Peer-reviewed veterinary case report
Transdermal mirtazapine to boost appetite in cats with kidney disease
By Quimby, Jessica M et al.·Published in Journal of Feline Medicine and Surgery·2019·Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA, United States·View original on Crossref →
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Original publication title: Assessment of compounded transdermal mirtazapine as an appetite stimulant in cats with chronic kidney disease
- Species:
- cat
Plain-English summary
A group of cats with chronic kidney disease (CKD) and poor appetite were given a special gel containing mirtazapine to see if it would help them eat more. The study found that both doses of the gel significantly increased the cats' appetite and led to weight gain. Most cats showed improvement in their eating habits, with some gaining up to half a kilogram. While some cats did meow more than usual, the treatment was generally well-tolerated and could be helpful for cats that need an appetite boost, especially where other medications aren't available.
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Abstract
Objectives The aim of this study was to assess the appetite stimulation properties of compounded transdermal mirtazapine (CTM) in cats with chronic kidney disease (CKD). Methods Two sequential double-blind placebo-controlled crossover prospective studies were performed in client-owned cats with stable stage 2 or 3 CKD and a history of decreased appetite. In the first study nine CKD cats were randomized to receive 3.75 mg/0.1 ml CTM gel or placebo on the inner pinna every other day for 3 weeks, then, after a 4 day washout period, the cats were crossed over to the alternate 3 week treatment. In a second study, 10 CKD cats were randomized to receive 1.88 mg/0.1 ml CTM or placebo on the same schedule. Physical examination and serum biochemistry were performed before and after each treatment period, and owners kept daily logs of appetite, activity and eating behaviors. Mirtazapine concentrations in CTM gels and steady-state mirtazapine serum concentrations were measured using liquid chromatography/tandem mass spectrometry. Results Administration of both 3.75 mg and 1.88 mg CTM resulted in a statistically significant increase in weight ( P = 0.002 for both), increase in appetite ( P = 0.01 and P = 0.005, respectively), and increase in rate of food consumption ( P = 0.03 and P = 0.008, respectively). No significant difference in activity or vocalization was seen at either dose; however, individual cats experienced excessive meowing. Median weight increase for the 3.75 mg arm was 0.22 kg (range 0.04–0.44 kg), while median weight increase for the 1.88 mg arm was 0.26 kg (range –0.25 to 0.5 kg). Improvement in body condition score was seen in 5/9 cats in the 3.75 mg arm (P = 0.04) and 6/10 cats in the 1.88 mg arm (P = 0.004). Conclusions and relevance CTM increased appetite and resulted in weight gain in CKD cats despite significant inconsistencies in compounding, and may benefit cats in countries where an approved product is not available.
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Search related cases →Original publication on Crossref: https://doi.org/10.1177/1098612x19851303