Strange behavior after giving mirtazapine

Hi all,

I have an odd situation in my house. I have at least 2 of my 8 indoor only kitties have runny stools with a bit of bloody mucus at the end. I noticed it first with Autumn and brought her to the vet. She had a terrible UTI and had lost 2 pounds (she's normally around 10). The vet gave her antibiotics, anti-inflamatories and fluids and she's doing better. But  now I've noticed a couple of the other cats leaving blood behind....

On Saturday I was woken up by a horrid poo smell - someone had just dropped the mother of all bombs! I checked the spare bathroom box and my baby, Turtle, was crouched in front of the box. There was a runny pile of poo with a bit of blood on it, and when she stood up, there was bloody mucus. Her behavior also scared me, she is Mama's Girl and is always close to me. She NEVER hangs out by the litter box, and she hates the little grids I put in front of it to catch the extra litter. So given the bit of blood and her crouching on the grids, something was very wrong. I rushed her to the vet.

After some testing we found mild pancreatitis, a UTI (not as bad as Autumn's) and giardia. I guess giardia infections normally come from a bad water source, but I've used the same tap water I've always used, and they never go outside. She also lost 3.5 pounds!! She's small anyway, but now she's down to barely 6.5 pounds. The vet gave her a paste/pill combo for the runny stools, a paste for the giardia, an appetite stimulant (this is the mirtazapine), potassium and another tiny pill I can't remember. She's been on Prozac for some time as she gets nervous and pulls her long fur out.

After trying to hide her meds in various food and treats (she wouldn't touch any of them) I gave up and put the tiny pill, the prozac and the mirtazapine in the piller and gave her those. Within 45 minutes, her behavior became very odd. She started meowing almost nonstop, following me around, and not able to settle down. Her eyes were HUGE and her breathing was a bit too fast. It was about time for bed and she always sleeps under the covers with me. Last night she wasn't able to settle down much at all, shifting positions, going in and out of the covers, meowing, smelling my mouth, and acting like she couldn't get close enough to me. Needless to say I didn't get much sleep.

I called the vet this morning and voiced my concerns. They gave me a prescription of cyproheptadine to counteract the mirtazapine in case she had serotonin syndrome (she certainly had all the symptoms!)

I gave her the first dose of cyproheptadine about 2.5 hours ago, and so far I've not noticed a change. She's sitting on my lap, meows constantly if I have to get up, or even when she's trying to get comfortable and still won't eat. Has anyone else had an experience like this? I'm really worried about her.

I'm sorry, I don't have any idea, but wanted to check in to see how Turtle was doing.
I wonder if there was a bad reaction among the various medications she was taking.
PS: some medications can be compounded into a flavored (tuna! bubblegum!!) liquid.

Please bring her and all other cats that are sick to a DIFFERENT VET  I myself believe there is something very contagious going on here and by the sound of it, it might be deadly! I would try seeing a close city near by that has a different vet that is willing to check the situation out!  

                                       #DiegoJames

Thank  you, DiegoJames and Ritz, for your concerns. As for another vet, I have complete faith in mine, I've been taking all my cats to her for over 15 years, she knows me and them well. It is an all cat hospital only 2.5 miles away. Turtle gets extremely carsick, so the shortest drive possible is best for her.

I do agree that something contagious is going on. Yesterday I contacted my vet to tell her the strange reaction Turtle was having. They prescribed a new med that would counteract the mirtazapine. I told them I wanted to treat all 8 cats for giardia, since that seems to be what they could pass to each other, so they readied the meds for each of my other cats and I started them on it last night.

Today, Turtle is still extremely clingy. If she is not sitting on my lap or curled up with me under the covers, she is meowing and yeowling either in complaint or (I hope not!) pain. She still isn't interested in eating. She has developed horrid smelling egg-farts too! Her nose is warm and dry. Her eyes aren't dilated anymore and she seems to be breathing more normally.

I have an appointment to take her back on Saturday to recheck her liver enzymes. Thank goodness I work from home and can watch her all day. She's making that easy as she won't leave my side. All the other kitties seem to be doing ok, except for the fact they all hate me for giving them the yucky paste to cure giardia. :-)

I'm going to try a few more things to entice her to eat, otherwise I may have to resort to syringe feeding. That will be a challenge at best! She even turned down Science Diet A/D, which I hear is kitty crack!

8whiskers said:

 
Thank  you, DiegoJames and Ritz, for your concerns. As for another vet, I have complete faith in mine, I've been taking all my cats to her for over 15 years, she knows me and them well. It is an all cat hospital only 2.5 miles away. Turtle gets extremely carsick, so the shortest drive possible is best for her.

I do agree that something contagious is going on. Yesterday I contacted my vet to tell her the strange reaction Turtle was having. They prescribed a new med that would counteract the mirtazapine. I told them I wanted to treat all 8 cats for giardia, since that seems to be what they could pass to each other, so they readied the meds for each of my other cats and I started them on it last night.

Today, Turtle is still extremely clingy. If she is not sitting on my lap or curled up with me under the covers, she is meowing and yeowling either in complaint or (I hope not!) pain. She still isn't interested in eating. She has developed horrid smelling egg-farts too! Her nose is warm and dry. Her eyes aren't dilated anymore and she seems to be breathing more normally.

I have an appointment to take her back on Saturday to recheck her liver enzymes. Thank goodness I work from home and can watch her all day. She's making that easy as she won't leave my side. All the other kitties seem to be doing ok, except for the fact they all hate me for giving them the yucky paste to cure giardia. :-)

I'm going to try a few more things to entice her to eat, otherwise I may have to resort to syringe feeding. That will be a challenge at best! She even turned down Science Diet A/D, which I hear is kitty crack!

