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Hi- new to THIS group; crf cat Oreo & heart issues-Mirtazipine ?

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  • Susan
    HI : I just joined here, I ve been on the CRF group since Jan6th when my 15 year old was diagnosed with CRF. He s been on 88mg aspirin 2x s weekly since he was
    Message 1 of 4 , Feb 5, 2012
      HI :

      I just joined here, I've been on the CRF group since Jan6th when my 15 year old was diagnosed with CRF.
      He's been on 88mg aspirin 2x's weekly since he was 6 weeks old & has worked well. He lost the use of his back leggs then & regained them with the help of the aspirin.
      The vet prescribed Mirtazapine. He gave it to him onced & I haven't had to give it to him again, but after a recent repeat LONG vet trip, I haven't been able to get him to get back to doing well again. He has dropped a half pound in a week. I gave him 1/8th tablet today & saw my OLD OREO again, eating and being generally a happy & social cat.
      What I worry about is , is he at risk for a stroke with his heart problems on this ? If I only give 1-2 times a week ?
      Oreo has a heart valve that doesn't open or close properly ( hypertrophic obstructive cardiomyopathy)
      The radiologist also said after the his xray, it has remained "unchanged" in all these years, thankfully. One of the most important things in CRF cats & possibly the most is to keep them eating, so ? Plus, they found bacteria in his urine & is on 2 antibiotics, Baytril & Clavamox & I think, even with the pepcid, they are reaking havoc on his stomach, energy level & morale. Too many meds & irritation in his , once so perfect life. He can give you the "cold shoulder" if you go away for the weekend, he's just like that. So, I know this has to be depressing him. From what I've read, the Mirtazapine also works as an antidepressent, which I think he & I BOTH need, ugh. This has been so much stress as you all know. BUT I am skeptical about continued use of this, that's why I haven;t given it to him as the vet has requested, per the script.
      Thank you for your input
      For those of you with CRF cats, my story is there..
      thanks
    • Carol
      hi Susan, It definitely sounds like Oreo is battling the nausea that goes along with CRF. What we used for our angel Snowball was a little bit of
      Message 2 of 4 , Feb 6, 2012
        hi Susan,

        It definitely sounds like Oreo is battling the nausea that goes along with CRF. What we used for our angel Snowball was a little bit of Cyproheptadine, an antihistimine that's used as an appetite stimulant, and then we gave her separately the anti-nausea medication Ondansetron (injectable form). The combination of those really helped her a lot.


        Mirtazapine is used as an appetite stimulant and anti-nausea medication. We used it on Snowball, but stopped it because it caused her to have seizures because of an interaction with her Tapazole. The big problem with Mirtazapine is that it shouldn't be given with the hyperthyroid med Tapazole/Methimazole because the Tapazole inhibits the enzyme necessary to clear the Mirtazapine out of the liver. The Mirtazapine keeps accumulating in the liver, causing liver toxicity and that results in seizures. What we found with it, before Snowball started having seizures on it, was that it didn't work that well on a consistent basis. It worked for one day, then for the next two days between doses (it's only dosed every 3 days), she felt awful, so it never really worked that well for Snowball anyway.

        The Cyproheptadine, we only had to use a tiny dose on her of 1/8 tablet once a day, and the Ondansetron (we did the injectable kind), kept her comfortable. Though the appetite stimulant medications can possibly cause the heart rate to be increased, we didn't see a significant change in Snowball's heart rate whether she was on them or when she was off of them.

        The nausea that accompanies CRF is really terrible and came make them feel just awful. Another reason for nausea is when they're phosphorus is too high. That makes them feel really bad and they tend to not want to eat from that either. If Oreo's phosphorus is higher than 6.0, then he should be on a phosphorus binder. Here is information about Dr. Nagode's protocol for dosing. http://www.zzcat.com/CRF/supplies/binders.htm#drnagode

        I get the Ondansetron (also name brand is called Zofran, which is very expensive...the Ondansetron is way cheaper), at Thriving Pets. http://www.thrivingpets.com/index.php/ondansetron-zofran.html You can get a 20ml bottle for $24.95 which is an excellent price. Even with their shipping charges (I think it may be $10) it's still cheaper than any local pharmacy.

