Key takeaways
Tramadol treats chronic pain in cats and improves their quality of life.
The standard tramadol dosage for cats is 1–4 mg/kg, administered orally every eight to 24 hours.
The most common side effects of tramadol in cats are euphoria, dilated pupils, sleepiness, and discomfort.
Do not give tramadol to cats if the cat has a history of allergic reactions to opioids.
Veterinarians use tramadol, a generic opioid agonist, to treat chronic pain in dogs and cats. It’s not always the first choice for various reasons, so it’s usually used as an alternative or add-on treatment. Although some veterinarians may use it for acute pain, it may take up to 14 days of daily dosing for tramadol to hit its maximum analgesic effects. Tramadol is safe for cats. Side effects tend to be minimal if the drug is given as prescribed.
RELATED: Save up to 80% on tramadol
What is tramadol used for in cats?
Veterinarians use tramadol in cats as a painkiller. It’s often used as an alternative drug or add-on treatment for a cat with ongoing or chronic pain.
Chronic pain in cats
Like people, cats often suffer from ongoing pain due to conditions such as osteoarthritis, joint damage, nerve damage, inflammatory conditions, and cancer. Some of these conditions are very common. As many as 9 out of 10 cats have some form of degenerative joint disease. One study found that 61% of cats of various ages had at least one joint affected by osteoarthritis, and 48% had multiple osteoarthritic joints. That percentage increases in senior cats.
Unlike humans and dogs, it’s hard to tell when a cat is in pain. The signs are subtle and may just look like the cat is slowing down with age. The cat might not move around much, sleep more than usual, hide from people, not use the litter box, refuse to lie down, avoid stairs, change its grooming habits, walk stiffly, avoid jumping down, or not eat much. These are all possible symptoms that the cat hurts, but the only sure way to diagnose a pain condition is to find the cause. Diagnosing the reason may be quite involved.
Once a diagnosis is reached, the veterinarian will treat both the cause and the pain. Pain treatment usually involves more than one therapy, and painkillers like tramadol are traditionally part of the process. Veterinarians have several options. The use of tramadol is one possible choice, but it’s often used as a second choice or as an adjunct to another analgesic drug.
Tramadol is an opioid, but it also works like a serotonin-norepinephrine reuptake inhibitor or SNRI. It relieves pain through at least three separate mechanisms of action:
- First, tramadol is broken down into an active metabolite called o-desmethyl tramadol. That metabolite is also an opioid and is much more powerful at attaching to opioid receptors and blocking pain signals.
- Tramadol also works as a serotonin reuptake inhibitor, similar to antidepressants. In this way, tramadol reduces anxiety. Pain and anxiety are like a vicious circle. Pain produces anxiety, and anxiety worsens pain. That’s why some antidepressants are good at treating chronic pain.
- Finally, tramadol is a norepinephrine reuptake inhibitor, relieving pain in much the same way as muscle relaxants like clonidine.
The pain-relieving effects of tramadol take about 14 days of continual dosing for its analgesic efficacy to peak.
Acute pain
In veterinary medicine, tramadol is no longer seen as effective in providing acute pain analgesia. A veterinarian might use tramadol for perioperative or postoperative pain, but other analgesic drugs are preferred.
Is tramadol safe for cats?
Tramadol is well-studied and commonly used to treat chronic pain in cats. When given as directed by a veterinarian, tramadol can be considered safe for a cat.
Tramadol isn’t safe for all cats. Any cat that has had an allergic reaction to any opioid should never take tramadol. Cats with liver or kidney disease may require lower doses of tramadol.
Cats can become physically dependent on tramadol. Tramadol may become less effective at pain relief the longer it’s administered. When a cat has been given the drug over a long period, stopping the drug may cause withdrawal symptoms unless the dose is gradually tapered.
Side effects of tramadol in cats
The most common side effects of tramadol in cats are:
- Dilated pupils (mydriasis)
- Euphoria (behaviors such as heightened playfulness or friendliness)
- Sleepiness
- Salivating more than usual
- Vomiting
- Itchy face
- Dysphoria (behaviors such as hiding or lethargy)
Constipation and other gastrointestinal problems are common adverse effects in dogs and may also occur in cats.
See a veterinarian if side effects worsen or you notice signs of a severe side effect, including:
- Slowed breathing
- Excessive sedation
- Falling and lack of coordination
- Fast heartbeat
- Tremors
- Seizures
Tramadol’s most serious side effects are usually due to overdose or combining tramadol with drugs that worsen the side effects of opioids. These potentially hazardous side effects include:
- Slowed breathing (respiratory depression)
- Stopped breathing
- Serotonin syndrome is an uncommon but potentially severe complication of taking drugs that increase serotonin levels in the brain
Tramadol can sometimes cause seizures in cats or dogs. Before giving tramadol to a cat, tell the veterinarian if the cat has any history of seizures. If a cat has a seizure, immediately contact the veterinarian or take the cat to a veterinary hospital.
Interactions of tramadol with other pet meds
Tramadol is generally safe to give to cats, but some drug interactions can cause serious problems. Ensure the veterinarian knows about all the drugs, remedies, vitamins, and supplements the cat is getting.
Some veterinary guidelines specify that tramadol should never be given with selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine or monoamine oxidase inhibitors (MAOIs) such as selegiline or amitraz, an ingredient in some topical parasite treatments used in dogs. Combining these drugs with tramadol increases the risk of serotonin syndrome, sedation, or seizures.
