Pain management in Pets

Question 
Should tramadol be used as a first line treatment for pain caused by osteoarthritis in cats and dogs?

Answer

Despite being unlicensed, and recently being reclassified as a Schedule 3 drug, Tramadol is a popular oral analgesic for the management of chronic pain in dogs and cats. Tramadol is a centrally acting synthetic analogue of codeine that has two different principle analgesic modes of action. Tramadol and O-desmethyl metabolites exert an agonist effect at opioid receptors as well as inhibiting norepinephrine and serotonin re uptake in the central nervous system (CNS) thereby modulating descending analgesia pathways. Reasons for choosing Tramadol for the management of osteoarthritis pain include a perceived lack of side effects, particularly in relation to NSAIDs, cost (it is cheap), and perceived efficacy.
However it is worth noting that the evidence base for Tramadol in both cats and dogs for the management of chronic pain is very weak to non existent, and owner reported efficacy of a treatment, due to the placebo effect, is not the most robust means to assess efficacy of an analgesic treatment.
The analgesia provided by Tramadol is dependent on the action of the parent drug (which provides mainly non opioid mediated analgesia) and the production of metabolites (which probably provide opioid mediated analgesia). However in dogs, metabolism of tramadol is very variable, with a range of different metabolites being produced. Furthermore, many dogs produce very little of the metabolite that mediates opioid analgesia, limiting the analgesic efficacy of the drug in these dogs.
Cats probably produce more of the metabolite that mediates opioid analgesia, which is advantageous, but on the other hand, the opioid like metabolite is probably also associated with more side effects (sedation, drowsiness, dysphoria, nausea).
Given the current evidence base for Tramadol, NSAIDs should be considered the first line treatment for osteoarthritis related pain in both cats and dogs. There are NSAIDs licensed for this indication in both species and a large evidence base to support efficacy. Tramadol should be considered a second line therapy, either in dogs and cats that are intolerant of NSAIDs or to support NSAID therapy in animals where NSAIDs alone provide inadequate pain relief.

How to Become a Veterinarian

Becoming a veterinarian or how to become a veterinarian
Occupational Specialty: veterinarianClassification of professional specialization: research / investigation

The nature of work:A veterinarians plays a big and important role in pet health care, livestock, zoo animals, the animals that participate in sporting events and laboratory animals. Also plays a big role in the protection of human from animal diseases & vice versa. Some specializes in the application of basic knowledge and theories using new science and knowledge and it processes to treating pets in the backyard, such as cats, dogs, birds, rabbits and other domestic animals. Some work on the treatment of several different animals such as pigs, goats, sheep.
The veterinary also diagnose of health problems for the animals and give them medical vaccines against diseases, and treating infectious diseases of the animals in the field, treatment of fractures and heal the wounds, surgical procedure, giving animal owners advises on how to feed them, train them, breeding. Some of them responsible for large-sized animals such as treatment horses, cattle and securing proper food from farms and veterinary field. A veterinarian use medical equipment such as a microscope, a surgical equipment &diagnostic equipment such as X-ultrasound.

Working conditions:
Working a long hours, and they may work under demand through phone calls throughout their work at night and the holiday period and for a veterinarian who works independently solo may even work weekends and be responsible for all emergency telephone calls, always their workplace crowded and annoying . And a veterinarians who work on farms spend most of their time between the fields in the outdoors, are forced to perform surgeries for animals under unhygienic conditions, their dealings with animals that may become panicked and pain when detect them, which may expose them to biting, kicking, scratching.
Veterinarians working in the field of research and development are the cleanest places of work and non-annoying and are dealing with human beings instead of animals.

Academic qualification:
A doctorate in veterinary medicine duration is 4 years, in addition to training courses in how to deal with situations when animals panic and he has the patience and the length of mind and ability to deal with the animals because dealing with them difficult.