I AM concerned about widespread off-label use of medicines by members of the veterinary profession; as an example, I would like to cite the current trend to use oral tramadol under the prescribing cascade for the management of osteoarthritis in elderly dogs. Although there are no directly equivalent drugs to tramadol licensed for veterinary use, there are plenty of licensed analgesics. In a systematic review of the human literature performed under the Cochrane Collaboration (Cepeda and others 2009), tramadol was shown to be of only small benefit in treating arthritis in people, as patients reported a maximum 12 per …