URBANA — Veterinarians may want to rethink prescribing opioids for dogs to take at home, experts at the University of Illinois say.
Not only are oral opioids an ineffective pain reliever for dogs, some prescribed for pets are likely helping fuel the human opioid epidemic, they say.
Tramadol, an opioid pain reliever prescribed for both people and pets, has long been used to relieve pain in dogs suffering from certain ailments and after surgeries, according to Dr. Ashley Mitek, a UI veterinary anesthesiologist.
While that drug works well in people, she said, “we’re very comfortable in saying that it doesn’t help dogs.”
Injected opioids, on the other hand, can help dogs with pain relief while they’re hospitalized, Mitek said. But dogs’ bodies can’t metabolize oral tramadols the way human bodies do, she said.
“Any of the oral opioids are unlikely to work in dogs,” Mitek said.
Research has already raised concerns that at least some oral opioids prescribed for animals are being misused by people.
One study released earlier this year by the University of Pennsylvania looked at the numbers of opioid pills and patches that had been dispensed or prescribed for small animals by the university’s veterinary school from 2007 to 2017. Researchers found the quantity had risen by 41 percent a year while the annual number of visits rose by just 13 percent.
It’s likely the increase was driven by a goal to send animals home pain-free after procedures, Penn researchers said. But even when veterinarians prescribe opioids with the best intentions, there’s an increased potential for people to misuse or sell the leftover pills, they said.
Cats vs. dogs
A survey of veterinarians done by the Colorado School of Public Health also released this year included this finding: Thirteen percent of the veterinarians indicated they were aware of an animal owner who had intentionally made an animal ill, injured an animal or made an animal appear to be ill or injured for the purpose of getting opioid prescriptions.
The UI College of Veterinary Medicine’s in-house pharmacy dispensed about 200,000 tramadol pills from 2016 to 2018, according to Mitek.
Veterinarians have generally held that prescribing opioids for dogs was unlikely to hurt them, she said.
“But now we know it’s unlikely to help them, so we need to rethink how we control their pain at home,” she said.
Oral tramadol does actually work for cats, she said, though it’s not prescribed for cats as much as the more commonly prescribed opioid buprenorphine.
“We don’t want to deter people from using that in cats, or tramadol,” Mitek said.
Veterinarians may, however, want to carefully consider the quantities of opioids they prescribe for cats in one visit, Mitek said.
Buprenorphine is also prescribed for people — as a step-down drug to treat opioid addiction — and the potential also exists for people to misuse that drug when it has been prescribed for their cats, she said.
If sending dogs home from veterinary care on oral opioids doesn’t help with their pain, what will work?
Mitek said one option may be opioid injections given both before and after a surgical procedure while the dog is still in a veterinary hospital. A puppy brought in for a spay procedure, for example, could get these injections, stay overnight and then go home on other pain medicines.
Pet owners should also be aware of the importance of safely disposing of leftover opioids that were prescribed for their pets, Mitek advised.
If animals don’t need these drugs, the best option is getting the drugs out of the house and disposing of them safely at one of the prescription drug drop-off sites in the community, she said.
To help veterinarians and others who want to learn more about safe opioid prescribing for animals, four UI veterinarians — Mitek, Dr. Stephanie Keating, Dr. Maureen McMichael and the late Dr. Gary Stamp — along with Carle Dr. Brad Weir have created a free online course.
The course will also help veterinarians comply with a state law that took effect this year requiring anyone licensed to prescribe controlled substances to undergo three hours of education on safe opioid prescribing.