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7:12 PM, Anonymous said... My 2 year old chocolate lab was diagnosed with osteosarcoma yesterday. She has presented with a limp since mid-october but xrays have showed nothing until yesterday when finally they found evidence in her rear leg. Despite not weight bearing on that leg she has not whined, had trouble moving around etc. and has been very happy and well adjusted. After yesterdays xrays when she was coming out of sedation she was whimpering and it didn't taper off so the doctor prescribed 50mg of tramadol three times a day. She is about 70 lbs. When I came home from work today she managed to limp down the stairs to greet me. I gave her the afternoon dosage and shortly afterwards she began whining, really whining. She has not moved, will not elmininate (#1 or #2) even when I carry her outside. She is unable to do even the three stairs at all. She was FINE when I brought her in yesterday in all of these regards and although I know bone cancer is extremely painful I am having trouble believing that overnight she went from painfree (unless joint was palpated) to unable to walk at all and miserable). I am more concerned that she might be experiencing side effects of the tramadol. She is also disoriented and when she has tried to move has walked into doors etc. Should I decrease the dosage or discontinue? I don't want her to be in pain but what if the tramadol is making it worse instead of better???????
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7:52 PM, Anonymous said... Hi, I just wanted to update you. I brought my dog to a new Vet in my area. As it turned out it was not tramadol that made her loose the lose of her legs. To make a long story short her C6 was putting pressure on her spinal cord. She went into surgery yesterday and she is recovering now. They say she might event be able to stand on sunday.
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Hepatic: Metabolism of tramadol and M1 is reduced in patients with advanced cirrhosis of the liver resulting in a larger area under the serum-concentration-versus-time to curve tramadol and longer tramadol and M1 elimination half-lives (13 hrs. for tramadol and 19 hrs. for M1). In cirrhotic patients adjustment of the dosing regimen is recommended (see DOSAGE AND ADMINISTRATION).
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Do not stop using this medication suddenly without talking to your doctor. You may need to gradually reduce the dose. Withdrawal symptoms may occur when you stop using tramadol. Withdrawal symptoms include anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Call your doctor at once if you have any of these withdrawal symptoms after you stop using tramadol.
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Do not crush the tramadol tablet. This medicine is for oral use only. You should not crush tablets or diluted with liquid and inject into the body. Using this medicine by inhlation or injection can cause life-threatening side effects, overdose, or death.
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seizure (convulsions)a red, blistering, peeling skin rash; orshallow breathing, weak pulseContinue taking tramadol and talk to your doctor if you have any of these less serious side effects:
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4:01 AM, Anonymous said... Human prescribing information suggests that when immediate relief is not required, side effects can be reduced by starting Tramadol in small doses and increasing it incrementally at 3-day intervals until a therapeutic dosage is reached. I wish I'd done this with my dog. He is 14 y/o with severe arthritis including impinged nerve roots in both the cervical and lumbar spine. He's healthy otherwise. We're just giving him pain relief as long as he's with us. Unfortunately he's had problems with all the NSAIDs he's tried. We recently started hiim on Tramadol. For the first 3-4 days he was so sedated that he hardly moved - and when he did he was really clumsy - and I think the inactivity really aggravated the pinched nerve in his neck. His lifespan is in days or at most weeks anyhow (pray for him, our other dog, and his human family - thank you) but in another situation I might've been pretty upset about the new med permanently aggravating the problem it was intended to treat.
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Tell your doctor and pharmacist if you are allergic to tramadol or any other medicines. Tell your doctor and pharmacist if you are taking vitamins, nutritional supplements, and herbal products you are taking. tell your doctor if you have or have ever had seizures, head injury, infection in your brain or nervous system, increased intracranial pressure (increased pressure within the skull), diabetes, breathing problems or lung disease, or kidney or liver disease. Also tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have ever used street drugs, or have overused prescription medications. Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tramadol, call your doctor. If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tramadol. You should know that this drug may make you drowsy and may affect your coordination. Do not drive a car or operate machinery until you know how this drug affects you. Remember that alcohol can add to the drowsiness caused by this drug. The manufacturer states that tramadol should not be taken with alcohol containing beverages. You should know that tramadol may cause dizziness, lightheadedness, and fainting when you get up from a lying position. To avoid this, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Side effects
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MORE ON DOSAGE AND ADMINISTRATION: For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, the tolerability of Tramadol can be improved by initiating therapy with the following titration regimen: Tramadol should be started at 25 mg/day qAM and titrated in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg q.i.d.).Thereafter the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg/day (50 mg q.i.d.).After titration, Tramadol 50 to 100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg/day.
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"ULTRAM may induce psychic and physical dependence of the morphine-type (µ-opioid). Dependence and abuse, including drug-seeking behavior and taking illicit actions to obtain the drug are not limited to those patients with prior history of opioid dependence. The risk in patients with substance abuse has been observed to be higher. ULTRAM is associated with craving and tolerance development. Withdrawal symptoms may occur if ULTRAM is discontinued abruptly."
