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Old 01-02-2011, 07:51 PM   #1 (permalink)
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Tramadol and Metacam long term

Priscilla went back on Tramadol about a month ago, her front paw is really taking a pounding and I suspect arthitis is a factor now as well. She got back out to the park for a quick jaunt over the holidays and seemed to need a boost.

So I have started her back on Metacam as well.

She felt really good today, she was even tossing about the Christmas stuffies, and the old nubbins was awaggin'.

My question is that I realize the Metacam can be hard on her stomach. Any one used a schedule for usage, like using less or skipping days?
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Old 01-02-2011, 08:34 PM   #2 (permalink)
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My Winston was on both Meloxicam and Tramadol although not at the same time. Fortunately he didn't require the Meloxicam for a very extended period. And you're right...it is very hard on the stomach. I would speak to your veterinarian before skipping dosages etc. I'm not sure of the residual effect in dogs.

WRT Tramadol, Winston was on a very high dosage for osteosarcoma and he also had liver disease. Because he was on such a high dosage to manage the pain (which incidentally, osteo is very painful) the vet said the damage it was doing to his liver would probably end his life sooner than the osteo. His dosage was extremely high and it was administered in conjunction with another pain med, apo-keto-e.
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Old 01-02-2011, 08:42 PM   #3 (permalink)
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Thank you. First of all, yes I should have mentioned that I have three vets involved with her care, and they have pretty much left me with "use as needed" at this point.

I don't think I am dealing with any osteo pain anymore, since she was amputated. More so just that repeated BAM BAM BAM on her remaining front paw, and she is a big solid girl.

I may just give her the Metacam as a boost on the days she gets out to the park.
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Old 01-02-2011, 08:45 PM   #4 (permalink)
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I'm sorry I didn't realize your little girl had an amputation. Winston didn't have that option as he was over 9.5 when the osteo was discovered.

Good for you for having 3 vets involved with her care. You are a caring owner!
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Old 01-02-2011, 08:50 PM   #5 (permalink)
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I am sorry your boy never got that option, at least you had 9 years with him!

Priscilla is 9 in a couple weeks. I am so glad she got the 2 extra years after being tossed off for euthing...
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Old 01-02-2011, 09:02 PM   #6 (permalink)
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Wow! I'm going to have to find out the story with your Priscilla! And saved from euthanization. The ones who are saved really mean so much.

Winston was given one month from the time he was diagnosed and he lived for 6 months. The decision was made when I could no longer manage his pain. The dosage of Tramadol was twice an adult male human.

You and your Priscilla are 'fortunate'. And I mean that in the kindest of ways.
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Old 01-02-2011, 09:47 PM   #7 (permalink)
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I used it for about a year with a 13 year old lab mix. At that point, it was necessary for her quality of life. We monitored blood work every 4 months or so. It never did any damage to her liver, kidneys for the year she was on it. I lost her due to old age in general.
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Old 01-02-2011, 10:35 PM   #8 (permalink)
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We've had several dogs on long-term Tramadol/NSAID (usually Rimadyl instead of Metacam) and haven't really seen any problems. I know years ago when I worked for a general vet that we did bloodwork every 3 months on dogs who were on long term NSAIDs and I don't recall any that had any major liver enzyme elevations. If we saw any issues from the meds it was usually in the first 2 or 3 weeks of being on the drugs.

You might also want to have her on a joint supplement. I know I've said this a bunch on this forum, but I just can't say enough wonderful things about the results we've seen from injectable Polyglycan. We've had many dogs who couldn't undergo surgery (either due to other health problems or their owner's checkbook) who have had amazing turnarounds after begining the injectable protocol. Several of them could barely walk. We recently had a 15 year old Westie with bilateral torn ACL's who had to be carried in the clinic and 2 weeks later she was running up stairs! I'd be happy to give you more info on our protocol if you're intersted.

Good luck with Pricilla! I know you've done an amazing job with her so far; hopefully she'll have lots more happy time with you.
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Old 01-02-2011, 10:40 PM   #9 (permalink)
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Yes as I mentioned, Winston had liver disease when he started taking the Tramadol and because the drug is 'filtered' through the liver, this is something my vet indicated would deteriorate his liver more quickly.

Routine bloodwork will keep an eye on liver levels.
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Old 01-02-2011, 10:41 PM   #10 (permalink)
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Oh yes, I would love to learn more about that hyperdog!

All of the dogs are on arthritis supplements now. I have a few, Arthrogen, and the other one upstairs....lol.

I'll do another bloodwork when we go in for next x-rays. She coughed a couple times lately....... :-(
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Old 01-03-2011, 01:17 AM   #11 (permalink)
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If dogs experience Tramadol like humans do....I can give you an insight into what the experience is like as I was on high doses of tramadol for months after I fell from my horse and broke my back.