        I hope you can get Oreo's tummy feeling better.

        Carol and the gang




        -----Original Message-----
        From: Susan <jknsk2002@...>
        To: feline-heart <feline-heart@yahoogroups.com>
        Sent: Sun, Feb 5, 2012 9:45 pm
        Subject: [FH] Hi- new to THIS group; crf cat Oreo & heart issues-Mirtazipine ?





        HI :

        I just joined here, I've been on the CRF group since Jan6th when my 15 year old was diagnosed with CRF.
        He's been on 88mg aspirin 2x's weekly since he was 6 weeks old & has worked well. He lost the use of his back leggs then & regained them with the help of the aspirin.
        The vet prescribed Mirtazapine. He gave it to him onced & I haven't had to give it to him again, but after a recent repeat LONG vet trip, I haven't been able to get him to get back to doing well again. He has dropped a half pound in a week. I gave him 1/8th tablet today & saw my OLD OREO again, eating and being generally a happy & social cat.
        What I worry about is , is he at risk for a stroke with his heart problems on this ? If I only give 1-2 times a week ?
        Oreo has a heart valve that doesn't open or close properly ( hypertrophic obstructive cardiomyopathy)
        The radiologist also said after the his xray, it has remained "unchanged" in all these years, thankfully. One of the most important things in CRF cats & possibly the most is to keep them eating, so ? Plus, they found bacteria in his urine & is on 2 antibiotics, Baytril & Clavamox & I think, even with the pepcid, they are reaking havoc on his stomach, energy level & morale. Too many meds & irritation in his , once so perfect life. He can give you the "cold shoulder" if you go away for the weekend, he's just like that. So, I know this has to be depressing him. From what I've read, the Mirtazapine also works as an antidepressent, which I think he & I BOTH need, ugh. This has been so much stress as you all know. BUT I am skeptical about continued use of this, that's why I haven;t given it to him as the vet has requested, per the script.
        Thank you for your input
        For those of you with CRF cats, my story is there..
        thanks










        [Non-text portions of this message have been removed]
      • Susan Knapp
        Thank you.,I ordered it already. Both injectibles just in case and to have on hand. The appetite stimulants. I am bumping up the injectible pepcid to every
        Message 3 of 4 , Feb 6, 2012
          Thank you.,I ordered it already. Both injectibles just in case and to have on hand. The appetite stimulants. I am bumping up the injectible pepcid to every day 1/4 every day rather than eod.,,I hope that helps.
          Thanks for ur response.,,

          ------------------------------
          On Mon, Feb 6, 2012 8:50 AM PST Carol wrote:

