Cats & Mirtazapine (Page 2)
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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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My 16-year-old was diagnosed with CKD a month ago. Vet prescribed 2mg Mirtazipine every 48 hours if necessary. While at the vets, also got 200 ml of IV fluid. I've been to Tanya's website and I've tried the baby food, he's not interested in it. The med makes him eat after about one hour of being administered, and at the beginning, I was able to only give it to him every few days. But now it seems I will have to start giving it to him every 48 hours. Side effects are not too bad. Sometimes he looks a little depressed, but mostly he is vocal and he follows me around like my shadow. :) I asked my vet how long he can take this medication, and she told me as long as he needs to. I'm not ready to lose him, but he is losing a lot of his body mass. He was always a very picky eater and now it is so much worse. He will only eat Fancy Feast of Friskies, not exactly ideal for a CKD cat I know, but I would rather he eat something than a vet food he will turn his nose up to. I have read all of your posts, some gave me encouragement while others have scared me. I hope my baby will be one of those that's alright on this med. Thank you for listening.

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When my cat was recovering from fatty liver disease, she would go to drink and eat, but then just not. Turned out it was stomach acid and I was told to give her a quarter tablet of Pepsid from the store. An hour after I gave it to her, she was eating and drinking like a dog.

I hope things turned out well for you and your kitty.

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That is an antidepressant im taking it for depression its knowing as zispin it gives you a strong appetite im happy your cat is doing well,she will sleep a lot better as it contains a sedative taking at night

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Dear Laurel,

You don't say WHO is charging you this much for tablets. Is it your vet? I take it you're in the UK,too. If it IS your vet's charges which are too much, ask him/her to write you a private prescription and either take it to a chemist or go to a BRITISH on-line veterinary medicine website and follow the instructions for sending in a prescription. This is a good company: VetMeds Direct (look it up on line), Pet Prescription Ltd., PO BOX 1007, Ipswich IP1 9WF. They typically charge half the usual price for medication that a vet will charge. Good luck.

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Mirtazapine not expensive ? £10 for five tablets? £100 for fifteen weeks???
Can you recommend cheaper sources?

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Hello again, Barbara,

I hope your little cat is much better. I note your vet prescribed famotidine which is bitter. May I suggest you obtain some empty gelatine capsules and put the meds in one of them? Capsules are available on-line and cost - for size 5 (the smallest) around £3.50. I use them for my cat and it's a doddle to give her the tablets.

With best wishes.

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Hello Barbara, I'm in the UK and one of my cats takes mirtazapine at the rate of 2mg every other day. She, too, has chronic renal failure plus a lot of other medical problems which dictate that she will not be with us for very much longer. I can't tell you the price of individual 2mg tablets of mirtazapine as when I pay the vet, it is for a consultation plus blood tests, scans and X-Rays, etc., but I honestly do not think the tablets are very expensive. Please be warned: if you are considering purchasing tablets from an on-line source you may well end up with 'fake' tablets from China with disastrous consequences. If you purchase from an established on-line BRITISH veterinary pharmacy, you will first have to provide them with a prescription from your veterinary surgeon. What heartens me about your post is that your vet has prescribed the correct strength of tablet and the correct dosage. I have been horrified by posts written by people who are in the United States when they have stated their vets dole out 15mg tablets of this drug!!! It has resulted in the deaths of several cats. I mentioned this to my vet and said UK, European and Australian vets generally knock the US vets into cocked hats. Her reply was that although there are many good vets in the US, a 15mg tablet of mirtazapine would even overdose a huge dog! Thank God for the Royal College of Veterinary Surgeons. With best wishes to you and your cat.

