Especially in the age of online ordering, tramadol should definitely be cheaper than a prescription NSAID. I would think Canada would have better tramadol pricing than the US since so many US clients purchase online medications from Canada.
As far as your veterinarian not wanting to use it out of lack of familiarity, this is sad. If every veterinarian only practices the medicine that they have been comfortable with, then they are out of date. Medicine is constantly evolving. Also how does this vet ever use or become familiar with a new medication? ...and tramadol has been around for a very long time.
As far as backing two NSAIDs back to back... Yes this is not recommended however sometimes it becomes necessary. The problem is that the COX-1 negative side effects can be worse with two NSAIDs than just one, sometimes up to 20x as bad. Also the non-analgesic effects of NSAIDs can persist for up to two weeks in some cases. Can we still do it? Yes, but it depends upon each case. If there are liver or kidney concerns, then it may be best to wait the full two weeks for proper 'dry out' period. However the use of SAMe or Milk thistle can help the liver deal with NSAIDs. If we are not worried about the liver or kidneys, then a 2 week course of pepcid (famotidine) can help reduce the risk of any stomach problems. If your vet is still concerned about stomach issues, then sucralfate (carafate) can also be given to help the patient handle the second NSAID. Also, this is were I come back to tramadol again. If we need a dry out period, then a different analgesic can really help this patient. If your veterinarian does not like tramadol then perhaps ask about a fentanyl patch during this interim time. Fentanyl patches provide excellent analgesic effects for several days. They are not used for long term use typically due to their cost and the constant need of a sticky patch on the skin and risk of ingestion, etc...
Also, there are many veterinarians out there that use tramadol and are not shy of 'new medications'. Just FWIW.
Again, best wishes. I am very sorry for all that you are going through.
