Cats & Mirtazapine (Page 6)

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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Thanks for your ideas etc. Squeak did have blood and U/A's just 4 weeks ago and vet. doesn't see signs of hyperthyroidism, diabetes or cancer.. I guess we just wait to see how this plays out but I don't want to keep him on this drug very long either. It's always tough. We just lost kitty Gregson in August and our other 2 cats are also 14. So much for being a "foster fail". ??

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Keep us posted , hope squeaky will be k ,

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Thanks Cheryl.

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Squeak has had a turnaround ! He stopped vomiting and is eating like a champ! His coat looks better, he looks like he's gained some weight, has more energy and even cries for his meals. I don't know why , but I'll take it! Must be all the good wishes and positive thoughts from you and loving friends and family. Merry Christmas !!

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I believe the drug to counteract mirtazapine is actually another drug used off label as an appetite stimulant, cyproheptadine. It is supposed to be safer than mirtazapine. I agree with what everyone else has said here, that starting out with 1/4 tablet is WAY too much. I started out with 1/8th and that was too much, so was giving 1/16 and sometimes even just a flake. I didn't try upping the dose until it stopped working as expected.

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So glad to hear this good news !

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Yes Niko, I totally agree with what you have said here. That's the drug that I read about to counteract Mirtazapine if there are problems, but that is not without side effect either. I later wondered if 1/8 of a tablet would have been better, but look, you have stated that it was too much - I believe it - I bet that Smoky would have been affected by that also. I would give anything in the world to be able to take back giving my cat that pill - I really believe that that lead to her death. I would never even think about giving that pill to another cat if I get another cat and I surely won't be going to that vet again - not ever.

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My cat is taking Chlorambucil right now for lymphoplasmactic rhinitis, kind of a chronic nasal inflammation that causes her to have a runny nose and stuffy nose all the time. She doesn't feel good, sleeps a lot. Well the Chlorambucil makes her vomit half the time and I can tell the progression of her getting better goes backwards when she vomits. She also doesn't seem to want to each much on her own lately, but when I bring her food and sit with her she will eat decent. So the doctor is considering Mirtazapine but after reading all the reviews I am really nervous to give it. She said it should help with the nausea, increase her appetite and maybe perk her up. Not sure what to do, she has had a tough year. She had radio iodine last year to get rid of hyper thyroid, then had an FHO surgery to fix her hip. Now this.

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Mirtazapine is actually an okay drug. The problem is, vets think it is good for nausea. It really isn't. The best drugs for nausea are odansetron (my CKD cat gets 2mg twice a day) or cerenia, which I have not used. As far as mirtazapine goes, vets prescribe way too high a dose and the cat goes nuts, jumping around the house and meowing. Mirtazapine sometimes works really well for appetite, but just give a crumb. I think they come in 15 mg tablets. You will need to start with about 1/16 of this tablet. Then increase gradually if it is not causing the appetite to be better. If mirtazapine does not work for your cat, some people have successfully used cyproheptadine for appetite. Also if the mirtazapine works in tiny doses, Diamondback Drugs will compound them for you as smaller dose pills. They may also have mirtazapine as a transdermal that you apply to kitty's ear once a day. Check them out.
Heather B

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Can so embody help me? I've just been prescribed Mertazipine for my 14 year old Persoan Gustavo. He received it yesterday and the script calls for a tiny pice if pill every 24 hours for 8 days. Well, this is day two and he just received his second dose. I guess I'm asking how long before I start noticing his appetite improving? He has no appetite or thirst and I'm growing increasingly worried. Help please?

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I have used mirtazipine in 2 different cats and the 1/4 of 15mg tablet prescribed is far too much. Even just a few flakes can stimulate the appetite in a sensitive cat. Reactions I witnessed aside from ravenous hunger were extreme restlessness (not being able to sleep and walking around continuously for hours), meowing, and being very affectionate. Nothing as bad as some of the reactions I've read about. It is a very effective appetite stim but this can be accomplished at a much lower dose than prescribed! Be cautious, start at a low dose to see effects.

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Can someone help .I just came from the vet they put my 14 year old Sheba on this medicine after reading all the post on here i'm a little worried about the dosage.The vet prescribed 1/2 of this mirtazapine 15 mg 2 times a day.What are the risk?

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Wow this dose is way way too much !!!! I would Not give this med unless it is a last option !!! N I would give less than 1/4, usually given every other day , that dosage u were given may kill ur cat !!

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Dian do Not give ur cat that huge dose ,, it is wayyyy too much and may kill him .. I'm not sure why ur vet prescribed this med , but unless my cat was near death and No other options available I would NOT give this med !! This med should not be given for nausea !!! And this med has been known to kill cats with renal / kidney issues , any reaction,, if u have already this med I'd rush my cat to the er vet asap

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My dog and cat were both given Cerenia when they were in kidney failure along with fluids. They both went downhill, QUICKLY, after receiving this drug, dying within days :( Please be wary of Cerenia!!!!!!!!

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Or let them die with you surrounded in love if that's what they tell you. My kitty just died a few days ago from kidney failure and cancer, he had a great life of 16 years. He told me enough was enough with medicines, treatments, etc. He also "told me" he wanted to die on his own terms, not through a vet coming to the house and giving him shots. It was very hard, but we comforted him and showered him with love and talked to him, telling him about how much we loved him and all our fun times together. We had very strong pain medicine prescribed by the vet if he ever seemed to be in pain (I know cats hide it so well). We all hung outside on the porch (his kitty sister and doggy sister and my husband and I) with him his last 2 nights, as he requested. Petted him and talked to him for hours under the stars, he loved it outside. We were able to bury him in our backyard, where he loved to be, I actually cut off a large chunk of my long hair to bury with him as he was so comforted my hair, always climbing on my head, being in my long hair, etc. Just do what is right for your kitty, not for yourself. It is very hard to this verses to keep hanging on when they've told you it's their time. I learned a lot by doing the opposite when my dog died of kidney failure almost 1 year to the day before my kitty. They trust us implicitly.

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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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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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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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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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