CBD as an Alternative Supplement to Tramadol

September 10, 2020 13 min read 0 Comments

A tan dog lays on green grass in front of a fence covered in green ivy

Claudia Bensimoun author of CBD as an Alternative Supplement to 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 syntheticcodeine analogue, is a weak mu opioid receptor agonist. In addition to opioid activity, it inhibits neuronal reuptake ofnorepinephrine 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 asselegiline, 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-desmethyltramadol, 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 cleartramadol 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 ofmorphine 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 astudy published inThe 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.

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

a vet in blue scrubs examining a red and white husky

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 toVeterinary 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,36inadequate for dogs undergoing ovariohysterectomy,37and both inferior to carprofen and equivalent to placebo for dogs with osteoarthritis.38Despite 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.


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.


Sold out

CB2 receptors

Cannabidiol (CBD) may be beneficial for cancer pain in dogs by acting indirectly on the CB2 receptors. This differs from how THC acts on CB1 receptors, in that THC may be more beneficial in helping ease pain caused from nerve damage in dogs. As usual, consult with your veterinary oncologist for advice.

A recent study at Cornell University found that CBD works for pets with chronic pain, and demonstrated evidence that CBD did reduce inflammation and chronic pain in pets. It also found that pets on CBD did not build up a tolerance to CBD, so doses did not have to increase with time.

“Dogs received either CBD oil at 2 mg/kg every 12 hours or they received placebo oil, according to the abstract. Dogs were treated for four weeks with a two-week washout period. The dogs’ owners completed questionnaires and veterinarians conducted assessments—including physical exam, hematology and serum chemistry—before treatment and at weeks two and four. The Canine Brief Pain Inventory score and Hudson activity score (a visual analogue scale questionnaire used to assess pain and lameness in dogs),” via Dr. Sarah Wooten, DVM, Veterinary News.

Additionally, CBD has the ability to destroy certain cancer cells, and prevent the growth of blood vessels to tumors. This natural supplement also offers antioxidant properties, and may help slow down tumor growth in dogs with cancer.

There is new research that shows how CBD may be effective with improving the efficiency of chemotherapy in people with cancer. That said, it’s important to work together with your veterinarian when supplementing CBD oils, tinctures, treats, or capsules.

According to the World Health Organization (WHO) “CBD oil may have the potential to kill certain cancer cells, and stop tumor growth in blood vessels. It also may help with chemotherapy side effects in both human and pet. Hemp contains other natural compounds like terpenes and flavonoids. That said, limonene, which is a terpene, has been found to have anticancer properties. CBD can be converted to tetrahydrocannabinol (THC) under experimental conditions; however, this does not appear to occur to any significant effect in patients undergoing CBD treatment.”

It’s important to discuss treatment with your veterinarian to strike the right balance with CBD oils that will be effective with pain management for dogs with cancer. Additionally, it’s necessary to make sure that your CBD oil contains no tetrahydrocannabinol (THC), the component of the cannabis plant that will give your dog a “high.”

Is it safe?

Yes, CBD rarely has side effects. If there are side effects, they may show up in the following ways:

  • Lower blood pressure
  • May act as a blood thinner by increasing levels of Coumadin in blood
  • Nausea
  • Fatigue
  • Irritability

CBD oil tincture tips

  • Begin with a lower strength tincture since tinctures are highly concentrated. (consult with your vet first)
  • Consider the strength of the tincture and your dog’s weight, health conditions, and age prior to purchasing.
  • Higher-strength tinctures are more cost effective, yet pet parents should be cautious about using the more potent tinctures at first on their dogs.
  • More potent tinctures offer more potency and other cannabinoids which may be beneficial for certain canine health and behavioral issues.
  • Consider all the CBD oils and only the most reputable dog brands. CBD oil is a new market which needs more transparency, and more long-standing research.
  • Most tinctures contain hemp seed oil extract that is mixed with a neutral oil like coconut or hemp seed oil. Opt for the highest-quality products for your dog.
  • Opt for the latest versions which offer CBD combined with supplements that offer numerous health benefits. Some brands have multiple CBD pet lines for different health issues.
  • As a pet parent, do your research and consult with a CBD savvy veterinarian or expert for the best CBD oils for your dog’s specific heath conditions.
  • Look for simple dosage instructions that you understand.

Inspect the CBD mg amount in your tincture

Pet parents need to inspect the “total” amount of CBD “mg” oil within their pet products. Read labels, and read the ingredients list. That said, pet parents should be aware that there may be a variety of ingredients within the CBD oil, and that they need to look out for the “pure” CBD content “mg” amount. This is stated on the ingredient label as a percentage. Consumers can also contact the manufacturer to find out more about their CBD products.


Who can use CBD?

Today, thanks to all the recent studies, many pet parents are seeking pain relief for the pets via cannabidiol with the use of CBD pet treats, tinctures, capsules, transdermal patches, lotions, shampoos, and more!

Your veterinarian will usually recommend chemo and radiation, surgery, or even a combination of all three treatment methods if your dog has cancer. Because current studies have demonstrated the efficacy of cannabinoids in reducing tumor growth, and also in helping fight inflammation, pain, and anxiety, it may be beneficial for your furry best friend together with other treatments. Tramadol does not reduce inflammation, yet CBD does.

Remember to always work closely with your veterinarian so that your dog can get the best combination of treatments possible, whether they be natural or traditional pain relief. Pain management needs to be effective with the least amount of long-term side effects.


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Meet The Author 

Claudia Bensimoun author of CBD as an Alternative Supplement to Tramadol

Claudia Bensimoun

Claudia Bensimoun is a freelance journalist and author, and specializes in veterinary content, and eBooks. She's a long-time feature writer for Animal Wellness magazine, Fido Friendly magazine, and the United States Dog Agility Association. In addition, Bensimoun has written for numerous pet websites, magazines, newspapers and online publications. Her interests include wildlife conservation, animal welfare, disaster/humanitarian relief, veterinary research, and veganism.