CBD for pets is a hot topic everyone seems to be talking about these days, except our vets. Why is that? On this episode of Tripawd Talk, we welcome back Stephen Cital, a veterinary anesthesia and pain specialist, educator, author and expert in the field of cannabis for dogs and cats.
Tune in below to learn about:
- The latest information about CBD for pets
- What we know and don’t know
- Why your vet doesn’t want to talk about it.
- Specific conditions CBD has been proven to help with in clinical studies.
- How to choose a good product
- And the importance of reviewing a manufacturer’s Certificate of Analysis before buying any CBD for pets.
Download the podcast or read the entire transcript below to get started learning about the latest cannabinoid studies and breakthroughs for dogs, cats and people too!
Tripawd Talk Radio Podcast Transcript:
CBD for Pets: Using cannabinoids for pets, what we know, and why your vet doesn’t want to talk about it!
TRIPAWDS: Please welcome Veterinary Technician Specialist and Director of Education and Development at ElleVet Sciences, Mr. Stephen Cital. Welcome back to the Tripawd Talk, Stephen. Thanks for joining us.
CITAL: Hi, everyone. Thank you so much for having me.
TRIPAWDS: Hey, Stephen! We are so happy to have you back. Thank you very much. It has been a while since you’ve been on the show. And the last time you were here, we talked about pain management for cats and that is one of our most popular shows and blog post, so you are giving information that people really want to know about and we really appreciate that. Thank you for being here.
CITAL: No problem. And I always feel bad for the cat because they always get left behind. I think I said that last time and I think I need to say it because they never get as much of attention as they should.
TRIPAWDS: They don’t. But thanks to you and all the great work that you are doing. They are getting there. But now, you’ve gone on on a little bit of a different career path right now. And you are the Director of Education and Development for ElleVet, is that correct?
From anecdote to evidence, how cannabinoids help pets.
CITAL: I am not in practice anymore, which was a big life change and have moved on to a full-time position with ElleVet Sciences, looking at cannabinoid therapy in companion animals.
TRIPAWDS: Tell me more about how you got interested in CBD and with pets and just let our audience know where you are coming from and why you decided to go to ElleVet.
CITAL: Absolutely. So I’m fairly transparent in all the things that I do because I think that’s really important for credibility and integrity of not only companies but certainly the people that work for these companies as well. And what we really sparked my interest in cannabinoid, they are these molecules that come from the marijuana plant or the hemp plant really stems from personal recreational use. I came from California and marijuana is legal for 21 and up, adults, for recreational uses and I’ve certainly partook in some of those plants that are available to us. And it’s not a far stretch when you are using things on a recreational basis to see their application or at least their potential for use in a medical way. And certainly, we see that with the booming medical cannabis industry. Hence, we have so many states now legalizing at least medically and certainly recreationally.
When it came to cannabinoid molecules and particular things like CBD in companion animals like dogs and cats, that was actually brought to my attention and my interest was sparked by pet owners. So working in the Bay Area in California, we certainly had pet owners that were interested in using things like CBD for their cats and their dogs. And at that time, this is maybe four years ago.
At that time, we just didn’t have a lot of information or I didn’t know a lot about it. And kind of took a deep dive into some of the research and figuring out what we actually know about this stuff, what lab animal species have these things like CBD been tested on, how they’ve been tested on regular dogs and cats for that matter. And certainly having clients come in with animals that were dying or have some terminal illness and asking what we thought about using these, and because this animal or this pet was terminal and uncomfortable, we told them we don’t know a lot about this, we don’t necessarily know the dosing really well, but it’s probably not going to hurt.
And at that time, we would have the euthanasia discussions and then that date for that euthanasia would pass and I would call up the client not trying to pressure them into euthanizing their animal but ask them, “Hey, we had kind of talked about maybe it’s time to euthanize Phyto at this point because his disease has progressed so much and his quality of life was poor. And they would say to me, “Well, since starting this CBD product, their quality of life has improved and I don’t want to euthanize them anymore.” And I was like, wow! Maybe I need to pay more attention to this. So I did.
And again, just based off all these anecdotes, really from these clients coming and are using this product really, really sparked my interest, and then I felt more comfortable discussing these things with pet owners whose animal didn’t have a terminal disease or an endpoint to their life. And to my surprise, I found some companies, in particular, ElleVet, that were actually invested in to doing some of the science.
