Cats & Mirtazapine (Top voted first)

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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how long after giving your cat the first dose did it take for your cat to start eating?

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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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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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Update on Gracie; Gracie lost her battle with the horrible side effects of the hyper thyroid on Nov 25th. The mirtazapine did help her eat and the gel formula was SO much better than the pill, dislovled or not. When giving it to her disolved she still had that horrible taste in her mouth and it upset her so. We were unable to give her the thyroid med because it took her appetite away and eating was an important factor in trying to keep her alive. Our Vet hydrated her and the next day she experienced labored breathing (fluid was building around her lungs, not sure if related to the hydrating, vet said no it wasn't ??) and complete lethargy. The next day she was so bad we had to put her down, her suffering was not an option for us. Good luck to all with their pets in distress, we do what we can for them until we must make the decsion that is best for them.

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Paula, thank you for your condolence on the passing of our Gracie. We were terribly lonely without her and just this week brought home 3 cats from the SPCA. One has the respitory virus, considered a special needs cat. Our Vet was not concerned about mixing these cats as the virus is in about 90% and they don't even check for it anymore. Needless to say caring for her will not be a problem after the 10 months of caring for Gracie. They are a joy and making themselves right at home. This week they will go for their checkups and should any medication be needed, well, we just have to work from there. I urge all who have lost one of their dear pets to adpot as soon as possible, you won't regret it. Taking 3 from the SPCA opens up 3 places in their 'no kill' facility. Good luck to all who are treating their pets illnesses.

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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 17 year old cat responded favorably to Mirtazipine, but having to shove pills in her mouth was beyond unpleasant for both of us. I now give her the transdermal version, and life is much better. Sometimes it takes slightly longer to work - a few hours vs. 45 minutes with the pills. She is tiny, just under 6/5 pounds, so I give her half the usual prescribed dose (3.75mg) as needed, which varies from every 3 days to every 2 weeks. Sometimes she gets a little 'twitchy' with it. But she eats, which is critical. You just rub the stuff on the inside of their ear flap. She doesn't love it, but it is nothing like the pill. It's getting to where she stays still and lets me do it without caring all that much. It's been a life saver. Literally.

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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 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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From north west UK. Last week we lost our little cat Ronnie; she was 20 years and 3 months old. Her twin sister Reg went into mourning. They both have / had thyroid trouble and have been on Hills thyroid diet. Ron had a stroke over night and we found her in a bad way in the early morning. We took her to the vet who said she was beyond help and sent her to sleep. Poor Reg wouldn't eat or drink and wandered round looking for Reg, it was terrible. We had showed her the body of Ron before burial and Reg said her goodbyes, then She just gave up. There wasn't much of her anyway a tiny little thing. We took her to the vet expecting the worse. I pleaded with the vet to give her an appetite stimulant that I had heard / read might jolt her out of the blues. The vet rang someone and they suggested a pill of mirtazapine. They explained the side effects and we thought it was worth the risk. They gave her the pill, that night was horrible. She was staggering like a drunk, her head tilted to one side meowing constantly. We took turns on death watch 3 hours each all night, trying to comfort Reg. We really did think we had done the wrong thing, then she fell asleep. Then in the morning she was a bit brighter and started to drink some water. I put her some food out, a pouch of the high value recovery sensitive stuff they have for after operations. We were gob smacked she wolfed the lot down and fell asleep, woke up an hour later straight to the food bowel and ate again. For 3 days she has been eating like a hungry dog. We are hoping she will pick up now and she is back in tomorrow for a check up. She didn't have the strength to morn her sister, she was tiny, but we are hoping that she will have a few more months. We know at her age there isn't much longer for her, but we didn't want to let her go without trying everything that we could.

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For Cathy and Gracie: I'm happy to know about the gel. I, too, had a very difficult time trying to get a pill in my Persian. She has such a flat face and a tiny little mouth. My vet made a suggestion that has worked beautifully for me. I put the 1/8 pill in a tiny container (like a bottle cap) and add 4 or 5 drops of water (or broth or cat food juice). Let it sit for a few minutes until the pill dissolves and then draw it up into a 1cc syringe without the needle. I then lift her lip and squirt it in the side of her mouth. She can't spit it out like a pill, and I don't have to stuff it down her throat. It's bitter and she hates the taste, but I give her a treat afterwards. It is SO much easier this way, and now my baby doesn't hate me every time I give her meds. Hope this helps. -A

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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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Jay, thanks for your input. It confirms my fears that she was given MUCH to large of a dose. I'll confer again with the vet regarding giving my cat a much lower dose. I WILL NOT give her anything larger than a 3 mg dose.

P.S. what causes all the talking when they first take the drug?

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My cat, Patti, just decided to stop eating several months ago. She began to starve herself. Our vet ran tests and checked her for everything. Except for her anorexia, she was in perfect health. We finally tried Mirtazapine. It seems to have saved her life. She is eating again and gaining her weight back. Her energy has also returned.

There is only one funny side effect: she likes to follow me around everywhere I go now and discuss everything. She seems to want to talk about everything, so that's what we do. I had no idea she was so opinionated.

.

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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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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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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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My cat has CKD and had stopped eating and the vet prescribed Mertizipine 2.5 ml every three days. She did eat but she became very restless and started howling and she seem uncomfortable with this medication. I started giving her Kidney Support Gold and after about ten days I took her off Mertizipine and that now has been about 4 months and she eats very well and seems to feel well overall. No more Mertizipine. She does get Famotidine twice a day for nausea which accompanies CKD.

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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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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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