Tramadol is a fully synthetic opioid analgesic that is categorized by the FDA as a Schedule IV controlled substance. It is not approved by the FDA for use in dogs or any other animal in the management of pain and pain syndromes. However, this has not prevented many veterinarians from actively prescribing the analgesic especially in the management of moderate to severe pain. Because of its ability to bind with natural opioid receptors in the brain, called endorphins, its painkilling effects are deemed comparable to opioid analgesics sans the risk for abuse, dependency, and withdrawal.
Tramadol, through its active metabolite desmetramadol, is primarily indicated in the management of moderate to severe pain brought about by a variety of health conditions that will benefit the most from a centrally acting analgesic. More specifically, tramadol is indicated in the following conditions.
- Pain in canine osteoarthritis
There are no words to describe the severity and intensity of bone pain. And while dogs may not be able to verbalize their pain experiences, they can nevertheless manifest these through other means, typically through changes in canine behavior. What is clear is that canine osteoarthritis affects almost all dogs, although some are more predisposed to its development than others. Suffice it to say, the loss of bone density at the ends of long bones can send fragments of bone tissue into the joint capsule such that if the dog moves, the terminal ends of the opposing bones will be scraping against each other leading to pain. While tramadol doesn’t cure osteoarthritis, it nonetheless blocks the transmission of pain signals so your dog will not be able to feel the pain.
- Cancer pain
If you think bone pain is severe, the algesia emanating from a growing tumor is even more painful since the growing mass can significantly compress on peripheral nerves. This sends massive algesic signals to the dog’s brain that it becomes overloaded with such inputs. Tramadol doesn’t cure canine cancer but it can make your dog’s life easier by making sure that the pain signals don’t reach its brain. Unfortunately, this only works on certain types of cancer pain since severe oncologic states will already require a real opioid analgesic, usually morphine.
- Pain in diabetic neuropathy
Among human diabetics, neuropathy is a very common complication leading to massive injuries of the nerve fibers all throughout the body. The same complication has been observed in diabetic dogs. While canine diabetes will require an entirely different therapy to address the issue of hyperglycemia, tramadol can help by impairing the transmission of pain impulses to the brain. So, even if peripheral nerves are already damaged and are actually shooting impulses to the dog’s brain telling it just how painful the experience is, the brain won’t be able to receive and integrate these signals.
- Post-operative pain
Surgical incisions, regardless of how precise the cut, can still bring a lot of pain since there is extensive tissue damage, albeit in a highly controlled manner. Tramadol can help alleviate the pain associated with surgical procedures.
- Other pain syndromes of moderate to severe in intensity
It should be clear that the activity of tramadol is in the blocking of pain impulse transmission from the peripheral nerves to the central pain processing regions of the brain. Since the transmission is effectively blocked, then the dog will not be able to ‘sense’ the pain. This makes tramadol highly valued in the management of pain syndromes of moderate to severe in intensity.
- Other indications
Tramadol, because of its effects on other receptors in the canine brain, can also be used in the management of non-surgical intervertebral disc disease, lameness, canine cough, anxiety, and canine degenerative myelopathy which is described as a progressive condition marked by the deterioration of the spinal cord, typically as a result of intervertebral disc disease.
Benefits of Tramadol
It is quite easy to see why a lot of veterinarians actually recommend the use of tramadol for dogs. This is despite the legal status of the drug as being not approved for veterinary management of pain by the US FDA. In case you’re wondering what benefits tramadol can bring to your pooch, we’ve outlined them out for you.
- Alleviates pain
It is very clear that the most important benefit of tramadol is the alleviation of pain. While we can always consider our pooches to be particularly tough, maybe even tougher than we are, but this doesn’t automatically mean that they don’t feel pain anymore. And while they may not tell you outright that they’re in pain, there are many telltale signs that they are in agony. Whining, changes in behavior, aggressive tendencies, and many more can be seen from dogs that are in pain. Giving them tramadol can help them not feel this noxious stimulus even for a brief moment while you and your vet are looking for ways to address the root cause of the pain experience.
- Enhances comfort
This is a natural offshoot of the alleviation of pain. An increase in comfort levels can have any implications. It can mean that your dog will be able to rest and sleep a lot better or perhaps enjoy the very things it used to experience. More often than not, the enhancement of a dog’s comfort levels simply means that it will be able to rest fully, allowing its body to heal and recuperate from the physiologic insult.
