When to give mirtazapine?

Hi all,
My kitty Mango ate about half her dinner last night after eating well all day (she grazes). She ate nothing overnight, which is unusual, and is refusing four different kinds of foods this morning. She did eat a little deli turkey, but not enough for me to feel comfortable giving insulin, so we skipped her one unit of vetsulin. I've got some mirtazapine - when is the time to start that? After how many skipped meals?

Thanks for any advice.
Savin

 

I myself would not giver mirtazapine without direction fro a vet since it is a prescription drug. It is better to try to find the cause of the inappetance rather than use a drug.
Are you home testing? If so what are BGs?
How is Mango acting otherwise?
I myself try to syringe feed vice using a drug not knowing the cause. However, some cats are not amenable to syringe feeding
What dose (mg) were you planning to give?

 

Her BG was 313 right before she should have eaten. I got her to eat about a piece of deli turkey, but that's it. She hovered over the water bowl for a bit; now she's back to sleep. We skipped her 1 unit of vetsulin. She's acting a little low-energy and a little standoffish. We did have a nice trip to our outdoor deck, where she can walk around protected and smell things, but she's way less interested in cuddles than usual. I was planning to give her 1/4 of a 15 mg tablet of mirtazapine.

 

Is she drinking? Your description is ringing alarm bells for me, when a cat won't eat they are telling you something, I would phone the vet for advice rather than giving her medication.

 

Have you tested for ketones?

 

She is indeed drinking. I am waiting for the vet to call me back.

 

I have not. How do I do that?

 

By testing the urine with special strips, the best way is with a blood ketone meter but most people don't have them, it can take time for ketones to appear in the urine. I use keto-diastix.

 

You can get the urine test strips at any pharmacy

 

The practice now seems to give less
http://www.ncbi.nlm.nih.gov/pubmed/26228539
http://veterinarymedicine.dvm360.com/mirtazapine-cats-how-much-too-much

 

I have urine strips that say "Diastix". Just got a reading I don't quite understand, so I'll quote exactly from the bottle: she has a "%" of "1", which is a "mg/dL" of 1000. Is this worrisome?

 

Diastix on measure glucose in the urine. Keto-Diastix measure both ketones and glucose in the urine.
https://www.amazon.com/Bayer-Keto-Diastix-Reagent-Strips-Urinalysis/dp/B001V9UXSI
For ketones you want a negative to trace color comparison. It is frequently hard to tell a negative fro trace. You have to read/compare the strip color the specified amount of time after exposing to urine since the strip color gets darker with time

 

1% is fine - she is spilling a little glucose into the urine but with the blood reading you have this is not unexpected. With the keto-diastix it takes 15 seconds to read for ketones so you have to time it carefully.

 

I would also talk with your vet. I use the mirtz and ondansetron for nausea for my CKD cat. I was very hesitant because many cats have lots of vocalizing but for my guy he is much more social and eats like a normal cat. he is very lovey too LOL
I also use cypro (we rotate from mirtz and cypro)
I would always make sure there is no underlying issue.....but for us with the CKD it has been very helpful. (he actually gets less that 1/4 of a 15mg... about 1/6 of a 15mg he is 12#)