As a synthetic, centrally acting opioid analgesic, Tramadol inhibits the reuptake of adrenaline and serotonin. Tramadol is used in human medicine for the management of osteoarthritis pain and is gaining acceptance in veterinary medicine to treat mild to moderate pain in dogs and cats. In addition to its analgesic properties, tramadol may also have some mild anti-anxiety effects.
Tramadol is used preoperatively, peri-operatively and in chronic pain situations. It is a scheduled drug and can provide analgesia with less sedation or fewer of the undesirable side effects found with other opioids. Tramadol may be used concurrently with non-steroidal anti-inflammatory drugs. It can be given orally with or without food.
Tramadol is used in dogs and cats for management of chronic and acute pain. There is a fairly large range in dose and dose intervals in the literature, which may be indicative of interpatient variability. Based on one small study of eight cats, it would appear that twice a day dosing is adequate, and that the incidence of side effects may be higher in cats than in dogs.
This is a relatively new drug in veterinary clinical practice. Preliminary results are promising and there should be more clinical experience and studies published in the relatively near future.
Tramadol has been used in rabbits and ferrets for the management of mild to moderate pain. Uses in the rabbit include postoperative pain, fracture care, and pain after dental procedures. It may be used with NSAID drugs.
There are limited reports on injectable tramadol use in horses and foals. One particularly interesting report discusses the use of tramadol sedation for endoscopic examination. The tramadol sedation produced no significant changes in arytenoid cartilage abduction, which would make it an attractive drug for the evaluation of the upper airway. Tramadol may also be used for long-term pain management through an epidural catheter.
Tramadol should be avoided or used with caution in patients taking other drugs that also increase circulating serotonin levels, including monoamine oxidase inhibitors (MAOs), selective serotonin reuptake inhibitors (SSRIs), SAMe or tricyclic antidepressants (TCA). Elevated serotonin levels can lead to “serotonin syndrome.” Symptoms of serotonin syndrome include sedation, restlessness, altered mentation, muscle twitching, hyperthermia, shivering, diarrhea, loss of consciousness and death.
Other drugs that may interact with tramadol include: digoxin, quinidine, and warfarin.
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