More Mirataz questions

FeebysOwner

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Feeby has been on Mirataz - 1/2 dose every third day - since 11/9. Until recently, this dosage schedule has seemed to make a difference to the point she has maintained her weight - without side effects. But her eating is decreasing again and is not always picking up with a new application. It is even affecting her bedtime 'night cap' of some baby food meat but she will mostly still eat it when my husband gives her some as an early-AM snack. I am now wondering what I need to do differently.

I have heard that its efficacy wears off over time, but is that possible in just two months? I could change her dose to every other day, but I am not seeing that the current regimen is reaping results even in the first 24 hours after application. So, would moving it to every other day even make a difference?

I am cleaning her ears, so I don't think there is a residue build up affecting the next application.

She is H-T and early CKD. Most recent tests (12/7) show insignificant changes in her numbers since her previous tests which were done last July. She is not vomiting; her litter box use is still the same as it has been for months. Her routine has otherwise stayed the same. But she is sleeping more, with her preference being inside a paper bag for most of her daytime naps.

What has been your experience with Mirataz - how frequent were increases needed, when did it stop being effective, and so on? Thanks for any input.
 

mrsgreenjeens

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We were using it irregularly, just whenever we noticed Tinky's eating really slowed down, and even using it that way we noticed it stopped being effective pretty quickly. I'd say within a month or so, and we didn't use it even every three day after the initial 14 day (everyday) treatment.

There are other appetite stimulants you can try, other than Mirataz and Mirtazipine. Maybe you could switch between a few of them? Or maybe she's just getting really picky. I know that's Tinky's issue, because even after an ultrasound, he's in perfect health. I almost wish we could find something wrong with him so we could fix it :sigh:. For almost thirteen years now it's been a chore getting him to eat. I still can't figure out how he maintains his weight.
 

silent meowlook

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When was the thyroid levels last checked? How are you giving the thyroid medication? Sounds like the Mirtazipine is trans dermal. Do you alternate ears? It sounds like another trip to the Veterinarian is in order. It could be the progression of the kidney disease or something else. The thyroid could also be to suppressed.
 
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FeebysOwner

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When was the thyroid levels last checked? How are you giving the thyroid medication? Sounds like the Mirtazipine is trans dermal. Do you alternate ears? It sounds like another trip to the Veterinarian is in order. It could be the progression of the kidney disease or something else. The thyroid could also be to suppressed.
Feeby's last blood work was 1/5/2022 - thyroid at 3.4 (range .08 - 4.0), which the vet said was not enough of a jump to increase her Felimazole yet. She receives 1.875mg AM/1.25mg PM.

Her Creatinine was 2.9 (range 0.6 - 2.4) - just a point jump from blood work done last July (2.8), so vet and the CKD forum think that is stable for now. Her phosphorus is 6.2 (range 2.4 - 8.2), a little higher than I would prefer. The vet doesn't want to treat it yet either, and the CKD forum said it wasn't bad but, it 'wouldn't hurt' to consider a phos binder. I hate to do that without getting the vet to agree so we can monitor it appropriately.

I alternate ears and clean each before the next application. Mirataz is the transdermal form of Mirtazapine, so yes, it is applied to the pinnae of the ear.
 

silent meowlook

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Ok. Good that you are keeping up with her lab work. Could she be getting nauseous? If she is, the mirtazipine won’t work. Maybe ask your Vet about Cerenia?
 
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FeebysOwner

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Could she be getting nauseous? If she is, the mirtazipine won’t work. Maybe ask your Vet about Cerenia?
One of the next questions for the vet. When she first recommended Mirataz, I asked about it being nausea that was causing the lack of appetite. She wanted to try Mirataz first. So, she might be amenable to adding an anti-nausea med/or using one in place of Mirataz. Or perhaps another appetite stimulant - which I need to research so I know what else is available. I realize not all cats who are nauseous vomit, but that is one thing (knock on wood) that Feeby does NOT do - throw up.
 
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