The Walk-out: Veterinary staff make or break a visit
By Kim Campbell Thornton
July 13, 2010
I just got back from the veterinary twilight zone, and I’m furious.
It’s never a good sign when you walk in and don’t recognize any of the staff behind the counter. I was taking Twyla and Harper in for checkups, for which they are at least a couple of months overdue, if not longer. I signed in and after a few minutes one of the newbies informed me that they weren’t due for checkups. Would a tech check be okay?
“So, they don’t need to be here?”
“Oh, no, they need heartworm tests and vaccine titers.”
Well, first of all, I had questions for the vet, at least for Twyla, or I wouldn’t have brought them in. And I could see getting them the heartworm tests. Heartworm disease is up a bit in neighboring Los Angeles County, and I now occasionally see mosquitoes in our area, which is a new thing. But they don’t need a bordetella vaccine–they don’t go to dog parks or dog shows and they don’t get boarded at a kennel–and I don’t believe they are due for rabies vaccines yet. I don’t see the point in getting titers annually if current recommendations are to repeat vaccinations no more than every three years.
“They don’t need vaccinations,” I said.
Then the tech firmly inserted his foot in his mouth.
“Do you have proof of that? Because we can’t just take your word that they don’t need vaccinations. If you had the vaccinations done elsewhere, we need to see those records.”
Now, anyone who knows me will tell you that I have infinite patience and good temper–well, a few people might argue with that statement, but spouses and relatives don’t count. I find that as I get older, however, I am less willing to suffer fools.
At this point, another tech came up and he tried to get her to confirm that vaccinations or titers were required. Nope.
“You used to not push annual vaccinations at this clinic. Has that changed?” I asked. Oh, no.
By this time I was in a bad mood and just walked out. This is a really busy week for me ,and I just wasted more than an hour of it. For nothing. Twyla is still scratching, I still don’t know why she’s panting weirdly at night, I didn’t get my questions about flea control options answered (I have issues with the spot-ons), I didn’t get blood drawn for a geriatric panel for Twyla, and I still don’t know how much OFA hip x-rays for Harper will cost.
I like my vets. They’ve been progressive about vaccinations and other issues for years. They don’t typically treat me like an idiot. Now, if they could just train their staff.
Update: I spoke to one of the regulars today, and she was properly appalled. She has made a pop-up note in our file that we don’t do bordetella or annual titers. I’ve also left a voice mail with one of the partners, so I imagine he will be calling back later today or tonight.
Get another vet, fast. If the front staff is behaving that way there is a reason, and none of them good ones.
Comment by Darlene — July 13, 2010 @ 4:28 pm
I’ve had the “only good vet” in a bad practice before, and while it works for a while, eventually it all blows up — most notably if she’s sick or on vacation and you need ANYTHING AT ALL, and the idiots behind the front desk or the other vets don’t know their butts from, well… my DOG’S butt.
Not that I’m bitter or anything.
Comment by Christie Keith — July 13, 2010 @ 4:34 pm
First, CONGRATULATIONS for walking out. Full applause here.
Second, you should know that these receptionists and vet techs were trained; they are trained to rip off the customer. The only mistake this vet made is that he/she did not have a flip book of clients who know their ass from their elbow.
As I note here >> http://terriermandotcom.blogsp.....count.html
_ _ _ _
“…the receptionist is instructed to pressure every owner of a boarded dog to buy “extras,” from additional walks, to toe-nail paintings to baths and “updates” for all shots.
At some vets, any surgery, no matter how minor, seems to require an overnight stay. To hear some vets tell it, every dog, no matter where they live in the U.S., should be on heartworm medication year-round.
And the teeth? They will require annual cleaning, and with it expensive pre-anesthesia blood work.
This is how a veterinary career starts today.”
_ _ _ _ _
As I note here >> http://terriermandotcom.blogsp.....-care.html
“To be clear: these front office people know next to nothing and generally have been hired to give the real veterinarian cover in case the client calls ‘bullshit’ to the veterinary equivalent of ‘Can I supersize your meal?’”