I think it was in 2017 I found out that ElleVet Plant existed and that they were doing an osteoarthritis study at Cornell University. And so, I had a lecture that I was going to be giving in January of 2018 and I found them in the exhibit hall and we chatted a little bit and I said, “Would you please listen to me lecture about this stuff?” And they did and it has been history ever since. And what’s really cool is I think they have an amazing team, dedicated veterinary professionals that have been in the industry for a long state of time, an amazing advisory board of all the top names, the rehab specialists, the surgeons, neurologists, all the top veterinarians in the country part of this advisory board to make a quality, safe, and effective products for pets. So that’s how I got into it.
TRIPAWDS: Wow! All this in four years, that’s incredible. I mean that just shows how much you were – you grew this passion for this product. And just so our audience know, I mean Stephen, you are based in California and you kind of turned your life upside down to take this direction. You went to the East Coast, right?
CITAL: Oh my gosh, yeah. So I’m in Maine now. And if anyone wants to send me anything, you’re more than welcome to send me corn tortillas. Apparently, they don’t have them up here in Maine. It’s all flower tortillas. And being a Mexican, it’s difficult to survive.
TRIPAWDS: You got it. I’m here in Southern California right now. We’ve got tortillas coming out of our ears. I’ll bring you some.
CITAL:: Oh my gosh!
Why vets don’t want to talk about CBD for pets
TRIPAWDS: There are still so many vets out there that are really reluctant to talk about CBD. Why?
CITAL: I think there is a couple of key reasons that veterinarians or veterinary practitioners whether it’s a technician or a veterinarian are concerned about talking about these certain types of products, in particular CBD products, and that’s largely because we didn’t learn about this system that this molecule thing that CBD work on in school. We don’t know anything or we didn’t learn anything about this and know cannabinoid system, we didn’t learn about this in pharmacology class.
And then certainly, the other road bump that we have when discussing these types of products is there’s a lot of really confusing information coming out of veterinary professional organizations so things like the VMA, Veterinary Medical Association and Veterinary Medical Board as far as the legality of this product. And what we have to understand when we are starting to talk about cannabis products in general is cannabis is kind of like the catch net for two different types of plants, Cannabis sativa (L.) is the actual genus of the plant, so the scientific name of this special plant that creates this molecule like THC or CBD.
What we have defined in the law now, which again, is not well-disseminated to all the regulatory bodies and just general people is hemp has a very specific definition in the law and that’s having less than 0.3% THC compared to marijuana, also known as cannabis in a lot of legislation as the states are writing this stuff has greater than 0.3% THC.
THC is the molecules that can make our pets sick or have these what’s called the psychotropic effect so they can get high just like people can but it’s scary for them because they are not intentionally getting high. They are not trying to get this euphoric feeling or space out or get the munchies or have an increase in heart rate. That is very scary for them.
How the Farm Bill Changed Everything
We have to first, understand what products we are using and the legality of that product in your state. So at this point, veterinarians, because marijuana is still a scheduled plant drug so it’s up there with things like heroin and LSD and all those other scary pretty hard drugs, they are not allowed to discuss, recommend, or prescribe those types of products. But what we did see changed at the end of 2018, so I think this is even before we talked the last time or after we talked the last time, we had a bill passed called the Farm Bill, and that legalized or de-scheduled hemp and all its derivatives from the DEA.
Hemp is no longer a scheduled plant like marijuana is, and is allowed to be transported, grown, and processed in all the states. What that bill also did was makes it even more confusing the regulatory side, is that bill did allow states to govern how they want to implement hemp-growing manufacturing programs, so not all the states have bought into this yet even though it’s legal at the federal level.
What the federal government did with that act though is protect hemp growers and farmers and manufacturers, protect them in that they are allowed to transport hemp products through any of the states regardless if the state has bought into actually creating a program itself to manufacture, grow, or produce hemp products.
Does that make sense?
TRIPAWDS: Now, it does. Yeah, thank you. And that explains why hemp – I mean CBD products are in gas stations now. I mean they are everywhere.
CITAL: I think the last piece when it comes to actually using these products or discussing these products with their veterinarian in the hospital is the veterinarians are very confused because they are getting this mixed information form organized veterinary medical associations about the legality of these things. And what hemp products are considered now are supplements or nutraceuticals, so they fall in this weird unregulated by the FDA category. So in veterinary medicine, there are only drugs and there’s food that FDA actually demand that they must be safe and proven to work and all the fun things.
