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ByFloSin
26th February 2014, 08:32 PM
Rebel is on a small cocktail of meds for both SM/CM and also a low grade heart murmour.

He is sensitive to changes in air pressure, with vocal expressions of pain if I miss a sudden change, which happened yesterday.

He is prescribed Gabapentin: 100 mg up to 300 mgs daily if needed by the vet, but I must confess that in the recent bad weather this has become 500, which I know is the maximum recommended dose.

He has 20 mgs Frusemide for his heart 2 times daily

He is given Metacam once daily at half the dose for his weight of 11 kgs because the vet is worried about the potential for liver damage when combined with the other drugs he takes.

The prescribed dose of Tramadol is 3 x 25 mgs daily.

With a few glitches on my part Rebel is kept comfortable and happy. His quality of life is generally good, except of course when the neuro pain occasionally breaks through. His appetite is insatiable.

What I am wondering about is whether it is necessary to give him the Tramadol when air pressure is low and his pain apparently absent? Is it likely to be more effective if used out of necessity or does it work better with regular and continuous use?

I'm afraid I have lost all confidence in his usual vet and that I must take the initiative in the use of the prescribed medications, which is why I am asking for advice here. :bang:

germarey
1st March 2014, 05:42 PM
Hi

Have you tried Omeprazole or Cimetidine yet they allegedly reduce the CSF pressure in the spine. Dont use without your VETs ok though.

Margaret C
27th March 2014, 05:03 PM
"Tramadol works as a painkiller in two ways. First on the opioid system (i.e. similar to morphine) and secondly on the serotonin system. Both inhibit the firing of “pain nerves”. The effect on the opioid system occurs immediately ie one dose could have an effect but in contrast the effect of the serotonin system requires more sustained therapy.

Therefore one could make the argument that tramadol can be used as a single dose or few days therapy as a “top up” when there is break-through pain (I commonly use it for this) or continuously for more sustained relief. It is typically combined with other drugs although it doesn’t have to be.

However the effectiveness of tramadol may depend on the individual and there has been a report which has suggested that the rapid opioid effect may not be realised in some dogs. Therefore if being used as single doses for break-through pain then it needs to be established (by trial) in each individual that this is the right drug for them.

Hope that helps!

Dr. Clare Rusbridge BVMS DipECVN PhD MRCVS
Chief of Neurology Fitzpatrick Referrals
Reader in Veterinary Neurology University of Surrey"

Kate H
27th March 2014, 05:42 PM
Oliver has been on Tramadol recently for his arthritis, which was making his back very hunched up. It seems to have worked well, his back is relaxed and I don't feel he needs another course of it at the moment. The main problem with it has been that - from Oliver's face - it tastes absolutely horrible and he really didn't want to swallow either the capsule or the emptied out powder. We got round it by our vet finding another human version, which is rather fragile 50mg tablets (designed to be melted on the tongue by humans) that can be cut into neat 25mg doses in a pill cutter and taste of mint! Thanks for consulting Clare for us, Margaret - the more information we have about these drugs, the better we can help our dogs.

Kate, Oliver and Aled

Soushiruiuma
27th March 2014, 09:07 PM
Tramadol was one of the many things Thistle was taking. I used it anytime she needed an extra dose of the gabapentin (breakthrough pain) to help her until the gaba had time to kick in, we were using a liquid formulation and often was more comfortable within a few minutes. I also tried using it as part of the bedtime combo, it may have gotten an extra 30 minutes of sleep (I never slept more than 2 hours at a time in her final month), but I did not find the effects to last. Opiates also require increasingly higher doses if used chronically, and one side effect is constipation- I'm not sure where tramadol falls on the opiate spectrum for both of those but it is worth bearing both effects in mind if you start using it regularly.

The liquid that we had did not taste bad (ours was a human formulation), I tasted it to see if it would pair better with cheese or peanut butter- turns out it pairs perfectly with everything (Thistle's opinion).