Need some answers re: Mirtazaine side effects

Hello,

My Calico was recently diagnosed with diabetes. She was not eating her normal amount prior to the diagnosis but she is now really eating only very small amounts. She is only eating small amounts of soft food. My vet said I could try Mirtazapine 1/8 of a 15 mg tab, every 24 hours for 3 days. I am thinking of going this route tomorrow morning but am a little weary after reading some of the side effects on line.

My calico is very big and I belieev she is at risk of hepatic lipidosis if she does not start eating her regular amount. Can anyone please tell me if you have given this to your cat and if you noticed any serious side effects. The vet is closed on Sunday so I would need to get the medication tomorrow. I believe my cat was not feeling well to start off with and the stress of the vet visits, ect... may have turned her away from food even more. I am really hoping anyone can tell me if there feline friend has tried this.

LM

 

I do use Mirtaz for Squeaker when he needs it. I haven't had a problem but I have read of quite a few who have had issues ranging from the cat being stuperous to being rather hyper. If you don't want to risk an adverse effect you could try baby food meat. Just make sure it doesn't have veggies, onion, or garlic. Also use a pinch of grated parmesan cheese just for added enticement.

 

Lots of people here have used Mirtz with no problems, but there can be issues you should know about.

One of our members (@KristinK21 ) ran into problems with it not long ago so there's a lot of good information about it in THIS THREAD

 

1/8 of a 15 mg tab, every 24 hours is a high does. The old standard was 1/4 of 15 mg every 3 days and frequently adversely affected the cat's behavior. The revised dosage is 1/8 of 15 mg every other day.
https://www.researchgate.net/public...d_placebo-controlled_crossover_clinical_trial

 

Thank you for all you replies. I am trying so hard to get Chicklet to eat. I have bought numerous canned foods. I recently bought nip as I read that this may stimulate appetite. I will be trying the parmesan cheese. Can any one recommend any baby foods. I know that some companies will not note that they added onions or garlics as they have added such a small trace amount. I am trying not to force feed as Chicklet appears to get even worse when she is under any type of stress.

LM

 

I'm so sorry your Chicklet isn't feeling well. I wonder if you might want to ask your vet for something for nausea, such as Cerenia? Nausea often presents as lip licking, sniffing but walking away from food. If a cat is nauseated, even with an appetite stimulant, they won't eat. My kitten Buster was hospitalized awhile back due to illness; he was given 1/8 of a tablet of Mirtz, but only every 3rd day; to counter balance any nausea, he was given Cerenia 1/4 of a 16mg tablet and this helped a lot.

If you are in the US, BeechNut Chicken with Broth or Turkey with Broth Baby Foods are usually available at Walmart and Kroger. Otherwise, this is what I give my kitties when they don't feel well. Gerber has a tiny bit of starch, but most say it doesn't have any effect on BG, both do not have onion or garlic.

 

LM, Beechnut is not available in Canada. the only plain meat baby food I've found is Heinz Beef and Broth and Chicken and Broth. No onions or garlic in it but it has rice starch for thickener which may have an effect on BG but this is a minor issue when you need to get them to eat. I find the new formula is thicker than it used to be so warming it up and stirring to a more creamy consistency (I put the jar into a bowl of hot water) seems to be more accepted by my crew than straight out of the jar. I've purchased it at Walmart and Loblaws but I imagine most supermarkets carry it.

 

Just in case you haven't seen this post: Suggestions on How to Stimulate Kitty's Appetite
You might find something that will help...

 

Gerber chicken and gravy/turkey and gravy are only meat, cornstarch and water.

 

Unfortunately, I don't think the Gerber is available here either. For such a large country, land mass wise, our population is small and our selection of products is considerably less than that of the US.

LM, How is Chicklet doing? When you have a moment, we'd love to know how things are going!

 

I am almost positive that this will be too high of a dose of this medication , how much does your cat weigh?

 

My veterinarian told me that cyproheptadine can also be used as an appetite stimulant and it has a lesser half life to leave the kitty's system. I would just check to see what mg and dosage via your vet. After my experience with mirtazapine I cannot in good conscience recommend it.

 

Hi LM,

How is Chicklet doing? Is she eating? And how are you? It's very scary and draining when our little ones are off their food.