PBurns
Comment by PBurns — July 13, 2010 @ 4:37 pm
I changed vets recently just because of the front desk staff.
It’s the whole package or notta.
Comment by Ericka Basile — July 13, 2010 @ 4:38 pm
You hit the nail on the head - manage their staff. Many vets seem to empower their staff to “run the show.” They get an inflated sense of importance and become a gatekeeper who is difficult to get through. It’s not like there aren’t 3 vet clinics on almost every block. If I can’t speak direct to my vet, I don’t go there.
Comment by Pamela Picard — July 13, 2010 @ 4:52 pm
I am so sorry you did indeed waste your time there today, and certainly hope my clients don’t have similar problems. Please take your appropriate anger and discuss this with your vet. They may not even know what happened and need to. Obviously, there was a disconnect, and I agree with Pamela’s statement that you need to be able to talk to your vet. Please don’t hesitate to ask for the vet if you are hearing something that sounds like nonsense because well, it IS!
Comment by Kelly Byam — July 13, 2010 @ 5:21 pm
You might want to call the office and ask for your favorite vet to call you back and tell him that as long as he has idiots at the front desk - you’ll be taking your business elsewhere. If no one tell them - they might not notice until it is too late.
Comment by cheryl — July 13, 2010 @ 5:23 pm
I worked many years in a vet hospital. I bet your vet would appreciate the head’s up if the front office staff is acting contrary to the vet’s philosophies. They cannot fix staffing problems if they don’t know what’s going on.
Comment by Jackie — July 13, 2010 @ 5:30 pm
You did the right thing leaving. I changed vets a few years ago because of exactly the same treatment. I loved my old vet & his newer partner, but the office staff totally changed when they became a VCA hospital. And not for the better. After dragging my chi in sick 3 times in 1 day because of their screwups & still not having the test results I needed, I said enough.I agree,discuss your reasons with the vet so they are aware. However it seems impossible to me that they wouldn’t be aware that their techs & staff are doing this.
Comment by Leslie K — July 13, 2010 @ 5:45 pm
What everyone else said. Nice picture of you, btw.
Comment by Susan — July 13, 2010 @ 5:47 pm
I will talk to them, but at the time I was so annoyed that I thought it was better just to leave.
Comment by Kim Thornton — July 13, 2010 @ 5:49 pm
Call the practice manager or owner and tell them what happened, how much of your valuable time was wasted, and ask what they intend to do to make it right.
If you have a long-term relationship with this practice, give them a chance to salvage it.
If they choose not to, immediately instruct them to prepare your animals’ records for transfer to a new practice.
One of the things that I value most about my vet — where I’ve been taking my animals for fifteen years — is that the same technicians have been there the whole time — and they are smart cookies.
Comment by H. Houlahan — July 13, 2010 @ 6:03 pm
It is SUCH a good picture I immediately updated the ABOUT page. :)
I have an excellent relationship with the front staff of my veterinary hospital. And with the techs, too. I respect and adore them all, and we do not BS each other.
But, I have also had a bad relationship with front desk staff (years ago), and my veterinarian got an earful then, you may well believe it.
Strangely enough, he owned the practice then and now he’s head of general medicine for the VCA specialty practice I absolutely love, and I was prepared to hate.
I really would prefer not to patronize a chain, and I would have left when the practice was sold had it not been for MY veterinarian. I have subsequently developed good relationships with other veterinarians in the practice, and with the techs and the front desk.
When Heather was put down, the receptionist, the tech and the veterinarian were all crying with me. And the practice manager and a half-dozen veterinarians and support staff were waiting in the hallway to tell me how sorry they were.
There were all there, too, when McKenzie had her litter, so we’re a team on both sides of the life-cycle.
But if I had an experience like you just had, complete an utter BS, I would have done the same thing… I would have left to calm down. And after I got home, there would have been some major ass-kicking, or at least some serious phone calls. Which I’m thinking there will be, in your case.
A good topic of discussion here, and I hope we get a lot of it from vets, techs, staff and clients all.
