Unintended feline weight loss may be associated with serious consequences:
Poor appetite and weight loss needs to be treated swiftly
There’s no time to waste when a cat’s eating habits change and they start to lose weight
A study found that cats lost a median of 8.9% body weight in the 12 months before diagnosis of chronic kidney disease (CKD)
Weight loss was identified as early as 3 years before diagnosis and accelerated following diagnosis of CKD2
Similar study results were seen in cats with cancer, renal failure, and thyroid disease, with weight loss beginning > 2 years prior to diagnosis18
On average, cats presenting with weight loss have been losing weight for about a month19
To improve patient outcomes, you can help cat owners understand that time is of the essence
Some of the more common underlying diseases could be:15, 21-22
Therefore, both identifying weight loss and diagnosing the underlying cause are important in successful treatment.
Mirataz is the first veterinary licensed medicinal product for body weight gain in cats experiencing poor appetite.
The active ingredient, mirtazapine, addresses reduced appetite and induces significant weight gain in as little as 14 days23
This can allow for a swift response to initial symptoms – improving condition and wellbeing before you have a definitive diagnosis, alongside providing support to patients already receiving long term treatment.
Mirataz is a transdermal medication which may be easier for your clients to administer to cats that are unable to take oral medication due to poor appetite, nausea or vomiting. There is no need for the cat to eat in order to receive their medication, so you can be assured of good patient compliance.
Innovative child-resistant packaging allows you to confidently prescribe Mirataz for owners to use at home, reducing the amount of time cats need to be hospitalised.
The exact mechanism by which mirtazapine induces weight gain and addresses poor appetite appears to be multifactorial.
The pharmacodynamic action of mirtazapine involves interaction with several different receptors involved with appetite, nausea and emesis.
Specifically, antagonism of 5-HT2 and histamine H1 receptors may account for the orexigenic effects of the molecule24
Mirataz treated cats demonstrated a significant increase in body weight in as little as 14 days23.
Cats* with a documented history of ≥5% body weight loss were randomised to receive either Mirataz ointment or placebo once daily for 14 days. Changes in body weight between the two groups were evaluated from day 1 to day 14.
The mean percent change in body weight for cats receiving Mirataz was +3.9% compared to only +0.4% in the placebo group. This equated to a mean weight gain of 150 grams in the Mirataz group versus only 10 grams in the placebo group. This change was considered statistically significant (p < 0.0001).
Mirataz is indicated for weight gain in cats experiencing poor appetite and weight loss resulting from chronic medical conditions. Cats within the Mirataz field trial23 were diagnosed with varying underlying diseases25 (see below) and were receiving a range of medications alongside Mirataz including fluids, antibiotics, corticosteroids, antacids, anti-hypertensives, antiemetics and anti-thyroid medications26.
Underlying diseases diagnosed in cats within the Mirataz field trial25
When analysing cats with suspect renal disease specifically27 the mean percent change in body weight remained at +3.9% in the Mirataz treated group with no significant difference in incidence of overall adverse reactions in comparison to placebo.
These results were similar to a previously published study of cats with chronic kidney disease, which reported a mean weight gain of 180 grams in the mirtazapine treated group compared to an average 7 grams weight loss in the placebo group. In addition the treatment group saw significant increases in appetite and activity, and decreases in vomiting when compared to placebo28.
Application of Mirataz has been found to be well tolerated. Application site erythema and behavioural changes were the most commonly reported adverse reactions during registration24. Vomiting was also described, however over a quarter of cats had pre-existing vomiting upon study enrolment due to underlying conditions23.
The use of mirtazapine in cats is not a new concept. Human tablets and compounded versions of mirtazapine have been used off-label, with a range of dosing regimens and rates described29. However:
Overall, the PK data supports daily administration in cats with unintended weight loss caused by a range of underlying diseases.
The combination of documented pharmacokinetic data and a licensed formulation provides confidence. By using a licensed veterinary medicinal product, you can be assured that it has been subjected to rigorous European standards for the registration process ensuring only medicines that meet defined standard of quality, safety and efficacy are authorised.
Mirataz should be administered topically by applying a 3.8 cm ribbon of ointment (approximately 2 mg/cat, equal to 0.1 ml) with a gloved hand, onto the inner pinna of the cat’s ear once daily for 14 days (see diagrams below).
We suggest that the first dose is applied in the consult room, enabling demonstration of correct application, before the owner continues use of Mirataz at home.
Daily applications should be alternated between the left and right ears. If desired, the inner surface of the cat’s ear may be cleaned by wiping with a dry tissue or cloth immediately prior to the next scheduled dose. We recommend wearing gloves and handling the pinnae with care.
Care should be taken to avoid contact with the treated cat for the first 12 hours after each daily application and until the application site is dry. It is therefore recommended to treat the cat in the evening. Treated cats should not be allowed to sleep with owners, especially children and pregnant women during all the period of the treatment.
Assessment of nutrition for feline patients with chronic medical conditions is an essential part of determining optimum management protocols. Although undertaking serial measurements of body weight can provide an insight into the nutritional status of a patient, in depth evaluation of additional factors (such as body condition score, muscle mass, dietary history and adequacy of caloric intake) provides greater clinical insight upon which nutritional plans can be built.
In the short video below, Dr Jessica Quimby, DVM, PhD, DACVIM, discusses this important topic in more detail and provides a practical overview of the nutritional assessment of feline patients.
Veterinary recovery diets play an important role in the management of unintended weight loss. An ‘ideal’ recovery diet is: 6-7,9-10
As well as a highly digestible, energy- and fat-dense, high-protein diet, specific nutrients can provide extra support to aid recovery.
To provide immediate and short term nutrition support SPECIFIC Intensive Support are complete dietetic pet foods for cats and dogs for nutritional restoration, convalescence and feline hepatic lipidosis. The diets have a high energy density, high concentrations of essential nutrients and highly digestible ingredients.
They have high levels of omega-3 fatty acids from fish oil and ß-1,3/1,6-glucans to support recovery and the immune system.
*Per protocol population (Cats which completed the entire study through 14 days +/- 3 days) +Safety population (Cats which received at least one dose of Mirataz/Placebo)