Adverse Reactions To Drugs

[Sheridan]

This thread comes out of my thread about Grumpy and what turned from an upset tummy into an adverse reaction to a drug called Tramal. This drug is a long-lasting opiate that's normally used for cancer; it's supposed to last for 12 hours. The emergency vet said that it was mild (so mild that it's not a controlled substance) but his reaction to it was hideous. By the time I got him out of the vet, he couldn't jump up into the car. When I got him home, he couldn't jump out of the car and my attempts to lift him out didn't work. We had a full blown beserker dog episode and he clearly had no idea who I was. I left him in the car for the rest of the night after making further attempts to get him out and took him to the vet the next day. I muzzled him to get him out and back into the car. I left the muzzle on him for the trip home and the same beserker reaction happened. This time, as he was muzzled, I finally just jerked him out of the car and crated him still with muzzle. In all, he'd spent around 14 hours in the car. He went to sleep in the crate for some hours and I let him out. He was fine but very tired. I fed him, took him for a short walk, and then he slept again. Indeed, he slept until 2 pm on Tuesday. He is still very tired. The vets (his own vet) advised that the blood tests they took showed nothing abnormal. I would not recommend Tramal as a drug for pets due to the side effects.

TRAMAL

(also known as Tramadol, Ultram, Mabron, Ralivia, Ryzolt, Tradonal, Tramacet, Tridural, Ultracet, Zamadol, Zydol and Zytram)

Use: long-lasting painkiller used to treat moderate to severe pain; often used for cancer patients in humans and animals

Side effects (this is from a pamphlet on Tramal, which should be read in its entirety):

* dizziness

* sedation, fatigue

* headache

* constipation

* nausea, vomiting

* sweating

* dry mouth

* indigestion

* changes in appetite

* skin reactions

* sudden onset of low blood pressure, collapse

* muscle weakness

* tremor

* seizures

* respiratory depression

* improvement of mood

* confusion

* sleep disturbance

* blurred vision

* difficulty in passing urine

* Serotonin Syndrome: signs of this vary and are not specific; they may include fever, sweating, confusion, agitation, diarrhoea, muscle twitching, difficulty with walking and balance.

* skin rash (red spots or patches), itching hives, skin lumps

* swelling or puffiness of the eyelids, face or lips

* chest tightness, wheezing or pain in the chest

* heart palpitations, faintness or collapse

* hallucinations

* convulsions

Taking Tramal with other drugs or if your dog has another illness: Tramal should not be taken if your dog is on some other drugs, particularly antidepressants, so please tell the vet exactly what drugs your dog is on, if any.

Before agreeing to your dog taking Tramal: please tell the vet if your dog has reacted badly to drugs previously; if your dog suffers from stomach problems; has had fits, convulsions or seizures before; has a kidney or liver problem; breathing problems; or has an intolerance to certain medications or ingredients of certain medications.

Articles on Tramal:

Australian Prescriber: Trouble with Tramal

Better Health Consumer Medical Information: Tramal pamphlet

NSW Health: Tramadol Position Statement from the NSW Therapeutic Assessment Group

[LizT]

I haven't had any experience with Tramal with dogs but was given it for myself to take after having had an ultrasound guided cortisone injection directly into a bursae in my shoulder to treat Bursitis. It was lucky I took it before I was going to have a sleep as I felt very "fuzzy", confused and was flying high on it until I zonked out.

I did read up on the drug afterwards and found it on some veterinary sites too.

Your poor dog must have had some kind of sezure on it. Lucky you weren't bitten. And through no fault of his own.

[Poodle wrangler]

Sorry to hear about your dog being unwell.

All drugs have side-effects and it's often hard to separate a side effect from the underlying illness.

Tramal's widely used in hospitals (humans) for pain.

Nausea/ vomiting is the most common side effect I've seen, especially when given as an injection.

If you read up all possible side-effects of medication, you'd never take a tablet again ...

[Sheridan]

Sorry to hear about your dog being unwell.

All drugs have side-effects and it's often hard to separate a side effect from the underlying illness.

Tramal's widely used in hospitals (humans) for pain.

Nausea/ vomiting is the most common side effect I've seen, especially when given as an injection.

If you read up all possible side-effects of medication, you'd never take a tablet again ...

Rather stupid to give a dog who's suffering from a bad tummy a drug that could cause nausea and vomiting then, isn't it.

[Tru Borders]

OMG Sheridan thats awful!!!

I hope you and Grumpy are now ok.

My heart skipped a beat reading the other names for it as Asher is on painkillers at the moment.

Im glad you are both ok now and that no one got seriously hurt or ill.

[Sheridan]

What's Asher on, huskyheaven?

[Meea]

Both of my dogs (deerhound and cattle) have had Tramal with no problems.

ME however - I took it once and have never been so sick - I would have bitten you myself!! I was very hesitant to let the dogs have it based on my own experience but have since used it several times for them without any problem.

[cavNrott]

My Rottweiler, Sophie, was taking 3 x 100mg of Tramal each day for 9 months. She had osteosarcoma of the mandible. She was also taking Metoclopramide to prevent nausea.