Comment by Gina Spadafori — July 13, 2010 @ 6:14 pm
I hate to say it, but I have often been treated in a condescending manner at vet’s offices (not my current vet). They treat us like we are idiots and don’t know anything about dogs. I am very irritated when I see one of my clients come home with a bunch of unnecessary add-ons. I don’t blame you for being pissed off!
Comment by Terry Albert — July 13, 2010 @ 6:30 pm
I have fired an outstanding dentist and a very good doctor (after a few warnings) for awful front office staff. I then told both docs “you’re very good, but your desk staff sucks, and I will never accept being treated the way they seem to think is acceptable, nor should any other patient.” A veterinarian is no different. You done good, Kim, and I’ll be interested to hear the veterinarian’s response to your complaint.
Comment by David S. Greene — July 13, 2010 @ 6:36 pm
I left my vet and never went back when they refused to euthanize my dog and told me to go to the emergency vet because it was 10 minutes to closing and they didn’t want to take the time. I had been a client there for 20 years - this dog had hemangiosarcoma and was dying (both of which they knew). She had been going there for 13 years. I was stunned by their callousness. Fortunately I was able to get hold of the vet that had diagnosed the hemangio and she had a much more humane view of where a loved dog should spend her last breaths - certainly not in the turmoil that is the emergency vet.
Comment by Mandy Book — July 13, 2010 @ 6:42 pm
I like my vet but do not know the names of any of the front staff. There are two locations and maybe 8 vets so it gets confusing. I like my vet and have been told one of the other vets is similarly good.
Great comment about being tougher as we get older. I think people owe other people respect, but I no longer understand the term being “nice.” Good people appreciate polite honesty.
Comment by Erich Riesenberg — July 13, 2010 @ 7:42 pm
OMG, Mandy! That’s horrible! SHAME on them for dealing with you and you pet that way! SHAME! Bad enough for a walk-in, but an established client? I’m horrified.
Yes, I know I brag on my vet a bit much, but he once stepped out of a wedding to return my call when he saw my name on caller ID. If he’d needed to, he would have come in, I know.
Comment by Gina Spadafori — July 13, 2010 @ 7:55 pm
I know a good vet practice in Mission Viejo if that is somewhere you would consider. They have had the same front desk staff for the 3 years I’ve been going there which is one of the things I like about them. I stopped going to a VCA which I had previously liked when the vets and the front desk staff started turning over every month.
Comment by Alison — July 13, 2010 @ 8:33 pm
I recently changed veterinarians, not because of the office staff but because of the vet. When I interviewed the vet, I liked her and she answered all my questions. The problem is that she only works a few hours a week, so I am usually required to see the other vet. He is not a people person and seems not to be thrilled about animals either.
About a month ago, I took my 17 yr. old Chinese Crested who was suffering from neck/back pain. A vet I volunteer with at a spay clinic had told me that her old dog gets Tramadol for arthritis pain. I asked the tech if it would be appropriate for my dog. I guess she told the vet I had asked because he got very upset - saying the drug was an opiate, only for severe pain, not something he would give me, & I should stay off the internet. By the end, he was yelling at me. If he did not want to prescribe the drug, it was fine. His rant was unexpected and upsetting. I want to be able to ask my vet questions without fearing he will yell at me. I have 4 senior dogs with multiple health problems that will require more and more vet visits. I will never go back to that office and have already found a different vet who at least seems nicer and more compassionate.
Comment by Susan G. — July 13, 2010 @ 8:35 pm
That’s extra-scary given that Tramadol is NOT an opiate and is used for moderate pain, not severe pain. It’s the drug of choice in human medicine for patients who can’t take NSAIDs and for whom Tylenol is not enough or for some reason not tolerated.
It’s one thing to have strong opinions, but when the facts they’re based on is wrong, that’s just terrible medicine!
Comment by Christie Keith — July 13, 2010 @ 10:28 pm
About tramadol - it *is* an opiate. From Plumb’s Veterinary Handbook, tramadol is a “synthetic mu-receptor opiate agonist that also inhibits reuptake of serotonin and norepinephrine”.
