{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:36:43Z","timestamp":1753893403368,"version":"3.41.2"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Vet. Sci."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Alongside the United States\u2019 growing landscape of legalized recreational marijuana intended for humans, cases of canine marijuana toxicosis have been on the rise. Most commonly these dogs have mild clinical signs and respond well to supportive therapies. However, patients might still be ataxic, unable to walk, or remain heavily sedated at the time of discharge. Our hypothesis was that flumazenil would improve the level of consciousness, brainstem reflexes, gait, and stance in dogs with marijuana toxicosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventeen dogs presenting for marijuana toxicosis were enrolled. MGCS and Canine Marijuana Severity Score (CMSS), were used to assess level of consciousness, brain stem reflexes, gait, and stance. Flumazenil 0.01\u202fmg\/kg was administered IV once. Baseline values immediately before flumazenil administration, 5\u202fmin, 15\u202fmin, and 30\u202fmin after flumazenil were recorded. Serum was collected and analyzed for delta-9-THC using ultraperformance liquid chromatography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a significant change in MGCS and CMSS following flumazenil administration (<jats:italic>p<\/jats:italic>\u202f=\u202f0.0033 and <jats:italic>p<\/jats:italic>\u202f\u2264 0.001). The median CMSS at baseline was 17 (10\u201319), at 5\u202fmin was 18 (10\u201321), at 15\u202fmin was 18 (12\u201322), and at 30\u202fmin was 19 (14\u201322). There was a significant difference between the concentration of delta-9-THC and clinical sign score (<jats:italic>p<\/jats:italic>\u202f=\u202f0.0275).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The administration of flumazenil to dog affected by marijuana toxicosis might result in improved gait, stance, and level of consciousness. There might be some discriminative ability of the CMSS to stratify the severity level of canine marijuana toxicosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fvets.2024.1516181","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T13:54:26Z","timestamp":1734530066000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Flumazenil may improve gait and mentation in dogs presenting with marijuana toxicosis"],"prefix":"10.3389","volume":"11","author":[{"given":"Alyson H.","family":"Fitzgerald","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuntao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott A.","family":"Fritz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex M.","family":"Lynch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique","family":"Ramras","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacy D.","family":"Meola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1111\/j.1476-4431.2012.00818.x","article-title":"Evaluation of trends in marijuana toxicosis in dogs living in a state with legalized medical marijuana: 125 dogs (2005-2010)","volume":"22","author":"Meola","year":"2012","journal-title":"J Vet Emerg Crit Care"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e0261909","DOI":"10.1371\/journal.pone.0261909","article-title":"Prevalence and characteristics of cannabis-induced toxicoses in pets: results from a survey of veterinarian in North America","volume":"17","author":"Amissah","year":"2022","journal-title":"PLoS One"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e0250323","DOI":"10.1371\/journal.pone.0250323","article-title":"The impact of state cannabis legislation, county-level socioeconomic and dog-level characteristics on reported cannabis poisonings of companion dogs in the USA (2009-2014)","volume":"16","author":"Howard-Azzeh","year":"2021","journal-title":"PLoS One"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.2460\/javma.24.02.0092","article-title":"Clinical examination findings and electrolyte abnormalities of dogs with marijuana\/tetrahydrocannabinol toxicity: 223 cases (January 2017-July 2021)","volume":"262","author":"Binagia","year":"2024","journal-title":"J Am Vet Med Assoc"},{"key":"ref5","first-page":"19","article-title":"Two hundred and thirteen cases of marijuana toxicoses in dogs","volume":"46","author":"Janczyk","year":"2004","journal-title":"Vet Hum Toxicol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1016\/j.cvsm.2018.07.008","article-title":"Toxicology of marijuana, synthetic cannabinoids and Cannabidiol in dogs and cats","volume":"48","author":"Brutlag","year":"2018","journal-title":"Vet Clin North Am Small Anim Pract"},{"volume-title":"Cannabis potency data","year":"","key":"ref7"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1111\/vec.12899","article-title":"Successful treatment of a severe cannabinoid toxicity using extracorporeal therapy in a dog","volume":"29","author":"Culler","year":"2019","journal-title":"J Vet Emerg Crit Care"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1053\/j.tcam.2013.03.004","article-title":"Marijuana poisoning","volume":"28","author":"Fitzgerald","year":"2013","journal-title":"Top Companion Anim Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0187197","DOI":"10.1371\/journal.pone.0187197","article-title":"The endocannabinoid system in canine steroid-responsive meningitis-arteritis and intraspinal spirocercosis","volume":"13","author":"Freundt-Revilla","year":"2018","journal-title":"PLoS One"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"18150","DOI":"10.1073\/pnas.1113444108","article-title":"The major central endocannabinoid directly acts at GABAA receptors","volume":"108","author":"Sigel","year":"2011","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/0006-3223(86)90003-x","article-title":"Antianxiety effects of cannabis: involvement of central benzodiazepine receptor","volume":"21","author":"Sethi","year":"1986","journal-title":"Biol Psychiatry"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1097\/ALN.0000000000004846","article-title":"Time to wake up! 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