Sophie had no adverse reaction to the Tramadol. In fact I think without the Tramadol to mask her pain she probably would not have had the excellent quality of life she had right to the end and I would have lost her much sooner.

Her appetite was excellent, she was playful, happy and pain free. Her temperament was as kind and gentle as it had always been.

I have never had Tramadol myself but after seeing Sophie doing so well and the benefit she receive from it I would have no hesitation in giving it to any of my dogs to relieve severe pain.

It seems your dog had an unusual reaction to the drug. Though I think it unusual for a vet to prescribe Tramal for an 'upset tummy'.

Edited August 6, 2009 by cavNrott

[Got Spots]

as a doctor i find tramal a very difficult drug to use and very rarely prescribe it for anyone

not to mention it acts on similar receptors to a sort of antidepressants such as zoloft - can cause a nasty thing called seratonin syndrome which in extremes can be fatal but very rarely

i find in humans it either has dreadful side effects or works well - more likely dreadful side effects

personally instead of going for mild opiates i would go for very low dose opiates at least then you have a more reliable effect rather than tramal

same with codiene - such as panadiene forte - really just constipates people and has no pain relieving effect - pain teams very rarely give panadiene forte now days

more likely to use paracetamol plus something like ibuprofen or similar drug - can give them at the same time b/c they are completely different drugs and they work really really well. pity we can't use panadol in dogs

but this waffling is just a doctors opinion

[Sheridan]

That's good info, Neats, thanks.

[Tru Borders]

Sheridan, Asher is on Metacam (Oral). All seems ok so far and he has been on it for 2 and a half days now.

[Rappie]

Any animal can react adversely to any drug - it does not mean the drugs themselves are bad.

I prescribe tramadol reasonably frequently and find it to be very useful and quite well tolerated across a wide dose range. I have had the occasional dog react badly to it and we do not use it in those animal again (I see more frequent reactions to antibiotics and NSAIDs). It is a synthetic opiod, but it is also an effective analgesic and gives us options for dogs with gastrointestinal and renal issues or where we can't assess their metabolic function.

The options for take home pain relief that is not an NSAID is quite limited once we exclude tramadol. S8 drugs are regulated and not dispensed for administration by the owner except in very specific circumstances.

It's always worth discussing any concerns with your veterinarian prior to administration but not all outcomes can be predicted.

[Sheridan]

Would you prescribe as a painkiller for a dog who presented with a tummy upset?

[Rappie]

Would you prescribe as a painkiller for a dog who presented with a tummy upset?

My usual first choice would be an injectable opiod like buprenorphine (Temgesic - an S8). The downside is that its duration of action is variable, usually 6 to 8 hours, maybe 12 if you're lucky. I don't have access to injectable tramal but if I didn't have a choice of S8 drugs (and some practices don't have much of a choice) then I would consider it for non specific abdominal pain. I use it quite often (orally) for post op pain control at home after abdominal surgery.

Without knowing the cause of abdominal pain I would be quite hesitant to reach for a NSAID.

Edited August 6, 2009 by Rappie

[tdierikx]

I found that when taking Tramal myself, I would take a Maxolon tab about 15 mins before taking the Tramal, and then I wouldn't vomit. Nasty drug, but it certainly kills the pain of an abscessed wisdom tooth... *grin*

That said, after taking it myself, I'd never give it to any of my dogs... it definitely sends you a bit loopy...

T.

[Her Majesty Dogmad]

My old Italian Greyhound had a bad reaction to the antibiotic CLAVULOX. He would vomit copiously and be lethargic when on a course. He also had IBD so initially, it wasn't known if it was an IBD attack but it turned out to be Clavulox causing the trouble so his file was marked never to be given that particular tablet.

I've had many other dogs go on it without a problem though.

[grabonsam]

My 26kg, 6 yr old boy has used it. 50mg 2-3 times a day for a week. No adverse side effects, just a bit drowsy for a few hours, and it provided great pain relief for him.

I was very impressed at how well it worked for him.

[moosepup]

Never tried Tramal on a dog but my mum took it once for what the doctors thought was Trigeminal Neuralgia (facial pain so severe its even be nicknamed "The Suicide Disease"!) and she has sworn that she will NEVER take it again. She has never been so sick. I'm surprised it was given for a tummy upset?? I would be very hesitant in giving it to anyone, especially my dog. Maybe the dosage is an important factor also?

[Trishm]

When my greyhound was given Stemetil to stop vomiting, she had a bad reaction to it, she wanted to chew everything, someone had to be with her for 24 hours to try to stop her, she even chewed my new wooden kitchen cupboard doors. If she wasn't trying to chew something she was digging at the floor, bedding or carpet.

Needless to say her file has been marked accordingly.

Trish

[poodlefan]

Never tried Tramal on a dog but my mum took it once for what the doctors thought was Trigeminal Neuralgia (facial pain so severe its even be nicknamed "The Suicide Disease"!) and she has sworn that she will NEVER take it again. She has never been so sick. I'm surprised it was given for a tummy upset?? I would be very hesitant in giving it to anyone, especially my dog. Maybe the dosage is an important factor also?

Darcy has had Tramal for bad back pain. There were no adverse reactions.