So the vet wasn’t wrong about that, and not wrong to be suspicious of a client that comes in asking for drugs. BUT it sounds like a major misunderstanding that the tech initiated and the vet was having a bipolar kind of day - an inexcusable visit that you should not have had to endure!
Comment by Susan G. Wynn, DVM, RH — July 14, 2010 @ 3:37 am
Wow, so many bad vet experience stories here. I think Mandy’s takes the cake, though. When I ran a veterinary practice, I fired a receptionist once for telling a client that they needed to take their dog to the emergency clinic because it was half an hour to closing, when our policy clearly was we’d see anything that came in or called during business hours, even if it meant staying late (and the vets never complained!).
Kim, I too, think that you should talk to your vet (or rather, the practice manager and/or owner of the practice) about the experience if you like them in general. How they will handle it will tell you whether you’ll want to continue to take her pets there. (Actually, if you’ve been a longterm client there, somebody from the practice should be calling YOU to find out why you walked out and to apologize, but that would require the staff to notify someone in charge about what happened, and my guess is that they probably didn’t.)
I did want to offer a different view to some of the commenters who complained about veterinary staff being trained to “rip off” clients. Veterinary medicine is a business, and clinics can’t continue to provide care if they can’t stay in business. That being said, there is an art to selling a professional service like veterinary care, and if it comes across as an “upsell” and as wanting to fleece the client, then it’s not done well. As a former veterinary practice manager, I trained my staff to always offer the best possible care to each client by educating them about why the service is being suggested or offered. By providing the reasons behind the service, it allows each client to make decisions based on each individual pet’s needs, the client’s financial situation, and other, individual factors. By educating rather than selling, the client will never be made to feel like they’d be a “bad owner” if they don’t take advantage of all the services being offered.
Comment by Ingrid King — July 14, 2010 @ 4:00 am
One of the biggest things I see missing in vet offices today is the proper respect for the customer’s intelligence. We are ultimately the ones responsible for our dog’s health so we have to have the final say. This business of “our office’s way or the highway” on the part of vet techs or even the vets themselves is just plain wrong.
But if we just walk out it doesn’t change anything.
When that happened to us a couple of months back I made it a point to talk to the owner vet (who we love) and let her know what happened. She was really listened and understood me and things DID get better.
Just my 2 cents……
Comment by Sandy Mesmer — July 14, 2010 @ 4:57 am
That experience would be heart breaking in a way for me. If I were treated this way, I would speak to my vets we have known intimately for years with the rescue. But it is a family owned business, so know the staff well and they never change.
Ingrid, this is something I wish my vet staff would do. Not to sell, but show new products and educate me on my options. Ask about flea/tick needs…hw pills, ect. I forgot again yesterday to pick up the frontline.
Comment by Mary — July 14, 2010 @ 5:58 am
A good friend and I were discussing how she has 5 dogs and the last two times she went to the vet, she saw the vet for about 3 minutes and the vet techs (she is one) did all the shots, wound care etc,yet she was charged for office visits fee for all 5 dogs. She got a new vet. In these days were you can save a lot of money by going to a pet store for shots from a Doc in the Box, one would think customer service would be paramount. I agree, great picture Kim and I stopped titers to when vets went to every 3 years.
Comment by Nancy Freedman-Smith — July 14, 2010 @ 6:32 am
BTW, I would LOVE a massive flea blog from you guys. Fleas are pretty bad in the North East this year due to warm weather, and so much of what I have been trying is not working.
Comment by Nancy Freedman-Smith — July 14, 2010 @ 6:37 am
@Sandy Mesmer—At the time, at least if she has a temper like mine, the best thing Kim could do is walk out. It’s never a good idea to try to have a reasonable discussion when you are very VERY angry. Even if the anger is justified. Now she can go back/call/write and explain her feelings properly.
