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Questions about Mirtazapine

March 11th, 2013, 06:16 PM
Tabitha is having some issues and I am wondering if anyone has had any experiences using Mirtazapine? My regular vet is away for a week and I received a call from one of her partners today. I recently had Tabitha in as I suspected a urinary infection which we are treating with Orbax. In addition we ran a full panel of blood work since its been a couple of yrs. It does not appear to be very good. I have been told to ensure that she gets Tumal K or potassium along with the antibiotic.

The partner vet thought that Tabitha should maybe get some of the Mirtazapine to increase her appetite?? I havent finished reading yet but alot of the stuff indicates that it is an anti depressant more than an appetite stimulant. I am also concerned that if she has renal issues then will this cause her more problems??

Her current weight is 2.36kg :(

Her test results showed that she likely has pancreatitus as well. I was concerned about some of the higher numbers in the blood work.

For example
Urea Tabitha 21.60 Normal range 5.0 - 13.0
Creatinine Tabitha 297 Normal range 49-173

The rest of the test I am not 100 % sure on what it all means. Her thyroid was on the low side but I am not sure if that is a concern.

I will speak to my regular vet next week but as I am sure you all would be worried.

I am hoping Sugarcatmom or Growler may have heard of this medication.

She has been on the antibiotic for about 3 days now and seems to be feeling a bit better....she doesnt appear as grumpy!!

March 11th, 2013, 07:24 PM
Sorry that Tabitha is having a rough time right now! I have used mirtazapine on one of my cats in the past and it did work great at kick-starting his appetite, but he had completely stopped eating and the situation was getting serious. I'm not so sure I'd use it on a cat that was still eating just to get them to eat MORE. If it was me, I'd probably try other methods first. Mirtazapine is indeed an antidepressant, for humans (also known as Remeron). In cats, it increases appetite and lessens nausea. Kinda like how cyproheptadine (aka Periactin) is an antihistamine for people but works as an appetite stimulant for cats. Mirtazapine only needs to be given once every 3 days though, whereas cyproheptadine is given twice a day.

There can be some unpleasant side effects with mirtazapine, such as restlessness and something called serotonin syndrome. It is a potent drug, after all. That's why if there are ways to increase food intake without going the chemical route, I'd recommend trying those first. Does Tabitha like any particular treats? Can you crumble them on top of her food? My guys love 100% freeze-dried meat treats like PureBites or Whole Life and if they become picky about a particular food, dusting their meals with some of those gets them eating it again.

Tabitha has renal disease, correct? What is her urine specific gravity, do you know?

If she does have pancreatitis (was an fPLI test done?), she really should be on pain meds (but NOT Metacam!!). That should also help with her appetite.

March 12th, 2013, 07:33 AM
Hi SCM! Yes Tabitha does have renal disease.

My concern has not been about eating. Tabitha has been 6 pounds all her life and her weight never changed more than an ounce or so(until recently). She is quite petite. She currently wats a bit of dry in a "mobility diet" from the vet which I consider more of a treat than anything because she eats so little of it.

She was converted over to wet approx 5 yrs ago and was and still is a very finicky kitty with wet. I have learned to change it up as far as the protein is concerned or she just wont eat it. She is give a 3 oz can every day but she rarely eats all of it.

She has not stopped eating yet?? and she has always eaten this little so thats why I am not sure if I want to try it. They also said that it creates like a euphoric type side effect where she may be vocal etc...I dont think I want to put her through that.

My regular vet mentioned metacam in small doses but also understood my concern because I am pretty sure that is what made us loose Bomber. She said when we talk next week we can discuss options.

SCM Tabitha's fpl is pretty high @ 44.00 .

As for the urine specific gravity she was dilute the last time we ran the urince culture and sensitivity. If I remember correctly is was something like 1020?? not 100% sure. We could not get a urine sample from Tabitha this round but we knew for sure she had an infection so she just treated it. She also mentioned that if she had something lilke pancreatitius the Orbax would help with that.

I am trying to figure out how to post the report here...

Thanks SCM!


March 12th, 2013, 04:14 PM
I cant figure out how to post the blood work results...The document is too large no matter what I do with it.

SCM if there is something you would like to see from it just let me know and I will post the numbers. The high ones I posted already and also the fpl test I posted.

March 21st, 2013, 09:27 AM
Well I finally managed to have a discussion with the regular vet. She said that Tabitha's blood work has changed from a couple of yrs ago. However she wasnt overly concerned. She would like me to try a couple of things to help Tabitha out. First off we are going to try the Mirtazapine and see how she reacts. If she goes loopy on it we will discontinue. It is only 1/8th of a pill so hopefully this increase her appetite.

The vet also recommeded dermal codine which if I understood her correctly this is for pain management and it is a cream rubbed into her ears.

In addition she would like me to give Tabitha a phosporus binder? I have to take the the time to look into this part as I am not sure what the reasoning is?? we talked about so many things that I honestly forget??

Tabitha has stopped urinating outside the litter box but I had to do some major cleaning of carpets in the bedrooms where she was going. As a result I have had to place litter boxes in the bedrooms which she is now using instead of the floor!

March 29th, 2013, 09:52 PM
A little update.

Tabitha seems to be feeling a bit better. She is getting the dermal codine for pain and the antibiotics must have kicked in as well as she seems a bit happier.

We have cleaned the area very well where she was urinating and I have placed a litter box and some matting and she is using the box instead of the floor.

We also tried the Mirtazapine and that didn't go very well. They had warned of side effects where the cat is a little bit loopy and vocal. Well Tabitha had the most horrible loud meow's it was awful. She was very restless and somewhat unsettled. It lasted a couple for a couple of hours. This was an appetite stimulant.

So we are continuing the Orbax, the potassium and also a phosporus binder in her food and the pain meds which is a cream in her ear.

We will be following up with the vet after she finishes the meds.:thumbs up

Jim Hall
March 30th, 2013, 08:56 AM
i have used cypro but only occasionaly for a kick start or when sick It turns du into a love bug is tabitha into catnip ? i have used that on food