appetite stimulant stronger than mirataz?

[louisstools]

Looking for a stronger alternative to mirataz for an appetite stimulant. Mirataz in comparison is more like a light suggestion to eat and I want something that just dominates my cat's will and can force them to eat regardless of what they want. Does such a thing exist? Or is mirataz the best?

Obviously I will ask my vet but I find with medical providers you get better results if you can go in with the right "code words" to use to get them thinking properly.

 

[FeebysOwner]

Some cats do better with the oral version - mirtazapine - than with the transdermal mirataz. A lot of folks, vets included, think that the transdermal form of most meds are less effective/potent. However, having said that a lot of cats who are on mirataz/mirtazapine, also need an anti-nausea med. The anti-emetic effect in mirataz is sometimes not enough.

There is nothing worse than making a nauseated cat hungry. And IMO the nausea will win out every time.

 

[louisstools]

As you probably expect with me making this post, my cat is fighting even stronger than ever to avoid eating. I'll have to make a vet visit this week to see what we can do - more meds, tube, etc. I just need something to override her brain and force her to eat. I'll bring these ideas up and hopefully we can figure something out.

 

[FeebysOwner]

You could also ask about CBD oil, I suppose.

 

[fionasmom]

Several years ago I was given cyproheptadine for a cat and I recall that it worked. I don't know if it has fallen out of favor, but I agree that using mirtazapine versus Mirataz might work. There is another one called Elura which is for CKD cats, but I found it underwhelming.

 

[louisstools]

Both great suggestions - thanks!!!!

 

[stephanietx]

What issue is your kitty having that is making it not want to eat?

 

[louisstools]

What issue is your kitty having that is making it not want to eat?

After two years, thousands of dollars, every test under the sun, and working with a behaviorist for over a year, I have no idea. She just doesn’t want to eat.

 

[ForeverGraciesMom]

Following. Elura works for us, but so did the transdermal mirataz. I only switched her to Elura because the mirataz has been on backorder. Elura works quickly and makes my girl seem ravenous for a very short period of time.m, but always such a relief to see her eat something. Prednisilone has helped too, but the steroids have other long term side effects that can be more serious than they are worth.

 

[louisstools]

ForeverGraciesMom Yeah, we tried a small steroid shot back in early December to see if it would help with her appetite. It didn't help with her eating but there was a 2 weeks or so where she might have jumped easier off the couch. Never went back for another one given there was no observable change in the eating.

 

[FeebysOwner]

When you go back to the vet to ask about cyproheptadine, Elura, and CBD oil, please don't forget to ask about an anti-nausea med too.

 

[louisstools]

FeebysOwner All good ideas. If I'm not mixing people up, I believe your cat also has a poor appetite. If that's the case, does your cat at least show interest in food like eating is something she wants to do? I ask because my cat has no excitement around meal times and really doesn't give a crap about food. Even opening a new bag is like not enough for her to get off the couch and investigate. Even during meals, it might take 15-20 minutes of coaxing at the bowl before she does the first bite and even then she'll do long pauses between bites like she's "psyching herself up".

 

[FeebysOwner]

If I'm not mixing people up, I believe your cat also has a poor appetite. If that's the case, does your cat at least show interest in food like eating is something she wants to do?

She's inconsistent. Most of the time, someone needs to put the dish in front of her face to see if she is or is not interested in eating. She might want to eat one moment, and not the next, or reject her food only later to appear interested. She never really seeks out food on her own, but will go to her water dish without prompting. If she is on the bed, and we leave a dish of food on the bed, sometimes she will go to it and eat a bite or two, other times not. If she does eat, it is never more than a few bites at once.

But Feeby is nearly twice Missy's age and has numerous health issues, so I am sure both things play a role.

I went back and looked at a couple of your threads from about a year ago - was that the last time she had blood work and a full exam done? I am just wondering if it should be repeated to see if there have been any changes to some of her numbers. Was a recheck on her teeth/gums/mouth ever done?

 

[GranolaLouise]

Some cats do better with the oral version - mirtazapine - than with the transdermal mirataz. A lot of folks, vets included, think that the transdermal form of most meds are less effective/potent. However, having said that a lot of cats who are on mirataz/mirtazapine, also need an anti-nausea med. The anti-emetic effect in mirataz is sometimes not enough.

There is nothing worse than making a nauseated cat hungry. And IMO the nausea will win out every time.

My cat would be so nauseated, and yet DRIVEN to eat. She would just throw up right over the food bowl. (she also had ckd)It was heartbreaking to see her so driven to eat in her pain . Her hunger was never satisfied and she was on a half dose of the transdermal.

 

[louisstools]

I went back and looked at a couple of your threads from about a year ago - was that the last time she had blood work and a full exam done? I am just wondering if it should be repeated to see if there have been any changes to some of her numbers. Was a recheck on her teeth/gums/mouth ever done?

Last September and her bloodwork was immaculate. It was actually better than it was the year before. she doesn’t have any teeth left other than her fangs and the little bitty teeth in between. they do a thorough check, as best as they can, whenever we go in for an appointment, and in September and December. Everything looked fine. she is, unfortunately, a very healthy cat. but your description it’s pretty spot on with how Missy eats. It’s just random.

