DOI
https://doi.org/10.18849/ve.v6i2.401Abstract
PICO question
In dogs with osteoarthritis how effective is treatment with tramadol in reducing the severity of the clinical signs associated with pain when compared to no treatment?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Two papers were critically reviewed. There was one randomised crossover controlled trial and one non-randomised controlled trial
Strength of evidence
Strong
Outcomes reported
Budsberg et al. (2018) found no significant differences in the objective gait analyses (vertical ground reaction forces, and peak vertical force) between baseline and end of treatment, between tramadol and placebo. Similarly, there was no significant difference in the proportion of dogs with positive response based on the subjective Canine Brief Pain Inventory questionnaire (CBPI) between tramadol and placebo. The positive control of carprofen yielded significant differences to both placebo and tramadol in all outcomes measured.
Malek et al. (2012) found no significant differences in the objective outcomes measured (gait analyses, and total daily activity) between tramadol and placebo. There were significant improvements in the subjective CBPI (total score, pain severity and pain interference score) between the baseline and end of treatment, within the tramadol group. However, there was no significant difference in the percentage change of the total score, pain severity or pain interference score between all treatment groups including tramadol and placebo
Conclusion
In dogs with osteoarthritis, the use of tramadol alone did not demonstrate any significant analgesic effects
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Belshaw, Z., Asher, L. & Dean, R.S. (2016). Systematic Review of Outcome Measures Reported in Clinical Canine Osteoarthritis Research. Veterinary Surgery. 45(4), 480–487. DOI: https://doi.org/10.1111/vsu.12479
Brown, D.C., Bell, M. & Rhodes, L. (2013). Power of treatment success definitions when the Canine Brief Pain Inventory is used to evaluate carprofen treatment for the control of pain and inflammation in dogs with osteoarthritis. American Journal of Veterinary Research. 74(12), 1467–1473. DOI: https://doi.org/10.2460/ajvr.74.12.1467
Brown, D.C., Boston, R.C., Coyne, J.C. & Farrar, J.T. (2007). Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis. American Journal of Veterinary Research. 68(6), 631–637. DOI: https://doi.org/10.2460/ajvr.68.6.631
Brown, D.C., Boston, R.C., Coyne, J.C. & Farrar, J.T. (2008). Ability of the canine brief pain inventory to detect response to treatment in dogs with osteoarthritis. Journal of the American Veterinary Medical Association. 233(8), 1278–1283. DOI: https://doi.org/10.2460/javma.233.8.1278
Budsberg, S.C., Johnston, S.A., Schwarz, P.D., DeCamp, C.E. & Claxton, R. (1999). Efficacy of etodolac for the treatment of osteoarthritis of the hip joints in dogs. Journal of the American Veterinary Medical Association. 214, 206–210.
Budsberg, S.C., Torres, B.T., Kleine, S.A., Sandberg, G.S. & Berjeski, A.K. (2018). Lack of effectiveness of tramadol hydrochloride for the treatment of pain and joint dysfunction in dogs with chronic osteoarthritis. Journal of the American Veterinary Medical Association. 252(4), 427–432. DOI: https://doi.org/10.2460/javma.252.4.427
Davies, M. (2012). Control of off-label use of medicines. Veterinary Record. 170(26), 680. DOI: https://doi.org/10.1136/vr.e4399
Johnston, S.A. (1997). Osteoarthritis: Joint Anatomy, Physiology, and Pathobiology. Veterinary Clinics of North America: Small Animal Practice. 27(4), 699–723. DOI: https://doi.org/10.1016/s0195-5616(97)50076-3
Kögel, B., Terlinden, R. & Schneider, J. (2014). Characterisation of tramadol, morphine and tapentadol in an acute pain model in Beagle dogs. Veterinary Anaesthesia & Analgesia. 41(3), 297–304. DOI: https://doi.org/10.1111/vaa.12140
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Moreau, M., Dupuis, J., Bonneau, N.H. & Desnoyers, M. (2003). Clinical evaluation of a nutraceutical, carprofen and meloxicam for the treatment of dogs with osteoarthritis. Veterinary Record. 152(11), 323–329. DOI: https://doi.org/10.1136/vr.152.11.323
O’Neill, D.G., Brodbelt, D.C., Hodge, R., Church, D.B. & Meeson, R.L. (2020). Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK. Canine Medicine and Genetics. 7, 1. DOI: https://doi.org/10.1186/s40575-020-0080-5
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