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Mirtazapine

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  • lilloise52
    Hi, My Tigg is 11 years old. My vet has prescribed Mirtazapine to boost her appetite hence her eating, she s lost a lot of weight already... Her creatinine was
    Message 1 of 20 , Mar 29, 2013
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      Hi,

      My Tigg is 11 years old. My vet has prescribed Mirtazapine to boost her appetite hence her eating, she's lost a lot of weight already...

      Her creatinine was over 8 at diagnosis and her BUN 79... She also has HCM, diagnosed at age 5, so no IV hydration or SubQs, vet is adamant. I first had her on Famotidine for stomach acid, not sure that ever worked, and there's a scenario where the med can actually increase the loss of appetite, so I asked about an appetite stimulant, hence the Mirtazapine, 1/4 of a tablet every 72 hours. Tigg has lost a lot of weight (18lbs in October, but she's a big cat, part Main Coon) down to 14.5 at CKD diagnosis and probably less now.

      Has anyone actually used both the Famotidine and Mirtazapine at the same time, or how to tackle stomach acid (not nausea per se)? Tigg is very sweet but not a lap cat, I've tried a syringe but the stress involved is counter productive, working on "finger feeding", some appetite would make all the difference and would lower her numbers also.

      Thanks for any thought or suggestions, I'm new to this forum and trying to digest all the information on Tanya's website...
    • Carol
      hi, We used Mirtazapine and Famotidine at the same time. What we found though, was that the Mirtazapine didn t really work all that well after the first day.
      Message 2 of 20 , Mar 30, 2013
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        hi,

        We used Mirtazapine and Famotidine at the same time. What we found though, was that the Mirtazapine didn't really work all that well after the first day. You can't give it any sooner than every 3 days, because it takes that long for it to clear out of the liver.

        Is Tigg hyperthyroid and on Tapazole/Methimazole? If she is, then you should not use Mirtazapine. The Tapazole inhibits the enzyme necessary to clear the Mirtazapine out of the liver, so it doesn't clear and accumulates and creates a toxicity, which in turn, causes seizures. This happened to our angel Snowball. No one told us about the interaction between the Mirtazapine and thyroid meds. Snowball was on the Mirtazapine for a couple months and one day had this really bad seizure. I found out later through some research and reading on the hyperthyroid group, about the drug interaction. Snowball recovered, and we never used the Mirtazapine again.

        What we do use is Cyproheptadine for appetite stimulant and Zofran (Ondansetron) for anti-nausea.. those are much safer and we think work better.

        If Tigg's Creatinine is 8 and BUN 79, that's really high! Our Misty has heart and kidney problems too, and we give her smaller amounts of subQ's twice a day so as not to put her heart in trouble. If you divide up two smaller amounts, say 50ml twice a day, then the heart handles it better. Yes, we're taking a chance... tempting congestive heart failure, but Misty's kidneys are pretty bad, so we try to balance it with what the heart needs.

        Carol
















        -----Original Message-----
        From: lilloise52 <mlawebb@...>
        To: feline-heart <feline-heart@yahoogroups.com>
        Sent: Fri, Mar 29, 2013 9:05 pm
        Subject: [FH] Mirtazapine





        Hi,

        My Tigg is 11 years old. My vet has prescribed Mirtazapine to boost her appetite hence her eating, she's lost a lot of weight already...

        Her creatinine was over 8 at diagnosis and her BUN 79... She also has HCM, diagnosed at age 5, so no IV hydration or SubQs, vet is adamant. I first had her on Famotidine for stomach acid, not sure that ever worked, and there's a scenario where the med can actually increase the loss of appetite, so I asked about an appetite stimulant, hence the Mirtazapine, 1/4 of a tablet every 72 hours. Tigg has lost a lot of weight (18lbs in October, but she's a big cat, part Main Coon) down to 14.5 at CKD diagnosis and probably less now.

        Has anyone actually used both the Famotidine and Mirtazapine at the same time, or how to tackle stomach acid (not nausea per se)? Tigg is very sweet but not a lap cat, I've tried a syringe but the stress involved is counter productive, working on "finger feeding", some appetite would make all the difference and would lower her numbers also.

