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Cat Forum / Health and Behavior / April 2007Tramadol
Hi all, My cat has intestinal lymphoma. A large tumor has formed, and we think he may be beginning to have some pain because he cried a little the last time the onocologist examined his abdomen (though I've been told that this kind of cancer does not tend to cause much pain--that it's the nausea that causes the most discomfort as the disease progresses). Anyway, he was prescribed tramadol, and I've been wanting to find out a little more before giving it to him. I've read that it's an opiod, has few side effects, and they don't THINK it's addictive. Anyone have experience giving this drug to their cat? Thanks, Caroline > Anyway, he was prescribed tramadol, and I've been wanting to find out > a little more before giving it to him. I've read that it's an opiod, [quoted text clipped - 3 lines] > Thanks, > Caroline I can't be certain, but if opiates are taken over a long period, then they are addictive.. However, if your vet is prescribing them I am sure that she/he will have considered that thought, & would never put him through withdrawal symptoms.. they would cut them down slowly over a period of time, so that he doesn't suffer the pain of withdrawal symptoms. And, if they are consider giving him opiates, then he most be in some pain there.. Talk to your vet about it all. I am certain that they will give you good advice.. S;o) >> Anyway, he was prescribed tramadol, and I've been wanting to find out >> a little more before giving it to him. I've read that it's an opiod, [quoted text clipped - 6 lines] > I can't be certain, but if opiates are taken over a long period, then > they are addictive.. What happens is that a *tolerance* develops so that if the person (or cat) stops taking them, they need to be weaned gradually, as withdrawal symptoms can result. This is not the same as "addiction" which (in humans) is associated with aberrant drug-taking behavior (e.g., behaviors like increasing the dose without the doctor's permission, seeking multiple sources for the drug, attempting to obtain it illegally etc). People who are addicted often need to go through special programs in drug detoxification centers etc. The reason I am making a point of making this distinction is that people are often prescribed opioid medications for chronic pain syndromes, and they do develop tolerances (i.e. that if they decide to discontinue the drug, they need to wean slowly to avoid withdrawal symptoms), but it would be inaccurate to say they are *addicted.* > However, if your vet is prescribing them I am sure that she/he will > have considered that thought, & would never put him through withdrawal [quoted text clipped - 4 lines] > good advice.. > S;o) I agree. Best regards, ---Cindy S. > What happens is that a *tolerance* develops so that if the person (or > cat) stops taking them, they need to be weaned gradually, as withdrawal [quoted text clipped - 9 lines] > slowly to avoid withdrawal symptoms), but it would be inaccurate to say > they are *addicted.* What is your source for this information??? It sounds like something you heard from a prescription drug addict as opposed to a doctor or medical authority. Charlie >> What happens is that a *tolerance* develops so that if the person (or >> cat) stops taking them, they need to be weaned gradually, as withdrawal [quoted text clipped - 13 lines] > heard from a prescription drug addict as opposed to a doctor or medical > authority. -------- I don't think what I've written above comes even close to sounding like it came from "a prescription drug addict." Here is the medline link to information about tramadol: http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a695011.html I am a medical person. Some of the work I currently do is for a pain clinic, which is affiliated with a major urban hospital. A pain clinic is a place where individuals with chronic pain problems go for treatment. The treatments may include (but are not limited to) any of the following: 1. Interventional injections such as lumbar epidural steroid injections for certain back problems (for example). 2. Trigger point injections. 3. Referrals for physical therapy. 4. Prescriptions for opioid pain medications. 5. Psychological therapy from a psychologist who specializes in the treatment of pain disorders with the use of modalities such as biofeedback, relaxation therapy etc. When patients at this clinic are prescribed opioid pain medications, the first step is a urine toxicology screen to ascertain that they are not taking illicit substances. They sign an opioid contract/agreement in which they agree not to increase their pain meds on their own and not to obtain them from any providers other than the ones at the pain clinic. Generally, patients with a past history of drug abuse are not considered candidates for opioid medications. Throughout the time the patients are taking the opioid pain meds, they are subject to random urine toxicology screening to ensure compliance. Some patients take opioid pain medications for years for chronic pain. They develop dependence, but they are not "addicts." When they no longer need/want the drugs, they wean off the drugs over a period of a couple of weeks, and they are done. They are not *addicts.* As I stated above, an "addict" is a person who is exhibiting the aberrant drug-taking behaviors I described in my first post and generally require treatment at a drug detoxification facility in order to get off drugs. People who are not "addicts" but merely dependent on the drug (which anyone who takes opioids for more than a short time period becomes *dependent*) merely wean off the drugs when they no longer require them. Tramadol is considered a very low level opioid, meaning, the risk of addiction is so small that the current wisdom is that tramadol is safe to use *even in patients with a past history of opioid addiction.