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Cbd oil for dogs with tramadol

CBD as an Alternative Supplement to Tramadol

There’s nothing worse than seeing your dog in pain. Managing pain in dogs has always been challenging because of the long term side effects of pain meds. Your furry best friend can’t say where or how much they hurt, so it’s up to you and your veterinarian to decide how the pain is managed, and discuss cannabidiol’s efficacy for natural pain relief.

CBD can help to manage acute and chronic pain, but may be needed in combination with other pet meds. Nutraceuticals like CBD are desirable because they rarely have side effects, although they may take longer to work. In this article, we’ll discuss why CBD for pets as an alternative to Tramadol may be effective in reducing your dog’s discomfort. Never combine pet CBD and Tramadol without speaking to your veterinarian first.

“Recent clinical studies of oral tramadol are also mixed but with a trend against any meaningful analgesic effects. One study reported that tramadol and dipyrone combined provided analgesia in dogs with chronic cancer pain and that addition of an NSAID did not improve the quality of pain control,” via Veterinary Practice News, 2018.

What is Tramadol?

Brand Name: Ultram

Generic Name: Tramadol

According to the Merck’s Veterinary Manual “Tramadol , a synthetic codeine analogue, is a weak mu opioid receptor agonist. In addition to opioid activity, it inhibits neuronal reuptake of norepinephrine and 5-hydroxytryptamine (serotonin) and may facilitate serotonin release. It is recommended for acute and chronic pain of moderate to severe intensity.

Due to its inhibitory effects on serotonin uptake, tramadol should not be used in animals that may have received monoamine oxidase inhibitors such as selegiline , in animals on selective serotonin reuptake inhibitors, or in animals with a recent history of seizure activity.”

Merck’s Manual explains that “In people, the principal active metabolite (O-desmethyl tramadol , M1) is more active at mu receptors than the parent drug. Cats produce significant amounts of M1, whereas dogs produce minimal amounts. Oral bioavailability is 93% in cats but only 65% in dogs. Dogs eliminate and clear tramadol more rapidly than cats. The dosing interval must be adjusted in cats. Adverse effects include decreased seizure thresholds, nausea/vomiting, and in some animals, altered behavior.”

Tramadol Use

Tramadol has been shown to reduce minimum alveolar concentration of sevoflurane in cats and is reported to have an analgesic effect after ovariohysterectomy similar to that of morphine in dogs. The take with Tramadol is that it can be used alone for mild pain treatment or together with other pet meds in a multimodal plan to treat moderate to severe pain in pets.

Your veterinarian is the only person that can prescribe Tramadol. What’s important to note here is that human Tramadol should never be given to pets, and that with both human or pet Tramadol the potential for overdose from an incorrect dosage is always a possibility.

Tramadol Overdose in dogs

The only way to get Tramadol is with a prescription from your veterinarian. Human Tramadol should not be given to pets since dosage differs vastly, and the incorrect dosage could lead to an overdose. Pet parents should only use Tramadol under the guidance of a veterinarian. Tramadol can also be problematic because your dog can become addicted to it, and could also overdose.

Work closely with your veterinarian and adhere to all dosage instructions to avoid adverse effects. Dogs can become tolerant to Tramadol in a short amount of time, and more Tramadol may be needed to have the same effects. Increasing Tramadol dosage could be dangerous, and could lead to an overdose.

Dogs can suffer from withdrawals when they stop taking Tramadol. That said, dosages should be decreased slowly. Always discuss this with your veterinarian beforehand, and don’t just stop giving your dog Tramadol.

Side Effects of Tramadol

Opioids relieve pain by acting on the central nervous system. Continuous administration of pain medication is more effective at relieving pain than by using “as-needed” dosing. That said, Tramadol may have a few adverse reactions

  • Constipation
  • Diarrhea
  • Dizziness
  • Drowsiness
  • Tremors
  • Nausea
  • Loss of Appetite
  • Sedation
  • Anxiety
  • Pupil Constriction
  • Coughing
  • Seizures
  • Decreased heart rate
  • Agitation
  • Peeling skin rash
  • Blisters on skin

Dr. Salisu Buhari, DVM in a study published in The Scientific World Journal explains that “Although Tramadol has a rapid onset of effect when given to dogs IV or intramuscularly, it can also produce unwanted side effects such as nausea, salivation, increased swallowing, and retching. Another effective analgesic strategy, epidural analgesia, carries the risk of nerve injury and side effects that include pruritus, urinary retention, hypoventilation and hypotension. In contrast, better patient compliance with minimal restraint was achieved in the SC group. In this study, none of the dogs suffered from adverse effects of tramadol, regardless of the route of administration. According to Hendrix et al., marked respiratory depression is not observed in dogs, even with morphine administration. In addition, although vomiting is reported to occur within 5–10 min of SC administration of morphine, this effect is not reported with other opioids.

