QUARTERLY BEAT
OCTOBER 2026
product remains in pet households, veterinarians will continue to see these cases… especially when it comes in “edible” forms that dogs are drawn to (like chocolate, gummies, etc.). Mechanism of Action of Kratom So, what clinical signs do we see with kratom toxicity in dogs and cats? Kratom contains two main alkaloids: mitragynine and 7-hydroxymitragynine. Mitragynine is the most abundant alkaloid in the plant (according to ASPCA APCC, comprising approximately 12–66% of the plant’s total alkaloid content.) It is metabolized hepatically into 7-hydroxymitragynine, which is also present in the plant at low concentrations. These alkaloids result in most of the signs seen when ingested by dogs and cats. These alkaloids also have an affinity for the mu-opioid receptor agonists and can result in a dose-dependent opioid-like sedation. The alkaloids are also thought to potentially affect other receptors such as the alpha-2 adrenergic receptors, along with serotonin, dopamine and adenosine receptors in the CNS. In humans, lower doses are associated with stimulant properties, while higher doses produce sedation and euphoria. However, in veterinary patients, clinical signs can be variable – either sedative-like or paradoxical. ence—it is measured Toxic Dose, Onset, and Duration Unfortunately, as with a lot of veterinary toxicants, the exact amount of ingestion is often unknown (e.g., think THC amount in brownies – it’s difficult if not impossible to calculate how much was in the product, how much ingested, how much was removed by decontamination, etc.). As a result, an exact mg/kg is often difficult to determine. Add to that, there’s variability in product concentration, formulation (especially extracts), individual metabolism, and incomplete exposure histories. Likewise, with kratom toxicity, there is a known wide variability in reported dose-response relationships (at least in humans). According to the ASPCA Animal Poison Control Center (APCC) database, clinical signs have been reported at doses as low as 0.15 mg/kg. Conversely, exposures up to 5878 mg/ kg have been documented without reported fatalities . Clinical Signs of Kratom Toxicity So, what should we expect with a kratom poisoning case in our veterinary patients? Clinical signs typically develop within a few hours of ingestion. In most cases, signs resolve within 24–48 hours with appropriate supportive care. Kratom exposure may produce a combination of sedative and stimulatory effects. The most commonly reported clinical signs in dogs and cats include: • Miscellaneous signs (e.g., lethargy/sedation) • Gastrointestinal signs (e.g., hypersalivation, vomiting) • CNS signs (e.g., depression, vocalization, agitation, hyperactivity, hyperesthesia, progressing to tremors, etc.) • Cardiac signs (e.g., tachycardia, bradycardia, hypertension)
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KRATOM TOXICITY IN DOGS AND CATS: A GROWING POISONING
TO KNOW ABOUT Dr. Justine Lee , DACVECC, DABT Co-founder, VETgirl
Never heard of kratom? You’re probably not alone, but this “natural supplement” may be more accessible than you realize and is one that veterinary teams should have on their radar. In this VETgirl article, we break down kratom toxicosis in dogs and cats, from its opioid-like and stimulatory effects to the wide range of neurologic, gastrointestinal, and cardiovascular signs it can cause.
You’re working an ER shift when a 4-year-old, MN, Labrador retriever presents for acute agitation, hypersalivation, tachycardiac, and vomiting. The pet owner reports the dog got into a “natural supplement” that the pet owner uses for chronic back pain. You’re sitting there racking your brain, and the pet owner identifies the “gummy” that she purchased on Google… turns out the supplement contains kratom. You pause for a second — WTH is that? Never heard of it? Sounds vaguely familiar? Not quite an opioid, not quite a stimulant, and definitely not something we learned about extensively in veterinary school! Welcome to the up-and-coming world of kratom toxicosis in dogs (and less commonly, cats). Kratom ( Mitragyna speciosa ), a plant indigenous to Southeast Asia, is a member of the coffee family (Rubiaceae). In some countries, the leaves have been chewed, smoked or even brewed (as a tea). More recently in the United States, it has been “advocated” for recreational use, chronic pain, and for opioid withdrawal. As a result, its use has surged in the United States for the past decade. Kratom comes in various forms: from edibles like gummies and chocolates to powders, liquids, capsules, and even more concentrated extract formulations (which may be more potent). Note that since this is a “supplement,” there’s no regulation (e.g., not regulated by the FDA, etc.), quality control, or monitoring of this over-the-counter product in the United States. That said, in over a dozen countries, kratom is considered a controlled substance. Thankfully, some states are now banning its use (including in alphabetical order at the time of writing this blog Alabama, Arkansas, Indiana, Louisiana, Rhode Island, Vermont, and Wisconsin). Although kratom exposures still represent a small percentage of total toxicology calls, the ASPCA Animal Poison Control Center (APCC) based out of Urbana, Illinois recently documented nearly a 400% increase in reported veterinary cases in 2025 compared to 2024. As long as this
While many patients exhibit mild sedation, others may present with more concerning neurologic or cardiovascular abnormalities. Because of kratom’s mixed receptor activity, clinical presentation can vary widely.
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