Cats & Mirtazapine (Page 5)

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Our 13 year old Maine Coon mix is in the last stages of renal failure. We didn't know anything was wrong until about a month ago when she stopped eating. It's been up and down ever since her diagnosis. Our vet prescribed Mirtazapine but, after reading the many negative comments, we put off giving it to her as long as we could. We finally had to because the effects of not eating in cats are liver shutdown and death. She's had no serious adverse reaction to Mirtazapine, and it has definitely helped her appetite. It is buying her a little more quality time with us.

I certainly wouldn't use or give this drug lightly, but as some posters have noted, in the end it's a risk v.s benefit judgment call.

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81

Thought I would update on my Cleo, now 19 (original post #33). The mirtazapine finally stopped working earlier this year as an appetite stimulant. Cleo's new vet prescribed cyproheptadine, an antihistamine and what she described as "an old fashioned drug, safer than mirtazapine). Unfortunately it made Cleo even more wobbly and didn't increase her appetite, so the vet said to take her off of it. She's lost a lot of weight and is now literally skin and bones. She's less than 1/2 the weight she was before the stroke. Tonight I just gave her a tiny bit of the old mirtazapine to see what would happen and while she was a little more active, she still hasn't touched her food. I have not tried B12 injections but my gut is telling me it's getting close to the time to say goodbye.

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82

Cleo passed away the day after I posted the update, April 3, 2014.

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83

Hi Niko. I'm so sorry to hear about Cleo's passing. You took a good care of her.

I just arrived at this thread now after wanting more info on the drug. My cat Romeo's main problem is heart disease and he's on benazepril and furosemide. But furosemide's constant dehydration is now giving Romeo kidney disease, as well. In the past few days, he seemed to be really dehydrated and is doing some lip smacking, so I actually gave a very small dose of fluids (we're talking about like 10mL-20mL) against doctors orders. (His heart is only mildly enlarged).

Anyway, he's been just really not eating for the last few days (less than a 3oz can a day) and I thought I don't have any choice now but to get an appetite stimulant. I think his lip smacking is probably due to him being nauseous from dehydration, so I will see if mirtazapine would help. I think I'll start off with a 1/16 of a tablet to be on the safer side.

This thread has been very helpful; and I'm grateful that posterers are coming back with updates on their cats.

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84

Dear Elizabeth, I'm so sorry 2 hear about your cat. I've lost 2 in the last 3 years. I have 1 left and she has renal failure 2. I also found a lump bigger than a golf ball in her throat . She is 14 years old. We have 2 put her 2 sleep in a couple of days. The vet said there's nothing we can do. And , she is like my child and this is so so hard for me. Anyway , I wish u luck with your cat and I totally feel. 4 u.

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85

I have been using Mirtazapine on a cat with sickness and it is great no side affects at all and it works

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86

@Romeo Mom, talk to your vet about possibly giving Romeo an anti-nausea drug called Cerenia. It seemed to help my Cleo feel better. Unfortunately I started her on it too late, but I could see improvements in the way she moved around that she wasn't feeling dizzy.

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87

Thank you all for the information. My cat who has kidney disease has not eaten in 3 days. I am giving her sub q fluids and she is drinking, but she has not touched a bite of food. She is elderly (not sure exactly how old as I got her from a shelter) and has thyroid problems as well. She has always been quite tiny-especially with her thyroid problems-but she is down to 4 pounds now.
I took the warnings here seriously, but I have no other options as if this doesn't work, I need to start considering her quality of life, so I had to give this a try. I just gave her the first dose, and am praying to see her eat something soon.

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88

I would like to again mention that Mirtazapine is available as a transdermal gel. Our Ickabod was in liver failure and he was skin and bones and his mouth was sore, so I told the vet I didn't want any pills or anything he had to swallow. They gave us the gel in a tube (like a needless syringe). The dosage was 0.2ml every other day. It was applied by rubbing it on the inside of his ear. The vet shaved the inside of one ear so the gel could make good contact with his skin. A couple things to note: The medicine was originally developed for people, so you need to put on surgical gloves to apply it or you will also be getting a dose of the medicine. It is light sensitive, so we stored it inside of a padded envelope in our pantry. I realize that there are concerns with the medicine, but when your animal is possibly dying, you have to make tough choices. I didn't note any adverse reactions to the transdermal gel. I am happy to report that Ickabod start gaining weight after a few weeks on the gel. We discontinued the medicine after about 3 months when his weight came back up to normal. Almost 2 years later he is as happy and healthy as can be and the vet till doesn't understand how he recovered from liver failure. Hope this info is helpful.