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My baby is 21 years old. She has never had to go to the vet other than when she was fixed and shots as a kitten. She has only had 2 short lived colds. Great genes I guess. 6 days ago, she had a problem walking because of my bad not clipping her nails, she hates it so much, well, this one grew into her paw, I had to clip it out, it started bleeding, I immediately put peroxide, it healed up. A few days later, she began to start walking again slowly her mind seems different. I took her to the vet to have her checked out, her lungs and heart are good, no infections, no fever, ears, nose or throat problems. The vet suggested blood test of course but I can not afford it until the end of the month. In the meantime she prescribed mirtazapine 1/4 15 mg pill to stimulate her appetite every 3 days but here is is 24 hours later and age is not eating or drinking. I am trying everything baby food, a high calorie boOster paste that has the taste of fish, tuna juice, she looks likes she is going to for drinking the water but then doesn't. I am sick to my stomach. I want to give her a little more of that mirax, I'm not sure if it is to soon. Any suggestions?

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Hi there

I wonder if you could help as I see you live in the UK too.

We took our indoor cat who is 17 years old to the vets last week as we had concerns she may not be able to see. On examination of her eyes, she was found to have detached retinas and veins see in the eyes so we were right and she had blood pressure taken several times and her BP was very high so we know that is probably the cause.

My question for you is that we had blood work and U/A's and the results have shown her thyroid function and red and white blood cells are fine but her potassium is very low and there is protein in her urine etc. We have been told by the vet that Crystal had chronic renal failure stage 2. On asking how many stages there are, we have been told there are 4 and that it is imperative that she starts taking potassium. It smells awful and we hope she will take it :( The vet has also prescribed famotidine (antiacid) but he has also prescribed Mirtazapine 2mg - 1 to be taken every 3 days. My question is, as you live in the UK, how much does your vet charge per tablet please?

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I ended up taking my cat to University of Penn. They did an ultrasound there too but they shaved his belly first. They saw polyps on his colon and thickening of his intestine. I was told it was probably lymphoma of the digestive system but to be 100% sure they would have to do a biopsy. I decided not to put him through the biopsy. He has been on prednisolone half a 5mg pill twice a day for a few months now. Recently, on weekends, when I'm home from work I'll give him a 3rd dose of 2.5mg at least 8 hrs from the last. He now throws up about once a week or less. I wrap the pill in a half of a pill pocket so it doesn't disolve on his tongue and I give him a few treats immediately after. I know first hand from taking pred that it tastes horrible and to take with some food. I was told that if it's lymphoma that the pred can slow it down, increase appetite, and is also is a pain killer since it reduces inflammation. This is all that he has been getting. I also changed his wet food to weruva packets cat in the kitchen since he likes these and doesn't throw them up like he does fancy feast. I feed him wet twice a day since it seems it's easier for him to digest. Sometimes I'll give it him more if I hear him eating dry. His dry food was changed to a mix of orijen grain freecat and kitten poultry flavor mixed with natures recipe grain free salmon. He loves temptation treats so that's what he gets immediately following his pill. Because I use the pill pockets and the treats he's so easy to pill. He will actually hop up on the cabinet I keep his cat food in so I don't have to bend down and wait while I give him his pill. If using pill pockets you only need half if the pill is small. Make sure to mold it around the pill so there is no chance of pill getting through. One time I was in a rush and some white pill got through and you would'very thought I poisoned the cat he was foaming at the mouth and carrying on. Anyway, this is all he is on right now. Originally, the vet told me to give him a 5 MG pill all at once. It made him so mean that I used my own judgment and started with the half dose twice a day. I plan to take him for a follow-up ultrasound in a few months since the vet told me this could also be IBD. University of Penn was slightly more expensive but we'll worth it. I hope this helps. I'm glad I decided no on the biopsy and possibly chemo especially after reading one of the posts on here (tongue biopsy). As for chemo, I volunteer at a cat rescue and someone came to look at a cat. Their cat had lymphoma and they put him through chemo which he seemed to tolerate very well. Cancer went away however it caused heart failure and he passed about a month after completing it.

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The mirtaz. Should work quite quickly, half an hour from dosing. Warning: only give a small crumb or your cat will become extremely agitated, yowl and even shake.

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How long did it take your cat to react/increase in appetite to the mirtazapine.