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frogsndogs said... Hi,My 12 year old Sibe was diagnosed with hip dysplasia when he was 2, and up until this past year, we have been able to keep his pain well managed with nutraceuticals (Glucosamine and chondroiton), vitamins and supplements (Vit C, Vit E, Fish Oil), acupuncture (works wonders!), acupressure, and massage. His age is finally catching up with him and early this year we put him on Rimadyl intermittently to control his increased pain. He started urinating frequently and having accidents in the house, so we tested him for UTI and kidney fxn. Both were fine, but we found elevated liver enzymes, so immediately pulled him off of the Rimadyl. Our vet prescribed Zentonil to try to help with the liver (this is working well), and Zubrin for the pain. One capsule of Zubrin was given and he immediately vomited it up - no tolerance. We then tried Metacam. He tolerated it for the first 10 days, then started vomiting again - no tolerance, and it didn't really seem to be helping anyway. Our vet has now prescribed Tramadol (1/2 50mg tablet b.i.d - he is 51 lbs.) and within the first 24 hours we saw an immediate change in his attitude. He is no longer the "grumpy old man" he has been the past few months. He actually wants to trot when we walk to the park, and he is asking to play catch with his ball again. We are wishing we would have been told about this drug months ago. He has been on it less than a week, but in this time we have not seen anything to indicate any adverse reactions. I just thought it would be nice to share some good feedback on this drug. This is a very helpful site and I appreciate everyones' input. I did notice that somebody had asked about interaction with DGP (Dog Gone Pain), but saw no response. Could somebody please address this, as we have been using that intermittently since last year?Thank you!DG in Colorado
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allostasis is the process of achieving stability through changes in behavior as well as physiological features. Allostasis appears to adjust as a person progresses into drug addiction and enters a new allostatic state, defined as divergence from normal levels of change which persist in a chronic state. Addiction to drugs can cause damage to your brain and body as you enter the pathological state; the cost stemming from damage is known as allostatic load. The dysregulation of allostasis gradually occurs as the reward from the drug decreases and the ability to overcome the depressed state following drug use begins to decrease as well. The resulting allostatic load creates a constant state of depression relative to normal allostatic changes. What pushes this decrease is the propensity of drug users to take the drug before the brain and body have returned to original allostatic levels, producing a constant state of stress. Therefore, environmental stressors may induce stronger drug seeking behaviors than in the presence of no environmental stressors.
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Symptoms of overdose may include: decreased size of the pupil (the black circle in the center of the eye) difficulty breathing extreme drowsiness unconsciousness coma seizure heart attack
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If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at
Tramadol is metabolized to M1 by CYP2D6. Quinidine is a selective inhibitor of that isoenzyme, so that concomitant administration of quinidine and ULTRAM results in increased concentrations of tramadol and reduced concentrations of M1. The clinical consequences of these findings are unknown. In vitro drug interaction studies in human liver microsomes indicate that tramadol has no effect on quinidine metabolism.
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This list is not complete and there may be other drugs that can interact with tramadol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
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Nancy Campbell RVT said... 50mg is mid range. What it sounds like to me is that the pain is not being controlled as well. Panting, whining and even the pacing is usually a sign of pain and discomfort. I would consult your veterinarian.Tramadol can be discontinued without tapering.
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Tramadol is a novel analgesic having both opiate agonist activity and monoamine reuptake inhibition that contribute to its analgesic efficacy. Opioid activity is due to both the parent compound and the more active O-desmethylated metabolite. Tramadol acts on the monoamine reuptake systems by inhibiting the reuptake into nerve terminals of both norepinephrine and serotonin. Apart from analgesia, tramadol may produce a number of symptoms including dizziness, somnolence, nausea, and constipation similar to other opioids. High doses of tramadol, often in combination monoamine oxidase (MAO) inhibitors or serotonin-selective reuptake inhibitors (SSRIs), have been associated with a serotonin syndrome consisting of convulsions, hyperthermia, muscle rigidity and pain.
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The second indication is for dosage titration in chronic pain where aspirin and/or paracetamol alone are inappropriate or have failed. For this indication two repeats may be prescribed, however no application for increased maximum quantities and/or repeats will be authorised. This is the only listing for tramadol which allows for repeats to be written without seeking approval from the Health Insurance Commission (HIC), and is specifically to facilitate dosage titration when initiating therapy with tramadol for chronic pain.
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Competing interests: Professor Schug has been and is involved in clinical research on tramadol, partially funded or supported by Grünenthal GmbH, Stolberg, Germany and CSL (New Zealand) Ltd., Auckland.
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Christie Keith said... Obviously we can't know for sure what is going on with your dog. In general, I'd say that it IS hard to know if this is an opioid response (Tramadol is sort of an opioid and sort of not)or if it's from pain. Usually, this kind of opioid response is accompanied by whining and a lack of recognition of the owner. In fact, whining is the single symptom the first vet who prescribed Tramadol to a dog of mine warned me about, as being from too high a dose for that dog. I have never seen it from Tramadol, but I have seen it from Fentanyl and from morphine. This does not sound like what your dog is experiencing, however.Sometimes we do see dogs whose owners say they are "sedated" when what they are is finally getting some deep sleep because their pain is under control. This does not at all sound like what you are describing, either.So, the answer is ... you need to talk to a vet who IS familiar with Tramadol and with pain management. This will be easy. Your vet can simply call and do a consult with any vet school's anesthesia consultants. They will be able to tell him how to evaluate the effect of this drug on your dog.Your vet also could go onto VIN (if he or she is not already a member, they can obtain a free 30 day trial membership; www.vin) and consult with the analgesia/anesthesia consultants there. It sounds to me like your dog is in a lot of pain and really needs some expert pain management here. Fortunately, that IS available, even if your own vet isn't an expert in that area. Please let us know how he does!Christie and Nancy
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