Re: 8/20 Tiberious PMPS 208 +2 188, +4 107,+5 135-Hypo! @ +6
Hi Susan,
A few things about Tramadol. It's different than your "normal" opiate in that it's centrally acting. This means in theory, it has less potential for addiction and is "gentler" on the patient. With that having been said, there are still some side effects that come with any type of opiate. These side effects come from how Tramadol works. By binding to specific receptor sites, it "blocks" central nervous system reactions....so it blocks pain. When it does that, it also slows down other things the central nervous system controls. The big one is respiratory rate. This is important because i
t's the big one that needs to be watched for when taking any kind of opiate drug. For Tiberious - it's a welcomed side effect, but again, make sure you are watching to make sure his breathing doesn't go too low.
The other things Tramadol can affect are: slowing the heart rate, lowering blood pressure (which may make him dizzy and lethargic), stomach (most common constipation, but can have diarrhea too), and nausea and vomiting.
In people, we titrate the dose, meaning we start low and increase slowly. This REALLY helps with the side effects and a lot of times, eliminates them all together. I'm going to copy and paste below the info from the drug's Package Insert and maybe you could give this to your Vet to show him/her how it's used in human's to control the side effects (the brand name us ULTRAM, so you will see that referenced here):
Titration Trials
In a randomized, blinded clinical study with 129 to 132 patients per group, a 10-day titration to a daily
ULTRAM dose of 200 mg (50 mg q.i.d.), attained in 50 mg increments every 3 days, was found to
result in fewer discontinuations due to dizziness or vertigo than titration over only 4 days or no
titration. In a second study with 54 to 59 patients per group, patients who had nausea or vomiting when
titrated over 4 days were randomized to re-initiate ULTRAM therapy using slower titration rates.
A 16-day titration schedule, starting with 25 mg qAM and using additional doses in 25 mg increments
every third day to 100 mg/day (25 mg q.i.d.), followed by 50 mg increments in the total daily dose
every third day to 200 mg/day (50 mg q.i.d.), resulted in fewer discontinuations due to nausea or
vomiting and fewer discontinuations due to any cause than did a 10-day titration schedule.
Dosing:
ULTRAM should be started at 25 mg/day qAM and titrated in 25 mg increments as separate
doses every 3 days to reach 100 mg/day (25 mg q.i.d.). Thereafter the total daily dose may be increased
by 50 mg as tolerated every 3 days to reach 200 mg/day (50 mg q.i.d.). After titration, ULTRAM 50 to
100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg/day.
For the subset of patients for whom rapid onset of analgesic effect is required and for whom the
benefits outweigh the risk of discontinuation due to adverse events associated with higher initial doses,
ULTRAM 50 mg to 100 mg can be administered as needed for pain relief every four to six hours, not
to exceed 400 mg per day.
Half life is pretty short on this drug....I wouldn't think you would still be seeing effects 24 hours later. I'm also of the thought that it wasn't hypo that you were seeing...but rather too much Tramadol affecting his central nervous system which would slow things wayyyyy down.
I know it sounds scarey, but Tramadol is not a bad drug and if used properly, can really be beneficial. A lot of times, this is the drug of choice for chronic pain because it's been a lot safer and MUCH less addicting than the other pain drugs. Good Luck!!
And you're still doing great. Good luck, and I'm looking forward to more updates. How's he doing today?
when Susan told me abt that! This whole ordeal has been very hard on us and I just wanted to thank you myself! 