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Keep in mind that sedation is a common side effect. Although not an issue for veterinarians or pet parents who would rather have their pets asleep, and be pain-free. Sleep also promotes faster healing and tissue regeneration.

Tramadol for cancer pain

The Merck Veterinary Manual adds that Tramadol can be used to treat both acute and chronic pain. Both acute and chronic pain fall within the range of moderate to severe on the pain scale.

Cancer pain is difficult to treat because there are numerous causes of cancer pain. The pain may stem from tumors, inflammation, or neuropathic issues. Like other forms of chronic pain, cancer pain does not always respond well to treatments that are commonly used. While it has helped many dogs become pain-free and mobile, there is a huge problem with long-term side effects, which are serious and may include potential liver damage.

That said, opioids remain a good source of veterinary treatment, and are often used together with other treatments like analgesics which include NSAIDs, tramadol, acetaminophen, and amantadine to help with chronic pain.

Opioids and NSAID’S for cancer and osteoarthritis pain

Cancer pain

An opioid and an NSAID are often prescribed together by veterinarians. This is because they have a stronger action in reducing cancer pain when combined. You will need to have regular follow-up visits with your veterinarian to ensure that the pain treatment plan is effective. Pain management treatment plans should be tweaked and managed regularly with correct therapeutic adjustments.

Osteoarthritis Pain. ( Degenerative Joint Disease). This condition is characterized by thinning of the cartilage, build -up of fluid within the joint, and the formation of bony outgrowths around the joint. Joint degeneration is the result of trauma, infection, the body’s own immune system or malformation during development. That said, when this results in the inflammation of the joint membrane, continued cartilage destruction and inflammation, and abnormal joint function, dogs feel intense bone pain.

Osteoarthritis Symptoms include lameness, swelling of the joint, muscle wasting, thickening and scarring of the tissue joint membrane. Progressive damage occurs resulting in the grating sound during joint movement, soft-tissue swelling around the joint, the formation of bony outgrowths, hardening and thickening of bone beneath the cartilage, and possibly a narrowed joint space. Veterinarians may prescribe Tramadol to block the transmission of pain signals in the dog.

Consistent trend against Efficacy of Tramadol is apparent in studies

According to Veterinary Practice News , preclinical studies show that “it has been difficult to convincingly show that oral tramadol is absorbed and metabolized to the active metabolites to a degree that would be expected to produce meaningful analgesic effects. While some studies do suggest adequate absorption and metabolism, most indicate that dogs generally appear to produce very little of the active metabolite of tramadol, and this seems to persist for too short a time to provide reasonable analgesia. While these studies vary in route, dosage, and formulation, the trend is clear that the absorption and metabolism of tramadol in dogs is unlikely to support effective clinical use as an analgesic, especially with oral administration. Studies evaluating intravenous tramadol and thermal nociception in dogs have also failed to find a clear effect. ”

“Clinical studies of oral tramadol are also mixed but with a trend against any meaningful analgesic effects. One study reported that tramadol and dipyrone combined provided analgesia in dogs with chronic cancer pain and that addition of an NSAID did not improve the quality of pain control.”

The studies demonstrate that “on its own, however, tramadol has been reported to be inferior to carprofen for dogs undergoing enucleation, equivalent to hydrocodone/acetaminophen with both being inadequate for dogs undergoing tibial-plateau-leveling osteotomy, 36 inadequate for dogs undergoing ovariohysterectomy, 37 and both inferior to carprofen and equivalent to placebo for dogs with osteoarthritis. 38 Despite differences in indication, pain assessment, and other important variables, these studies suggest oral tramadol is not likely to be useful as an analgesic for dogs for acute or chronic pain.”

Tramadol is often used as an oral analgesic in dogs and cats. New studies from 2018 demonstrate that it may not have meaningful benefits for dogs. It’s also now unclear as to how beneficial Tramadol is for pain in dogs. Studies are now showing that Tramadol should not only be used as a sole analgesic. “ More research in both species may help to clarify the potential effects of tramadol, but at this point the widespread use of oral tramadol is not justified by reliable scientific evidence, via Veterinary Practice News (2018.)