 

[FeebysOwner]

I know for Feeby, that the foods I feed her have different effects that can correlate to her lack of interest, to a degree. Some she likes better than others, and will respond accordingly. But, I also cannot feed her the ones she likes best over and over again, or they will lose favor with her. That is why, as I said before, she gets a rotation that extends from/to every 7-10 days in order to help prevent this. Can you give a run down of what all you have tried to feed her and if any of them made a difference on when she does or does not eat?

I am kind of getting the sense that you should ask for copies of her blood work results - at least for the last two times. It's not that I don't believe your vet, but this is not adding up and something is being missed. I know that sometimes things are overlooked by vets because they typically don't tend to look for trends and if the numbers are reasonable, they let it go. I'd be happy to look at them - just in case a second pair of eyes would be helpful. I'd also want to see the report results from the ultrasound too. I am a strong advocate of cat parents becoming familiar with tests and their results, and I have done so diligently with Feeby for many years now. It is not that I don't trust her/my vet, but it gives me some peace of mind to see the results myself.

If nothing were to seem 'off' in those results, then I think you've reached a point of needing to consult with an internal med vet for additional ideas. They too could look at the results just as a second opinion. A cat just doesn't want to eat for no reason - there is always a reason, and this has gone on long enough.

If I recall correctly, this all started when you had to deal with Mugg's death and the changes that appeared in Missy at that time. But, I think you have moved on from that, so I am not sure how you feel now is impacting Missy, but it could be. Just something else to consider.

 

[louisstools]

She had been on the same Purina RX food for a decade and around the death of Muggs we tried getting her on wet food because we ran out of the RX food and there was an issue finding the RX for the food and the vet wouldn't just give her the food she had always eaten because the RX was not in the computer because it pre-dated the electronic systems. (I never needed the RX b/c I always went to pick the food up in person monthly and the receptionist was German and I was the only customer who spoke German to her so she remembered me and never looked it up...and she eventually retired.)

Gosh, we tried just about every flavor, texture, and brand. I only found one that she consistently ate and that brand (Blue Tastefuls) had a lot of quality control issues and possible re-formulations to where she wouldn't eat it. So we went back to the kibble which she ate the best out of everything and that's what she gets exclusively. No treats or human food, just that kibble.

I understand why you're asking about bloodwork and the ultrasound, but the vet and behaviorist think is the cat is doing this out of behavior. We've evolved into having an weird dynamic between us for feeding and that's why she is behaving the way she does. I was hoping to find a stronger stimulant drug so we could work on the behavior without her eating dropping off a cliff and go to the vet armed with information. I tried stepping back this week to help correct the behavior and her eating, as expected, dropped off a cliff.

 

[FeebysOwner]

Thank you, I do remember about the RX food and the ordeal with not having a record of it. So, to simplify, has this vet been willing to give you a script for this food that she ate and liked for all those years, just to see what she might do? And, if not, why not? She was apparently doing just fine on it given she is in good health now. No, it may not be the answer, but it would sure be worth an attempt. It probably won't change things overnight, but it might help.

Maybe it is strictly behavior, but if it is no appetite stimulant in the world would resolve it anyway. Between reading your previous posts and what you just said now, I think I remember summarizing the situation in my head early on that she became needy when Mugg's died, and you were having trouble dealing with her new neediness and Mugg's death, and you didn't want to be put in the situation of having to baby her to get her to eat. I remember thinking that you may have kind of resented her at that time for putting you in that position.

I know you would go to the ends of the earth for her, but do you think that you harbor feelings that just keep feeding into these insecurities she has developed? A cat's behavior is always in direct response to their environment. You can't change behavior without changing what is driving it. If this is all behavior, it really isn't about the food at all. It is as you said, the dynamics - which are something you have to change. I know it would be wonderful for you to get her to eat again on her own, but I think that is only going to happen when you figure out how to fix the dynamics first, and that will eventually lead to her earing more normally again. Not the other way around.

I mean no offense, and I hope you don't take it that way. I am sorry that I didn't recall all of this before now. I just read so many posts/threads, that sometimes I forget things until something provokes my recall.

 

[louisstools]

FeebysOwner there’s a lot of ins and outs in this story so I’ll just fill in the timeline for you a bit. I actually got the prescription food thing sorted out four months after the other cat passed so this would actually be about two years ago this month. So she’s been eating this food for two years. And when I brought that food home the first time two years ago and offered it to her, she liked it more than any of the wet food and she would often literally walk over the bowl of wet food to get to the kibble. But she still never ate much.

And I take no offense because it’s a complicated story and also you help a lot of people out, so no worries there friend.

I think your spot on with your other points about to behavior. it’s like this vicious cycle where she doesn’t want to eat and that triggers me which triggers her response even more which then triggers my stress more.

i’m trying to step back and just take myself out of the equation, but she never picks up. I’m starting to wonder if maybe living with me isn’t the best situation for her.

 

[FeebysOwner]

Again thanks for filling in some of my blanks! I am not sure what you mean by stepping back. If it means that someone else is taking care of her food provisions, that might not be the answer, because the answer to her could be YOU. It is the back and forth triggering that needs to stop, not the part about you caring for her. And, the only one that can stop that is you. I know, much, much, much easier said than done.

Living with someone else at her age is a really sad idea, and I hope you can find other ways to deal with the triggers than that one.

I am glad you didn't take offense. It took a lot for me to say what I did and hope it didn't stop you from wanting to converse.