I finally broke down today and had the vet prescribe a pain reliever for Nick's arthritic knee. This weekend he was really struggling and yesterday wouldn't put any weight at all on the leg. I can see by looking at him from behind that there's hardly any muscle left in that leg. After 4 months of experimenting with supplements, I decided it's more important right now to get him using that leg again and try to build up some muscle, and worry about long-term effects later.

In the past he's had reactions to Rimadyl and Deramaxx, where he gets very spacey and drools a lot and doesn't sleep very well. The vet said she could try Metacam, but that's also an NSAID, so it's likely that it wouldn't agree with him either. So now he's starting on a minimal dose of Tramadol, and he can keep up his other herbs and supplements for joint issues, etc.

Has anyone used Tramadol? I know it's a synthetic narcotic, but aside from being addictive is it as damaging to the liver as the NSAIDs?

I haven't used it for the dogs, but its my personal pain reliever of choice. I take it daily and have almost since it came on the market. I have rheumatoid arthritis and I'm violently allergic to NSAIDS (and most other pain relievers). I get good relief from it, have no problem not taking it when I'm feeling good and my liver function is checked every 3 months with no problems so far. I use a tramadol + acetaminophen combination (Ultracet) because it works better for me, and even with the acetaminophen which can be tough on the liver long term I've had no problems.

Tramadol isn't an instant fix (takes up to an hour before I get any relief), but once it kicks in it really makes a huge difference. I do find that I get better relief is I stay on top of the pain, rather than letting things get really bad and then trying to get a handle on it. That may be tougher to do with a dog since he can't tell you when he's starting to feel it and you may not be able to tell he's in pain until its getting pretty bad.

Tramadol has been a godsend for me, personally. Before it was available I had no real options for pain relief.

Thanks for sharing, Sherri. Do you recall if it's the type of drug that takes a few days to show its full effects? Or should it be working in a day? I want to make sure I give it enough time to work before I up the dose if he's still in pain.

I get relief within an hour or so when I take it. It's an "as needed" med, at least for me, so I take it when I hurt, not on a regular dosing schedule.

I seen Tramodol mentioned as a good pain choice many times. It is one of the strongest, non-narcotic pain meds that can be bought. It is available as a generic. I HAVE to take it to go to the dentist, and I take it about an 1 1/2 hours before my appt. It does work, b/c otherwise the shots the dentist gives me won't numb me, but with the Tramadol, I can get thur the appt. I started with the name brand, but then moved on to the generic.

My dogs have chronic pancreatitis, and I can give Tramadol to them if the pain gets bad enough. I haven't yet given any. The pain was bad enough at one point, but at that time I didn't have a good vet working with me to tell me the dosage, and now they are getting meds that are helping with the problem. I have it at hand, tho, in case it does get bad.

Mmmm, me love Tramadol......

Oh, ahem, you meant for dogs.

I've read on the hip dysplasia forums that alot of dogs do well on it who can't handle the Rimadyl, etc. It might be worth a look-see on one of those forums, there's alot of pain management info with that population.

Good luck!

Thanks for all the feedback.

We started off with 1/2 a pill twice a day for two days. He looks like he's starting to use the leg again, but still holds it out to the side when he's standing still. I decided to up it to one pill twice a day this morning, and he looked to be using it more today. I think he's lost so much muscle in it that it's hard to tell if the limp is from the leg not really being able to support him or if it's still sore. I think I'll keep him at this level for several days and see what happens. I feel so guilty to think that I resisted doing this earlier because he clearly must have been in some pain the past 3-4 months. I'm just worried about long-term damage. Although he's 10-11 now, pretty old for a boxer, and we've managed to avoid medicating him for the past three years, so I guess I can't ask for more from him.

I know he's older now, but does the vet feel Nick might be a candidate for physical therapy? Indie's response to hydrotherapy was very good, it can be a great gentle therapy for rebuilding muscle and supporting the joints at the same time. It might be useful to give him some relief and reduce the need for medication. I hope you can find some way to help ease his discomfort. Poor guy, I know I hate seeing my animals in any pain. It's so difficult to watch.

The vet did suggest hydrotherapy, but I can't afford to take him for that on top of acupuncture. Plus he HATES water. It's a struggle to get him in the bathtub for a bath and he trusts us. He doesn't even like being picked up off our bed each night without flailing and struggling. I guess he's got control issues! I'm afraid he would totally freak out about it, and at his age that's never a good thing, but my main issue with it is the cost. I spent $500 on the rabbit at the vet (twice) last month and have another dog going in for $700 surgery to have five cysts removed this month (plus a new roof on the house). I wish money weren't a factor, but right now I don't have a choice.

Ouch, that is tough. FWIW, the hydrotherapy isn't what I thought when I went. Indie doesn't like baths or going in the lake and he did great. They walk them up a ramp into what looks like a plexiglass box which has no water in it. The door seals shut and then the water is filled slowly. They go very slowly and let the dog get acclimated. Some dogs don't even walk at first, they just get them used to going in the box and it filling with water, then later taking a few steps on the treadmill, then progress from there. It might be worth swapping out the accupuncture, I think the cost might be comparable and maybe you could alternate the two over time. Here's some info in case you're able to pursue it later.

http://www.therapyfordogs.com/

Houston took tramadol after his last back herniation. I would say it made him a little spacey and lethargic, but as he was on crate rest that wasn't an issue. One side effect to watch for is nausea, Houston threw up a couple of times while on it.

