Cats & Mirtazapine (Page 2)

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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Cathy--that's great news about your adoptions :-) Heck, we sound like we might already acquainted--like minds about adoptions, etc. If you get a chance to join the group Official National Cat Day on FB...I'm there and there are a lot of other like-minded cat lovers there :-) They will be happy to share in the joy of your new kitties :-) Congrats!

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My cat is 21 years old and has been living with renal kidney disease for 5 years now. Over the past 15 months we have been giving her Mirtazapine. 1/4 tablet every 3 days. Her appetite increased but it was effecting her nueroligically and we are pretty sure it gave her a stroke within the first week. After that time she would slump and creap around right after the pill and was very unsteady on her feet. Yesterday we think she had another as she could hardly walk and could not speak out loud. Due to her age the vet thought that doing a bunch of tests would not help. We are positive that the mirtazapine has caused her to stroke again and now we switched her to Cerenia but I am having a hard time finding out any side effects of this drug. Does anyone have any experience with this? She is still not talking and is very wobbly but walking a bit better now.

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I took Josie off of it--we skipped her normal dose on Saturday--she seems to be eating fine now and it was making her way too agitated. Now that I see that it could potentially cause a stroke, I won't put her on it again. I understand valium can sometimes be used to help cats with their appetites. If Josie declines again, I may talk to my vet about using it instead.

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rxchat.com/Discuss/dangers-of-mirtazapine-174426_s2.htm

Seems that back in 2007 a poster wrote that she thought mitazapine gave her cat a stroke too.

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JCar - I found this post from 2007 in this thread. I tried posting the link a couple times but when I submitted it I got a message that my message would be reviewed first and it may take a couple days to post... anyway this is from a lady named Jennifer:

It seems to me that Mirtazapine is a potentially dangerous drug with little information known about it. My veterinarian prescribed this drug in small quantities for my cat as an appetite stimulant, so I began reading articles on the drug and its effects. Although it is supposed to be used as an antidepressant for humans, it has a wide reputation for causing suicidal tendencies in children and young adults. It causes weight gain (the side effect my vet was looking for in my cat's case). It also can cause feelings of depression, and wooziness. I spoke with a nurse who took it and she said the effects of sluggishness and dizziness lasted 2 to 3 days. It can also cause nausea and headaches. It seems to me that these side effects are anything but what a person who is already depressed should be feeling. (suicidal tendencies that they didn't originally have, feeling tired and unwell physically, and weight gain that could cause feelings of insecurity or increased depression) Giving this drug to my cat was the worst thing I ever did. About an hour after administering it to her, she began crying, looking confused, and she could not walk straight. We figured the effects would wear off, but they seemed to worsen. The next day she was holding her head down, walking in circles (trying to walk straight) and she could not focus her eyes. We brought her to the emergency animal hospital, and they called a poison center. Even the poison center had so little information on this drug (especially being prescribed to cats) that they did not know how to counteract the effects. We believe that the drug actually caused a mild stroke in our cat, and the vet said this looked like it might be the case. On top of that, it has a 72 hour half life, so we just had to wait the drug out for her to even feel better. If this drug could cause a mild stroke in my cat, I could only imagine what it could also do to a human. With so little knowledge of the effects, and such long-lasting effects, it seems to me that it is a dangerous and harmful drug for doctors to be prescribing. A few years from now, when it actually is studied more, I bet that it will be taken off the market as another one of those trial drugs that did not work out. Until then, how many people (and animals) will it harm?

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I can understand everyone's concern about this drug. All I can say is it worked for Gracie, as some drugs work for some people and not for others. We did not have much choice as other drugs did not work for Gracie at all. It was a chance shot and it work for her about 11 months. She not being in the best of health to begin with consequentley died from stroke related problems however she made it to 16 years of age. She also suffered from arthirtis and was always anxious, (from day 1), but I do believe without the drug mirtazapine she would have died months earlier. This is a choice all must make when they are faced with sure death or the chance at few more months of life. I am comformtable with the choice we made and it seemed to work out for her. We do the best we can for those we love. Every day new drugs are tested and approved, just like for humans. Be steadfast in your devotion to your animal companions and research whatever drugs you need. This we do for kindness sake and be reminded no one is perfect. We still miss George and Gracie very much. With 3 more shelter cats, Domino, Dixie, and Tara, we are being kept very busy can see we are loved very much. Good luck to all.

