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1:54 PM, Anonymous said... I am writing to ask for help on my almost 15 year old siberian husky, who has been pretty healthy until the last few months. She was attacked by another dog at the kennel, had her ear bitten up and has had multiple infections and fluid in it since, losing hearing and eye sight on the right side of face. She has had renal insufficiency since 2003, but done well with use of glucosamine and chondrotin for arthritis. She has had to be on NSAIDS (Rimadyl, then Deramaxx and Tramadol periodically) for pain and swelling related to this attack. About one month ago, after becoming dehydrated for refusing to eat because the kennel (first time staying at the owner's home since the attack), forgot to give her her Deramaxx making it painful to eat, her weight dropped, Hematocrit dropped from 40 to 35, and her kidney enzymes skyrocketed, with a BUN of 123, Creatinine of 5.23 and Phosphorus of over 7. Also, learned her thyroid had shot up to T-4=6.5; she had been diagnosed Hypothyroid in September after she developed a pacing/panting episode pattern during the night. She had improved on this with discontinuing Tramadol, moving from Rimadyl to Deramaxx and starting .8 of L-thyroxine, and I had been giving her two capsules each day of Calcium Lactate (a phosphurus binder). After her numbers were so high, she was prescribed Epakitin ( a prescription phosphorus binder) and her numbers all significantly dropped, bringing her BUN down to 69. Unfortunately, she fell on Thanksgiving weekend and hurt her tailbone, ending up the local emergency vets on fluids and drugged up with hydromorphine, causing her to fall over and over again hitting her tailbone. I got her out of there and drove to a veterinary medical school a few hours away. She was found to have a UTI and about 25% kidney function and no broken bones. She's on doxycycline for the UTI and also started on Enalapril for hi BP she developed after her fall. No One can check with an MRI for slipped disc because she can't tolerate general anesthesia because of the kidney failure. Her numbers were all high again. My vet and the med school are coordinating care for her since then. Her numbers came down last week after being back on Epakitin, being off all NSAIDS and off her L-thyroxine (she's back to Hypothyroid again). She's started pacing again and the vet recommmended Tramadol, and I finally convinced her to restart .4 L-thyroxine, but just read the comment by Anonymous 4:42 am, aboout Acepromazine (does this affect the kidneys?). My dog's kidney numbers went back up last week, which may be related to use of Tramadol again 50 mg b.i.d., eating human tuna fish without the Epakitin added, as my dog stopped eating her prescription food with all the meds added. Just found something she'll eat with the Epakitin in it, called Spot's Stew, low protein, natural canned food from the pet store, with some regular chicken pieces added to entice her. The pacing and panting continue and after reading this site, I'm going to try and give her the Tramadol in four 25 mg doses. Also, I'll call the vet on Monday to see what she thinks about the Acepromazine. The description of this dog that benefited sounds just like my Nikita, who will almost get laid down, and then pop back up to pace over and over again, during the night. We've had over a week of sleepless nights, so I'm desperate to here back thoughts of folks on this website. I can tell by reading you're all dog-lover's and educate yourself as much as you can on your pets. What I've learned is that it is not the protein in food causing problems with kidney function, but the phosphorus that clogs them up, so a good phosphorus binder is important to use to help your dog's kidneys. I started with the Calcium Lactate OTC Capsules, and now the Epakitin seems to help, but unsure how these other variables are affecting the enzyme tests. I will keep you and your pets in my prayers and ask you do the same for Nikita and me. I look forward to any ideas, feedback. Thanks. Sleepless in Bellevue!
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Tramadol may cause drowsiness and dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Tramadol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Tramadol ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness. Tramadol may cause dizziness; alcohol, hot weather, exercise, or fever may increase this effect. To prevent it, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of this effect. Tell your doctor or dentist that you take Tramadol before you receive any medical or dental care, emergency care, or surgery. Use Tramadol with caution in the ELDERLY; they may be more sensitive to its effects. Tramadol should not be used in CHILDREN younger than 16 years old; safety and effectiveness in these children have not been confirmed. PREGNANCY and BREAST-FEEDING: Tramadol has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Tramadol while you are pregnant. Tramadol is found in breast milk. Do not breast-feed while taking Tramadol . When used for long periods of time or at high doses, Tramadol may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Tramadol stops working well. Do not take more than prescribed.
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Avoid using drugs that make you sleepy (such as cold medicine, other pain medications, muscle relaxants, and medicine for seizures, depression or anxiety). These drugs may slow your breathing or increase drowsiness when used together with tramadol.
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suz said... Hi, my 8yr old golden was just diagnosed with "soft tissue" sarcoma in her front right elbow.We are devestated,we are waiting on some more precise diagnosis but we have been told they feel it is a very aggressive type sarcoma. Bottom line amputation would probably only be a temporary fix and we will lose her anyway. We are just not ready to put her down, but we love her so much we don't want her to be in pain. Do you think Tramadol .50mg every 4-6hrs, combined with Rimadyl twice a day is enough for her pain. I just cant handle the thought of her suffering. Wish there was a pill for broken hearts. My 3yr. old twins keep telling me they "dont want her to go to heaven." Heartbreaking. Thanks for any advice. Suz
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dizziness weakness headache nervousness or anxiety agitation shaking hands that you cannot control increased muscle tightness changes in mood drowsiness blurred vision heartburn or indigestion upset stomach vomiting diarrhea constipation itching sweating flushing dry mouth Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
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Tramadol and its O-desmethyl metabolite (M1) are selective, weak OP3-receptor agonists. Opiate receptors are coupled with G-protein receptors and function as both positive and negative regulators of synaptic transmission via G-proteins that activate effector proteins. As the effector system is adenylate cyclase and cAMP located at the inner surface of the plasma membrane, opioids decrease intracellular cAMP by inhibiting adenylate cyclase. Subsequently, the release of nociceptive neurotransmitters such as substance P, GABA, dopamine, acetylcholine and noradrenaline is inhibited. The analgesic properties of Tramadol can be attributed to norepinephrine and serotonin reuptake blockade in the CNS, which inhibits pain transmission in the spinal cord. The (+) enantiomer has higher affinity for the OP3 receptor and preferentially inhibits serotonin uptake and enhances serotonin release. The (-) enantiomer preferentially inhibits norepinephrine reuptake by stimulating alpha(2)-adrenergic receptors.
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9:35 AM, Anonymous said... My 11 year old (70#)greyhound came up with a limp after having a lean back chair hit her right front paw. She started to limp immediately and has not stopped. I took her to the vet,who seems to think it had nothing to do with the accident. He took x-rays and thinks she has osteosarcoma (bone cancer) I took her her to a cancer specialist who isn't sure of the cause either. She prescribed 50 mg of Tramadol every 12 hours and 1.5 mg of Medacam once a day. The limp is still not any better at all. I increased the Tramadol to 75 mg 2 x/day but she still limps the same. Can I increase either of these medications or are there other medications I can try. Thanks for all your wonderful advice on this blog.
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[2] The socioeconomic costs, as well as the individual costs (i.e., the personal disadvantages in income and career), caused by the incarceration of millions of people are not included in this number. Nor are the many real wars fought in the name of the "War on Drugs" included.
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
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Seizures have been reported in patients receiving ULTRAM within the recommended dosage range. Spontaneous post-marketing reports indicate that seizure risk is increased with doses of ULTRAM above the recommended range. Concomitant use of ULTRAM increases the seizure risk in patients taking:
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Take this medication with a full glass of water. Tramadol can be taken with or without food, but take it the same way each time.
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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Click here for more information on
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