Tramadol Alternatives for Dogs - April 2024

What Is Tramadol Used For?

Tramadol is a medicine that veterinarians prescribe to owners for pain relief in dogs. Although doctors often authorize its use in treating pain in human beings, it is also safe to give to dogs under veterinary supervision.

A study from the Merck Veterinary Manual in 2013 suggests the intake of tramadol in the treatment of moderate to severe acute and chronic pain⁽⁷⁾. A veterinarian may prescribe tramadol for cases such as helping a dog recover after surgery or as a means to manage osteoarthritis pain⁽⁸⁾.

A doctor may recommend the use of tramadol as a painkiller if a dog is suffering from pain caused by any of the following:

• Cancer
• Lameness
• Post-operative pain
• Nonsurgical intervertebral disc disease
• Osteoarthritis
• General pain from injury or another condition

Tramadol can also be used in treating coughs, anxiety, and canine degenerative myelopathy.

Tramadol Dosage for Dogs Information

Tramadol is categorized as a schedule IV controlled substance and has been approved by the US Food and Drug Administration (FDA) since 2014⁽⁹⁾. Its classification means that the only way an owner can obtain it is through a prescription from their vet.

Veterinarians recommend a dosage of 0.5 mg/lb to 4.5 mg/lb every 8 to 12 hours, which is given by mouth. The time interval for application will vary as this will be based on any pre-existing medical conditions of the dog. A doctor, for instance, may give a pet about 1 mg/lb of tramadol for mild pain relief, while pain caused by cancer may warrant a higher dose⁽¹⁰⁾.

A veterinarian can also adjust the dosage of a dog based on their allergic reaction to the medicine. Mixing the medication with pet food can help hide its bitter taste while also preventing them from vomiting.

Owners should not give their dog tramadol that is meant for human conditions. The dosage for dogs and humans differs significantly, and supplying tramadol to a pet outside of veterinarian guidance can result in an overdose.

Veterinarians calculate the tramadol dosage for a dog based on its weight, while also considering other details regarding their health. For instance, the dosage for acute pain can be different from that for chronic pain control⁽¹¹⁾.

Common Side Effects and Risks of Tramadol for Dogs

As with most medications, there are some serious side effects of tramadol that pet owners need to know. Following the instructions of a veterinarian should make tramadol doses tolerable for most dogs. However, there are also several adverse reactions which include:

• Nausea
• Diarrhea
• Vomiting
• Loss of appetite
• Constipation
• Anxiety
• Dizziness
• Tremors
• Drowsiness

The severity of these reactions will vary, but it is always advised to call the veterinarian in case a dog experiences any of these symptoms⁽¹²⁾.

Another aspect that pet owners should consider is the fact that tramadol overdose can also occur among dogs. Such circumstances can happen by accident, especially when people in contact with the canine provide a higher dose than what was prescribed.

The following are the overdose symptoms of tramadol dog owners should know:

• Tremors
• Respiratory depression
• Low heart rate
• Tremors
• Seizures
• Sleepiness
• Excessive drooling
• Agitation
• Dilated pupils
• Sedation
• Uncontrollable movement (Ataxia)
• Coma
• Loss of consciousness

Additionally, a study made by the medical journal JAMA on more than 80,000 osteoarthritis patients revealed that tramadol increased their risk of mortality. It showed that human patients have significantly higher mortality rates after more than a year of follow-up compared to those that took non-steroidal anti-inflammatory drugs⁽¹³⁾.

Although the research did not involve dogs, a connection can be made in prescribing tramadol and its association with higher risks of death.

Is Tramadol an Effective Analgesic for Dogs?

As part of the opioid family, tramadol has become quite popular in veterinary medicine due to its ability to relieve pain and its low potential for abuse. However, there is an ongoing debate on its clinical efficacy, especially in treating dogs.

Researchers in preclinical studies found it difficult to prove that the oral intake of tramadol can produce meaningful analgesic effects in dogs. Some studies suggest adequate results⁽¹⁴⁾, but the majority indicate that tramadol may not be the best option for canines^(15-18). 

Although certain points of these studies vary, there is a pattern showing that the absorption and metabolism of the drug in dogs are unlikely to hold effective clinical use for pain management. The results of a study on the intravenous application of tramadol on six healthy Beagle dogs was also indecisive⁽¹⁹⁾. 

In 2018, a study from the Journal of the American Veterinary Medical Association investigated the effectiveness of tramadol for the treatment of osteoarthritis in dogs. The research showed that in the ten days of treatment using the said medication, no clinical benefit was observed⁽²⁰⁾.

There are mixed results in clinical studies on oral tramadol, but the trend is leaning towards the medication not having reasonable painkilling effects.

A study in 2013 reported that tramadol combined with metamizole has proven to be clinically effective in treating moderate to severe pain in dogs with cancer⁽²¹⁾.

By itself, tramadol is considered to be inferior to several medications that provide similar analgesic effects^(22-24).

Tramadol is a common prescription for pain relief in small animal medicine, particularly in dogs. While it may appear to have a wide safety margin, evidence from research suggests that it does not provide meaningful benefits to canines.

