# Mirtazapine



## Vickie1 (Dec 30, 2011)

Morning.

Biggles isn't taking to his steroids very well at all. Today was his 3rd dose and he hated it. I have discussed mirtazapine with the vet and he says give it a go.

It is often used to stimulate appetite and suppress nausea. Biggles has cancer and is dying. But if we can improve his quality of life we're prepared to give it a go. We don't thoink he's in any distress at present. He still sleeps with us. Still goes outside, has the odd drop of milk and sits on the sofa with us.

We're just hoping we can perk his appetite up a bit. Does anyone have any experience of this drug.


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## ella (Jan 1, 2009)

Hi

Yes, I have experience of mirtazipine with my lad, Henry, who was poorly for six months, turned out he had cancer, and he sadly passed away after his long battle...

The mirtazipine worked very well to stimulate appetite BUT it did make Henry very edgy/anxious and sort of spaced out. From memory I gave it every few days and on that day I made sure I was at home (I could work from home) as I was always worried that he might have an accident during the stupor (can't think of any other word for it). The first time was very distressing to watch, but once I realised it was the drug (and it DID make Henry eat more) it was easier to handle.

It really did work, but I think it's worth warning you of the stupor - my vet had warned me, but I didnt really understand what it would do.

Although Henry was very poorly, I wouldnt have changed the last months and weeks for anything, let me know if you need any info

e


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## Vickie1 (Dec 30, 2011)

Thankyou very much. How long did this stupor persist for and when did his appetite come back (how soon after starting the medication?).

Biggles only weighs 4kg now and he used to weigh 7kg..he's a big cat. I'm amazed he's still as lively as he is...he's hardly eaten a thing for 3 weeks


We know he hasn't got long but if he can just eat something it might but him a couple of extra weeks of decent quality life.


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## ella (Jan 1, 2009)

The desire for food was within an hour from memory (it was last year) and the stupor for about 12 hours or so, but the appetite was kind of restored for a couple of days. I syringe fed for a few weeks, and the mirtazipne helped to return Henry's desire to eat.

Has the vet suggested Hills A/D food (highly palatable and very calorific)? Henry survived on this, despite only wanting biscuits for years. It smells quite strong and meaty, and is a sort of pate, and Henry really loved it. You can add water so they can just lap it up.

I tried lots of different foods! Tuna, tinned sardines in tomato sauce both were hits, but the A/D food was the winner.

If Biggles likes cat milk, Whiskas cat milk is also easy for them to drink..... Also, keep food bowls upstairs and downstairs, he might just eat a bit when passing....

I'll keep thinking of other things I tried.

Thinking of you and Biggles


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## Vickie1 (Dec 30, 2011)

Not tried Hills A/D. Though will mention it when we get his prescription this afternoon. It's difficult leaving bowls around the house as we have two other cats who will take full advantage of that scenario!

One thing he does like is ice-cream..he had two bowls last night.

I just feel sooo sorry for him. Part of me just wants this to be over with but part of me also wants to spend time with him before he goes.

It's a balancing act of quality v quantity. Last thing i want is for him to suffer. As soon as any nasty symptoms start we'll have him put to sleep.

Vet says he'll give a sedative before Euthanasia injection which i'm glad about.

Thanks Ella


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## buffie (May 31, 2010)

Meeko my Raggie was on Mirtazapine for a short time and as ella has said it worked very well with stimulating appetite.
It did make him very vocal and a bit hyper for a few hours after taking it but the difference it made was worth it.He had a quarter tablet every 3 days for a couple of weeks which for him was enough to kick start his appetite again,but he wasnt as ill as your boy.
If your vet is suggesting it ,give it a try as for the steroids I'm not surprised he doesnt like it,they must taste awful my boy hated them and would foam at the mouth and be really miserable with them.No matter how I tried they always seemed to stick in his mouth.
Hope the meds help and that Biggles has a bit longer with his family.


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## ella (Jan 1, 2009)

Vickie1 said:


> I just feel sooo sorry for him. Part of me just wants this to be over with but part of me also wants to spend time with him before he goes.
> 
> It's a balancing act of quality v quantity. Last thing i want is for him to suffer. As soon as any nasty symptoms start we'll have him put to sleep.
> 
> Vet says he'll give a sedative before Euthanasia injection which i'm glad about.


I understand completely how you feel. Henry's passing was very peaceful. The vet staff were brilliant, and made it much easier than I was expecting. In fact the vet shed a tear with me, and was so sad. Henry had been his special 'project' for months....