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89

Hi everybody. I REALLY appreciate all your tips. I have a 14 yr 3 month old Somali girl cat named Charly. She was showing (you know) those signs of not feeling well for at least the last 9 months, hiding, scrunching herself up, turning her back to me but I couldn't find anything wrong. Blood tests were normal. Then in April, her urine specific gravity was slightly dilute. About a month ago she started vomiting a lot. Of course, I attributed this to eating grass or hairballs (which she did have), so I gave her hairball medicine which she promptly threw up in volume. Luckily, I had a vet appointment to check her teeth that week. When I got there I said "There is a new problem, she wont stop throwing up". The vet freaked out a bit, and she never does that. It turns out Charly's weight was way down to 7 something pounds and she was pretty bony. Somehow, I had missed this. So she gave her a B-12 shot an anti-emetic shot, sub cutaneous fluids (about 100 ml) and a few Mirtazapine tablets, 7.5 mg and a probably diagnosis of renal failure. My instructions were to give her a half tablet every 3 days. After the first night of giving her a 1/2 tablet I thought I was going to have to take her to the emergency vet. She was staggering and had her head cocked in a strange position that did not change. I watched her that night and in the morning she was okay. I took her off the mirtazapine and she began to vomit again. I put her back on 1/4 tablet which would be about 1.875 mg. She vomited less, but I could tell it was not enough, so I took a chance and put her back on a half tablet again. It seems to be working quite well now and not making her stagger. I guess she just has to get used to it. One problem that I am working on is that the 7.5 mg tabs are not really meant to be split, which I'm concerned may affect its pharmacological properties. So what I am doing in the interim is splitting a new 7.5 mg tablet in half and giving her a half but then for the next dose doing the same thing and not using the half that has already been split and sitting for three days. I think the tablets are supposed to be stored with a dessicant in the dark, but I am having trouble confirming that over the internet. So I'd be much more comfortable just giving her the dose she needs and not having to split the 7.5 mg pill. When I see the vet next week I am going to ask her what she thinks of the transdermal form, mirtazepine in a suspension and mirtazepine in a capsule (compounding pharmacy). By the way, Tanya's CRF site is fantastic and from there I got the idea of feeding her Gerber's Second Foods Chicken and Chicken Gravy. She loves the stuff and is currently keeping it down. She also (sometimes) loves Temptations "Mix-Ups" with the kitty ship's captain on it. Thanks again everyone.

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90

Hi, I hope that your kitty is still doing fine. I had a 16 1/2 year old cat that developed hyperthyroidism - the day we took her to the vet she hadn't eaten her lunch - not at all normal for her - she was prescribed mirtazapine - 1/4 of a l5 mg pill. She also only weighed 6 lbs. l2 oz. (her ideal weight was 8 lbs). Shortly after giving her the pill I found that she was breathing harder than normal - which is not good for a cat with hyperthyroidism that could very possibly have heart issues. When she tried to eat she acted hyper and tried but then only ate a few bites, then stopped as if it was hard to eat in this state. I think that a cat that small in weight should only take 1/8 of a tablet or maybe even less to start. I know that there are many people on the site (which is very helpful) that said that it worked for their cat - it didn't for mine at that dosage - one, maybe because she was older, and, two, maybe because she weighed so little. I have read also on Tanya's CRF site that caution should be used when giving Mirtazapine to a hyperthyroid cat - it has something to do with the thyroid medication interacting with the Mirtazapine because it changes levels of some kind. I honestly think that the pill contributed to Smoky's death in the end. It is such a delicate balance when cat's become ill. I wish that I would have never tried that pill with a cat that had hyperthyroidism .

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91

Hi, just wanted to let you know that my cat also weighed 6 lbs. 12 oz (ideal weight 8 lbs). She was 16 1/2 years old and diagnosed with hyperthyroidism. Tried Mirtazapine - 1/4 tablet l5mg. I would say, if you are going to try this med, to give less - 1/4 tablet was too much for my cat - she started having labored breathing. I wish that I would have tried 1/8 or less first - to me it is better to be on the safe side, especially when you don't know how your cat will respond to a medication and also depending on what your cat has.

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92

My cat just died of a convulsion fit after anxiety. It all set in after first quarter pill of the mzapine and doc said it would wear off...we waited, and he just died. 4 yrs old.

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93

I'm so very sorry to hear this. I learned the hard way - I would never give my cat Mirtazapine pills - my vet said the same thing - that it would wear off, but I read that there is something that they can take that can counteract the Mirtazapine if a bad reaction occurs. Also my vet said that Mirtazapine is given to a lot of very sick cats without problems but that doesn't mean that something bad can't happen. Also, I think it sounds like it would be better to give 1/8 a tablet to sick kitties. Your kitty was pretty young - my cat was 16 1/2.....I was devastated and it has been a year and I am still very sad about this whole thing.

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94

How very sad . Had you know you could have rushed your kitty to en emergency facility . There are medications that can be given for a bad reaction to this med

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95

This is true that there is a drug that can be used to lower serotonin levels if there is a reaction to Mirtazapine but when I researched it, that drug also can have side effects like elevated heart rate, etc.

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96

There was someone else on here that posted had they not rushed their cat to ER he would have died . There were actually 2 different meds given to counteract the reaction . I'm sure if you checks the posts you will c what this guy said about his ordeal .

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97

Reading about your experiences is really eye opening about what my vet hasn't told me,which really makes me mad . Nothing about side effects or that my 14 year old kitty Squeaky is probably in liver or renal failure. He stopped eating but was vomiting every day. Took him in, his blood work is perfect but he'd obviously lost weight and his pupils are always dilated. She gave him this drug and it does make him eat for 3 days but the minute it wears off he's vomiting again. It's hard to let go because he really doesn't seem sick except for that. Anyway, thanks for your comments about your experiences because it's been very helpful .

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98

If his blood work is normal then it can't be renal or liver issues . So there has to be another cause of the vomiting , has vet tried to find out what's wrong ?? Thyroid issue? Diabetes ? I'd work on finding out what is wrong ?

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99

Dear Cynthia,

I would definitely find out if your cat had a T4 count done for hyperthyroidism. My cat Smoky, who was 16 1/2, had perfect bloodwork, but had thrown up and not eaten lunch and we took her to the vet and she had hyperthyroidism. Weight loss is a big red flag and I also heard that dialated pupils can be a sign. Don't settle for things that don't make sense to you, you can never get your kitty back again so go with your gut, don't give up, and get to the bottom of things. Also, at 14 years of age, hyperthyroidism is very common and treatable.

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100

Treatment of this disease is quite complex. You may be able to prolong your cat's life with ALL the right treatments. Check out "Tanya's CKD" on Google. I am on the discussion board and it is awesome. We call mirtazapine "meowzapine" A little goes a long way. Hope your kitty is doing well

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