Cat given Mirtazapine, now he's vomiting

Hello,

My cat stopped eating almost 2 days ago, with no other symptoms.  His energy levels were up, still going outside all day, cuddling, drinking water ... just not eating.  So we had the vet check him out and he gave Basil Mirtazapine to stimulate his appetite.  Within the hour he vomited, and an hour or two later vomited again.

Now his behavior has changed and he is not himself.  Seems so uncomfortable and obviously still not eating.

Has anyone else experienced vomited from Mirtazapine?  It seems weird that an anti-vomiting drug would make my cat vomit.

Thanks for your help,

Lisa

Hi Lisa

This isn't a good day to go to a vet since its jan 1, but he needs a vet and a proactive vet.  Just prescribing an appetite stimulant without addressing the underlying cause isn't sufficient IMO.  There is always a reason why a cat stops eating, and the reason needs to be found and quickly.  Loss of energy is likely due to lack of food, and possibly made worse by the cause of lack of appetite.  Your vet should have counseled you on how to hand feed using a feeding syringe.  After 2 days of not eating a cat is at risk for hepatic lipidosis, a very dangerous liver disease.  You cat needs nutrients, now, and a vet appointment with a vet who will pay more attention to what's going on.  I'm very surprised your vet didn't syringe feed on the spot.  You may want to consider a different vet.

How old is your cat?

Below is a good youtube video and two comprehensive articles on syringe feeding a cat, which I would suggest you do if you cannot get to a vet today.   The first article mentions special foods, you won't be able to get those today without a vet so just get a very smooth pate cat food and mix with a little water to make it soupy, or get chicken baby food, stage one only.  You don't have to have a blender.  And you can get 6cc syringes (without needles) at a drug store.  The video shows you drawing up the food through the tip of the syringe, but another way is to remove the plunger and send it it the back way which you might find easier.


http://virtuavet.wordpress.com/2010/03/15/how-to-syringe-feed-a-cat/

http://www.ehow.com/how_4516886_hand-feed-sick-injured-cat.html

Stephen

Hi lisa
How much does your cat weigh and what was the dose of mirtazapine the vet prescribed?

Mirtazapine is actually not a medication that is made to be used in cats. It is a human anti depressant medication. Actually a pretty hefty one at that. I took this medication for over two years. I fell upon a blog of it being used in animals as an appetite stimulant a while back and I can see the logic because it does increase appetite. I gained over 50 lbs while on it.

But it can be very dangerous if given in too high of a dose from what I read on this site and what many pet owners experienced from giving it to their cats. Also it seemed not many vets knew the proper dosing. So I'm curious how much you gave to your cat and exactly how much he or she weighs.

It could just be a coincidence that he is vomiting on the drug.  It could just be whatever is causing the lack of appetite is also causing the vomiting.  Did the vet do any testing or anything to determine the cause of the lack of appetite in your cat?

Hi everyone.

I'm feeling a little irritated by the lack of investigation from our vet.  He did the basics ... temp, palpating, etc ... and decided to dish out the drugs.  I'm not sure how much my cat weighs but he's 11 months and a smaller cat.  He was administered 1/4 tablet of 15 mg, and obviously this was way too much for him.

I tried syringing him water and he vomited that up a few minutes later.  And he only vomits when something is forced into his stomach, otherwise he's okay.  His energy is good and there is still no temp but he refuses to eat or drink.  He seems sad too.  I really do NOT want any more meds given to him and am just taking it hour by hour to assess him.  If things don't improve soon I will take him to another vet.

Right now he's laying on my lap watching the birds outside.  We slept all night (I like in Hong Kong so it's now morning) so that is good.

Thanks again and keep the suggestions/info coming if you have anything else to contribute!

Lisa

http://www.medschat.com/Discuss/dangers-of-mirtazapine-174426.htm

That is the one site that I read a lot of people's cats having some bad reaction to it. Some people's cats were fine. Just so you can compare what's going on with ur cat. Hope he is okay and it just comes out of his system.

Update!

It's now been about 24 hours since the Mirtazapine was given, and I'm finally starting to see real improvement.  I let him be all day and then a few hours ago I tried once again to syringe him about 2 mLs of water, and he was able to keep this down.  So then I gave him 3 mLs of homemade chicken broth and another 3 mLs about an hour later.  And then a miracle happened!  I laid some wet food out and he ate some.  I was so happy.  He's still not 100% but I see this as real improvement.

Oh and also, I gave him some cat grass earlier in the afternoon and he LOVED this.  It was the first thing he had eaten in a few days so I encouraged him to eat as much as possible.  I figured there would be at least a little bit of water and nutrients in the grass.  Maybe the grass and broth helped to stimulate his appetite.  Not sure, but I hope this all keeps improving more.

I think the old-fashioned way of healing is often the best: Nature.  

Thanks again for your help and if there's a turn for the worse I will let you know.  Otherwise, consider him healed!

So glad to hear he is improving.  I hope the trend continues for him

Yay! Great news!

Grass can make some cats throw up. Do not be alarmed if this happens. My cats always throw up when they eat grass.