Comment by Original Lori — July 14, 2010 @ 7:55 am
I did wonder if the vet thought I might be drug-seeking when I asked about Tramadol. The thing is that I had been coming to that office for over a year with four different dogs and had never asked for pain meds. Plus, my dog Tyke with the sore back only weighs six pounds. I don’t think I would get much of a high of of drugs dosed for him.
I did not have a problem so much with what the vet said to me, as how he delivered the information. I want a vet who I am not afraid to talk to or question.
Comment by Susan G. — July 14, 2010 @ 8:03 am
I believe I can help with the flea request! Maybe later today. :)
Christie
Comment by Christie Keith — July 14, 2010 @ 8:08 am
Well, I never thought the day would come when I would argue with you, Dr. Wynn, but as I understand it, while tramadol has a weak mu agonist activity that technically puts it in the opiod class, that action isn’t thought to account for its analgesic benefits, which are far greater than its mu agonist activity could provide. And it’s only slightly reversed by naloxone, too.
I’ve seen it referred to as a “quasi-opiate,” although Plumb’s calls it an opiate without qualification. But I guess I’d argue with them, too.
Comment by Christie Keith — July 14, 2010 @ 8:27 am
What a frustrating experience! In addition to letting the practice manager/vet know when front desk staff have been idjits, I think it’s really important to also let the practice and the employees know when they are doing something you like. Even if it’s something small like not leaving you endlessly on hold when you call, or asking after another pet in the household, or just being polite and friendly.
My vet is making some long range plans for their business and asked if they could call me at home just to talk about what keeps me coming back to them and what add’l services/facilities would I find of value. Just the fact that they are interested scored huge points with me. Top on my list of things that keep me coming back was their friendly, knowledgeable front desk staff and vet techs.
Among other things, goat care was on my wish list for their practice. As it turns out our vet loves goats, did a special rotation with goats in vet school, and said I can call her with any goat emergencies. Score!
Comment by Melinda — July 14, 2010 @ 9:39 am
Thanks Christie. Can’t wait to read it.
Comment by Nancy Freedman-Smith — July 14, 2010 @ 11:01 am
I have been going to the same veterinary clinic for almost twenty years not just because of the veterinary - he’s awesome - but also because of the staff. Two have been there as long as I have and a couple of others for more than ten years.
No one ever tries to ‘up sell’ me and if new products come out, they are explained to me with pros and cons. If I come in with a question, I am answered as an intelligent being.
Every once in a while a new staff member is hired that doesn’t fit their office mentality - so to speak - and he/she never lasts long! smile….
Liz
Comment by Liz Palika — July 14, 2010 @ 3:38 pm
I don’t feel obligated to stay with anyone if I’m not happy or feel I’m being ripped off. I’m free to change since my guys’ life is at stake! It’s my $$$.
Mandy, so sorry for your loss and for their callousness. There is no reason for them to treat you that way. I believe in karma!
Comment by Sandra — July 14, 2010 @ 3:46 pm
I’ve seen an unfortunate increasing trend of veterinary staff (including vets) that treat me like an idiot. Including a dimwit newbie DVM who started to explain heartworm disease to me in baby language. Discussion ended when I shot her The Look That Kills and stalked out.
An increasing number of clinics also want to take my dogs away from me even to do simple things like vaccinations - and this even after I show them my card and tell them I’m a professional trainer with more than a decade of experience handling other people’s snarky and sometimes terrified dogs.
The small town large and small animal clinic that operates out of an over-glorified pole barn gets most of my business because they treat me and my animals with respect. I was also lucky to find a fancy ortho clinic that does the same.
Comment by Janeen — July 14, 2010 @ 6:23 pm
I pity the front desk staff, veterinary tech or veterinarian who tells Christie anything that that isn’t defendable based on peer-reviewed research.
I’m a writer: In the written word I’ll make my case. In person, I tend not to bother. Too many family dinners, I suspect, when even the topic of the weather would be argumentative. We Italian girls tend to be respectfully silent, while plotting revenge that will be equally silent.