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Everyone please be sure to read my post on this thread of a year ago. Also, don't give up on your ckd Maine Coon until you have gone to Tanya's CKD, looked it over and gotten yourself on their message board. My kitty crashed with kidney falure in August of 14 and is still doing well with their advice on all the proper meds, tests and an initial round of antibiotics. Heather B

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Hi Amey,
My little girl is fine with 2mg of Mirtazapine every other day with no need for any other medication. The tablets are bitter which can cause cats to foam at the mouth if they aren't immediately swallowed. Some owners have cited the mouth-foaming as a sign that Mirtazapine is both dangerous and possibly poisonous; IT ISN'T! Dosage MUST be kept to 2mg and administered EVERY OTHER DAY. To prevent cats reacting to the bitterness of the tablets, I suggest coating the tablet in margarine or butter which helps it slide down the cat's throat and creates a barrier against the bitterness. Another tip: to encourage a sickly cat to eat, try giving it baby food with no milk additives such as chicken casserole, chicken and vegetable and rice, etc. Jars of baby food intended for infants 4 - 7 months are fine. Administer the food on the tip of a teaspoon and initially feed just two teaspoonfuls for the first few feeds at two-hourly intervals. Be patient and if the cat turns away its head, take away the spoon then try again when the cat settles. It's a matter of perseverance; however, if the cat totally refuses the offered food, try another flavour. You can also try giving special cat milk - not the kind for feeding orphaned kittens, but that designed for adult cats and can be bought in the supermarket. The milk is especially formulated and usually contains less than 2% lactose. Lactose can upset cats' stomachs and cause diarrhea.
Good luck with your pet, Amey. With best wishes, Lyon

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Hi-my cat is going through exact same thing. Had bloodwork and xrays-nothing wrong but no eating. He's on the anti nausea and acid reducer and just gave him the stimulant a few hours ago-but he still hasn't eaten. How did everything turn out with your cat?

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Hi, I'm in the UK and have a wonderful veterinary surgeon with whom I have been going to for over 30 years. I have owned cats for at least 43 years, too. One of my elderly cats (16 years old) suddenly stopped eating and was given every conceivable test, scan and x-ray available with no conclusive results. All her organs were in good condition, there were no masses or tumors to be found but she'd lost a 10th of her body weight. Her coat and eyes, however, were shiny and bright. I bought her the full range of cat foods available: dry (Royal Canin & Hills); wet - all makes known to cat and man, tuna and sardines, but nothing induced her to eat. Hand-feeding, petting, sitting up nights with her, all to no avail. And then my vet said we'd try her on Mirtazapine at the rate of 2mg every other day as a last resort. Literally within half an hour of having her first tablet, she began to eat. She managed 3 x 100gr pouches of Whiskas that day and another pouch overnight and hasn't looked back. She has absolutely no side-effects, sleeps peacefully and, when a foolhardy small spider decided to run across the floor, she was out of her bed, pounced and flattened it! I've got my dear girl back again. I watched my cat being born: I'd given her mother all the proper nutritional care whilst pregnant and since her birth, my girl has only eaten the very best of foods. She was weaned with care and diligence, and her diet has only consisted of properly balanced and veterinary approved food. She's never had any previous illnesses. It's wonderful to see her back to her old self again - admittedly a little slower than she was as a kitten, but the same alert, loving and happy little cat she grew into. I'm extremely thankful to my brilliant vet and to Mirtazapine. Why, I wonder, can't American veterinary surgeons dispense Mirtazapine in 2mg tablets? It seems an awful faff to be cutting 15mg tablets into quarters with the risk of over or under dosage. To all those cat owners who are experiencing a worrisome and difficult time, the only advice I can give is to consult a first-class veterinarian and preferably one who is a feline expert. And I wish you all the very best of luck and a successful outcome for your beloved pets.

