Tramadol for Dogs, What Is the Dosage?

Tramadol, is an oral pain medication for dogs & cats (and humans). We focus on dogs in this discussion, but another Caring for Pets blog entry will discuss Tramadol and cats.
 
What is Tramadol used for?
Tramadol is an oral pain medication that helps dogs with pain including
  • 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 pet home from the vet clinic following dental treatment, spay or neuter surgery, declaw surgery, or wound treatments with just Tramadol.
 
If your pet is in pain, request Tramadol and another pain medication or pain therapy. For example, take home Tramadol and a drug like meloxicam, that is a nonsteroidal anti-inflammatory drug (NSAID). Some commonly prescribed pet NSAIDs that are used along with Tramadol are Aspirin, Meloxicam (Mobic) Etogesic, & Piroxicam. If your dog can have an NSAID with its Tramadol, then it might be prescribed Gabapentin, Amantadine, or Tyelenol.
 
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 dog’s feel good neurohormones helps prevent the depression that can accompany pain.
 
The second way Tramadol acts is as a direct pain reliever, similar to morphine. Unfortunately, Tramadol is far less potent than morphine—it has about 5% of the effectiveness of morphine. This is why dogs that are in pain should not be prescribed only Tramadol.
 
How often can Tramadol be given?
Tramadol can be given from one to four times a day. Some drugs, NSAIDs for example, can only be given once a day, but Tramadol can safely be given up to four times a day.
 
Although it’s convenient for us to give a pet medication only once a day, it’s better to give Tramadol at least twice a day to provide more consistent pain relief than a once-a-day dose provides.
 
What dose of Tramadol is used for dogs?
Dogs can have 1-5 mg/kg of Tramadol. For example, a 20 kg dog can have 20-100 mg of Tramadol up to four times a day. Your veterinarian may prescribe a schedule something like this for a 20 kg dog:
  • start with 50 mg of Tramadol twice a day,
  • if still painful give 50 mg three or four times a day
  • if still painful, give 75 mg three or four times a day. etc.
 
What if the maximum dose doesn’t provide pain relief for your dog?
Signs of pain are: restlessness, irritability, no desire to play, reduced appetite, etc. If you’re not sure if your dog is in pain, use common sense—if you just had a similar surgery or injury, would you be in pain?
 
If your dog is painful, and is receiving the maximum dose of Tramadol (5 mg/kg four times 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, massage, joint supplements, gabapentin, SAMe, maropitant (Cerenia). A multimodal approach to pain in dogs is always more effective than a single approach.
 
Cautions with Tramadol
Generally, Tramadol is a very safe medication for dogs, but side effects may occur especially in very young or old dogs 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 dogs or those with liver or kidney disease, Tramadol is initially prescribed at the low end of the dose range (1mg/kg) and with less frequency (once or twice a day rather than three or four times a day.
 
Don’t give high doses of Tramadol to dogs with epilepsy without discussing this with your veterinarian. Epileptic dogs may be better off with lower doses of Tramadol and high doses of Gabapentin.
 
Dogs with liver disease may benefit from lower doses of Tramadol than do dogs with healthy livers.
 
What to do if your dog has side effects
If your dog 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 of Tramadol, giving it less often, giving supplements to support the liver, or using antinausea meds like Cerenia (approved in Europe and Canada, but not the US).
 
Tramadol and cats
Although cats can be prescribed Tramadol, don’t’ give the combination drug with Tramadol and acetaminophen (Ultracet) to cats!!. Cats can receive Tramadol but not acetaminophen (Tyelenol).

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