As painkillers go, it's pretty good, although it doesn't remove the (extreme) pain so much in the beginning, as space you out so much that you don't really notice it (until the dose wears off). In the first few days it can make you feel quite nauseus, but once a residual level is maintained, it is very effective. It also has a side effect of an uplift in mood, so counters the depression you'd otherwise have in the predicament.

after being on it longterm, the withdrawl as you taper off it is pretty uncomfortable and harrowing, with electric shocks running through the neck muscles, vertigo, and dissasociation. (not a pleasant experience). I was also on celebrex at the same time...which didn't seem to do anything. I was on Tramadol from late Nov 2009 until mid march 2010. The only unpleasant side effect I noticed whilst on it was jaw clenching and little appetite. (the up side was I lost heaps of weight, despite being bedridden for 3 weeks)
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Old 01-03-2011, 06:35 AM   #12 (permalink)
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Just as a statement, not all people experience tramadol period like that - I take it for migraines, and I know at least 5-6 other people that take it for back pain. I've never had nausea or spacing out, and I've never seen an animal made nauseous from the drug.

She's already using the tramadol, and I have hundreds of animals on the drug. As dobes2kh said, the dose can range GREATLY (and I discussed her dose with her, pushing for higher ones if I recall!) and the dosing frequency can change as well. My girl, the one day prior to her amputation but after she fractured her leg, was on SUPER high doses just in an effort to keep her down!

Tramadol at a normal dose doesn't do a thing to make my dogs quiet. Other narcotics, almost universally, have been MORE effective on all the dobermans I've seen and owned and lived with - I half dose their butorphanol, half dose buprenorphine, I've had to take fentanyl patches off, and hydro, HA! A single dose of butorphanol lasted all my dobes at the time over 12 hours (which it DOES NOT last!). So the fact that tramadol, at a standard dose, does NOT sedate them is something big and it's why I go for this over many others.

As for NSAIDs, Mercury takes metacam (it's the only one he tolerates) occassionally for leg pain when he's active or after training/showing - he had an external fixator on the leg he severed the tendon on, and it's still rough down there.

Tyler, my old blue boy was on Rimadyl for over a year consistently - it was one of the only things that kept him alive and moving (he was also on Duralactin, Dasuquin, Tramadol, and tons of other things) - I monitored his liver enzymes and he did just fine. Missing one dose left him unable to move.

I have many dogs on long term NSAID use - they are good drugs, and necessary - but it requires owner compliance and vigilance, and monitoring blood work. I recheck values one month after starting and then at least every 4-6 months for the life of the pet. Any vomiting, diarrhea, or anorexia the drugs are stopped ASAP. With judicious use of these drugs I honestly haven't seen a case of NSAID induced liver disease (just two dogs that ate a full bottle and got GI side effects).

I'll also state that my own cat ate Rimadyl out of Tylers bowl - 2 days of fluids and she was fine, no long term side effects. She reached toxic dose on that, but we saw her eat it (Saw her steal it) - she scarfed it immediately.

These drugs have gotten a bad rep on the internet because of the extreme stories shared, poor use, and inattentive owners and vets that continued to give drugs when things were looking poorly. I have it on labels, its on your bill, its in your chart - STOP the drug the minute you see vomiting, diarrhea or stops eating. i teach owners how to look for icterus (yellow mm).

As an aside, Metacam I believe is metabolized not through the liver, but through the kidneys - it's risk is not liver disease but kidney failure. I use it more in dogs prone to liver issues or with a history of elevation, and I use it extensively as one of my only pain medication options in exotics (almost every one i see gets it for surgery, dentals, GI stasis, etc). It's also the only one approved for long term use (IN OTHER COUNTRIES NOT US) in cats... (just a little bit bitter over that...). I use metacam more than any other NSAID, and I love it. Even if the liquid smells like ferrets.
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Old 01-03-2011, 09:11 AM   #13 (permalink)
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I should have explained that I was on 100mg every 6 hrs and had had no pain relief prior except for nitrous oxide whislt I lay in ER for 6hrs which probably explains why I experienced such an effect the first few days. There is no way I could have coped without it though. I also agree it doesn't keep you down...as I was up walking a bit after the first week (just shuffled to the loo in the first week). going for short walks in the 2nd week (although spending a lot of time in bed between exercise), and then relatively long walks in 3 weeks (with lots of bed recupperation). I was pushing myself to be able to walk for my graduation from uni at the end of the 3 weeks as I had fallen 2 days after my final exam. I was driving short distances by 4 weeks. ....all whilst still needing and being on 100mgs every 6 hrs. (The pain killing effect lasted 7hrs in me before the pain returned significantly...except for graduation day where I did too much walking and sitting and I had to take my next dose 2 hrs early.)

just thought I should clarify what I meant by high doses
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Old 01-03-2011, 09:47 AM   #14 (permalink)
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[QUOTE=doberkim;829158]

She's already using the tramadol, and I have hundreds of animals on the drug. As dobes2kh said, the dose can range GREATLY (and I discussed her dose with her, pushing for higher ones if I recall!) and the dosing frequency can change as well. My girl, the one day prior to her amputation but after she fractured her leg, was on SUPER high doses just in an effort to keep her down!


I wasn't sure if you recalled that Kim! Yes I remember when I sought your advice and you mentioned administering a higher dosage for Winston. And we went really high!!! His appetite was always ravenous...I couldn't seem to fill him up.

Sometimes Winston would be a bit 'loopy' on the drug. But when it got to the point that at 200mg dosages, he was feeling pain after an increasingly shorter time, I knew the time had come and I believe his liver was barely functioning.

The vet gave Winston one month and he survived 6 months and 10 days. Much longer than my father who died in less than a month. They used to console each other; both of them cancer victims.
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