Faythe- I'm so glad to hear mirtazapine helps with weight gain! My doctor has given me a script for it as I cannot gain weight and keep losing due to GI problems. 

My doctors are at the point where they don't know what to try next as we are running out of treatments and they keep putting me on experimental drugs. What dose were you on and did it cause side effects for you (other than the weight gain)? Did it help with digestion at all?  Any problems with elevated liver enzymes?

Lisa- I would ask for bloodwork on your cat to rule out kidney problems or any major health issues. Usually mirtazapine is saved for issues like kidney disease or severe health problems. 

As for the link to the dangers of mirtazapine, you have to keep in mind that it is a drug often used in animals that are already dieing, animals that have completely stopped eating and would otherwise be pts.

A lot of digestive issues are just minor upsets which pass quickly. I think the reason the vet did not want to do a complete workup is that it is expensive, and in a young cat it may not show anything at all. Did they do a fecal check?

Sarah- at the end of being of the mirtazapine I was taking 45 mgs but that is because I kept going off and going back on because I was battling between myself if the negative weight gain in my case was worth the positive outcome I had from the medication itself.

I was taking it as an anti-depressant, and after trying many many different medications, most of which did not work, some which helped a little, mirtazapine was the only one that actually had a noticeable difference in the way I felt. I actually had a clear mind for once.

Originally 30 mgs was a perfect dose for me. It did take me about a month to get used to it and adjust to a perfect sleep schedule to where I was not groggy in the morning. I was used to staying up untill about midnight one am, and when I did that I absolutely could not wake up in the morning I was in a coma until about 11am 12 noon. So I had to start going to bed almost right after I took the medication at about 830pm lol and then I could wake up fine at 7am and as soon as I showered I was fine. It does take some getting used to but once you do you are fine. Other than that I had no ill side effects.

Also I do have liver problems and my liver enzymes stayed completely under control while on mirtazapine which was another good thing about it.

Unfortunately for me in the end I could not live with gaining all that weight. I'm a small person to begin with so 40 lbs makes a huge difference when you are 5'1" tall.

Yes, we have had the vomiting experience with Mirtazapine.  My cat, Chica is 15, FIV + recently diagnosed with intestinal lymphoma.  She started getting picky with eating nearly 8 weeks ago.  After a few days of this, I took her to the vet.  Blood tests showed nothing, and even her white blood cells count was Ok-ish.  But she kept getting worse, so I took her for a scan and we discovered the cancer.  After researching options, I decided not to go with chemo.  I was hoping prednisolone and anti-cancer supplements would turn her around, and give us more time with her but her appetite just disappeared.  So we tried Mirtazapine.  Initially she showed some interest in food, but  Mirtazapinemade her drool and throw up.  I stopped giving it to her, then started again, giving it separately from other medicines, just in case there was a bad reaction.  She vomits immediately - within seconds of taking it.   I am giving it to her in a compound (liquid) form via syringe as she is so difficult to pill.  There is something about this medication that makes her gag.  The instructions say to shake vigorously before administration, which I do, but she always seems to labor over swallowing it.  My vet has prescribed it daily in amounts of 0.1 ml.  - really tiny.  Yet it causes her to puke.  Her other oral meds she takes without any issues (prednisolone and a bunch of fish oils, and other herbal treatments).  I am so desperate to get her to eat.  Some days she will nibble something; others she won't.  She does drink plenty.  I feel that she is failing fast and that no amount of supplements I give her are of much use since I can't get her to eat.  

I know I'm really late to the party, but my vet just prescribed this for my old lady Zombie. He did a complete blood Work, and her thyroid and kidneys and liver are fine. She drinks water but just wouldn't eat anything. So this morning I gave her the first pill (I don't know the exact dosage) and within thirty minutes she was eating like a champ. Even wanting seconds! She didn't finish her bowl so I let her have the rest.
Forty minutes later, she started meowing awfully, like she was very uncomfortable (think long low moans). I recognized this from one of my boys as the "I'm gonna be sick" sign, and got her to the laminate floor in time. Up came all the food, and about 30 minute later she got sick again. Now she's just laying about, but you can tell she doesn't feel good. I'm wondering if this is a side effect of the medication, or maybe from her stomach being over filled because she hasn't been eating, maybe her stomach shrank? I'm hesitant to give her the next pill, any suggestions?
She's 13 and weighs 11 pounds, and like I said her blood work was fine. She just has had no real appetite for a few weeks.

I have used Mirtazapine to increase appetite for several cats with differing illnesses.

In your case, I think the cat ate too much too fast...and it all came up. After not eating, the cat's stomach/capacity shrunk. You have to pace the cat's eating after you give this pill.

The first day, the cat is crazy, howls, wants to eat too much too fast. You have to give the cat ONLY little bits at a time...and wait between feedings. Don't go too fast.

On subsequent days, you can give a bit more, but still pace them.

That said, there may be more going on her internally in her gastrointestinal system.
Before I give another pill, I would see if she continues to vomit.

Repeat vomiting, combined with lack of appetite, may indicate a blockage, a mass, pancreatitis, IBD, cancer or any number of other ailments.

I would re-consult with your vet. Further diagnostic work may be needed.