Christie, on the other hand, was born to be a litigator. What you see in print isn’t one-tenth as remarkable as watching her make her case in person. I have been present on a couple of occasions when someone tried to pull academic credentials on her (veterinarian, human doctor, what-have-you), and I just stepped back so I didn’t get hit by flying bits of their entrails that they’d be holding in their hands a few minutes later.
I once called her a 6-feet-tall, liberal lesbian version of Antonin Scalia. Bring your major league “A” game — if you have one — or you’re toast. As Scalia can quote case law from memory, Christie can quote journal citations the same way.
Over the years, though, she has mellowed considerably, and now most fools she suffers, albeit not gladly.
When it’s “game on,” though, get popcorn fast: The show will be a great one, but they rarely last long before the other side figures out they’re out of their league.
I would have left simmering, as Kim did. Christie …. not so much.
Comment by Gina Spadafori — July 15, 2010 @ 6:24 am
Kim, I love the photo!!! I am unhappy with my vet now as well. He has so many clients now, he won’t do appts. They want me to drop the dogs off. Um, that is not happening with my spaniels. They are now seeing another vet. I want to see the doctor’s face, not just talk to him on the phone.
I haven’t read all the above comments, so this may be repeat information….you might look into Comfortis for flea control. I just switched over to it because I don’t like the topicals either. The Comfortis is great so far, but I didn’t use it on my elderly dog. You probably wouldn’t want to use it for Bella.
Comment by Teri Wilson — July 15, 2010 @ 7:43 pm
I’m just entertaining myself imagining Antonin Scalia as a lesbian.
I think he’d be considered “butch” if so.
Comment by H. Houlahan — July 15, 2010 @ 11:44 pm
I am just entertaining myself imagining him imagining people imagining him as a lesbian.
You know, if we could actually get him to do it, his head might explode.
Or he might like it. Hard to tell.
Comment by Gina Spadafori — July 16, 2010 @ 6:41 am
Thanks, Teri. By the way, everyone, I spoke to one of the partners, and he said he would be “all over it” because that’s not their philosophy. The young man will be getting some schooling, it sounds like, on how to communicate with clients.
Comment by Kim Thornton — July 16, 2010 @ 7:09 am
I left my former vet becasue of the front desk staff.. I listened to them tell an older woman with a “fluffy”.. that if she did not get her dog tested for HW and gave it the medicine it “could kill her dog”.. this after she told them she had given the medication faithfully every month.. when she checked out.. her bill was over 150.00.. for the medication and her “visit” with the tech for a blood draw..not only was the information WRONG.. the woman looked smart enought to know when to give medication to her dog.the woman was obviously embarresed that she was not doing the right thing for her pet…. and we all know dogs do NOT die if given a pill for HW without a yearly test.. try this book.. it has saved me tons of money and my dogs are better off for it..
“How to Save Money on Veterinary Care Without Mortgaging the Kids”.. by Busby.. an old time vet who has more oommon sense than most..
Also the same vet kept sending “time to spay Fluffy” over and over again to a friend who told them from the beginning that her bitch was to be used for breeding.. she finally sent the card back with the message.. “what are you smoking??” and never went back.. personal agendas should be left at the door when you come to work.. especially in this field..
I now have a repro vet that I really like.. but even so I look over all of the “estimates” before signing and frequently eliminate ones I find not necessary..
Glad your vet responed .. we will be interested to hear of future visits.. I find that if you can find one.. the independents are better than the “box store” vets…
Comment by bestuvall — July 20, 2010 @ 1:56 pm
Yeah, ole doc Busby has some nifty ways to save money… like “does not routinely examine patients before surgery.” Or “does not perform nor offer to perform surgical prescreenings on animals.”
How about how he routinely uses vitamin K to control intra-operative bleeding but doesn’t check to find out what CAUSED the bleeding in the first place?
Or the way he re-uses disposable syringes, or how he only sterilizes his instruments in cold solution, which he changes only once a month?
And he saves TONS of money by not having ANY gas anesthetic in his clinic whatsoever, nor any oxygen.
Or by saving up the contaminated phenobarbital from surgeries and uses it for euthanasias.
