Published results can be found here.

Study Start Date: 06/01/2010
Study End Date: 06/01/2012

Mirtazapine is a medication that has been used in human medicine as an antidepressant. The drug has recently gained popularity in veterinary medicine due to the presence of several desirable side-effects, namely its significant anti-nausea, anti-vomiting and appetite stimulating properties. In this study we will compare the appetite stimulating and anti-nausea properties of mirtazapine in comparison to placebo. We believe that this medication will improve the appetite of cats that are "finicky" due to their kidney disease and result in weight gain and improved quality of life.

Study Design:
Prospective, Placebo-controlled, Cross-over, Randomized, Double-blinded

Sample Size:
30 cats

Inclusion Criteria:

• Cats that have been diagnosed with chronic and stable kidney disease and have a creatinine between 2.0 and 5 mg/dl and a poor appetite are potentially eligible for entry into the study.
• A current CBC, chemistry, UA, culture, BP and T4 are required prior to enrollment.
• Other concurrent therapies such as diet, famotidine, potassium supplementation, and subcutaneous fluids are acceptable as long as no changes are made during the study period.

Exclusion Criteria:

• Other systemic illness (diabetes, inflammatory bowel disease, hyperthyroidism, cancer, liver disease, heart disease)
• Complications of kidney disease such as kidney infection or decompensation, hospitalization and intravenous fluid therapy

Study Controls:
NA

Study Endpoints:
NA

Samples:

This is a double-blind, placebo crossover study. The cat will have a complementary physical exam and chemistry panel at the beginning of the study. Mirtazapine or a placebo will be given every two days for three weeks. After this three-week period, there is a four day wash-out and a second physical exam and chemistry panel. The cat will start another three weeks of mirtazapine or placebo. After completion of the second course the cat will receive another physical exam and chemistry panel. During each period the owner will be asked to fill out daily assessments of the cat's habits, demeanor, appetite and any instances of vomiting. Serum should be drawn for a chemistry panel before, between and after each stage of the study. Serum can be stored frozen and shipped to CSU at the end of the study.

Costs/Reimbursements:
This study can be performed at the veterinarian's clinic. Participating clinicians will receive a $200 incentive for each cat enrolled and will be reimbursed $36 for each of the three exams required by the study. The chemistry panels will be performed at CSU at no cost. The costs of T4 analysis and urine culture will also be covered. The owner receives 6 months Purina NF and 2 months compounded mirtazapine after the conclusion of the study.

Full Disclosure information:

• The study is funded by a grant from Nestle Purina Company.
• The investigator does not have a conflict of interest.
• The study will be published if results are negative.
• The study will be reported on VIN.
• The authors will acknowledge VIN if the study is published.