Mogs
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Hello everyone,

I was much too scared to give the Mirtazapine after reading all the side effects. She will eat small amounts of soft food that is full of carbs. She is not interested in the high protein, low carb foods. I believe that food transition may take some time. I have made an appointment at an "all cat vet clinic". I am also going to try introducing a raw patty tomorrow to see if she has any interest at all in it. Thanks for checking in.

LM

 

Hi LM,

Remember that cyproheptadine is an alternative appy stimulant (but be sure to check liver status with the vets first). A tiny amount can go a long way. It's a lot milder in action than the mirtazapine and a teensy dose can give appetite a boost for perhaps 12 hours.

Perhaps ask your vet about a whether a B12 injection might be a good idea? It can help with appetite.

Sometimes the food transition does take a while. I'm glad that Chicklet is eating some food - that's the main thing. You can work insulin around the higher carbs. If you can keep her eating little amounts very frequently that will help.

I don't know whether this might help you but when Saoirse gets a bit finnicky warming the food a little bit and crumbling up a freeze-dried chicken treat on top tempts her to eat better. Maybe that's something that Chicklet might like?

Will keep an eye out for updates from you.


Mogs
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This forum and the people are quite exceptional!!!!!! I will take all the suggestions and give them a try. I am so glad that I came across this forum. What a life saver during a stressful period.

LM

 

Isn't it just! A few years ago I lost one of my little ones to hepatic lipidosis and when Saoirse lost her appetite shortly after being diagnosed with FD and pancreatitis I nearly went insane with worry.
I'm very grateful for all the help I received from members here - then, and many, many times since.

Just in case you haven't seen this before, here is a link to a very useful source of information about nausea symptoms. It may help you to identify if a particular food might be making Chicklet feel a bit queasy.

Nausea Symptom Checker and Treatment Info (from Tanya's Site)

If Chicklet is experiencing nausea ondansetron and Cerenia can help a great deal with that. Slippery elm bark is a natural treatment that may help. (More info on these at Tanya's Site.)

When you talk to the vets it might be a good idea to do a blood test to see whether Chicklet might have mild pancreatitis. (FD and pancreatitis are often bedfellows). It would be no harm to rule it out.

There's another useful page on Tanya's Site with tips to encourage eating:

Persuading Your Cat to Eat

The 'sleepy eating' trick is a really good one. Get some food ready while Chicklet is sleeping. Bring the food to where she's sleeping, wake her up gently and immediately put the dish in front of her face.



Mogs
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I used Mirtazipan with no problems. Since it's a cut irregularly shaped pill I packed the mirtazipan in a gelatin capsule. To give the cap some mass I filled it with parmesan cheese. Some cats like the flavour of the grated parmesan so if the cap breaks or gets chomped it masks the Mirtazipan.

Every drug has side effects and to be honest I think there's more drama than fact sometimes. I got the Mirtazipan from my Vet and dosing and any reactions were filtered through him. If it wasn't for the appetite enhancement Wess would have lasted for as long as he did. All cats have their own special quirks. Wess went cold turkey on carbs. I gave him the stinky varieties of Fancy Feast pate warmed up.

 

I agree that most if not all drugs have side effects. I also agree that some cats get on OK with mirtazapine. But as a guardian of a cat who did have a bad reaction to mirtazapine I can assure you that concerns over the side effects of mirtazapine are not overly dramatic.

I've been prescribed umpteen psychotropic drugs myself (for PTSD), one of which was mirtazapine. It is a very strong drug and if it does disagree with the creature taking it - cat or human - the side effects can be very strong, very unpleasant and frankly quite alarming. I can attest to this having personally experienced an adverse reaction to the drug (much worse than side effects of other meds I have been prescribed) and also having witnessed a bad reaction to it in my own cat. The risk of inducing serotonin syndrome as a result of ingesting mirtazapine is increased further if it is administered alongside other serotonergic medications such as Prozac or buprenorphine, both of which are used to treat cats (an example of the latter being the adverse reaction of Kristin's Nova as reported here recently).

The interaction between mirtazapine and buprenorphine is of particular concern for caregivers of cats being treated for severe pancreatitis. If both pain relief and appetite stimulation are needed then, liver markers permitting, cyproheptadine may be a safer choice as an appetite stimulant.