In the animal world, supplements and nutraceuticals are not regulated by the FDA. So the FDA is not going to the manufacturers and making sure everything on the label is correct, they are not demanding scientific studies. So there are a lot of scary products out there. And what had happened is the veterinarians, because these associations are saying they are not FDA approved, are then just saying, “Oh, we can’t use them or talk about them in general.” When the reality is, they are using unapproved supplements and nutraceuticals every single day. I’m sure all of us have bought glucosamine or maybe they got some Denamarin or some FortiFlora or maybe they are using [0:14:30] [Indiscernible], those are also non-FDA approved supplements and nutraceuticals sold in veterinary medicine.
We have this whole long prohibition and stigma against cannabinoids or cannabis in general that has also played into these factors as far as discussing maybe a little bit more of a conservative approach to using these types of products compared to other supplements.
TRIPAWDS: OK. That – yeah, I mean to put it in the same category as something like glucosamine, I mean it’s kind of crazy but I’m really encouraged to see that in every session at a veterinary conference that we have attended over the last couple of years especially the talks that you’ve given, the room has been packed and veterinarians are hungry for this information. They are learning it and they are getting there and it’s getting out to the veterinary technicians and everybody in the community so that we can get good information when we take our dog or cat into the clinic.
The CBD conversations must happen!
CITAL: I’m going to stand in my soap box for just a second. This is a show geared towards pet parents and I can’t encourage pet parents more to really encourage your veterinarians to go learn about this stuff because then they can have this safe conversation with you because there are potential risks for some of these products and they should be aware of that and they shouldn’t be scared of talking about this with you.
And I think the other thing that has been happening is because veterinarians, some veterinarians are scared to talk about these things or they think that there are certain restrictions which are largely unfounded. What’s happening is it’s forcing us, the consumers, the pet parents, to have to get maybe less credible information from the person at the gas station or from what are called the “budtender” at these dispensaries or something, from a high school, or why are we getting medical information for our sick pet from people that are not qualified?
Please, please, please encourage your veterinarians to get involved, learn about this stuff, and hopefully we get an advocate for it because we are going to use it, we as the consumers, whether they give their blessing or not.
Studies about the science and evidence of CBD
TRIPAWDS: Why are people using CBD? What is documented right now and what do you expect to see documented in the coming year or two?
CITAL: Yeah. Speaking for the science and not to a specific product right now, the stuff that we have actual evidence for is certainly the alleviation of discomfort associated to things like osteoarthritis. So that is now documented through the Cornell study. There’s a couple of other osteoarthritis studies that are going to be coming out literally any day now and we do see efficacy there, which is very, very exciting. Again, as far as decreasing discomfort in these animals with diagnosed osteoarthritis.
There was also a pilot study, it’s a fairly small one, so pilot study means they are usually small, kind of discovery studies to see if they need to look further or change their protocol in their upcoming studies. And there was one released this last summer by Stephanie McGrath Lab out of Colorado State University looking at the use of things like CBD for epilepsy in dogs. And what they found or what they discussed in the paper was the owners and the clinicians felt there was a decrease in frequency, severity, and length of seizures in these animals. But unfortunately, they did not meet that 50% reduction that they wanted to see and set up in the protocol.
Technically, the conclusion was that it wasn’t statistically significant in helping things like epilepsy. With that said, the dose that they used in that particular study was low in my opinion. And what they are doing now is they are actually increasing, almost doubling the dose for their 3-year long study which I think they will actually probably meet their criteria of 50% reduction.
With that said, we also have another study going on out of Massachusetts. It’s a different group of neurologists and the hospital is actually being funded by ElleVet Sciences, doing an epilepsy study with their particular product. And what’s interesting about different companies sponsoring these studies, which is really exciting because generally veterinary medicine doesn’t get a lot of money to do studies, hence, there aren’t a lot of studies for a lot of the things that we do, is each of these manufacturers because these products come from a plant, we can’t tell the plant, “I need you to produce 50% of your derivatives of CBD, 0.2% THC, and CBG.” We can’t tell these plants what to do, and they can change from year to year and grower to grower.