          >hi Susan,
          >
          >It definitely sounds like Oreo is battling the nausea that goes along with CRF. What we used for our angel Snowball was a little bit of Cyproheptadine, an antihistimine that's used as an appetite stimulant, and then we gave her separately the anti-nausea medication Ondansetron (injectable form). The combination of those really helped her a lot.
          >
          >
          >Mirtazapine is used as an appetite stimulant and anti-nausea medication. We used it on Snowball, but stopped it because it caused her to have seizures because of an interaction with her Tapazole. The big problem with Mirtazapine is that it shouldn't be given with the hyperthyroid med Tapazole/Methimazole because the Tapazole inhibits the enzyme necessary to clear the Mirtazapine out of the liver. The Mirtazapine keeps accumulating in the liver, causing liver toxicity and that results in seizures. What we found with it, before Snowball started having seizures on it, was that it didn't work that well on a consistent basis. It worked for one day, then for the next two days between doses (it's only dosed every 3 days), she felt awful, so it never really worked that well for Snowball anyway.
          >
          >The Cyproheptadine, we only had to use a tiny dose on her of 1/8 tablet once a day, and the Ondansetron (we did the injectable kind), kept her comfortable. Though the appetite stimulant medications can possibly cause the heart rate to be increased, we didn't see a significant change in Snowball's heart rate whether she was on them or when she was off of them.
          >
          >The nausea that accompanies CRF is really terrible and came make them feel just awful. Another reason for nausea is when they're phosphorus is too high. That makes them feel really bad and they tend to not want to eat from that either. If Oreo's phosphorus is higher than 6.0, then he should be on a phosphorus binder. Here is information about Dr. Nagode's protocol for dosing. http://www.zzcat.com/CRF/supplies/binders.htm#drnagode
          >
          >I get the Ondansetron (also name brand is called Zofran, which is very expensive...the Ondansetron is way cheaper), at Thriving Pets. http://www.thrivingpets.com/index.php/ondansetron-zofran.html You can get a 20ml bottle for $24.95 which is an excellent price. Even with their shipping charges (I think it may be $10) it's still cheaper than any local pharmacy.
          >
          >I hope you can get Oreo's tummy feeling better.
          >
          >Carol and the gang
          >
          >
          >
          >
          >-----Original Message-----
          >From: Susan <jknsk2002@...>
          >To: feline-heart <feline-heart@yahoogroups.com>
          >Sent: Sun, Feb 5, 2012 9:45 pm
          >Subject: [FH] Hi- new to THIS group; crf cat Oreo & heart issues-Mirtazipine ?
          >
          >
          >
          >
          >
          >HI :
          >
          >I just joined here, I've been on the CRF group since Jan6th when my 15 year old was diagnosed with CRF.
          >He's been on 88mg aspirin 2x's weekly since he was 6 weeks old & has worked well. He lost the use of his back leggs then & regained them with the help of the aspirin.
          >The vet prescribed Mirtazapine. He gave it to him onced & I haven't had to give it to him again, but after a recent repeat LONG vet trip, I haven't been able to get him to get back to doing well again. He has dropped a half pound in a week. I gave him 1/8th tablet today & saw my OLD OREO again, eating and being generally a happy & social cat.
          >What I worry about is , is he at risk for a stroke with his heart problems on this ? If I only give 1-2 times a week ?
          >Oreo has a heart valve that doesn't open or close properly ( hypertrophic obstructive cardiomyopathy)
          >The radiologist also said after the his xray, it has remained "unchanged" in all these years, thankfully. One of the most important things in CRF cats & possibly the most is to keep them eating, so ? Plus, they found bacteria in his urine & is on 2 antibiotics, Baytril & Clavamox & I think, even with the pepcid, they are reaking havoc on his stomach, energy level & morale. Too many meds & irritation in his , once so perfect life. He can give you the "cold shoulder" if you go away for the weekend, he's just like that. So, I know this has to be depressing him. From what I've read, the Mirtazapine also works as an antidepressent, which I think he & I BOTH need, ugh. This has been so much stress as you all know. BUT I am skeptical about continued use of this, that's why I haven;t given it to him as the vet has requested, per the script.
          >Thank you for your input
          >For those of you with CRF cats, my story is there..
          >thanks
          >
          >
          >
          >
          >
          >
          >
          >
        • Carol
          We gave our guys the Pepcid injectable too, every day, once or twice daily as needed. ... From: Susan Knapp Thank you, I ordered it
          Message 4 of 4 , Feb 6, 2012
            We gave our guys the Pepcid injectable too, every day, once or twice daily as needed.

            -----Original Message-----
            From: Susan Knapp <jknsk2002@...>


            Thank you, I ordered it already. Both injectibles just in case and to have on
            hand. The appetite stimulants. I am bumping up the injectible pepcid to every
            day 1/4 every day rather than eod.,,I hope that helps.
            Thanks for ur response.,,





            [Non-text portions of this message have been removed]
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