himself on his professionalism and was anxious to appear before the board and clear his name. When his day in court (so to speak) came, Dr. Knox had an opening statement prepared. He first stated that he believed his license gave him wide latitude to make judgments and recommendations for patients as long as client-informed consent accompanied his medical recommendations. In addition, his ethical responsibility required that he act in the best interests of his patient. As a result, he honestly gave his professional opinion about the use of cannabis derivatives in pets. He finished by saying he never prescribed an illegal substance.

The board heard him out. They advised him that at this time in this state there were federal and state prohibitions concerning the possession, prescription and use of cannabis. They understood that regulations were different in California and that things might change in his home state in the future. Nevertheless, the board members said he must cease and desist recommending and directing clients to procure a banned substance. No further sanction was issued.

Dr. Knox told the board, with all due respect, that legislating progressive change to assist pet patients in the state should be a priority. It's always more admirable to be in the forefront, he argued, not to be reluctantly dragged from behind.

Do you agree with the board or Dr. Knox? Let us know at dvmnews@ubm.com.

Dr. Rosenberg's response:

Let's start by talking about cannabis for pets, not human beings. Therapeutic cannabis formulations for dogs don't impair dogs' judgment. Dogs cannot acquire or abuse the medication. On the other hand, there are clearly medicinal benefits. So, the real issue is potential irresponsible use of cannabis by dog owners.

I see myself as an animal advocate. Veterinarians and responsible pet owners-emphasis on the word responsible-should lobby legislators to allow cannabis derivatives to assist pet patients in need. Rome wasn't built in a day, nor were state board regulations. We must continue to help animals that can't help themselves, which requires innovative cooperative change at the federal, state and local levels.

Dr. Marc Rosenberg is director of the Voorhees Veterinary Center in Voorhees, New Jersey. In his private time, he enjoys playing basketball and swing dancing with his wife. Although many of the scenarios Dr. Rosenberg describes are based on real-life events, the veterinary practices, doctors and employees described are fictional.