Mirtazapine stopped working!

mfena0720

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Anyone find Mirtazapine just suddenly stops working?

We've been using the ear gel for a few weeks now (at a lower dose than the full 1.5 inch strip and not every single day but only when needed) and the past two doses have been unsuccessful for my cat Oliver. I actually gave him a higher dose today about 6 hours ago but he's basically eating the same amount as he was without it, which is about 40% less than what he should be eating.

If anyone has experienced this, I'm wondering what was done to combat this. Will a drug "holiday" help and for how long? Did you alternate with Ciproheptadine or some other stim? Or does the Mirt just never work again?

Also, I've tried some usual tricks: Hand feeding, no sodium people tuna, waking him up from a dead sleep with handfeeding, offering a treat before handfeeding, putting out a kitty buffet of 3 or 4 different canned foods, cheese, etc. and it's hit or miss. He''ll take a few bites, then leave. He has suspected GI issues. No official diagnosis yet.

TIA for the help :thanks:

Emm
 

jarn

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This may be too simplistic, but I've give medication the same way (gel in ear) to a cat before. It can build up, so to speak. Have you been cleaning the ears? Perhaps the mirtazapine not working as well is because it's not getting absorbed the same way?
 

neely

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Just a quick question, are you alternating ears when applying the Mirtazapine? And, one more question, how long did your vet prescribe using the medication for? I would recommend calling your vet to give them an update and ask their advice since you mentioned they suspect GI issues.

In the meantime, I thought this Article might give you some helpful tips about how to get your cat to start eating again:
How To Get Your Cat To Start Eating Again
Best of luck, please keep us posted on your progress. :alright:
 

babiesmom5

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I have two cats on this Mirtazapine ear gel for IBD, CKD. It is best administered on a daily basis so as to deliver a consistent therapeutic dosage. You alternate the ears, one day left ear, next day right etc, but once a week, I take a warm wet washcloth and gently clean out the ears. This gel leaves a film which can build up and decrease effectiveness of absorption.

The other issue may be that whatever suspected GI issues your cat has may be worsening, thus decreasing or negating the effectiveness of the Mirtazapine gel. I would definitely consult your vet about getting a confirmed diagnoses.
 

WeHave4

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Our cat Alice was never diagnosed with anything specifically, although her pancreas levels were on the high side. She has been taking prednisolone (2.5 mg.) every day, with mirtazapine used as needed. The original doseage was for 1/4 tablet every 48 hours for 3 days. That was too high, plus what we needed it for was long term, just to boost her appetite. I dropped the doseage down to 1/8 tablet, but of course then you wind up with pieces of a size you can only guess. So, I erred on the smaller size. But, what to do with the crumbs? How about taking a piece of cheese (soft), and incorporating them, making a ball. Too sticky. So white bread then. Bingo. Once dry, they could go in the pill popper same as any pill. I kept using smaller and smaller pieces because I was looking for an effect where the increase in appetite was just good enough. Then I started pulverizing 1/4 pill to powder, and dividing it up into 25, and eventually even 50, using a magnifier. These micro doses worked fine for several years. But then a few months ago, she seemed to need more to get the same effect. I started upping the doseage. They were no longer working the way they did. Recently, I even gave her 1/4 tablet, with not much response. I also started giving her mirataz, and at first I would just give her about 1/4", but I had to increase that as well, although I just read on here that a film can build up decreasing the effectiveness, so her ears might need to be cleaned. She saw the vet this morning, and they are doing blood work. Meanwhile he wants me to stop giving her the mirataz or mirtazapine altogether, saying if she doesn't eat for a day or so, no big deal. She actually is overweight - 16 pounds. But, that is a separate issue. Yes, I would like to get her weight down, but not like that.
 
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