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Hi, I just lost my only cat who was diagnosed with leukemia (bone marrow), the last drug he was given happened to be Mirtazapine, 1/4 tablet of 7.5mg prescribed by the vetinarian..he only took it once.
My cat was on prednisone tablet but having trouble giving it so we ask for a liquid form which is prednisolone which cost a little more but works faster and easier to give. My cat was eating until I decided to give him chemotheraphy as his blood count (white blood cells was high.
He had one shot still continuing on the prednisolone and after few days stopped eating that's when the vet prescribed Mirtazapine to boost his appetite.
He ate just a little and next day nothing he got so weak he started hiding and i felt he was dying, I had to frantically search for him as he is an indoor cat and try to feed him by mouth and hydrate him but it was all too late, he passed away .
I felt it like it was my son who passed away, We loved our cat so much it hurts because he gave back so much love..searching for answer, dont know if it was the chemo,mirtazapine or the combination with prednisolone but I knew he just got worse after taking Mirtazapine.

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After reading the posts here and on the other thread about this drug, I wonder if elderly cats are like elderly humans and can't tolerate full doses as well as younger folks do. And since this is an anti-depressant, maybe it has to be given in steps to a full dose. So I just gave a 1/16 (1/4 of the prescribed)of a 15mg tablet to my 12 yr old. He seems a little spacey, but he is eating. Will see how this goes. If he tolerates this well, Monday I'll give him an 1/8.

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I'm sure senior cats are just like senior people and the strength of the drug can have an adverse effect. We noticed that with the ear gel the dose was taken in slower, (absorbed thru the ear skin), than a tablet and seemed to work a lot better for Gracie. However any drug can adversely affect them as they have no way to tell us how it makes them feel. I kept a daily journal on Gracie for almost a year. It was the only way I could accurately track how much she was eating, what she wanted to eat, when she got what med, how she was reacting, etc. I encourage anyone medicating an animal to keep a daily log. You just can't remember all their history accurately and it helps shows patterns in their behavior, not to mention how it helps the vet at checkup time.

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Scrap has not taken Mirtazapine for 12 days now. Her appetite has been good. No ferocious eating but a good appetite. She has had only 3 doses of Cerenia. The shot, and 2 more half pills. She is still unsteady on her feet but has her full voice back. I know I am lucky that she is 21 but I always dreamed of her living to 25. The Cerenia does not seem to have any adverse affects on her tho I am concerned that is it made and approved only for dogs and there is little to no information on side effects. Even a dog should only take it 4 days in a row. She is supposed to take it daily but the vet said to go ahead and give it to her every 3-4 days or as needed. I will keep everyone posted.

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Our 15 yr old cat Bonzo has chronic renal failure for almost a year and we have to give him 1/4 of a mirtazapine 15 mg pill every 5 or 6 days. By day 5 he is almost eating nothing but I stretch to day 6. He gets more sleepy for a day but then is fine. We recommend Pill Pockets called feline greenies and they come in different flavours. It makes giving pills very very easy. I give him one in between doses so he won't associate it with pills.

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Thanks Paula! Scrap is hangin in there with the Cerenia!

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I've given foster cats Mirtazapine to get them to eat with no ill effects and have never had to given it more than twice with a cat.

Now with my own 17yo Cleo, who had several vestibular episodes last year and was presumed by her neurologist to have had mini-strokes, she has gradually lost about 2 lbs. since then. Recently she left her breakfast totally untouched - a rarity - and I administered about 1/4 of 15mg tablet of Mertazapine. Within the hour she had gobbled down her dinner; 4 hours later wanted another dish; and 4 hours later again was meowing for more food. She was almost back to her old self, appetite and energy-wise, and I think it even helped her balance. She wasn't staggering as much. So, let me be clear: Cleo had already had strokes before I gave her Mertazapine. The drug did not cause her strokes.