Tramadol Alternatives for Dogs

Seeing as tramadol lacks effectiveness as a pain reliever for dogs, it is understandable why owners would look for alternatives to this medication.

Dr. Jennifer Coates, a DVM writing for Pet MD, recommends a couple of FDA-approved alternatives to tramadol: gabapentin, and amantadine⁽²⁵⁾.

Gabapentin for Dogs

Gabapentin, an anti-seizure drug, can help in treating chronic pain in dogs⁽²⁶⁾. Although doctors do not yet fully understand its mechanism of action, it is believed to lower the release of neurotransmitters in the brain associated with the feeling of pain.

However, gabapentin works best when administered together with other pain relief medications such as an NSAID (non-steroidal anti-inflammatory drug) or opioid. Since it operates mainly within the nervous system, gabapentin is also seen as a potential medication for anxiety and seizure disorders⁽²⁷⁾.

Amantadine for Dogs

Another alternative to tramadol for dogs is amantadine. In a controlled study, the medication showed that it could improve physical capability in canines suffering from osteoarthritic pain⁽²⁸⁾.

In the same study, dogs receiving amantadine with NSAIDs were more active compared to canines that only had NSAIDs.

Amantadine is considered as ‘extra-label’, which means pet owners will need to follow the advice of their veterinarian carefully to avoid complications.

CBD Oil for Dogs

Cannabidiol (CBD) is a more natural, and perhaps safer, alternative for tramadol use, including other pain relief medications for canines.

A study in 2019 reveals that the endocannabinoid system (ECS), or the system that regulates the function of cannabinoids in our bodies, is the same for all animals except for protozoans and insects⁽²⁹⁾. It states that the ECS in animals is universal and that it provides the same function regardless of the species.

The study goes on to reveal that dogs possess a large number of cannabinoid receptors in their brain. In fact, it shows that these animals have far more of these receptors than in human beings⁽³⁰⁾.

Since humans are already consuming CBD for its health benefits, experts are hinting that the non-psychoactive phytocannabinoid can also be used on dogs.

A research investigator from the Michigan Medicine Chronic Pain and Fatigue Research Center notes that the ongoing preclinical studies on animals show that CBD is capable of reducing moderate pain in the body⁽³¹⁾.

Similar to humans, a study also found that dogs can tolerate the consumption of the active ingredients of CBD oil well. Twenty healthy Beagle dogs were put to the test and showed that a predominantly CBD-based oil formulation is safe and tolerable in canines⁽³²⁾.

Most of the CBD products for dog health are available as treats, chews and tinctures.

There are, however, possible adverse effects of CBD intake on dogs, which include low blood pressure, drowsiness, and dry mouth⁽³³⁾.

Since the FDA does not yet approve it, a CBD dosing chart for canines does not exist.  

Consulting a veterinarian is highly recommended for pet owners who are planning to incorporate CBD in their canine’s diet.

Conclusion

The prescription of tramadol on dogs may be safe under veterinary supervision, but the studies show that there is a probability that continuous intake of the drug can lead to severe health risks.

Evidence of other pain medications being superior in terms of tramadol’s overall analgesic effects is also another side to consider.

Tramadol may be capable of treating chronic and acute pain in dogs, but a more natural alternative, such as the use of CBD, might be a healthier option in the long run.

No matter which form of treatment is desired, small animal owners should always consult their veterinarian first to avoid complications.