Or not keeping records or even his drug log book, as required by law.
And those are just the things he acknowledged when the State of Minnesota restricted his license.
Comment by Christie Keith — July 20, 2010 @ 2:20 pm
Well, I was going to respond, but … I don’t have to. :)
Except to say, well, my grandfather died in 1969 at the age of 63 of a heart condition so easily treated now that it’s a routine outpatient procedure.
I don’t want good ol’ doc “I don’t need any CE” treating me OR my pets, because I have some common sense. I spend a good deal of money on top-quality veterinary care — including the use of boarded specialists — but I do not spend one thin dime on unnecessary care.
There is a difference. Learn it.
Comment by Gina Spadafori — July 20, 2010 @ 2:32 pm
Wow. As a front desk staff person at a vet hospital myself I am horrified at some of the stories. I can attest that I was never trained to push products on people. And if there are practices out there like that then I would look at the people requiring the staff to do that, which is the practice owner. (usually one of the Dr’s) I certainly don’t get a commission on anything sold so there is no reason for hard sell tactics. Heck I have people get mad at me for NOT carrying enough products! (“Why don’t you carry THIS flea stuff instead of that kind?” Sorry we can’t help you, this is the product our Dr.s prefer.)
I’m super happy at the clinic I work at and our team of front desk staff. Even more so after reading some of these stories. Our job is to provide services, (like filling prescriptions), sell products that people want, and help get the patients ready for visits. The Dr’s answer the questions and deal with the clients one on one, even if that means a phone call later to answer a question we cannot.
I also cannot imagine any of our Dr.s yelling at a client for anything. So unprofessional!
Comment by Marie — July 20, 2010 @ 5:42 pm
Christie:
This may be semantics, but tramadol IS an opiate. As you say, its other effects are important in its analgesic activity (see quote from pharmacologist Mark Papich below), but the structure is an opioid structure, so that’s how its classed.
If you have references to say it is NOT an opiate, I’d love to see them - please email me on FB as I have a hard time finding this thread.
Quote from Papich:
“Tramadol is an analog of codeine that has multiple effects. Although tramadol has opiate-mediated effects, it has low abuse potential and is not registered as a controlled substance. It has become available in generic form, and is inexpensive. The exact mechanism of action to explain tramadol’s analgesic effects is uncertain. However, various possibilities exist: tramadol has mu-opioid receptor activity and it also inhibits the reuptake of norepinephrine (NE) and serotonin (5-HT) (Laugessen et al, 2005). One of the isomers has a greater effect on serotonin reuptake and greater affinity for mu-opiate receptors. The other isomer is more potent for norepinephrine reuptake and less active for inhibiting serotonin reuptake. The metabolite (desmethyltramadol, also called M1) may have greater opiate effects than the parent drug (for example, 200x in opiate receptor binding). Taken together, the effects of tramadol may be explained through inhibition of serotonin reuptake (similar to fluoxetine and other antidepressant drugs), action on alpha-2 receptors (similar to medetomidine and xylazine), and activity for opiate mu-receptors (similar to morphine). There is considerable support for the serotonergic effects being important for the analgesic efficacy of tramadol. It can induce changes in the CNS similar to that observed with conventional antidepressant drugs (Rojas-Corrales et al, 2005; Oliva et al 2002). The serotonin-mediated effects may be synergistic with the opiate-mediated effects from the active M1 metabolite (Rojas-Corrales et al, 2005).”
Comment by Susan G. Wynn, DVM, RH — July 21, 2010 @ 3:12 am
Thank you Dr. Wynn for taking your time re: Tramadol. My Whippet was given that for pain when he had 1/2 his thyroid removed in ‘08(thyroidal carcinoma). I copied the info for future reference. BTW, when he was diagnosed with a mast cell tumor in ‘06, I heard of your protocol with acupuncture in treating mct’s. It’s a long story what I went through, but I went holistic. He’s going to be 14 yrs old in Sept. I like your website :). I also lived in Sandy Springs.
Comment by Sandra — July 21, 2010 @ 12:32 pm