        Thanks for any thought or suggestions, I'm new to this forum and trying to digest all the information on Tanya's website...











        [Non-text portions of this message have been removed]
      • catchat21498
        Anyone use this medication? Our vet said it is ok to use this for Sophie. New recommendations.... 1/8 tablet 15 mg everyday I know it was 1/4 tablet every 3
        Message 3 of 20 , Apr 8
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          Anyone use this medication? Our vet said it is ok to use this for Sophie.

          New recommendations....

          1/8 tablet 15 mg  everyday

          I know it was 1/4 tablet every 3 days.


          The cardiologist was not aware of this dosing.


          Thanks,

          Chris

        • Carol
          hi Chris, I used it on my angel Snowball, with not great results. It seemed to work for a day, but then for the next two days, not much at all. You can only
          Message 4 of 20 , Apr 8
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            hi Chris,

            I used it on my angel Snowball, with not great results.  It seemed to work for a day, but then for the next two days, not much at all.  You can only give it every 3 days, because it takes that long for the liver to clear it out of the system. I would NOT give this medication every day!  

            The other thing, is if you are giving thyroid medication (Methimazole/Tapazole) you should NOT give Mirtazapine. The thyroid meds inhibit the enzyme in the liver necessary to clear it out of the body, and what happens is that you get liver toxicity because the drug keeps accumulating in the body and the cat can have seizures.  This is what happened to my angel Snowball.  She was on it for about a month, one day had a horrible grand mal seizure that almost killed her.  I never used it on any of my cats ever after that.

            Carol and angel Misty




            -----Original Message-----
            Anyone use this medication? Our vet said it is ok to use this for Sophie.
            New recommendations....
            1/8 tablet 15 mg  everyday
            I know it was 1/4 tablet every 3 days.

          • Yahoo
            Here is a link to a study by Quimby on Mirtazapine which the new dosing is based on if anyone is interested.
            Message 5 of 20 , Apr 8
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              Here is a link to a study by Quimby on Mirtazapine which the new dosing is based on if anyone is interested.


              I also want to add I gave Millie 1/8 every other day which reduced side effects significantly but didn't help much with appetite. 


              Sent from my iPhone

              On Apr 8, 2015, at 4:05 PM, "catchat21498@... [feline-heart]" <feline-heart-noreply@yahoogroups.com> wrote:

               

              Anyone use this medication? Our vet said it is ok to use this for Sophie.

              New recommendations....

              1/8 tablet 15 mg  everyday

              I know it was 1/4 tablet every 3 days.


              The cardiologist was not aware of this dosing.


              Thanks,

              Chris

            • J. R.
              Hi. Just a thought, if Mirtazapine is contraindicated as mentioned below, there is another appetite enhancer called cyproheptadine. It is antihistamine based
              Message 6 of 20 , Apr 8
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                Hi.
                Just a thought, if Mirtazapine is contraindicated as mentioned below, there is another appetite enhancer called cyproheptadine. It is antihistamine based rather than anti depressant (mirtazapine is anti depressant based).

                It might be worth asking your specialist about that if there is a concern.
                I would not give any medication or supplement without clearing it first with the specialist due to contraindications or additive/blocking capabilities.\

                We do use a very small amount of the compounded mirtazapine with our HCM kitty on occasions to up her appetite...but we're not talking about much or often.

                -JR & Crew



                On Wednesday, April 8, 2015 3:04 PM, "Yahoo lkaras@... [feline-heart]" <feline-heart-noreply@yahoogroups.com> wrote:


                 

                Here is a link to a study by Quimby on Mirtazapine which the new dosing is based on if anyone is interested.


                I also want to add I gave Millie 1/8 every other day which reduced side effects significantly but didn't help much with appetite. 


                Sent from my iPhone

                On Apr 8, 2015, at 4:05 PM, "catchat21498@... [feline-heart]" <feline-heart-noreply@yahoogroups.com> wrote:

                 
                Anyone use this medication? Our vet said it is ok to use this for Sophie.
                New recommendations....
                1/8 tablet 15 mg  everyday
                I know it was 1/4 tablet every 3 days.

                The cardiologist was not aware of this dosing.

                Thanks,
                Chris


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