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I do understand now why you go to the same vet. Good idea getting them all on meds! Have you tried putting the meds in a wet treat and dunking the treat in some kind o f wet food to eliminate the sent of the meds? Sorry I know it isn't the best tip but, I was wondering if it would help.

That paste doesn't mix well with anything. I've tried mixing it in wet food and cat milk, and she wouldn't touch it. I have to just squirt it in the side of her mouth. If it's a pill, I have a piller that works pretty well on her. Syringe feeding will be a different story. She won't let me contain her longer than giving her a quick pill.

As for eating - she's eating something one time, and only a little of it, then she won't touch it. Along with various flavors of wet food I've tried 4 different kinds of dry food, cat milk, cheese, turkey, egg yolk mashed with butter and I'm going to try cream cheese. She just licked a little of my plain greek yogurt off my finger, but just a little. After one taste of anything, she's done with it. Very frustrating little diva she is!

can you possible get it in pill form? It would be a lot easier on you and you cat!

I don't think so, but I'll ask the vet. she has an appointment on Saturday, but if she doesn't get any better or eat today, I may take the day off tomorrow and take her in early. I hate having sick kitties - worrying about them so much makes ME feel sick!

So earlier you mentioned the little kitty won't eat. This is serious and also please to to the vet about setting up a diet that he/she will eat. Hope for nothing but the best for the kitty!

You may have to resort to syringe feeding.  The A/D is very good for syringe feeding.  Many of us here have used it because it is nutrient and calorie dense.  I have nursed a cat through fatty liver which can result from a cat not eating.  I know the syringe feeding is a pain but sometimes it is necessary.  My cat was also very difficult to syringe feed.  When he had fatty liver they put in a feeding tube and it took about a month for him to recover.  A month is actually a fast recovery.

Oh boy Denice, that sounds like a traumatic ordeal for you AND the kitty!

DiegoJames, I just called the vet. I've gotten her to eat just a tiny bit of A/D but only if it's off my finger. The vet told me to bring her in Friday if she doesn't improve.

I'm going to start syringe feeding her this afternoon. She hates being confined in a towel or anything like that, so this will be a very messy challenge. I have already taken friday off to be with her and take her to the vet.

Ugh, it's so difficult when your kitty is ill and you don't know what to do to help her!

Ask the vet for a different appetite stimulant.  My cat is on Cyproheptadine, she hasn't eaten normally since Friday (we just discovered she may have chronic pancreatitis), she has eaten a full 5.5oz can of food today between what she ate at the vet and at home already.

cprcheetah, that's exactly what the vet switched her to last night. She's gotten two doses so far. She acts like she wants to eat, but she won't, she just smells it and walks away meowing. I have a syringe of A/D mixed with water ready to go. I'm just waiting for my dinner break to do it.

Is she on anything for pain?  Does she act like she is nauseated --licking lips etc?

No, she hasn't had any meds for pain. When the vet tech heard her in the background while on the phone with me, she said it didn't sound like pain meows, more like she wants me to know she doesn't feel well and to pay attention to her.

As for licking her lips, she always does that. But it is different right before she's going to vomit, and she hasn't done that (yet).

Well, I just tried to syringe feed her and it was an unmitigated disaster! I closed us off in the bathroom with towels on the floor. First I tried scruffing her, that didn't work, she just thrashed around and meowed (screamed really) and I couldn't really get the food in her mouth. Then I tried wrapping her in a towel - BIG mistake! She completely freaked out - full panic mode until I released her. I got more food ON her than IN her.

I don't know how else to do this. I live alone and there's really no one to help me tonight. I'm on the verge of tears of frustration and worry.

Here are some ideas on helping your kitty eat: http://www.felinecrf.org/persuading_cat_to_eat.htm   I know your cat doesn't have kidney disease but it has good information in it.   Here is a video that helped me when I had to force feed my bridge kitty Tabitha.

 

It's ok hang in there!

The lady and the cat in the video have gotten good at it.  There is a learning curve for both you and the cat.  The main thing is to go slow and try to relax.  Cats pickup on our stress.  I know it's difficult and it takes a lot of patience.  Even with the feeding tube I had to go real slow other wise it wouldn't stay down.  I didn't have the experience but there have been people here whose cats vomited the feeding tube.  With the feeding tube the food has to be really thinned out with water.  I gave 60 mls that was diluted half and half with water which would be 30 mls of food and it would take about 20 minutes.  I was using the A/D and fed him 4 times a day.

great video cprcheetah, thanks!

Unfortunately, Turtle freaks out the moment I drape part of the towel around her. She will have absolutely NO restraint or she becomes a whirling dervish of angry kitty (she's a long haired Tortie, and she is FULL of Tortie-tude!). She thrashes, twists, turns, screams, lashes out, howls, and will not stop moving until you let her go. It becomes quite traumatic for the both of us.

She is also very adamant about not being picked up at the moment. The only thing she wants is to sit on my lap. That's it. If I get up she follows me around and howls until I sit down. Sometimes she gets up on her own, but comes back within 30 seconds.

I'm not sure if she's nibbling on any of the 4 dry foods I have out, she may be. I do know she hasn't napped all day, and the last two nights she's been restless and vocal. She insists on sleeping under the covers with me, and she is moving around more than normal and of course meowing more.

She also refuses to let any of the other cats near her or, since she's always on my lap, me. I feel bad because i haven't been able to give them much attention, but I can't separate myself from Turtle. I tried putting her in the bedroom with her own food, but that didn't help and she just yowled at the door.

Did I mention she's only 4 and has never been really sick before?

I hope tomorrow goes fast so I can get her into the vet on Friday!

Crazy as this may sound, but what about placing old towels on your lap and have diluted food within reach? Let her get up there, pet her. Let her smell the syringe and very gently go from there? Or is she nauseous too?