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I'm going through the same thing as you right now, and I've been giving 1/8th of a pill every 72 hours. He still goes through the initial period of meowing and restlessness, but he does eat. 1/16th didn't seem to work as well, but I'm considering (after reading your comment) giving him 1/16th every 48 hours rather than 1/8th every 72. They are all different, but I haven't yet found that happy medium of less side affects from mirtazapine and still eating enough. Good luck to us both....this is not a fun thing to go through. <3

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For "Mountain"....I hope and pray you see this note; and, though it is November 18th as I type this and you lost your beloved kitty back in September, please accept my heartfelt condolences and deep respect for how you handled your situation. Like your kitty, mine has just turned 16 and has lived with renal failure for a while and has just within the week been diagnosed with cancer at back of his tongue. In hindsight, part of me wishes I'd not allowed the vet to pressure me so quickly to put him through the biopsy, because ever since they cut those small tidbits out of his tongue, he is not eating enough to keep a bird alive, much less a cat. He has a mild painkiller every 9 to 12 hours, and oddly he tried to eat some decently first 3 days after the biopsy, but now last 36 hours, he's begging me me for food BUT everything I put in front of him he sniffs, barely licks and walks away from. It appears now that unless something drastic changes he will die from starvation instead of the cancer.....His personality and outward behavior is still oblivious to what's happening inside him, i.e. as my best friend said "we know he's dying but he doesn't know he's dying"...

Of course I am heartsick of what is inevitable BUT certainly am most mindful of not forcing him to stay longer than he's comfortable being here. So, that is why I am watching him carefully and looking for the slightest changes that indicate he is becoming listless, lethargic, no longer playful or jumping on bed with his catnip mouse to play, etc. But, what again is really breaking my heart that I have NO answer for right now is how he is constantly pawing on me as he always has when he was hungry and wanting food, but yet he doesn't seem to be able to eat any of the baby food or mushy pate,etc. that vet told me would be the gentlest on his tongue and mouth. NOW, the vet says for $550 they can put a temporary feeding tube in his neck until his tongue is more healed from the biopsy for him to eat again on his own. His demise is inevitable with the cancer diagnosis; as I said earlier, it just seems so sickening if he were to die from results of starvation instead of the cancer..vet implied he probably had 3 to 6 months left BUT if I can't get him to eat, we all know he can suddenly turn and be near death in a few days to a week. So what to do? Feeding tube, no feeding tube? I don't want to go to a sterile vet office to put him down, nor do I really want to pay 300 bucks I've been quoted for a vet to come to our house for her final moments...I would prefer he pass away in his sleep like my mom's cat did naturally...but, am I correct in reading your story that perhaps you gave your kitty that very powerful pain killer and just let it take it's course so your kitty went to sleep and just didn't wake up? My apologies that I am all over the place, and am grateful for understanding and any suggestions if you see this. Thank you and God bless.

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My cat was recently prescribed mirtazapine. He had blood work, 2 ultrasounds, xrays, and a u/a. He's been loosing weight and had a day of constantly throwing up. He spent 2 days at the vet's on IV fluids. I read about this and was wary of the side effects after reading all these posts. My cat is originally 14 lbs but is down to 11. The vet prescribed 1/4 of a 15mg pill every 72 hours as needed. I give him less than 1/16th of a pill every 5 days. So far no pupil dilation or other side effects. He isn't restless or more vocal than usual. It has increased his appetite. I wanted to give him some time to see if the weight loss was due to a virus since he was throwing up but plan to take him over the bridge to University of Penn Vet to see if they can find out why he isn't eating without the mirtazapine. The vet had also given him cerenia for nausea to start. I haven't had to give him this but have been giving him zantac 1/8th pill once a day. This was after I called the vet since I read that cerenia isn't supposed to be given more than 5 days in a row to a cat. Considering the vet didn't tell me this and it was on the packer insert that came with the meds and she agreed with me when I pointed that out I definitely plan to take him to another vet for a 2nd opinion.

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Mirtazapine has done wonders for my 18-year-old Maine Coone with moderate kidney failure. Her appetite had been very poor, and she got down to 6lbs. The vet prescribed 1/8 of a tablet every 48 hours, and my cat is now eating twice as much as before, is gaining weight, vomiting less, and is purring all the time (before she seemed depressed). It really improves her mood so that she seems much happier, and I'm sure getting enough to eat helps her feel better, too. Some vets say to give 1/4 tablet every 3 days, but that is often way too much at once which causes restlessness, meowing, etc. and can even cause serotonin syndrome. Of course, the big disclaimer is that every cat is different and may have a different reaction, but it's been a huge boost for my kitty.

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