In this VETgirl online veterinary continuing education podcast, we review the use of tramadol in dogs. Does it work? Well, you may have heard over recent years that tramadol has been put on the hot plate, receiving much attention for its role as an analgesic in canine patients. The reason for doubting tramadol's pain relief properties stems from the pharmacokinetics of the drug and differences between human and canine pain receptors. Tramadol is a weak pure-mu opioid agonist. It is metabolized to O-desmethytramadol, which is the metabolite responsible for tramadol's ability to inhibit the reuptake of noradrenaline and serotonin in nerve endings, thus making these two neurohormones more available to continue blocking pain signals. However, dogs produce very little of this active metabolite. Perhaps this difference in metabolism is why clinicians have trended towards recommending higher doses of tramadol (doses ranging from 1 to 10 mg/kg). Previous studies have been complicated by a placebo effect when measuring analgesic outcomes, and the placebo effect is a difficult bias to overcome when creating a study design. So, Budsberg et al out of University of Georgia (Go, Dawgs!) wanted to evaluate tramadol as an analgesic in the treatment of chronic osteoarthritis in a study entitled Lack of effectiveness of tramadol hydrochloride for the treatment of pain and joint dysfunction in dogs with chronic osteoarthritis. In this study, the authors aimed to evaluate objective measurements of pain relief in orthopedic dysfunction associated with tramadol use in dogs suffering from osteoarthritis.