Laurie's Blogs.
Sep 2018
Maybe 'Trama-Don't Bother!'
The drug tramadol is getting knocked down a peg or two! A recent (Feb 2018) veterinary study showed that tramadol provides no clinical benefit for dogs with osteoarthritis of the elbow or stifle joint. The researchers (Budsberg et al)1 from the University of Georgia studied the effectiveness of tramadol, to carprofen (Rimadyl), and placebo in a randomized, controlled study.
Each group received each treatment in a random order (with a 7-day washout period between). Testing of each substance was done for 10 days. Improvement was measured using force plate analysis and the Canine Brief Pain Inventory scoring system.
And?
Well, the results showed no improvement when tramadol was given compared to either baseline or placebo.
A good article that interviews various veterinarians on the tramadol controversy can be found at:
Some of the comments are that tramadol may have a calming effect, and be useful for the emotional links that pain has on the brain. So, if you are a practitioner who has seen good results with tramadol (and I know there are some of you out there), then perhaps it would be better to think of this drug as an emotion-modifying drug as compared to a pain modifying drug. One vet warns about Serotonin syndrome.
Note: Serotonin syndrome is a potentially fatal condition in which there is excessive nerve cell activity. It is usually caused by the use of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs). To be honest, we saw it at my clinic once in the ‘early days’ of Tramadol prescription. The poor dog was beside himself… looked a bit like a junkie: shaking, twitching, agitated, and not at all acting like himself. Unfortunately, it did become fatal in his case as well!
So, the bottom line is that IF you are wanting to use tramadol, then do so in knowing that it’s not controlling pain. Something else will have to be ‘on board’ to help with that. Additionally, watch for behavioural changes in the animals to whom it is prescribed.
As a referral rehab practitioner, you may need to be the one to advocate for different pain management or to swiftly alert the referring vet of a reaction.
And now you know!
1. Budsberg SC, Torres BT, Kleine SA, Sandberg GS, Berjeski AK. Lack of effectiveness of tramadol hydrochloride for the treatment of pain and joint dysfunction in dogs with chronic osteoarthritis. J Am Vet Med Assoc. 2018 Feb 15;252(4):427-432.