These products that manufacturers are making, they can be vastly different. So it’s really hard for veterinary professionals. I think this ties into the, “I don’t know what to tell you,” is we can’t necessarily extrapolate the results from one study and expect the same success with a different product for the same condition that it was used for in the study, if that makes sense.
Because they can be so diverse because they’re from a plant. Some of the other stuff that we have documented so far is that we know things like CBD in particular are going to be safe for our pets. We have three PK studies now done, one is that of Colorado State University where again, Dr. McGrath’s lab did an oral, two oral forms with an oil, one with a capsule and one with a transdermal formula. They were using actually pretty high dosages. They were using 10 and 20 mg/kg twice a day which is a lot higher than I think most practitioners would recommend that are familiar with these types of products.
But again, found that they were safe. They did see an increase in what’s known as the alkaline phosphatase or ALP which is a specific liver enzyme. And we think that’s largely associated to the metabolism of these products. So we are giving these animals this brand new compound, the liver is like, “Whoa! What is this stuff?” And it certainly got extra of this enzyme. It doesn’t necessarily mean the liver is dying or it’s sick or it’s scared or whatever unless we were to see other liver enzymes increase in particular the AST or ALT at the same time.
What’s interesting is even though the Colorado State University study and the Cornell study were not collaborative, they did not work together, the Cornell study also saw an increase in ALP in these old dogs particularly the one that were on traditional non-steroidal anti-inflammatories and the dosages there were actually much different. So like I said, the Colorado State University study was using 10 and 20 mg/kg. The PK studies out of Cornell University were using 2 and 8 mg/kg, so much lower and still saw that increase in ALP.
What’s confusing about all of this is the animals that were used in a more recent study were all younger, healthy animals. It’s a 12-week study. Again, this was using the ElleVet product. For this 12-week study, a 2 mg/kg in cats and dogs, the dogs and the cats in that study did not see an increase in ALP outside the normal reference ranges for this 12-week, which is very good and promising.
I think really speaks to the population that were used in the studies and certainly the dosing as well. So, maybe the Colorado State University, the dosing was higher that induces is ALP increase and because the dogs that were used in the Cornell study were really old and some of them were on other medication that drug to drug interaction made the increases were not super positive as to why it was increasing but we didn’t see anything outside of the normal ranges.
As to this 12-week study in cats and dogs, there was one silly cat that did have a spike. It is always the cat that ruins all this set of data. But there was one cat that did have an increase in the ALP which is a little bit more of a concerning liver enzyme but it peaked at 4 weeks and then went back down and no other liver enzymes were increased. And because there is this one cat that has one particular marker, it was not considered statistically significant in the overall study but it is notable that if you are going to have your pet on these products, you should one, let your veterinarian know that they are going to be on this product so we can look for things like this and two, it may be worthwhile to have regular monitoring, similar to what we do for animals that are on non-steroidal anti-inflammatories for a long period of time, which is typically doing blood work every six months.
How to understand a Certificate of Analysis when buying CBD
TRIPAWDS: Let’s talk about choosing a product because people – it’s a Wild West out there and people are coming in like all sorts of crazy products. And recently, the FDA came down hard on I think it was 15 different companies. And let’s talk about that. Let’s – I know you can go on and on about it so please do.
CITAL:: Yeah. As far as choosing a product, you are absolutely right, it is the Wild West out there. Everybody and their brother is jumping on this bandwagon because it is a huge booming industry and it’s predicted to go up to like a 5 – no, I’m sorry, a $25 million or $25 billion industry within the next five years.
CITAL: Everybody is wanting to jump on to this particular industry to make a little bit of cash. But with that, we see poor production. We see poor products being put on the shelves. And then we created a super saturated market so it’s not easy for pet parents to choose a safe or reliable product. And so, the best way we can really protect ourselves at this point is by asking a company or inquiring with a company about a piece of documentation and it’s known as the Certificate of Analysis. And on the Certificate of Analysis, it should be done by a third party testing lab. The USDA has recently put out some guidelines as well that hemp should be tested by a third party 17025 certified laboratory.
What’s going to be on this Certificate of Analysis is a breakdown of the cannabinoids, so these molecules that come from the hemp plant and their concentration, so we can actually see, “Oh, this product has 50 mg/ml of CBD in it compared to this other product that has maybe 3 mg/ml in it.” So you can help yourself by not only doing a little bit of backwards map and figuring out how many expense it’s going to be costing per milligram especially if you have a larger dog but it will also help your veterinarian appropriately dose your pets.
