Tramadol in the anxious dog
February 13, 2023 7:44 AM   Subscribe

Our bestest boy is seemingly in a mental crisis. Being a big dog, he has hip problems in his old age. He was previously on 3.75mg of Metacam and 50-100g of tramadol, as needed. But that got upped at his last check-up.

At his last check-up, his vet wanted to go to daily tramadol (25mg every 12h, but up to 150mg as-needed), and everything was fine for about a week. This boy has terrible anxiety problems since the day we rescued him, and last night it feels like he had a psychotic break. We were all laying in bed quietly, then he sort of jumped like something startled him, and then he literally did not go to sleep last night. He just paced and whined. All night. And this has continued into the morning.

It doesn't seem like he is in pain, since he's been walking non stop and isn't guarding the areas we know to be sore. He was just in the backyard splaying his hips all the way back like a puppy.

I've read that tramadol can cause heightened anxiety and hallucinations, and that seems like it jibes with his apparent reaction to nothing, last night. The vet wants to up the dosage. Is this the right course of action?
posted by hwyengr to Pets & Animals (9 answers total)
Our previous dog had very bad dysphoria in response to opiates - any opiates. They did seem to help with the pain but they made him fucking miserable. (I also get dysphoria with opiates, and it is in fact miserable!) Tramadol did not end up being workable, unfortunately, and we did not end up finding a solution for his pain. I very much doubt that upping the dosage will fix this if it's in fact a side effect.
posted by restless_nomad at 7:59 AM on February 13, 2023

Handsome guy!
I agree with you and would not want to increase something that may be causing these side effects - it is so hard to watch my dog when he is clearly upset and anxious (in our case, it was shadows/noises in a new apartment - though he is fine now and episodes are rare). I'm not sure why a different pain reliever can't be tried - I am not a vet so there may be a good reason. I currently have one dog on Gabapentin for post-op dental (short term prescription), and one on Hydrocodone for chronic cough (long term prescription, very low dose).

My anxious dog has Trazadone on hand for anxiety - though I have found it less than useful for unexpected anxiety events because 1. dog won't take pill when anxious and 2. it takes a while to take effect. But, if it's not too harsh to take daily maybe request that to try?

Good luck and I hope you find a solution that works for him. I hope the vet will have more options for you.
posted by Glinn at 8:57 AM on February 13, 2023

I have a couple of fosters who have been on Tramadol for reactivity, anxiety and trauma, and one of them has been on it long term. The vet chose it over other drugs because it has a high safety margin and it tends to not cause dependence. For one of the two dogs, it's literally saved him from euthanasia due to aggression. For the other, it's allowed him to lower his anxiety to respond better to training and socialization after a lifetime of living in a hoarder house and having no socialization in public or with people.

If the drug is causing this, then it absolutely make no sense to up the dosage and expect a different result. There are other medications they can try that won't have that side effect.

I am not a vet, but my understanding is that the drug causing anxiety isn't a common side effect, so I'd definitely talk to the vet about that.
posted by answergrape at 9:07 AM on February 13, 2023 [1 favorite]

This can still be a pain response, internal pain can make dogs too uncomfortable to lie down. I learned this the hard way. I don't know Tramadol off the top of my head, but is there any mention of spleen or liver damage in the side effects?
posted by Lyn Never at 9:56 AM on February 13, 2023

My dog was on tramadol post cancer surgery last summer (and a fentanyl pain patch). I found that she also didn't settle usually within a half hour of getting the pill she'd begin to get restless, so after three days (and her pain management going pretty well with other items like gabapentin), I took her off it. She seemed to sleep better, though still got up a lot, paced and re-settled. But you know, cancer surgery and wearing a cone is uncomfortable. About three days after stopping it (and probably healing a bit more) she started sleeping through the night.

For long-term issues, such as joint issues and her slipped lumbar disks, we're using gabapentin as needed and injections of adequan (once every three weeks, subcutaneously - the vet tech taught me how). The adequan actually helps her body maintain her cartilage and in some cases rebuild it. It actually made a world of difference. We were afraid in 2020 that we'd have to put her down she was in such pain, lost her appetite and was losing control of her back legs. But about three months later, she was able to walk a mile.

You might want to bring that up with your vet, I had to suggest it to mine after reading about it on MF in a dog thread. It's not for every dog, after the initial course the dog will need blood tests to make sure it's not causing liver or kidney damage.
posted by typetive at 10:20 AM on February 13, 2023 [1 favorite]

There have been pretty recent studies indicating that tramadol isn't effective in controlling pain in dogs.

I've had luck with Carprofen/Rimadyl (NSAID), which is similar to Metacam (metacam is easier on the belly) with my dogs.

Trazadone (requires prescription), Benadryl and CBD treats also help with agitation. If you go with the CBD treats, you might need to experiment with dosage. My boys get one in the morning, but two at night. The trazodone is saved for fireworks or if I have workmen in the house.
posted by dancinglamb at 10:37 AM on February 13, 2023

my experience is that it can be just as complex getting the right meds for a dog as it is for humans.

agree that advocating to your vet for some other options seems indicated. if your vet seems staunch on continuing with tramadol, you could ask what they would consider as indicators that it’s not working— what their plan for discontinuing would be, and what their thinking is. i would ask what other meds they think you can consider. if they have no other options for you, i would look for a second opinion (there are definitely other options— trazadone has been mentioned, also gabapentin, and weirdly clonadine has worked well ime). i am not a vet, and your vet may have a great rationale for wanting to try an increase of tramadol… or they could just be using the one tool they’re familiar with.

good luck to you and your sweet buddy!
posted by tamarack at 10:27 PM on February 13, 2023

Anecdotal here but I found success treating anxiety in my dog with Prozac. We tried everything under the sun, that was the magic bullet. He has anxiety and flu biting disorder (which leads me to believe he may have some OCD).
posted by christiehawk at 9:10 AM on February 14, 2023 [1 favorite]

I've read that tramadol can cause heightened anxiety and hallucinations

It can. At least in this human. But with a dog it's harder to know what's going on. Try something else. Talk to the vet. Carprofen is, like most pain meds, hard on the liver. But depending on the age and life expectancy of the dog, that might not matter - not to be harsh. Just saying there comes a time when the vet will say, at this point, we don't have to worry about this causing long-term harm.

\Gabapentin is also an option. (Unless your vet doesn't think it's right for your dog.)

Walking non stop is not a good sign. This is anxiety. And very likely an adverse reaction to something. Healthy energy and constant motion are not the same thing.

You are fortunate that you can afford quality care for the bestest boy.
posted by Lesser Shrew at 4:08 PM on February 18, 2023

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