I know it sounds early, but it's worth thinking about whether you want ashes etc whilst you still can think clearly, (I have Henry's in a special box with his blanket and a toy, and a lock of his fur) It meant that at the time, the vets already knew what to do, without me having to verbalise it.....


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## jill3 (Feb 18, 2009)

Hi Vicki.
This time last year I was trying to give food to my elderly girl who was very ill.
The vet gave us Royal canin recovery food in a small Tin.
If Biggles likes fishy food then he will like this.
It is very soft food.
My cay Yazmin loved this food and it really did help her.
It was only when she refused to eat it and hid away I then knew it was her time to leave us.


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## denflo (Apr 29, 2011)

Dennis was on Mirtazapine most of the time he was poorly, it worked a treat and he had no unwanted side effects from it at all. He was prescribed a quarter of a tablet every three days. The steroids do taste awful which is obviously why Biggles is really not keen on taking them, do make sure that you follow the tablet with something nice, a piece of chicken or a treat to make it a little easier. Are you able to get the tablet into his mouth to swallow or do you have to mix it with food? During the last few days of Den's illness, it got very difficult to give the steroids I think he struggled to swallow them and therefore got the taste in his mouth - he was always perfect to give tablets to before this. Which steroids are you giving? There are two commonly used ones, prednisolone and prednisone, the former being the best one as the body is able to make use of the entire drug, unlike prednisone. 
As I have said on your other post, whilst he is still interacting with you and showing a willingness to carry on with life, enjoy it and take each day as it comes, there will be good and bad days, but whilst he is still able to pick up, then just go with it, it stops so very quickly and at that point you will know.


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## Paddypaws (May 4, 2010)

I have not used Mirtazapine, but have used Cyproheptadine/Periactin with good results and no obvious side effects. It is not all that common in UK but used a lot in US,and you can find info on Tanya's CRF site.
I would also try syringe feeding if he will tolerate it, I used the Mikki kitten feeding syringes, wider one with the tip cut back a bit, and regular Gourmet Gold pate from supermarket which I found easier to handle than the A/D, you kind of force it into the syringe with a teaspoon.
If he likes ice cream why not try some full fat cottage cheese, it is very palatable and offers good protein, also less likely to give him a squitty bum.
I would also plan the end now as someone above advised. I had the vet come to me, then take the body away overnight and then I went up to the Crem myself, could not bear the thought of using a delivery service.
Give him a big hug from me.


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## Vickie1 (Dec 30, 2011)

we've tried the mirtazapine and it hasn't done anything really. Biggles continues to just pick at food but at least he's drinking. He doesn't appear any weaker just yet and we take him back to the vets tomorrow. It's heartbreaking to see him like this..i feel so sad about it all.


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## jill3 (Feb 18, 2009)

I hope tomorrow the vet will be able to give him something. You could ask about the royal canin recovery food in a small tin.
It did help my elderly cat.

Will be thinking of you and Biggles.x


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## ella (Jan 1, 2009)

Maybe the vet will alter the dose. Mine started high and then we reduced it a bit.

As Jill says, the recovery food/ Hills a/d may help a lot......

Thinking of you both


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## Vickie1 (Dec 30, 2011)

We've been to the vets. Decided to put Biggles to sleep tomorrow evening. He's actually lost no more weight than last week but how i've no idea!

He's hardly eating a thing and just looks thouroughly miserable. His eyes are still bright and he still sits with us but his quality of life must now be poor. Vet thinks it's the right thing to do and even if we clung on a few more days she thinks it should happen before the weekend if we are to avoid suffering.

This will be my first pet bereavement and i'm dreading it. I've had him since being a kitten and he's grown up with me and being a part of all our lives and he's such a loveable, sociable, friendly cat.....i'm going to miss him too much.

The vet say's they'll sedate him first and then give the injection while i hold him...so. so sad.


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## jill3 (Feb 18, 2009)

Vickie I am so sorry.
Having a pet put to sleep is one of the hardest things to go through.
With the help of your family, friends and us friendly lot on here we will be here for you.
You now know it's time for him to go to Rainbow Bridge. 
You have looked after him with so much love and care and now you are doing the right thing.
He will go to sleep peacefully and it is very quick.
Give yourself plenty of time to grieve and take care of yourself.

I am a believer that one day we will meet up with our lost ones again.


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## Lulu80 (Nov 30, 2012)

You have my deepest sympathies, and I'm sending you lots of love. Xx

Nothing I can say will make it any easier or make you feel any better. But you we doing the right thing by your cat, although it might not seem that way.
I have made the same decision a few years ago now, and although it was the hardest thing I have ever done, it was the best thing for my boy.
I miss him everyday, but all the pain was worth it..for all the happy memories I have.