Cancer

All dog breeds are susceptible to cancer, and pet parents need to be aware of what symptoms to look out for. Certain dog breeds like the Boxer are prone to brain cancer, of which symptoms may include difficulty walking, impaired vision, and facial paralysis. Today, one in four dogs will develop neoplasia, with over 50% of dogs over the age of ten developing cancers.

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Symptoms of Neoplasia in Dogs

The American Veterinary Association (AVMA) lists the following as signs to watch for:

  • Abdominal swelling
  • Bleeding from the mouth, nose or other body openings
  • Difficulty breathing
  • Difficulty eating
  • Lumps, bumps or discolored skin
  • Non-healing wounds
  • Persistent diarrhea or vomiting
  • Sudden changes in weight
  • Unexplained swelling, heat, pain or lameness
  • Visible mass/tumor

All dogs can develop neoplasia which can affect any organ or tissue in their body. According to the American Veterinary Medical Association (AVMA) treatment response will depend on the severity and the type of neoplasia, as well as the availability and effectiveness of the therapy. The earlier neoplasia is treated, the better chances of a good outcome.

“Despite a lack of metastasis, benign tumors can sometimes have damaging effects on the patient; for example, brain tumors are often benign but the pressure they create on the surrounding brain tissue can be life-threatening. Although some neoplasms (especially the more aggressive cancers) cannot be cured, treatment can prolong your pet’s life and improve their quality of life,” via AVMA.

Pet meds for cancer

Although CBD oils are beneficial when dealing with pain, pet parents need to keep in mind that veterinarians may suggest an array of pain medications which are part of a cancer treatment program. These pain medications will include the following:

  • Non-steroidal anti-inflammatory Drugs (NSAIDs)
  • Corticosteroids (anti-inflammatory) like cortisone as a second type of pain reliever
  • Opioids which include morphine and codeine for advanced cancers with prolonged and severe pain.

As with all medications given in higher doses, there may be side effects.

What is CBD oil?

Hemp refers to the cannabis varieties that are grown as an agricultural crop, and also contain low amounts of THC(tetrahydrocannabinol). THC is federally illegal in the US if it contains a higher amount than the O.3% allowed for use, though it’s been approved for both recreational and medical use in Canada, and numerous US states.

According to Fido Friendly magazine, “What you may not know when purchasing a CBD pet product is that the certificate of analysis (COA) is most important. “COA’s that are good will list cannabinoids, heavy metals, aflatoxins, microbial analysis, and solvents from extraction. All of these should all be tested for, to ensure it’s a safe product, and the cannabinoids should be below 0.3% THC with at least 20 mg/ml of total cannabinoids preferably CBD and/or CBDA,” via Claudia Bensimoun.

We’ve all questioned the varying cannabidiol potencies in different CBD pet brands, and wondered as to the outcome if not used properly. Pet parents play a huge role in their pet’s health, and with our dogs being family members, CBD product safety is key. Dr. Wakshlag explains to FIDO Friendly that “most of the CBD oils on the market are relatively low potency therefore most people under dose their dogs – so they will not see the beneficial effects.”

What you may not know when purchasing a CBD pet product is that the certificate of analysis (COA) is most important. “COA’s that are good will list cannabinoids, heavy metals, aflatoxins, microbial analysis, and solvents from extraction. All of these should all be tested for, to ensure it’s a safe product, and the cannabinoids should be below 0.3% THC with at least 20 mg/ml of total cannabinoids preferably CBD and/or CBDA,” explains Dr. Wakshlag, DVM, via Fido Friendly.

He adds that “We also are not 100% sure as to whether CBD is an effective nutraceutical supplement that can be used safely with other supplements on a daily basis. Dr. Wakshlag says that “this is an unknown – but we think that it can go with other typically used pain relievers used in dogs. We just don’t have data on other drugs at this point. But its looking promising that there are not many interactions.”

Is CBD legal?

For all CBD pet products to be legal, they need to have less than 0.3% THC. CBD is natural, safe, and is derived from hemp and cannabis. Most CBD dog products will use CBD from hemp. That said, there is no “high” and dogs will not consume THC or tetrahydrocannabinol, resulting in psychoactive effects with your dog getting “high”. CBD is a non-psychotropic phytocannabinoid, and yields therapeutic and medicinal purposes for dogs.