5 days have passed and only when I got home today did I notice some of her breakfast still in the dish. So I've given her another 1/4 tablet. For me it's been nearly a miracle drug for cats that have stopped eating.

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Scrap had another "episode" and she has not taken mitazapine for at least 2 months now. She was not having strokes prior to taking it. I think it affects different cats in different ways. Just like people. After the last episode about 2 weeks ago, she has gotten some of her balance back, but has not stability anymore walking. I agree, the Mirtazapine did increase her appetite and she did take it for a year plus but it also did not help her vomiting, which was part of the problem we were trying to fix. The Cerenia was helping a lot but she has also started vomiting about once a week still. The nausea is still there apparently.

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JCar, you're obviously giving Scrap the best of care as having her get to 21yo with renal failure is quite a feat. I think at some point the effectiveness of anti-emetics and other drugs, just as with subQ, decrease as the disease progresses. I'm sorry, I know what you're going through as I've had two cats with RF and neither lived as long as your Scrap has. It's a rollercoaster and my heart goes out to you.

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Our Bentleigh is in renal failure and would not eat for 3 days no matter what I tried--and I tried alot of things. Our human medical pharmacist compounded the Mirtazapine into a chicken-flavored elixir which I gave--with minimal problems (our cat is NOT easy to pill!!). Within 2 hrs he was crying around the fridge wanting to eat. What a mood lift for his mom who has tried everything to this point and needs to either see him able to eat and feel better or help him get to heaven. One day at a time--but for now--he is hungry again!!!

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I forgot to mention in my earlier post that Cleo was taking amlodipine for high blood pressure, which decreased her appetite. Now she's on a course of clindamycin for higher titers of inactive toxoplasmosis, and this really kills her appetite. If she doesn't eat something right away, she'll throw up the clindamycin and the pill pocket.

I also did try giving her even smaller doses, about 1/8th of a tablet of mirtazapine. This dose works initially but over the next 3 days Cleo will eat less and less and become more lethargic. Tonight I'm trying a 1/4 tablet of mirtazapine, then when she's hungry will give her meds in pill pockets and then dinner. I hope this strategy works.

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This site seems to have updated info on mirtazapine, including signs of serotonin syndrome (an overdose):
felinecrf.org/persuading_cat_to_eat.htm#mirtazapine

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Niko- thank you for the kind words. I do appreciate it. I will spoil her as much as she will allow. She has started jumping again but tends to fall when getting down off beds, but she gets up okay. I'm just thrilled to see her attempting to do things she loves. Cerenia- the med that is only approved for nausea in dogs, works pretty well. I hesitate to brag about her as things turn on a dime and usually after I brag on how well she is doing. Cerenia keeps her eating well and throwing up less frequently. She takes a half a tablet every 2.5 days. The vet requested I try to mix it up the last visit, see if I could give it to her less often as you are only allowed to give it for 4 days in a row and they should not take for 4 days after that. (thats for dogs anyway). Well, I tried 1/4 every 2 days and was not happy with the results and felt guilty for taking her out of her comfort. So we are back to 1/2 every 2.5. I am also giving her B12 shots and think that is helping her tremendously. She also takes 1/8 of a pepcid daily. Her concoction is working out for now. I really like the B12- she is very active ( for 21) after the shot and most of the week inbetween. Bents mom- see if the vet can set you up with B12. They are pretty easy to give and very reasonable, around 35 dollars for probably 2 years worth with the needles.

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Hi Bonzo, I happen to notice that most of the post regarding Mirtazapine had a doage of 1/4 tablet on 15mg.
My Vetinarian had prescribed 1/4 tablet of a 7.5mg when my cat stopped eating but he also was taking prednisolone at the same time as he had high white blood count.
I was wondering if 1/4 of the 15mg isn't too strong. You can read my original post if you like. Hope everything works out fine for your cat,try to do everything possble for him or her as its not a good feeling losing a a pet.

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