Make sure to tell the veterinarian if the cat is taking any drug that makes the cat sleepy, such as other opioids, antihistamines, benzodiazepines, cannabidiol (CBD), or other central nervous system depressants. Tramadol interactions with these drugs can cause excessive sedation or respiratory depression.
The veterinarian will probably avoid prescribing tramadol with supplements that improve liver health, called SAMe supplements, as there is an increased risk of serotonin syndrome when used together.
Never give a cat pills that combine acetaminophen with tramadol, such as the brand-name Ultram. Acetaminophen is toxic in cats.
Tramadol dosage for cats
The veterinary literature recommends many tramadol dosages, ranging from 1 to 4 mg, taken every eight or 12 hours. Some dosage recommendations go as high as 10 mg every 12 hours, some as low as one to two mg per kg every 12 hours. The variability in dosage recommendations is due to the effectiveness of tramadol in individual cats.
Tramadol’s published recommended dosages include:
- Starting dosage: 1-2 mg/kg administered every 12-24 hours
- For chronic pain management: 1–4 mg/kg given by mouth every eight to 24 hours
Due to the variations in concentrations, the veterinarian is unlikely to use human versions of tramadol. The smallest tablet contains 50 mg of tramadol, which is too much for a cat. The tablets are scored to allow them to be divided in half, but even 25 mg is too much. The veterinarian will instead prescribe tramadol tablets or oral suspension in dosage strengths appropriate for a cat.
Can cats overdose on tramadol?
Veterinary literature has not specified a maximum dosage for cats. However, cats can overdose on tramadol. Signs of an overdose include dilated pupils, hypersalivation, rapid heart rate, poor coordination, lethargy, agitation, and slow, shallow breathing (respiratory depression).
If a cat has been given too much tramadol or shows signs of an overdose, immediately call the veterinarian or take the cat to a veterinary medicine emergency hospital.
Can I give my cat tramadol every day?
When prescribed for chronic pain, tramadol is given to the cat every day two or three times a day. Although side effects are relatively minimal, long-term use causes dependence and tolerance.
How to give your cat tramadol
Pet parents must give their cat tramadol doses two or three times daily. They can provide the cat with tramadol tablets or an oral solution. Tramadol tastes bitter, so the cat may resist tramadol tablets after getting the first one. Liquid tramadol can be flavored to mask the bitter taste.
To give your cat tramadol:
- Administer this medicine as instructed by a veterinarian or veterinary professional.
- Do not change the dose unless instructed to by the veterinarian.
- Tramadol can be given with or without food.
- If you don’t know how to give a cat tablets or the cat starts fighting back, ask a veterinary professional to show you the most effective tramadol administration.
- If the cat vomits up the tablet, try giving the tablet with food.
- If the cat spits out the tablet, try putting the pill in a favored treat or ask the veterinarian about switching to tramadol liquid.
- If you’re giving the cat liquid tramadol, measure the medicine with a device supplied by the veterinarian or the compounding pharmacy. Do not use kitchen utensils or tableware.
- If a dose is missed, skip the missed dose. Give the next dose as scheduled.
- Tramadol tablets should be stored at room temperature and protected from moisture.
- Tramadol oral solution should be stored according to the instructions given by the compounding pharmacy.
- Tramadol is a controlled substance, so keep tramadol securely out of the reach of children and other people. Don’t leave opioids like tramadol in open areas where anyone can get at them.
Tramadol alternatives for cats
Tramadol is not the only treatment for chronic pain in cats. Other analgesic drugs may be more effective or cause fewer problems. These include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as robenacoxib or meloxicam
- Other opioid analgesics such as buprenorphine
- Amitriptyline, an antidepressant
- Gabapentin, a nerve pain medication
- Amantadine
- Corticosteroids
The veterinarian may suggest a biologic drug called Solensia (frunevetmab). This drug, a monoclonal antibody called a nerve growth factor inhibitor, prevents pain nerves from transmitting signals. Injections are given once per month, and a year of treatment will cost about $1,000.
Natural or complementary treatments that don’t involve drugs include:
- Weight loss
- Environmental changes such as ramps, padded beds, heated beds, larger litter boxes, and raised bowls
- Physical therapy, massage, or joint manipulation
- Dietary supplements such as glucosamine-chondroitin
In more severe cases, a veterinarian may suggest surgery or other medical interventions, such as stem cell therapy or platelet-rich plasma injections.
Summary
Veterinarians use tramadol to treat chronic pain in cats. Tramadol is generally safe for small animals when the veterinarian’s oral administration instructions are followed. Pet owners should notice only mild adverse effects, but serious problems can result from overdosing or combining tramadol with other drugs due to the potential for toxicity.
Sources
- Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats, Veterinary Journal
- Degenerative joint disease in cats, American Association of Feline Practitioners
- Feline chronic pain, DVM 360
- Focus on pharmacology: Management of chronic pain in cats, Today’s Veterinary Practice
- Pain management for cats, VCA Animal Hospitals
- Tramadol, Clinician’s Brief
- Tramadol, Plumb’s Veterinary Mediation Guides
- Tramadol, Veterinary Partner
- S-Adenosylmethionine (SAMe, Denosyl, Novifit, Vetri-SAMe, Zentonil, Denamarin), Veterinary Partner
- Solensia frunevetmab solution prescription veterinary drug information, DailyMed (NIH National Library of Medicine)
- Tramadol hydrochloride tablet prescribing information, DailyMed (NIH National Library of Medicine)