Lots of love xxx


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## buffie (May 31, 2010)

So terribly sorry to read this.It is such a difficult decision to have to make but rest assured it is the right decision.
Biggles will thank you for letting him go and will be waiting for you at rainbow bridge.xx


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## Vickie1 (Dec 30, 2011)

Thankyou for all your support. We've just taken him up to our bed for his last night with us and hopefully he'll sleep well. Me and my other half have just hugged and cried our eyes out. He's gone downhill so rapidly over the last 24hrs. The vet said this is what happens..there little bodies can cope so well then they just give up and can no longer fight what is going on inside..that time has now come for biggles. he'll be at the rainbow bridge soon..happy, well and in the sun waiting for us to join him.....God bless his little soul.


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## Jesthar (May 16, 2011)

*hugs*

We lost our family dog to cancer - oh, so many years ago now... and even now I still know exactly how far to lean down to tickle behind his ears if he were sitting next to me. The pain heals with time, but memories live on forever 

The decision is so hard, but you do know when it is the right time. Tears are most definitely allowed, and indeed recommended, same as for any loved family member. It will be hard, and some won't understand - but there are plenty who will, including everyone here.

*hugs* again,

~Jes


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## ella (Jan 1, 2009)

I'm so sorry to hear this

I'll be thinking of you


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## denflo (Apr 29, 2011)

I too, am so sorry to hear this, cancer is such an awful disease, some are lucky and respond to treatment, but all too often this is not the case or treatment is just not an option. At times like this, we are fortunate if we have a good vet who we trust and it sounds like you have. It is the worst decision in the world to have to make when you love your animals this much, but sadly it is one that a lot of us have to make. What you are doing is a final act of love and one which he is lucky that you are able to make to stop his suffering. 
Feel free to grieve as you need, it all takes time, but you should take comfort in the fact that you did the best thing for him. Take care of yourselves, everyone on here understands what you are going through and we are all here for you x


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## Vickie1 (Dec 30, 2011)

We go to the vets in 45 minutes. Biggles has actually perked up a bit today. He's been outside and had a mooch around in the street. He's had a small bottle of cat milk and a few mouthfuls of tuna. He still sleeps a lot. My other half upped his steroid dose this morning to 7.5mg and that seemed to perk him up. He does seem settled when he sleeps and doesn't appear in pain. Yesterday he just looked worn out and i'm wondering if the mirtazapine had something to do with that. maybe.

I feel we are just delaying the inevitable and we are just looking for excuses to not have him put to sleep.....this hurts more than anything i've ever known.

Deep down we know what needs to be done and i think an hour from now it will be done


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## Lulu80 (Nov 30, 2012)

My thoughts are with you.im sure that together with advice from your vet you will make the right decision.

I know how awful you feel..and send lots of hugs xx


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## Vickie1 (Dec 30, 2011)

Biggles is now frolicking at the rainbow bridge.

He went to sleep quite easily. A sedative injection then the final injection and off he went.

I cried like a baby. The vet was fantastic and said now was the right time and that even messing with his tablets again would probably buy him a few days at most and that's if it even worked.

I feel sort of relieved now..no more worrying. But a deep sense of loss and no more mr biggles to greet me when i get home from work and no more biggles to snuggle up to in bed.

In time i know lots of happy memories will take over and that he's still alive at the rainbow bridge.

Thankyou all for you wonderful support through what has been a terrible time for me and my parner..i love you all from the bottom of my heart xxxxx


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## buffie (May 31, 2010)

Thinking of you both as I know exactly how you must be feeling ,knowing it was the right thing to do doesnt make the pain any less.
Run free in the sunshine Biggles .


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## Lulu80 (Nov 30, 2012)

I'm so sorry for your loss xx
You have my deepest sympathies, I'm sure biggles in safe and happy at rainbow bridge, waiting for when you meet again.

Hugs xx


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## Biawhiska (Mar 28, 2008)

I'm really sorry, I know how much it hurts. But he is in a better place now and free from pain xx


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## jenny armour (Feb 28, 2010)

this was prescribed to my raggie sonni when he had a cold last year, and of course he lost his appetite. it gave him his appetite but because he has trouble with his fits and balance, it completely knocked him off his feet and he developed a head shake, so i took him off of it. i was to give him 1/4 of a tablet every four days


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## ella (Jan 1, 2009)

So many of us understand how you are feeling now. I hope you'll stay around on the forum, and there's always lots of support when you next post

Take care


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