Just curious ...what supplements have you tryed?
We use supplements for arthritis as well as problems with IVDD and have had wonderful results when used correctly...
The pain meds talked about are very hard on the system...you might be trading one problem for another (although there are times when needed) but I would never use pain meds on a regular basis....
Sorry your guy is in pain....
Have you tryed these supplements in combinations?
Ester-C up to 1000mg per day (when a dog is having problems)
Salmon/Fish oil...high in Omegas...like SeaPet
Gluc/Cond....
Standard process also makes some supplements that I really like
Ligaplex
Muscleoskeletal
Good luck

Just a mention that for less severe athritis, could try homeopathic Traumeel or Zeel (stronger). Crush and give away from food twice a day. But, for really bad pain, it might not be strong enough. But well worth trying first in alot of cases.

I don't know if it's too late for you to see this, but Harley takes Tramadol for her knees. She's had 3 knee surgeries from March '07 to May '08. If she is really in a lot of pain she is allowed 200mg every 8hrs, but I try to keep her around 100mg every 6hrs as needed. Also, if your doctor is willing to actually write you a prescription, I go to our local grocery store and get 180 pills for $10 because it is on their generic list. Hope that helps and that your guy starts using his back leg soon.

WE're going to need some kind of response to acute pain for Lulu. She had a bad night last night and I gave her a baby aspirin and have kept it up today (actually the Bayer Lo-dose). But that can't be sustained for as long as she really needs.

We've been very happy with the Cetyl-m with restoring her range of motion (she can sit with crossed paws now!). And she's taking multiple anti-inflammatories. But sometimes there's breakthrough stuff. Yesterday she played too rough with Tully when we were walking her.

I'll have to bring it up with my doctor. They love Deramaxx there but I'm not a fan of it - even for short courses. I'll have to ask about the Tramadol.

Just an aside, because I am bubbling with joy:

I WILL NEVER NEED TRAMADOL AGAIN!!!!!

We now return you to your previously scheduled discussion. I just happened to have realized that, just now.

I can tell you that when Gina was at the e-vet on Monday morning when I suggested Tramadol, Metacam for anti-inflam and Torb for Narcotic...one of our rehab fosters told me that her experience is that Metacam doesn't seem to last all day like Rimadyl does.
I hate that I am giving any of it to her, but sometimes, you just have to go the drug route to get over the humps.

What brand of Cetyl M are you using? I have Gina on Agility and fish oil and Distress Remedy right now. When we go to see Dr. Wynn next Friday I plan to share with all of you what she recommends for Gina..I am sure many can benefit from the info.

I'm using that one advertised on the Golden web site. I'm feeling too lazy at the moment to look it up - it's got a picture of a BC catching a frisbee on it. I need to get some more - it's no joke giving a loading dose to a 100lb dog! We're also using Connectin which is a product I like for having a nice therapeutic level of glucosamine for long term help, combined with natural anti-inflammatories like papaine and turmeric cucumin.

I had an email exchange with the woman in charge of Japanese Chin Rescue from the Japanese Chin Breed club here in the U.S. She's been following Gina all along and she told me that Gina's neck issue is indeed common and she has a 14 y/o chin with it and her experience is that Tramadol works better in Chins than Rimadyl/Metacam or Previcox. I am going to call the vet this morning to see if we can safely do a switch.

Becca, I have been studying up on inflammation/arthr in dogs and from what I understand, you really have to get the inflammation down to get the dog to abosorb the MSM/Gluc, etc, so it makes sense that they have the anti-inflamms in with it. If you can give me the link to the Golden Site, I will look it up for sure.

Becca - I was just talking to my vet about pain relief, knowing that Cousteau will probably need it in the next few years. My vet knows how I feel about the typical NSAIDS and remembered that Adequan is experience a resurgence in popularity. He said the initial course is pretty expensive - I think it works out to something like $10-12/day for the first 6 days (possibly more, the cat was distracting me while we spoke) - but then it's every 4-6 weeks after that. It's given intramuscular and if I need to go that route, I'd give the injections at home once I'm shown what to do.

If you'd like I can get the dosages from my vet. He recommended just getting the stuff marketed to horses and adjusting down for dogs. I believe Cousteau at 70 lbs would be getting 1 cc, but definitely let me get clarification on that!

Yes, the first thing in joint disease is to get inflammation down and try to prevent future recurrence. We had a BC with mild hip dysplasia and the orthopedist at the time told us, "Inflammation is your enemy! Prevent it at all cost!"

So that's what I've been working on with Lulu. She was on a course of Deramaxx and it made a huge difference. But I'm afraid we're not quite past the point where we've got it all fully under control. She's WAY WAY better than when she first came in the house, still, but as usual I want to make it as good as possible all the time.