Cannabidiol (CBD) Oil for cancer pain

Hemp-derived Cannabidiol (CBD) oil with no tetrahydrocannabinol (THC) for dogs with cancer may be beneficial by helping to relieve the symptoms that go hand –in- hand with cancer treatment, that results in loss of appetite, pain, and nausea. Cancer most times causes pain due to inflammation, nerve injury and pressure on the internal organs.

What Drugs Will Interact with My Pet’s CBD?

While we still do not even know the extent that people’s medications will interact with CBD, even less is known about pet CBD medication interactions. That is simply because the research is lacking for both, especially in the pet field.

My veterinarian will not talk to me about CBD, but I would still like to make an educated decision on whether or not giving them CBD would be for the best.

We understand that this can be a very frustrating issue for a lot of pet parents. While CBD can cause some pet medications to be more or even less effective if consumed with CBD, there are similar precautions that have to be taken when giving your pet herbal supplements or even vitamins. There is always going to be a chance of interactions. The extent of them depends on body chemistry and prescription dose. What will affect one pet, may not affect another.

When CBD is ingested orally at large doses a group of liver enzymes in your pet may be temporarily altered. One of the most common interactions that relate to this is grapefruit for humans. CBD is also metabolized by cytochrome P450 enzymes preventing it from metabolizing other compounds.

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“The extent to which cannabidiol behaves as a competitive inhibitor of cytochrome P450 depends on how tightly CBD binds to the active site of the metabolic enzyme before and after oxidation. This can change greatly, depending on how – and how much – CBD is administered, the unique attributes of the individual taking this medication, and whether isolated CBD or a whole-plant remedy is used.” – Adrain Devitt-Lee, a researcher at Project CBD.

60% of all medications are metabolized in the liver via specific enzymes produced in it. CBD, like grapefruit, temporarily uses up the enzymes and/or inhibiting the action of others.

Drugs that may be used for pain relief in your pet such as NSAIDs (anti-inflammatory drugs), Tramadol, Gabapentin or anxiety relief such as Prozac all rely on the P450 enzymes. This does not mean your pet can’t take CBD, it just means you might want to be a little more careful when dosing it at first. And CBD can be a wonderful way to hopefully have your pet use less of the above medications.

NSAIDs can wreak havoc on the stomach and liver over long term use.

Tramadol and Gabapentin usually require an increased dose over time because the body gets used to it.

Prozac and any other anti-anxiety will have withdrawal symptoms if given over a period of time. Please do not ever take your pet off of these medications cold-turkey. It is very very important your pet is titrated down slowly off of them.

Here is how one of our clients uses CBD and Prozac together-

“I give my dog Blooming Culture pet CBD oil on a daily basis to help with her generalized anxiety. When we travel or fly I up her dose of CBD that day and add in her veterinarian prescribed Prozac. I have found in conjunction they work really well together for extreme circumstances.”

One of the biggest known and visible side-effects of dosing your pet CBD with any of these medications is tiredness, which can be easily remedied by adjusting their dose.

If you are thinking about switching your pet off their prescription medication or trying to lower their dose, do it slowly. You can first start with a low dose of CBD and talking to your veterinarian on the best way to ween off the particular medication.

All Drug Interactions are Not Negative

Since CBD can also enhance the effects of certain medications, this means that a lower dose of that medication or therapy can sometimes be used, which is a positive.

Drugs used for dog seizures is one. Since CBD also has its own anti-seizure properties, it has proven to work well in human clinical trials together with anti-seizure medications. The AKC Health Foundation recently announced that it will begin a major clinical trial to study the potential for pet CBD oil for use in drug-resistant epileptic dogs.

The second is chemotherapy. Dogs receiving chemotherapy for cancer tend to have a lot of unwanted side effects. Many pet parents use CBD oil as a way to curb some of them and make their pet more comfortable. The same way people going through radiation may use CBD or cannabis. But recent research has shown that giving CBD oil to your pet in conjunction with radiation actually may make chemotherapy more effective.

Some research states that CBD triggers TRPV2 channels, making the cancer cells more sensitive to chemotherapy.

A different study showed that rats with pancreatic cancer had 3X the survival rate when given CBD in conjunction with chemotherapy instead of only chemotherapy.

Again, please work with your veterinarian as much as possible to make sure every medication, natural or not is working together safely on your pet.

*This article is for informational purposes only. If you have pet medication interaction concerns, please always consult with your veterinarian first.