* In the USA, it is not even classified as a controlled substance. I hope the above information clarifies things. Best regards, ---Cindy S. >>> What happens is that a *tolerance* develops so that if the person (or >>> cat) stops taking them, they need to be weaned gradually, as [quoted text clipped - 31 lines] > > I hope the above information clarifies things. Best regards, I question whether many people can become physically dependent on narcotics without also developing a psychological craving. But, I don't know. My reason for challenging you was your use of the term "tolerance," which doesn't square with my understanding, i.e., "drug tolerance occurs when a subject's reaction to a psychopharmaceutical drug... decreases so that larger doses are required to achieve the same effect." (http://en.wikipedia.org/wiki/Drug_tolerance) Charlie > I question whether many people can become physically dependent on > narcotics without also developing a psychological craving. Any person who uses opioids for more than a short time is going to become physically dependent. This is just how the body operates and that is why stopping opioids abruptly will result in withdrawal symptoms, but this is a physiological reaction, not a psychological reaction. In some instances, people do develop a psychological craving, and that's when they would be considered "addicted," and start displaying the behaviors I previously described, things like: 1. They start increasing their dose of medications without asking the doctor, then they run out of medication before it is time for a legitimate refill. 2. They will claim that their medications have been lost or stolen and they need a refill. 3. They will try to obtain prescriptions from multiple doctors or seek drugs illegally. 4. They will routinely show up at hospital emergency rooms in the hopes of getting narcotic meds, etc. Most of the time, the above doesn't happen. Most of the people who receive prescriptions for opioid pain meds (including methadone which has a legitimate use as a medication for chronic pain) take only the prescribed dose, in accordance with the doctor's instructions, and do not request early refills on their meds or increase the amount their taking. They do not develop a psychological craving and are able to easily wean off the medication if it becomes ineffective or if they want to switch to non-narcotic medications, or they start having side effects or whatever reason. There are a number of people who suffer from chronic pain syndromes, and for some people, narcotic medications are the only meds that relieve that pain. Typically, they are prescribed these opioids at the pain clinic. Once they are stabilized on a certain dose, they are discharged back to their primary care physicians who take over prescription writing for that particular dose. Oftentimes, the patients are prescribed other non-narcotic medications called "adjuvants" that help to boost the effectiveness of the pain meds so that they can keep the doses of the opioids to a minimum. >But, I don't > know. My reason for challenging you was your use of the term > "tolerance," which doesn't square with my understanding, i.e., "drug > tolerance occurs when a subject's reaction to a psychopharmaceutical > drug... decreases so that larger doses are required to achieve the same > effect." (http://en.wikipedia.org/wiki/Drug_tolerance) Now, I see. The above statement is the definition of "drug addiction" NOT "drug tolerance." Many chronic pain patients stay on the same dose of opioids for years. If the opioid starts to lose effectiveness, this can usually be resolved by doing an "opioid rotation" to a different opioid (but at an equivalent dose) or adding an adjuvant medication. In general, Wikipedia is not a reliable source for information. The accuracy of Wikipedia is hit-or-miss (on any given topic). Best regards, ---Cindy S. > Hi all, > [quoted text clipped - 12 lines] > Thanks, > Caroline I never gave it to my cats, but I've taken it (brand name Ultram). It's not narcotic and has less side effects than most pain killers. It is prescribed when there is already nausea present since it has less chance of causing stomach upset. Hugs, CatNipped >> Hi all, >> [quoted text clipped - 15 lines] > I never gave it to my cats, but I've taken it (brand name Ultram). It's > not narcotic It is an opioid. >and has less side effects than most pain killers. It is prescribed when >there is already nausea present since it has less chance of causing stomach >upset. The major side effect in humans who take opioids is constipation. I don't know if this is one of the side effects that tramadol doesn't have. But at any rate, if Rose decides to go ahead with the tramadol, she might want to keep an eye on this. Cats can be given things like lactulose and Benefiber (in cat-sized doses) to combat constipation, just like humans. She should ask her veterinarian about this. Again, Pepcid may help her cat's nausea. She should ask her vet about this too. > Hugs, > > CatNipped Hugs from me too. Best regards, ---Cindy S. Anyway, he was prescribed tramadol, and I've been wanting to find out > a little more before giving it to him. I've read that it's an opiod, > has few side effects, and they don't THINK it's addictive. Anyone > have experience giving this drug to their cat? Hi Caroline. Sorry to hear about your kitty. My Meesha recently had surgery and was given Tramadol for pain relief. Meesha is a very affectionate cat, and the Tramadol seemed to intensify that (constant head butting, purring, seeking affection, etc.) which wasn't a bad thing in itself. However, the drug did make her aggitated and it took a while for her to settle down. We just decreased her dose, and she was fine. I do believe it helped her be more comfortable. Best wishes for your kitty, Lauren > Hi all, > [quoted text clipped - 4 lines] > it's the nausea that causes the most discomfort as the disease > progresses). ----------- As an aside, you might want to ask your doctor if you can give your kitty some Pepcid to try to combat nausea. I have a CRF kitty with presumed nausea, who had been moping around for weeks. Someone (don't remember who) mentioned that the cat might be nauseated and Pepcid might help. It worked like a charm and it's very benign. A cat-sized dose is 2.5 to 5.0 mg. Ask your vet about it. Best regards, ---Cindy S. |
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