1. Allweiler, Sandra (September 2013). Chronic Pain. Merck Veterinary Manual. Retrieved from https://www.merckvetmanual.com/management-and-nutrition/pain-assessment-and-management/chronic-pain.
2. Burke, Anna (2016, November 30). Tramadol for Dogs: Uses and Side Effects. Retrieved from https://www.akc.org/expert-advice/health/tramadol-for-dogs/.
3. Lascelles BD, Gaynor JS, Smith ES, Roe SC, Marcellin-Little DJ, Davidson G, Boland E, Carr J. Amantadine in a multimodal analgesic regimen for alleviation of refractory osteoarthritis pain in dogs. J Vet Intern Med. 2008 Jan-Feb;22(1):53-9. doi: 10.1111/j.1939-1676.2007.0014.x.
4. Mills PO, Tansey CO, Genzer SC, Mauldin MR, Howard RA, Kling CA, Jackson FR, Matheny AM, Boothe DM, Lathrop GW, Powell N, Gallardo-Romero N. Pharmacokinetic Profiles of Gabapentin after Oral and Subcutaneous Administration in Black-tailed Prairie Dogs (Cynomys ludovicianus). J Am Assoc Lab Anim Sci. 2020 Mar 25. doi: 10.30802/AALAS-JAALAS-19-000150.
5. Malcolm, Kelly (2019, October 30). Should You Take CBD for Pain? Retrieved from https://healthblog.uofmhealth.org/health-management/should-you-take-cbd-for-pain.
6. Dana Vaughn, Justyna Kulpa, and Lina Paulionis. Preliminary Investigation of the Safety of Escalating Cannabinoid Doses in Healthy Dogs. Front Vet Sci. 2020; 7: 51. Published online 2020 Feb 11. doi: 10.3389/fvets.2020.00051
7. Allweiler S. (2013 September). op. cit.
8. Burke, A. (2016 November 30). op. cit.
9. Manraj Dhesi; Christopher V. Maani. Tramadol. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
10. Veterinary Place. Tramadol For Dogs. Retrieved from https://www.veterinaryplace.com/dog-medicine/tramadol-for-dogs/.
11. Burke, A. (2016 November 30). op. cit.
12. Ibid.
13. Chao Zeng, MD, PhD; Maureen Dubreuil, MD, MSc; Marc R. LaRochelle, MD, MPH. et al. Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis. JAMA. 2019;321(10):969-982. doi:10.1001/jama.2019.1347
14. KuKanich B, Papich MG. Pharmacokinetics of tramadol and the metabolite O-desmethyltramadol in dogs. J Vet Pharmacol Ther. 2004 Aug;27(4):239-46.
15. Benitez ME, Roush JK, KuKanich B, McMurphy R. Pharmacokinetics of hydrocodone and tramadol administered for control of postoperative pain in dogs following tibial plateau leveling osteotomy. Am J Vet Res. 2015 Sep;76(9):763-70. doi: 10.2460/ajvr.76.9.763.
16. Giorgi M, Saccomanni G, Lebkowska-Wieruszewska B, Kowalski C. Pharmacokinetic evaluation of tramadol and its major metabolites after single oral sustained tablet administration in the dog: a pilot study. Vet J. 2009 May;180(2):253-5. doi: 10.1016/j.tvjl.2007.12.011. Epub 2008 Mar 3.
17. McMillan CJ1, Livingston A, Clark CR, Dowling PM, Taylor SM, Duke T, Terlinden R. Pharmacokinetics of intravenous tramadol in dogs. Can J Vet Res. 2008 Jul;72(4):325-31.
18. Giorgi M, Del Carlo S, Saccomanni G, Łebkowska-Wieruszewska B, Kowalski CJ. Pharmacokinetic and urine profile of tramadol and its major metabolites following oral immediate release capsules administration in dogs. Vet Res Commun. 2009 Dec;33(8):875-85. doi: 10.1007/s11259-009-9236-1.
19. Schütter AF, Tünsmeyer J, Kästner SBR. Influence of tramadol on acute thermal and mechanical cutaneous nociception in dogs. Vet Anaesth Analg. 2017 Mar;44(2):309-316. doi: 10.1016/j.vaa.2016.02.003. Epub 2017 Jan 7.
20. Budsberg SC, Torres BT, Kleine SA, Sandberg GS, Berjeski AK. Lack of effectiveness of tramadol hydrochloride for the treatment of pain and joint dysfunction in dogs with chronic osteoarthritis. J Am Vet Med Assoc. 2018 Feb 15;252(4):427-432. doi: 10.2460/javma.252.4.427.
21. Flôr PB, Yazbek KV, Ida KK, Fantoni DT. Tramadol plus metamizole combined or not with anti-inflammatory drugs is clinically effective for moderate to severe chronic pain treatment in cancer patients. Vet Anaesth Analg. 2013 May;40(3):316-27. doi: 10.1111/vaa.12023. Epub 2013 Feb 21.
22. Kögel B1, Terlinden R, Schneider J. Characterisation of tramadol, morphine and tapentadol in an acute pain model in Beagle dogs. Vet Anaesth Analg. 2014 May;41(3):297-304. doi: 10.1111/vaa.12140. Epub 2014 Feb 27.
23. E. M. Goudie-DeAngelis, Kerry J. Woodhouse, M. R. Raffe, F. H. David. Evaluation of analgesic efficacy and associated plasma concentration of tramadol and O-desmethyltramadol following oral administration post ovariohysterectomy. International Journal of Applied Research in Veterinary Medicine. Published – Jan 1 2016
24. Budsberg SC et al. op. cit.
25. Coates, Jennifer DVM (2014, May 12). Treating Chronic Pain in Dogs. Retrieved from: https://www.petmd.com/blogs/thedailyvet/dr-coates/2014/may/treating-chronic-pain-dogs-31653.
26. Mills PO et al. op. cit.
27. Grubb, Tamara DVM, PHD, DACVAA. Gabapentin and Amantadine for Chronic Pain: Is Your Dose Right? Retrieved from: https://todaysveterinarypractice.com/gabapentin-and-amantadine-for-chronic-pain-is-your-dose-right/.
28. Lascelles BD et al. op. cit.
29. Silver, Robert. The Endocannabinoid System of Animals. Animals (Basel). 2019 Sep; 9(9): 686. Published online 2019 Sep 16. doi: 10.3390/ani9090686
30. Ibid.
31. Malcom, K. op. cit.
32. Vaughn, D. op. cit.
33. Kriss, Randa (2019, October 27). CBD Oil for Dogs: What You Need to Know. Retrieved from: https://www.akc.org/expert-advice/health/cbd-oil-dogs/.