Appetite Stimulants in Cats

After finishing a week of holiday celebrations, the lack of appetite has hardly been a problem. Food has been freely available at every holiday festivity, and I am not looking forward to the weekly weight date. Perhaps I need to bring the stretchy pants out of hibernation.  Unfortunately, with change of routine, travel, and illness many cats experience a significant decrease in appetite. While a dog could theoretically go weeks without eating, a cat can into liver failure, called hepatic lipidosis (fatty liver) with less than a week of inappetence. Thus, the blog today is about ways to stimulate the appetite. I would like to say in most cases it is very important to find the reason for the lack of appetite. These are options to implement while investigating the cause(s). 

WHAT IS THE MOST COMMON APPETITE STIMULANT USED IN CATS?

 The one most commonly used, mirtazapine, was developed for human use as an antidepressant for moderate to severe depression. Mirtazapine acts to increase norepinephrine and serotonin in the brain. These are neurotransmitters associated with relaxation and comfort. It has strong anti-nausea properties by acting on the neuroreceptors in the intestine and stomach that communicate with the vomit center of the brain. It also acts as a strong appetite stimulant that was FIRST NOTED AS A BENEFICIAL SIDE EFFECT FOR CANCER PATIENTS. Obviously, a medication that addresses both nausea and appetite loss is an asset to treating many medical conditions. Administered orally every 2 to 3 days, mild sedation maybe noted. 

I HAVE HEARD OF A CONDITION CALLED SEROTONIN SYNDROME THAT IS OCCASIONALLY SEEN WITH THE USE OF MEDICATIONS SUCH AS MIRTAZAPINE. WHAT IS IT? 

Serotonin syndrome is a potential side effect should brain levels of serotonin get too high. The signs can occur 10 minutes to 4 hours after ingestion. Symptoms of serotonin syndrome in pets can include agitation, depression, aggression, vocalization, seizures, lack of coordination, muscle rigidity, muscle twitching, muscle spasms, tremors, change in heart rate, elevated blood pressure, changes in skin color, hyperthermia, and diarrhea.

 This syndrome generally requires a combination of serotonin-increasing medications. A partial list of these medications include the following: anti-anxiety meds (Prozac, clomipramine, Elavil), herbal supplement (St. John’s Wart), tryptophan, pain medications (tramadol, amantadine), anti-histamine (chlorpheniramine), and liver supplement (S-adenosylmethionine (SAMe).

WHAT OTHER DRUGS ARE UTILIZED TO STIMULATE APPETITES IN CATS?

1.     Periactin (cyproheptadine). In some cases it is rotated every 48 hours with mirtazapine. Sometimes, particularly with cyproheptadine, you may have some aggressive behavior tendencies. May also be worth a try to have compounded as a transdermal medication to apply to the ear flap.

2.        Midazolam, a sister drug of diazepam (Valium), will make a cat eat most anything. Sedation is a potential concern.  Oxazepam is a similar medication. These are not for long term usage.

3.       Prednisolone is often used to stimulate appetite. The side effects of eating, drinking, and urinating more often curtail use long term.

WHAT ABOUT VITAMIN B12 (COBALAMIN) INJECTIONS?

They may be used safely in many cases. I will discuss a deficiency of this vitamin with intestinal problems in both people and animals in next week’s blog. 

I AM INTERESTED IN MANY NATURAL APPROACHES AND I HAVE HEARD ABOUT AN ACUPUNCTURE SITES IN CATS THAT STIMULATES THE APPETITE. WHERE IS IT?

There is an acupuncture point that you can use (dry needling or acupressure). It is located on the dorsum of the nose, midline, where the haired and unhaired areas meet. 

DOES ELEMENTAL ZINC WORK AS AN APPETITE STIMULANT?

Yes, in an older paper out of Tennessee 1mg/kg of elemental zinc once a day may increase appetite by replacing if zinc deficiencies present leading to lack of appetite. Another theory, unsubstantiated suggests it increases a neuropeptide Y. 

CAN CATNIP BE UTILIZED FOR PICKY EATERS? 

 While catnip can work to stimulate the appetite in some cats, the result is mixed. 

I want to thank all of the blog followers for your kind words of support. The picture above is of my son, Jason, home for the holidays. The beach picture is from this weekend at Myrtle Beach. 

Betsy Sigmon DVM, Diplomate ABVP, canine & feline

Creature Comforts Animal Hospital

Cary, N