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Hi Laurie and readers-

So I just read your blog on Tramadol, and In my experience with my own pets and patients, Tramadol is a good medication for post-surgical pain and managing pain related to osteosarcoma and other end of life pain management issues, severe boney type pain or acute injuries, but my gut tells me that as a long term pain (read "chronic") option it is not a drug of choice. Tramadol is a synthetic opioid, and we know that in humans, opioids are addictive and ultimately not a good solution for chronic pain. In humans, PT, appropriate exercise, emotional work & support, biofeedback, acupuncture, chiropractic, and even some antidepressants are some of the ways chronic pain can be addressed.

Also interesting is the link between Serotonin Syndrome and Tramadol, and what mechanism is at work there. Must be something with receptors being all filled up. The symptoms in that poor dog you saw in your clinic seem to be just like opioid withdrawal to me. (Also along with all of this, the risk of death from overdose is a pretty obvious reality.)

It just makes sense to me that with our pets, we should think along the same lines, and consider carefully the meds used for pain, especially in a day and age where opioid use is at epidemic proportions, and as a whole need to be used less and dispensed with limitations and great care.

THANK YOU for bringing this discussion to the Forum! I look forward to the discussions!

I did have a patient who was put on Tramadol only as the post-op management following a TPLO. The poor dog was in such pain. He tippy toed for a full month until I was able to beg his regular vet to have a look at him and put him on something else / something additional. And then, he started putting the foot down within days.

So, I'm not sure it's as cut and dry as acute versus chronic. I do believe that it can be an adjunct med... but I think what the one article gets at (the Mercola article) is that the mechanism of action might not be to mitigate pain... but rather to have an effect on emotions. Which, while not adequately discussed or even measured in dogs, could be a very real reason for effectiveness. More of a coping aid as compared to pain management.

In regards to the serotonin syndrome, back when I looked it up (about 10 years ago), I found (people) articles that discussed not using it in combination with an anti-depressant. While our patient wasn't on antidepressants, and not many dogs are, there must be some pathway that becomes disturbed or distorted when Tramadol is put into the system. (I liken it to the fact that depression and addition has a genetic component, making some people more prone to those things... so perhaps there is a genetic component in dogs whereby the processing of tramadol makes things go awry.) Forgive me for not putting things into medical terms, I've not found an exact rationale... especially in the case of our patient.
He was still ON the Tramadol when he was acting like a junkie, not off of it and therefore not in withdrawal.
Here's a link to another Mercola article re Serotonin Syndrome: https://healthypets.mercola.com/sites/h ... -cats.aspx

I love your thought processing. I hope others jump into this discussion to give their experience and feedback in regards to Tramadol.

Thanks!

Laurie