Outside of just CBD, it will have all the other cannabinoids on there. It should also have a breakdown of what terpenes, and terpenes are the molecules from the plant that provides that aroma, that classic marijuana smell, that really heavy, earthy smell that I think we are all familiar with from our high school or college days or adult days depending on where you live.
But these terpenes also we believe have some therapeutic benefit. And what’s interesting about terpenes is terpenes are recognized by the FDA as GRAS, which is an acronym, no pun intended, which is an acronym that stands for Generally Referred to As Safe, so they are safe products that are in a lot of our food, our cosmetics, our lotions, all those kinds of things. So they add this aroma but they also help produce this thing called the Entourage Effect, which is essentially making the CBD or some of these other phytocannabinoid molecules in the product work better, which is really, really interesting.
We like to see a really product that really smells like those college and high school years because we know that that’s going to work better than something that’s known as an isolate. So an isolate product is just CBD and everything else is taken out. And what we know from not only human literature but some of the lab animal studies that are coming out is when you have all the molecules or most of the molecules from the plant together that were kept together, it seems to work better than an isolate product.
I remember when I first started learning about this CBD stuff, I was like, “Man! If we could just isolate this single molecule out and make it super concentrated, it’s going to work so much better than this whole plant or broad spectrum product.” We now know that that is not true in the slightest. So again, those are two things we want to look for on the Certificate of Analysis.
Does the CBD product have contaminants?
On the Certificate of Analysis, we should also be looking for other contaminants that can be in the product. And this is the big one, this is the kicker for us, because we know that a lot of these hemp extracts are still being imported from overseas where there’s less savory farming practices being done in the US, and so what can happen is pesticides and fungicide contaminants can still be in some of these tinctures and even these trees if they are not grown organically.
My personal preference is looking for a product that was grown organically so I just don’t even have to worry about that. But even if a manufacturer says it’s grown organically, you should still see that they are testing for pesticides and fungicides because you don’t know if there’s going to be pesticides or fungicides drip from a neighboring field, right? And the last thing we want to give our pets, our sick pets, are chemicals, nasty chemicals.
The other thing that we should be looking for are bacterial or pathogen or mycotoxin contaminants in these products. And so again, just like our human food, we have certain bacteria that are good and then we have certain bacteria that are bad and particular things like salmonella, E. coli. We don’t want to see those things in our product.
And then lastly is a section that should be known as the Elemental Analysis, and this is going to be looking for other contaminants like heavy metals in particular things like lead, even arsenic can be contaminating some of these products. So the only real way we have because they are not FDA-approved to protect ourselves is by asking for the Certificate of Analysis. If the company is unwilling to give you a Certificate of Analysis or they give you kind of a doctored one or one that’s kind of incomplete, I wouldn’t use it. I would not use it.
My one last little tidbit as far as arming yourself is I think we all like data and we all like a product that has some research behind it, so lean on the products that actually have some safety data behind it. 99.99% of the products out there don’t have safety data on there. They are a handful of products out there that do have these PK studies, that do have these efficacy studies, and do have these safety studies and I would lean on those because those are the ones that we have the most information on.
TRIPAWDS: Is there a place on the web or some kind of resource that has like a visual graphic of breaking down a Certificate of Analysis that you know about that we might be able to send people to?
CITAL: I have not seen what I would consider a comprehensive one. I have seen articles that people have written where they suggest that – they’re all generally OK but it wouldn’t be up to snuff if I were to be reviewing it. But I will say that we are working, I am working on a series of videos for pet owners with ElleVet Sciences which is going to be on our educational page on how to read these CoAs because it is, it is eye-crossing. You have to do some math. You have to look at all these acronyms and things that you are not familiar with. I mean I have to learn that when I was learning out these things.
When that’s available, why don’t I ping you back and you guys can send that out to your audience?
TRIPAWDS: Absolutely. That is so badly needed because I mean somebody like me, I think about this kind of stuff a lot and I look at that and I’m like, “OK, well, I guess it’s a good thing that you give this to me but I had no idea how to read it.” And with one company, they – their CoA was – it looked great as far as I could tell but they gave me the disclaimer when they emailed me and said, “We have not tested for heavy metals but we plan on doing so.”
