Tramadol?

[Maggiesmom]

I mentioned in my previous post about Sebastian that he had been prescribed Tramadol for arthritis pain, 1/4 tablet twice daily. Well, I've seen some strange effects with it, although it is not supposed to have many if any side effects. Sebastian seems a bit out of it, he did not want to be around me last night, although I cannot remember a night when he has not slept with me. When I do go in to see him, he is very affectionate, but something is off. He was withdrawn in the other bedroom. He is not eating well, either. I have called the vet and am going to discontinue the Tramadol for now. Has anyone else had this experience?

[Traci]

You should probably get him seen, Maggiesmom, since he is also anorexic, this may not be entirely related to the tramadol (although cessation of it is a good idea)...you may need to retest his liver/kidney enzymes and get him rehydrated. Is he on any other medications (other than the Cosequin)? Your vet may want to also evaluate the Cosequin dose, and reduce it's dose, since although it would be rare, the Cosequin might cause GI tract upset (rare in cats).

[Maggiesmom]

I'm taking him in the morning. He is not on any other medications.

[Traci]

If any other symptoms develop (vomiting, diarrhea, dilated pupils, obvious change in behavior or physical abilities), don't wait, get him seen immediately.

[Maggiesmom]

Absolutely. I checked on him at lunch and he seemed better. He had eaten some of his food and was a bit more social. The Tramadol I gave him last night would have worn off by now, so I think there is a direct correlation.

[Maggiesmom]

Update- Sebastian is doing much better. His symptoms disappeared after taking him off the Tramadol. Side effects are rare, but everyon (people and pets) handle opiates differently. The vet gave him a good report today. After stopping the Tramadol, Sebastian started eating again. The vet gave him a shot of Rimadyl for his arthritis, and I am to give him a few drops of Metacam as needed starting in 4-5 days. His arthritis discomfort is my main concern for quality of life right now.

He had his first IV fluids today, and ate even more. He obviously feels much better after that. I learned how to do it myself at the vet. I am to give him 200 cc's every other day. I hope I can do it, I am a bit nervous about how hard to stick him. Hopefully with this new regimen, he will be feeling much better.

[Traci]

Maggiesmom, I strongly advise seeing a new vet, preferrably feline-only.

Rimadyl is not approved for use in cats, and both the Rimadyl and Metacam are contraindicated in cats with renal insufficiency, since both are NSAIDS....combining NSAIDS in a cat are also not recommended!

I could understand the judicial use of Metacam, but it's a medication that should only be used for low-dose pain management, mainly after a procedure of significance, but not long-term for the management of arthritis. I'm also concerned with your comments "and I am to give him a few drops of Metacam as needed starting in 4-5 days.".....if this is the exact wording on the prescription label of the vial, your vet is taking huge risks by doing this. This medication is usually only prescribed for once a day dosing fr a maximum of 3-4 days, it is a very potent medication that must be used very carefully in cats. With renal insufficiency, I worry about the risks your vet is taking with an injection of Rimadyl, followed by Metacam in the following days. Did he bother to explain the contraindications with you, and did he bother to recommend blood monitoring while on either med?

Please, seek a more qualified vet, promptly (feline-only). I don't want to instill fear here, but I think your vet's approach is risky, especially given Sebastian's renal insufficiency.

[Maggiesmom]

Now I am worried. I'm glad I posted here to hear that response. I will look into a feline vet this week, there is a feline only cat practice here.

[Traci]

Good to hear, please post an update when you can....