I don't know how different it is for dogs, but when I have a flare up of my arthritis (most recently in my feet...ACK!) my rheumy ups my prednisone for 3 - 4 months...yes MONTHS....to make sure the inflammation is totally under control before tweaking other meds to try to keep the disease progress at bay. If we stop the extra pred too soon I'm likely to have another flare up because the underlying problem of the inflammation hasn't been totally dealt with. Based on that, I'm not surprised that its taking Lu awhile to be "as good as possible".

Much as I hate to increase meds (or take them even) for extended periods of time, this approach has made a world of difference in keeping my disease under control. I'm about 8 weeks into the increased prednisone and I feel like I can survive a grueling trade show where I spend 8 hours/day on my feet for a week (with pretty much no opportunity to get off of my feet). Two months ago I couldn't walk from the sofa to the bathroom without wincing and was really doubting that I'd be able to make the trip to Chicago next week. I hope you can get Lulu to the point that she feels as good as possible.

Thanks for all the feedback! I just wanted to update that Nick is more mobile now. I'm giving him one pill twice a day. He could probably use more, as he's still gimpy at night, but that could be from the muscle loss. Also we've had snow for several days, so the cold could be affecting him as well. He has an acupuncture appt on Monday so I will get an update as to how the vet thinks he's doing. So far though no side effects!

Because I am just like that and got a script for Gina...I did read up at vasg.org

TRAMADOL

a) Classification

i) An analgesic medication with a dual mode of action

(1) Mu opioid receptor agonist

(2) Monoamine reuptake inhibitor

b) General Information

i) An uncontrolled, oral analgesic for use in dogs and cats

c) Advantages/Recommended use

i) Acute or chronic mild to moderate pain management

ii) May be combined with other classes of analgesics including NSAIDs, NMDA antagonists, and gabapentin

d) Cautionary Information

i) May decrease seizure threshold

ii) Do not combine with TCAs, SSRIs, or MAO inhibitors due to the risk of serotonin syndrome

iii) Metabolism is principally via hepatic biotransformation, with a small amount excreted unchanged by the kidneys. Reduce dose or discontinue if significant hepatic or renal dysfunction exists

iv) Side effects, though rare, may include GI upset and sedation

v) This is a bitter medication that is not well accepted by cats even when compounded in a cat friendly liquid base.

e) Dosage Information

i) Dog

(1) 1 to 5 mg/kg (0.5 to 2.5 mg/lb) BID to QID

(b) Anecdotal reports include 10 mg/kg BID to QID for more severe postoperative pain

iii) Cats

(1) 1 to 2 mg/kg (0.5 to 1.0 mg/lb) BID to QID

ii) Tramadol is available in 50 mg tablets

f) Cost

i) Moderately low

Heh. You sound like me, Robin. I bet you read the inserts for drugs, too, if they come with them too - with the molecular structure and all?

The mu-opioid agonist means it stimulates the mu opioid site, which tells the brain to stop sending pain signals. This activity takes time because the drug has to "wait" for the receptors to clear naturally (during pain episodes they are blocked with natural inhibitors). Thus, meds that work this way work best when given on a regular schedule, before pain has grown too great.

Monoamine reuptake inhibitor means it acts as a mild antidepressant as well. This makes Tramadol one of the faster acting meds in this class (I can attest to this) and also the reason it's used for chronic or recurring pain (I can also attest to this).

But, it's also very easy to get dependent on this drug - for people anyway. I don't think dogs have dependency problems, do they? Funny - maybe they do but because they are not able to resolve it they just have to go "cold turkey."

Anyway, I have such a bad family history of self-medicating and substance abuse, that anytime I get these drugs for some reason, if I don't finish it for the acute problem, it goes in the trash. I even toss cough medicine.

So this is one reason I hesitate with the Tramadol.

I had forgotten about Pred as an option. She's going to be 11 and has a very minimal history of exposure to any pharmaceutical to this point. It might be worth talking to the vet. I'm really liking the Cetyl=m but I'd like to get to where she can go for a little playtime and not pay for it for a week.

Then if we could stabilize her there, it looks like I've got a good long-term plan for her.

Hmm. I'll call the vet tomorrow. I'm sure she'll have no problem doing an early followup next week. I think this weirdo bump is going down in size too and I'd like to see whether the vet has that impression too.

Yep, being an herbalist, I haven't taken many drugs in my lifetime and neither have my pets and while I like my vet, I want to make sure the dosing is correct. RE: Prednisone....we talked about steroids and the e-vet and my vet both discussed with me how new studies show that steroids have very little effect in a dog with joint pain and the risks are showing it's not the best idea anymore.... and that dogs with heart issues, it's too dangerous to take them.

In my research on Tramadol....you have to wean a dog off it...however, in my discussions with the head of the Japanese Chin Rescue (part of the REAL breed club), she has good success using it in her chins with joint pain and arthritis and doesn't even need the NSAIDS. She has a 14 year old chin that weighs 8 lbs like Gina, and they manage her cervical arthritis with 1/4 of a tablet of Tramadol twice daily. She told me that Chins react to meds differently than other dogs which further supports my theory that not all dog react the same way to drugs and herbs.