CITAL: Yup. Well, I’m glad they are transparent. That’s good.
What to expect when using CBD for pets
TRIPAWDS: What can we expect once we do find a product that we and hopefully our veterinarian are comfortable with?
CITAL: So once you actually find a product, depending on what you want to support the body with, so if you had a patient that maybe had a lot of arthritis and as far as dosing and how quickly you will see results, it is going to be patient-dependence in that there’s a thing called the endocannabinoid system tone, and that’s a big term for how many receptors in your body are empty and needing attention from cannabinoid molecules?
The endocannabinoid system in general is this big set of receptors just like we have serotonin receptors that we take medication for, right? We supplement our serotonin receptors with antidepressants. We have opioid receptors that we supplement with things like morphine when it’s in pain.
The endocannabinoid system receptors sometimes need a little bit of support as well with these cannabinoid molecules, things like CBD that we get from the plant. Depending on how many receptors you have open, how many natural chemicals your body is producing, that generally take care of those receptors. If you are not going to be taking some sort of supplementation, that’s known as the endocannabinoid system tone. Each patient is going to be a little bit different or each animal is going to respond a little bit differently.
But in general, I would say out of personal experience, lots of personal experience, we usually see effects just on the first few days to certainly a week. I think if you are not seeing results after two weeks, it may be worth looking at a different dosing regimen by either increasing or yeah, increasing the total dose or maybe the frequency to which you are giving these particular products. I would say give products a good two weeks to see if you see any changes and sometimes what happens is you aren’t necessarily paying attention to dramatic changes but then one day you noticed you’re like, “Hey, my dog’s legs aren’t shaking anymore.”
That’s what happened with my dog. I was like, “Huh! His legs aren’t shaking anymore.” And I felt like a fraud because I’m supposed to be the pain specialist and didn’t realize my dog was uncomfortable for such a long period of time. But you just kind of wake up and it’s like, “Wow! I think this stuff is working for him now.”
Can you use CBD with other medications?
TRIPAWDS: Is CBD safe to use alongside other medications like pain relievers?
CITAL: Sure. That’s a great question. And what the data so far is telling us is so far, it does appear safe to be giving these types of products with the majority of traditional pharmaceutical drugs. With that said, we should always be aware there are certain drugs that changed the enzymes that your liver produces. They – our pharmaceutical drugs or molecules in general that can be inducers of certain liver enzymes or inhibitors of certain enzymes and that will change how either your traditional pharmaceutical drug may work or how the CBD may work. Even though we have a lot of theoretical ideas about which drugs are inducers or inhibitors, we don’t necessarily see that manifesting in real life at this point.
One anecdote that I do think is worthwhile is if your pet is on higher dosages or chronic Gabapentin which is a very common drug that a lot of our older dogs are on, or maybe they are still on Tramadol which I think we discussed last time doesn’t work in dog but some dogs are still on it, we can see them be a little bit sleepy for the first few days. And whether that’s a drug interaction or maybe it’s because the CBD product just took that extra pain edge off, not really sure, don’t really have proof of that, maybe they are just sleeping more because they are more comfortable.
Instead of it being an actual drug interaction because it does go away within a few days. It’s usually not a concern for us.
TRIPAWDS: Anything else that you’d like to add about CBD in pets?
CITAL: I think I’m good. I think I gave you an earful. And yeah, just be on the lookout for the educational page that we are going to be putting on the ElleVet Sciences page. I encourage all pet parents to talk to their veterinarian about these particular products and ask them to look at the research and to get educated because this isn’t going anywhere. Pet parents want it. The industry is booming. They are going to have to become familiar sooner or later.
TRIPAWDS: You have said it perfectly. Stephen, thank you so much for being here. It’s always so educational and I just – I love that you are doing this now, this kind of work. I think you’ve really found your calling and we need people like you out there. So thanks for leading the way.
CITAL: Well, thank you so much.
TRIPAWDS: Stephen, we can’t thank you enough for your insight on this popular topic. With so much talk about CBD and some pretty confusing product choices out there, we look forward to helping Tripawd’s fans make smart decisions.
Learn more about ElleVet, the science behind their products and the studies they are performing on many CBD products at ElleVetSciences.com. Hear our previous talk with Stephen about managing pain in cats on Tripawd Talk Episode #73 and find all past Tripawd’s podcast at downloads.tripawds.com.
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