Mirtazapine or Cerenia

Dalice

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Which works best as an appetite stimulator? Mainly for the nausea associated with CKD.
I don't like the side effects of Mirtazapine. Vocalization, restlessness. I've decreased his dosage of Mirtazapine to 1.88 mg.
Any thoughts?
Thank you!
 

mrsgreenjeens

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When I still had kidney cats, we used Mirataz, which is the topical gel of Mirtazapine. We had absolutely no side effects using it that way. We also used famotidine (which is pepcid a/c) as an injectible to help with those early morning spit-ups.

And it also helped a lot to feed lots of small meals throughout the day AND night. I served probably 8 or 9 meals in a 24 hour period. They might have only been about one tablespoon of wet food mixed with water, but it kept something in her tummy so she didn't get too much acid build-up and then spit-up.
 
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Dalice

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This is very helpful.
I do feed him very small meals throughout the day.
He has had trouble lately with spit ups, always after waking from a deep nap. I will ask my vet about famotidine. He goes in Tue. for his wellness check up and bloodwork.
Thank you.
 

mrsgreenjeens

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If you are good at pilling, famotidine really is the same thing as pepcid a/c. We used it as an injectible because our girl was impossible to pill (even that 1/4 of the pepcid a/c pill :lol: ), and it is bitter so could not be added to food. Of course, you want to discuss with your Vet, but just letting you know in case you want to use one over the other.
 

FeebysOwner

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The 1.88mg dose of Mirtazapine might even be too high, especially if you are giving it daily. Vocalization is likely to increase as the dosage increases. Some of the folks using it only give their cats a dose every 2-3 days. If you are giving this to your cat daily, back it off to every 2-3 days and see what happens. Vocalization can also occur if a cat is hungry but nauseous at the same time.

I, too, use Mirataz to apply to my CKD cat's ear. She never gets more than 1/2 dose (1 ml) every other day despite the 'regular' dose being 2 ml every day. There is also a product called Elura that you might consider researching as an alternative to either form of mirtazapine.

Cerenia is commonly thought of more for vomiting, whereas ondansetron is used more for nausea. A lot of vets prescribe a 2 mg dose, but many of the users on the CKD forum web site seem to think 4 mg is more appropriate, and my vet agreed. This is the amount I give my cat twice a day. It might be an alternative to famotidine, or perhaps ask your vet if it can be used in conjunction with it.

If your cat is spitting up after waking up from a long nap, is that usually when he goes the longest without eating? My cat was prone to throwing up a bit first thing in the morning until I started giving her food so that she didn't go too many hours without eating something.

Just additional things you can discuss with your vet if you are interested.
 
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