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Dr. Gary
Dr. Gary, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 19324
Experience:  DVM, Emergency Veterinarian, BS (Physiology)
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As per my initial information, i just want to understand if

Customer Question

As per my initial information, i just want to understand if my dog was safe
Submitted: 3 months ago.
Category: Dog Veterinary
Expert:  Dr. Gary replied 3 months ago.

Hello.

I'm sorry, but I didn't get any other information- only this thread.

What is going on with your dog?

Customer: replied 3 months ago.
My 14.5 yr mixed breed medium sized dog was started on an initial dose of tramadol 200mg SR twice daily for arthritic pain. After all my own reasearch i feel this dose is too high. Blood tests were done prior but not a urine analysis. I feel for a dog of this age and condition 200mg is too high, especially since this opiate has no exact antidote. I have been doing lots of reading and most dogs seem to be started on 50mg-100mg. My dog has not had such strong pain relief since she was desexed in her very early years. Please help clarify this for me. Thank you kindly
Customer: replied 3 months ago.
My dog weighs 31 kg too.
Expert:  Dr. Gary replied 3 months ago.

To be honest, I really don't use Tramadol much anymore. I used to use it all the time, but typically with something else. In an arthritic dog, I would go with an anti-inflammatory like Rimadyl or Metacam. If that's not enough, I would add Gabapentin at 5-10 mg/kg twice daily. Gabapentin has been my go to pain medication either by itself or in addition to anti-inflammatory meds. It doesn't have the sedation effect that I see with Tramadol and it doesn't make them "high" like you see with Tramadol.

When I do use Tramadol, I typically go in the 3-5 mg/kg 2-4 times daily. In a 31 kg dog, I'd start at 100 mg twice daily as a low end dose. I'd go up to 150 mg every 6 hours as a high end dose. 200 is too high, in my opinion.

I hope this helps clear some things up. Let me know if you have any other questions.

Customer: replied 3 months ago.
Thank you gary. My dog did pass away the night she had her first dose of this medication. In my opinion she was unintentionally euthanized.
Expert:  Dr. Gary replied 3 months ago.

Oh, I'm sorry to hear that. The lethal dose of Tramadol is much higher than what you gave. I would expect well over 1000 mg before it could cause respiratory depression significant enough to cause arrest. Irregardless, I'm sorry for your loss.

Customer: replied 3 months ago.
I see. However I just looked at her blood tests from 3 weeks ago and her ALKP levels are up. From what I understand this indicates liver damage which is a contra-indication for Tramadol..?? I have attached the results
Expert:  Dr. Gary replied 3 months ago.

That ALKP increase is fairly mild. The more concerning thing is the anemia. It looks like he was destroying his own blood cells. In an older dog like this, I would bet there was cancer somewhere and a paraneoplastic syndrome where it caused the body to attack it's own red blood cells. This can happen quickly and cause life threatening anemia within days. That's probably the cause of death. I do think the Tramadol dose was high, but just not high enough to cause death.

Customer: replied 3 months ago.
I did notice the anemia too. U cant really treat it in older dogs can you?? It was just that nothing was told to me about her bloods...i assumed hearing nothing from the vet meant they were good
Expert:  Dr. Gary replied 3 months ago.

Sorry for the wait.

You can treat anemia with a blood transfusion, but the main focus is treating the cause of the anemia. That's always the tough part to figure out.