Mogs


EDITED TO ADD:

IMPORTANT SAFETY NOTE!

Possible Adverse Drug Interaction

Tanya's Site has a warning that using both ondansetron and mirtazapine at the same time may increase the risk of inducing serotonin syndrome. See following link for further details:

http://felinecrf.org/nausea_vomiting_stomach_acid.htm#ondansetron

.

 

Hi, new to this forum and reviving it based on the 1/2016 date. Came across this thread researching side effects of mirtazapine in cats. Gave my cat mirtazapine as prescribed by my vet this morning to stimulate appetite (my cat has an inner ear infection). The side effects of this drug were pretty traumatic both for me and my cat. It has been 12 hours and she is still experiencing side effects, but it appears to be wearing off some. About 30 minutes after giving her this med, she began crying, howling, pacing. I thought she was experiencing pain from the inner ear infection. Took her back to the vet and they told me mirtazapine can make cats vocal. Well, that is an understatement. My poor baby was completely beside herself. She was so hyped up and looked like she was having an anxiety attack. I have never seen my cat in this state. She was completely inconsolable. I could not calm her down at all and it would not stop. I was so afraid for her. She seemed to want to eat, but couldn't. Kept sniffing her food and walking away. She hadn't eaten much in the past 48 hours so I decided to try and give her something other than her normal wet cat food. I had a can of chicken so I chopped it up and she inhaled it. She kept wanting more. I don't know why she could eat this and not her cat food, but I won't ever give my cat this drug again. I wish I had researched it before I gave it to her. I generally trust vets when they prescribe drugs to my pets. I was surprised to see that many other people have had this experience with this drug. If you are reading this because your cat went through this, I feel your pain. If you are reading this to educate yourself on this drug, just know that the potential side effects can be pretty traumatic. It sounds like some pets tolerate it okay. But I would think hard about whether you want to take the chance with your cat. There are other appetite suppressants out there that don't have this potential risk.

 

Lexi, what dose in mg did you administer ?

 

I gave her 1/4 of a 15 mg pill, as prescribed by my veterinarian.

 

That dose has been determined to be too high
http://veterinarymedicine.dvm360.com/mirtazapine-cats-how-much-too-much
Here is the reference study
http://www.ncbi.nlm.nih.gov/pubmed/26228539

 

I wish I would have been provided some information about this drug when it was given to me for my cat. She is much better today. Still fighting the ear infection, but she is not walking around screaming all the time. What a horror that was. I hope I never have to give her an appetite suppressant again. If I do, it will be Cypro. No more Mirtazapine.

 

I have also had very good results with mirtz.... I give less than 1/4 of a 15 mg--just a tiny chip and my boy is so happy and loving and he eats! (12-13 pounds)
Cypro works for him as well but it is nice to not have to pill them 2x a day as opposed to 1x 3-4 days
I was so nervous but I was going out of town and my sitter cannot pill him--thankfully it worked wonderfully for him.
I put in a size 5 gel cap

 

Hi Jayla,

For future reference, try giving the cypro ground up and mixed with a tiny bit of puréed wet food. Try hand feeding the medicated morsel, or maybe smear it over nose and lips to let kitty lick it off. For reference, you can get cypro compounded as a liquid suspension, too.


Mogs
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@Lexi -

Very glad to hear your kitty is OK. When mirtazapine doesn't agree with a being (human or cat) it's not pretty (have experience with both). I'm really sorry you both had to go through that.




Mogs
.

 

I have used mirtazapine with great success. My cat Frankie probably lived an extra two years because of it, and I'm sure I would have lost Gracie by now without it. BUT I never use the dose you've been given -- too much! Even 1/8th of a tab is 1.875 mg. I have 1 mg capsules from the compounding pharmacy.

Recently I've been getting transdermal mirtazapine from the pharmacy at Colorado State University vet school, which is even better. They are doing a study on it. It's a cream that you rub on the bare area in front of your cat's ear. The medication releases gently and relatively evenly over a 48 hour period. The dose is .1 cc but since it's a cream you can easily adjust the dose down a little bit for an even more gentle effect. Your vet can order from them for you.