- Allows for greater mobility
For dogs that have canine osteoarthritis, every bit of movement is painful. It’s like having to drag your feet so that the joints will not scrape against each other. This can have serious implications on your canine friend’s mobility. If it cannot move, how else can it enjoy being a dog? Nobody wants to be forever plastered on his bed, dogs included.
- Fosters greater well-being
As we have already said, we are not really sure how you can measure canine well-being since it is more of a subjective interpretation of things that you see in a particular organism. We can only surmise from our own experiences that the absence of pain, the improvement of mobility, and the enhancement of comfort and rest can really spell optimum well-being for our pooches.
How Tramadol Works
Tramadol itself does not produce the many physiologic effects that are associated with this particular drug. Instead, extensive chemical analysis reveals that the active metabolite of tramadol, desmetramadol, is the one that possesses many of the physiologically important properties of tramadol. For instance, it has been shown the desmetramadol can bind to opioid receptors in the brain by up to 700 times more than tramadol alone. The tramadol active metabolite show special affinity for the mu opioid receptors and, to a lesser extent, delta and kappa opioid receptors. It possesses agonistic activities in relation to these receptors meaning it actually takes the place of natural opioids, known as endorphins, in the brain to bring about its superb pain killing effects. Endorphins are well-regarded for the prevention of the transmission of pain signals; hence, they are mostly considered as centrally acting analgesics.
Tramadol doesn’t only affect the opioid receptors in the brain through the action of its metabolite, desmetramadol, however. The drug is also known to be an inhibitor of the reuptake of both norepinephrine and serotonin. Inhibiting the reuptake of these substances leads to the increasing levels of such substances in the bloodstream where they can further exert their physiologic action. Norepinephrine and epinephrine are primarily responsible for the more effective management of stress by the organism while serotonin has been greatly implicated in a sense of feeling good. In effect, preventing the reuptake of these substances can lead to an increase in overall sense of wellbeing. We are not really sure how canine wellbeing can be objectively measured.
Tramadol has also been shown to be antagonistic to the action of M1 and M3 types of muscarinic acetylcholine receptors as well as alpha-7 nicotinic acetylcholine receptors. Nicotinic acetylcholine receptors are mostly found in nerves and muscles often at the junction between a muscle and a neuron. They are one of several mechanisms responsible for the initiation of muscle contraction. Because tramadol, or desmetramadol to be more precise, acts on these receptors by antagonizing their physiologic effects, this leads to the non-generation of muscle contraction via the nicotinic pathway. Of course, there are other ways of initiating a muscle contraction but this can help in reducing muscle spasms and muscle aches that often accompany pain syndromes.
Of particular importance are tramadol’s effects on the transient receptor potential ankyrin 1, also known as TRPA1. This receptor is found in the plasma membrane of many animals including dogs and is regarded as a sensing mechanism for the presence of environmental stimulants that can lead to the sensations of cold, itching, and pain. Blocking the action of this receptor can thus, help dogs feel a lot more comfortable because of the alleviation of pain, the maintenance of body warmth, and the reduction of pruritus.
Potential Side Effects
First and foremost, tramadol is not necessarily intended for dog use since its formulation is more geared towards people. This fact alone already gives us quite a few issues to be concerned about. And while almost every other veterinarian will actually recommend tramadol to a dog that is suffering from moderate to severe pain, this doesn’t mean there won’t be any side effects that you should be particularly concerned about.
According to experts, tramadol, when used in dogs, can produce the following side effects:
- Constriction of the dog’s pupils
- Loss of appetite
- Upset stomach
- Decreased heart rate
- Possible seizures
Sedation is the most common side effect of tramadol. For many, including veterinarians, this is actually not an issue since you would want your pooch to be sleeping so that it will not feel the pain. Inducing sleep through the sedative effects of tramadol also has the added benefit of inducing relaxation, allowing for faster healing and more effective regeneration of injured tissues.
Seizures are a grave concern since every second of a seizure activity means oxygen is not delivered to the tissues of the brain. These tissues are highly dependent on a good concentration of oxygen, without which they can go hypoxic leading to irreversible brain tissue damage.
