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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 26928
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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My 14yr old has lymphoma of the liver. He has suddenly lost

Customer Question

My 14yr old has lymphoma of the liver. He has suddenly lost his appetite past couple of weeks. Has been losing weight but, drinking lost of water. He is on chlorambucil and prednisolone and has been doing well until recently. His oncologist has done blood work on him his kidneys are normal his liver functions are with in normal range.We did a xray and ultrasound of his lungs and stomach that was fine. The only thing was a small tumor on the hip. We did a biopsy it did come back with sarcoma and he feels this might be the cause for his lose of appetite. He's schedule for a CT scan for surgery. He prescribed him mirtazapine every three days. We gave him his first dose on Thursday it hasn't seem to improve his appetite if fact it seems he has lost it completely. How long does it take for the mirtazapine to work?
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

We have more information with mirtazapine in cats than dogs. It appears to well tolerated in dogs and in one study we saw that the mean half-life was 6 hours; in other words, half of the given dose was eliminated by 6 hours after ingestion. In humans, this drug is rapidly and completely absorbed. We can interpolate, then, and assume that it should have been effective within the initial 12 hours of dosing. If you haven't seen that effect by now, it's unlikely that mirtazapine is going to be of value for Sebastian.

Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
Hi Dr. Michael,Thanks for your response. Is there any other options to help Sebastian's appetite?
Expert:  Dr. Michael Salkin replied 1 year ago.
cyproheptadine (Periactin) is a serotonin antagonist antihistamine used mainly as an appetite stimulant in cats as well. I would also feed Sebastian anything and everything he might be interested in - in other words, spoil him rotten. See if microwaving the food makes it more attractive to him. Consider strained meat baby foods and the very high fat prescription convalescent food Hill's Prescription Diet a/d. If you're not doing so already, administering an over the counter antacid such as famotidine (Pepcid) at a dose of 0.25 mg/lb once daily might afford Sebastian more comfort and encourage his appetite.
Please continue our conversation if you wish.
Expert:  Dr. Michael Salkin replied 1 year ago.
Hi Nicole Washington,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin
Customer: replied 1 year ago.
Hi Dr Salkin,I took Sebastian back to the Vet and they thought it would be best to put a feeding tube in him because of his weight loss.Best,
Expert:  Dr. Michael Salkin replied 1 year ago.

I understand. Thank you for taking the time to let me know .