Tramadol for Cats, What’s the Dose?

What's Tramadol?
Tramadol is an oral pain medication for cats & dogs (and humans). We focus on cats in this discussion, but another Caring for Pets blog entry discussed  giving Tramadol to dogs.

What is Tramadol used for?
Tramadol is an oral medication that helps cats with pain from
  • Abscesses
  • Arthritis
  • Incisions & recovery from surgery
  • Dental work
  • Cancer
Use Tramadol AND other pain drugs or treatments not just Tramadol
On its own, Tramadol is not a very effective pain reliever, so please don’t take your cat home from the vet clinic following dental treatment, spay or neuter surgery, declaw surgery, or abscess treatment with just Tramadol.

If your cat is in pain, request Tramadol and another pain medication or pain therapy. For example, take home Tramadol and a drug like meloxicam, a nonsteroidal anti-inflammatory drug (NSAID). If your cat can’t have an NSAID with its Tramadol, then it might be prescribed Gabapentin or Amantadine.

How does Tramadol work?
Tramadol acts on the brain in 2 ways, it promotes wellbeing and it acts like morphine. The most significant of these actions is the promotion of wellbeing.

Tramadol promotes wellbeing by blocking constant routing of pain signals through the brain, which means it blocks “windup.”

Tramadol also promotes wellbeing by increasing the feel-good neurotransmitters, serotonin and norepinephrine. Maintaining a cat’s feel good neurohormones helps prevent the depression that often accompanies pain.

The second way Tramadol acts is as a direct pain reliever, similar to morphine but Tramadol has only 5% of the effectiveness of morphine. Because Tramadol by itself is not a good pain reliever, cats that are in pain should not be prescribed only Tramadol.

How often can Tramadol be given to cats?
Tramadol can be given from once or twice a day. This is different than in dogs when Tramadol can be given up to four times a day.

What dose of Tramadol is used for cats?
Cats can have 1-2 mg/kg of Tramadol. For example, a 4 kg cat can have 4-8 mg of Tramadol up to twice a day.  This is also different than for dogs as they can have 1-5 mg/kg.

What if the maximum dose of Tramadol doesn’t provide pain relief for your cat?
Signs of pain are: withdrawal,  reduced appetite, irritability, restlessness,  etc. If you’re not sure if your cat is in pain, use common sense—if you just had a similar surgery or injury, would you be in pain?

If your cat is painful, and is receiving the maximum dose of Tramadol (2 mg/kg twice a day), don’t use more Tramadol; change what you’re doing. For example, use additional drugs and therapies (acupuncture, soft laser therapy, salt water therapy (Yes cats can benefit from swimming), massage, joint supplements, gabapentin, SAMe, or maropitant (Cerenia). A multimodal approach to pain in cats is always more effective than a single approach.

Cautions with Tramadol for Cats
Don’t’ give the combination drug with Tramadol and acetaminophen (Ultracet) to cats!!. Cats can receive Tramadol but not acetaminophen (Tylenol).

Generally, Tramadol is a very safe medication for cats, but side effects may occur especially in very young or old cats or those with liver or kidney disease:
  • sedation,
  • anxiety,
  • nausea & vomiting,
  • loss of appetite, or
  • itching.
To help reduce these side effects, especially in very young or old cats or those with liver or kidney disease, Tramadol is initially prescribed at the low end of the dose range (1mg/kg) once a day.

Don’t give high doses of Tramadol to cats with epilepsy without discussing this with your veterinarian. Epileptic cats may be better off with lower doses of Tramadol and high doses of Gabapentin.

Don’t give human sustained release Tramadol to cats (or dogs).

What to do if your cat has side effects
If your cat is taking Tramadol and has any of the signs described above, ask your veterinarian what you should do before administering the next dose. Your vet may suggest a lower dose, decreased frequency such as giving it every other day rather than once a twice a day, giving supplements to support the liver, or using anti-nausea meds like Cerenia (approved in Europe and Canada, but not the US). Cerenia also has the benefit of being a pain reliever.

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