While tramadol has not been shown to be addictive or habit-forming like other opioids, it still has the potential for inducing dependence even in dogs. As such, if ever you have to discontinue giving tramadol to your dog, you should not stop it at once. A good rule of thumb is to taper the dose gradually until you can safely remove it from your dog’s system. This helps minimize the occurrence of withdrawal symptoms which may be a source of additional concern to unsuspecting dog owners.
It is also possible that your dog may develop adverse reactions to tramadol. These can typically include, but definitely not limited to, the following.
- Shallow breathing
- Peeling skin rash
- Red blisters on the skin
Also noteworthy are allergic reactions which can include the following manifestations:
- Difficulty breathing or labored respirations
- Red, blotchy, itchy, raised skin lesions
- Puffiness of the face including the tongue and mouth
- Swelling in the throat
In such cases, prompt veterinary consult is a must to avert any untoward incident to your pet pooch.
Things You Should Know about Tramadol
Tramadol is a synthetic narcotic analgesic that is indicated in the alleviation of moderate to severe pain syndromes in human patients. It is not approved by the FDA for use in dogs. However, veterinarians do give it to certain dogs that may have a need for more definitive control of pain such as those with cancer, osteoarthritis, intervertebral disc disease, and many other pain syndromes. While it is safer than morphine and codeine, it does present serious issues of dependency, abuse, and withdrawal. It is thus highly recommended that tramadol be given only with the prescription of a licensed veterinarian and that all other efforts of pain management have failed.
What You Should Tell Your Vet before He Prescribes Tramadol
It is essential to inform your vet if your pooch has a history of seizures. As we have already noted above, seizures are very serious concerns. Also, if your pooch is receiving another narcotic analgesic, tranquilizer, sedative, or any other anti-anxiety drug, then your vet has the right to know this, too. Allergy to tramadol is an absolute contraindication. It should also be used with caution in dogs with stomach disorders, liver problems, and kidney disease as well as pooches that are lactating and/or pregnant.
How to Give Tramadol to Your Dog
There really is no chance of knowing if the tramadol dose you’re giving to your dog is appropriate or not since the product itself is not really formulated for canine administration. Nevertheless, current veterinary practice puts the recommended dose of tramadol for dogs at 0.45 to 1.8 milligrams per pound of your dog’s bodyweight. The frequency of administration is quite dependent on the nature and severity of the pain. If the pain is classified as having non-cancer origin, then the frequency of dosing is every 8 to 12 hours. However, if the pain is brought about by cancer or a growing tumor, the frequency of administration is more frequent at every 6 hours.
It is essential to adhere to the dosage recommendation of your veterinarian since tramadol is specifically for human consumption only, not for dogs. Always provide your dog with plenty of water to drink to facilitate improved clearance of drug metabolites. A water fountain can come in handy.
What to Do If You Miss a Dose
In situations where a dose was missed, the next succeeding dose can be given as scheduled. However, if the next scheduled dose is still several hours away, then the missed dose can be administered right away. If any, it is the doubling of a dose to make up for a missed dose that you should never do, no matter how tempting.
What to Do in Case of Tramadol Overdose
It is easy for dogs to experience tramadol overdose, though through no fault of their own. The tendency is for dog owners to give their pooches the same tramadol dosage taken by humans. Unfortunately this often leads to canine tramadol overdose. If such an event occurs, a visit to the emergency department of a veterinary facility is a must.
Some Drug Interactions
Monoamine oxidase inhibitors, antidepressants, warfarin, ketoconazole, digoxin, and any other drug or preparation that can somehow negatively impact or even potentiate the effects of tramadol should never be given concomitant to the administration of tramadol. Herbal products, nutritional supplements, and even OTC drugs for dogs should always be consulted with your vet for possible drug interactions with tramadol.
Tramadol is a very powerful and relatively safe pain reliever especially for human pain syndromes. Unfortunately, its use on dogs is not warranted by the FDA and as such there are serious issues that need to be adequately addressed. In such cases, it is critical that the administration of tramadol be performed according to the strict recommendations and guidelines of a licensed veterinarian who truly understands the ramifications of using a human pain reliever on dogs.