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Tramadol is available in the market with different brand names. Some of them are Ultram, Ultram ER, ConZip, Ryzolt, Qdolo, Citra, Etc.
Basic Information
What is Tramadol?
Tramadol is a synthetic, centrally acting opioid analgesic. It also inhibits the reuptake of adrenalin and serotonin. Tramadol is used in human medicine for the management of osteoarthritis pain and is gaining acceptance in veterinary medicine to treat mild to moderate pain in dogs and cats. In addition to its analgesic properties, tramadol may also have some mild anti-anxiety effects.
Tramadol is used preoperatively, peri-operatively and in chronic pain situations. It is a scheduled drug and can provide analgesia with less sedation or fewer of the undesirable side effects found with other opioids. Tramadol may be used concurrently with non-steroidal anti-inflammatory drugs. It can be given orally with or without food.
Dogs and Cats
Tramadol is used in dogs and cats for management of chronic and acute pain. There is a fairly large range in dose and dose intervals in the literature, which may be indicative of inter patient variability. Based on one small study of eight cats, it would appear that twice a day dosing is adequate, and that the incidence of side effects may be higher in cats than in dogs.
This is a relatively new drug in veterinary clinical practice. Preliminary results are promising and there should be more clinical experience and studies published in the relatively near future.
Rabbits and Ferrets
Tramadol has been used in rabbits and ferrets for the management of mild to moderate pain. Uses in the rabbit include postoperative pain, fracture care, and pain after dental procedures. It may be used with NSAID drugs.
Horses
There are limited reports on injectable tramadol use in horses and foals. One particularly interesting report discusses the use of tramadol sedation for endoscopic examination. The tramadol sedation produced no significant changes in arytenoids cartilage abduction, which would make it an attractive drug for the evaluation of the upper airway. Tramadol may also be used for long-term pain management through an epidural catheter.
Side Effects
• Tramadol is generally well-tolerated in dogs and cats.
• Potential side effects in the dog could include central nervous system depression, sedation, dizziness, GI disturbances, loss of appetite, vomiting and constipation.
• There is little information available in the cat, but additional side effects may also include dysphoria and mydriasis.
Precautions
• Tramadol is contraindicated in animals with a history of hypersensitivity to opioids.
• Tramadol has been shown to lower the seizure threshold in humans. It should be used with caution in animals with seizure disorders or with other drugs that may also lower the seizure threshold.
• Tramadol should be used with caution with other CNS or respiratory depressant drugs.
• Tramadol should be used with caution or at a lower dosage in older animals, debilitated animals, and animals with decreased liver or kidney function.
• Physical dependence is not as likely as with other opioid medications, nevertheless, animals that have been receiving tramadol on a chronic basis should be withdrawn gradually.
• Diversion of this drug for human use can occur. Veterinarians may need to be cognizant of “drug seeking” client behavior.
Drug Interactions
• Tramadol should be avoided or used with caution in patients taking other drugs that also increase circulating serotonin levels, including monoamine oxidase inhibitors (MAOs), selective serotonin reuptake inhibitors (SSRIs), SAMe or tricyclic antidepressants (TCA). Elevated serotonin levels can lead to "serotonin syndrome." Symptoms of serotonin syndrome include sedation, restlessness, altered mentation, muscle twitching, hyperthermia, shivering, diarrhea, loss of consciousness and death.
• Other drugs that may interact with tramadol include: digoxin, quinidine, and warfarin.
Overdose
• Oral overdose can lead to respiratory depression, coma, seizures, cardiac arrest, and death.
• Naloxone should not be used in the case of overdose with Tramadol. Tramadol is not a classic opioid and will not be completely reversed by naloxone.
About the Author
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University Of Pennsylvania School Of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Blood-horse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
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