Mirtazipine in dogs

Re: Mirtazipine in dogs

Laurence Webb — Tue, 16 Nov 2010 17:19:09 GMT

I'm not in the pocket of Virbac (although if they want to bung some money my way I have no objection) but I've had good results with both Ypozane and Suprelorin (not in the same dog at the same time!). As noted above, Tardak is expensive and short acting so we're not replacing our stocks but sticking with the tablets for BPH and the implant if we want chemical castration

Re: Mirtazipine in dogs

Virginia Campbell — Tue, 16 Nov 2010 15:52:08 GMT

Sorry posted before read other replies! Good to know about poss SEs of mirtazapine. Have used ypozane a couple of times for prostatitis in older dogs with a degree of prostatomegaly...worked a treat in conjunction with abs

Re: Mirtazipine in dogs

Virginia Campbell — Tue, 16 Nov 2010 15:48:10 GMT

15mg for wee dog, 30mg for big dog, q 24hrs. If small hard to pill dog, get the orodispersible tablets and dissolve them in water and syringe in. Works fairly well.

Re: Mirtazipine in dogs

Alex Allen — Tue, 16 Nov 2010 13:55:06 GMT

Given my position I'm going to be a little bias here - Ypozane Tablets every 5-6mths for BPH control. Of course they are made by us but they do have advantages over the progestagens of old.

If surgical castration is an option then it would provide the easiest answer especially as it removes the potential for testicular tumours complicating the prostatic disease at a later date. Perform the op sooner rather than later whilst the Tardak is still controlling the BPH.

Re: Mirtazipine in dogs

Michael Woodhouse — Tue, 16 Nov 2010 13:46:58 GMT

[quote user="Rach"]One last question - does it make any difference to recurrence whether I castrate him or keep him on tardak long-term? [/quote]

I always found Tardak a nasty irritant injection that occasionally gave you a bald spot at the injection site. It is also expensive. All these reasons meant that we would castrate every time.

Re: Mirtazipine in dogs

Rach — Tue, 16 Nov 2010 13:37:01 GMT

He is huge amounts better this morning thanks, and has suddenly started eating quite well, so have switched him onto oral meds and will stop the misoprostal (thanks for the info on that).

I was beginning to wonder if we'd missed something else going on so very relieved to see him so much brighter today.

One last question - does it make any difference to recurrence whether I castrate him or keep him on tardak long-term?

Thanks everyone for your replies

Re: Mirtazipine in dogs

Alex Allen — Tue, 16 Nov 2010 09:00:37 GMT

HI Rachael

From your findings sounds like infection caught in time and BPH will respond to the progestagens but will take 1-2wks to reach full effect. If your lucky you might even see an appetite stimulation effect from the delmadinone (megestrol is the better progestagen for appetite stimulation - just ask any cat owner whose cat has been prescribed the tablets!) Enro and Amox/Clav should be fine for bacterial prostatitis as both reach good concentrations in prostate/urine that should be well in excess of the MICs.

It is possible the colitis seen initially was associated with the prostate disease. The adjacent tissues in the pelvic canal can become inflamed and it is not uncommon for BPH cases to present as tenesmus and/or colitis.

One other word of caution relates to the use of misoprostol (or any other prostaglandin) - in some dogs it can cause inappetance, abdominal cramps and diarrhoea typically starting after a few days on this drug. Poor chap doesn't need that as well !

How's he been over the last 24hrs? Given the time on antibiotics, analgesics and the prostate reduction seen on ultrasound I'd hope to see an improvement in his general demeanour / appetite by now. If he is unchanged I'd be tempted to go back and looks for other problems - the BPH is a common disease in old dogs and may have been a concurrent disease.

Re: Mirtazipine in dogs

jd2008 — Tue, 16 Nov 2010 03:52:09 GMT

Dose for dogs is 0.4 - 0.7mg/kg SID. Maximum dose of 30mg/dog. Can reverse serotonin syndrome with cyprohepatidine (periactin)

Re: Mirtazipine in dogs

Martin Whitehead — Mon, 15 Nov 2010 17:52:04 GMT

Anecdotally, mirtazapine is effective in dogs (there is a trial ongoing in the USA to test this). I usually use 15 mg once daily in larger dogs and half that in smaller dogs. However, I agree with Alex Allen's comment regarding analgesia and regarding caution with this use of mirtazapine in prostate cases. There are other possible side effects too - I have just diagnosed serotonin syndrome in a cat as a side effect of mirtazapine....

Martin

Re: Mirtazipine in dogs

Rach — Mon, 15 Nov 2010 17:46:32 GMT

Hi Alex

Thanks for your reply, I wasn't aware of that side effect, glad I asked now, had avoided Periactin for that reason.

He has prostatitis (E.coli) and BPH, heamorrhagic D+ on admit which resolved after 24hr. #

Dx was confirmed on Friday and he was started on baytril and augmentin i/v (awaiting C&S), metacam i/v and all the gastroprotectants I could think of including misoprostal as I was scared of NSAIDs in an inappetant dog but used it in case he was heading towards sepsis, he was on vetergesic until last night but I stopped that as he seemed much more comfortable on abdo palpation. He was also given tardak on Friday.

He has never been pyrexic, even on presentation, in fact his temp is ~37 most of the time, not sure if this is a result of not passing F or he is on the verge of becoming septic...He also didn't have an inflammatory leucogram but did have a mild incr in globulins.

On x-ray and palpation yesterday his prostate seemed much reduced, he is getting brighter, just still not eating.

Any advice would be much appreciated, I haven't managed a prostatitis case before.

-also had heard about lidocaine infusions being of use in inflammatory pain - any experience of this?

Rachael

Re: Mirtazipine in dogs

Alex Allen — Mon, 15 Nov 2010 17:27:03 GMT

Hi Rach,

I would be very careful using NORADR / Serotonin uptake inhibitors in urinary cases - especially dogs with prostatitis. Urine retention is a known side effect with these drugs and may be a serious issue when combined with BPH / prostatitis. SSRIs datasheets carry warnings for BPH sufferers.

Anorexia - is this purely due to the prostate disease? Certainly possible - do not under estimate the pain / discomfort the dog may be in from this alone. You don't mention whether the prostatitis is primary, or linked to another disease such as BPH. Is there pyrexia? Abscessation? What drugs are you using for the prostate disease.

I'd be tempted to add in more analgesics before appetite stimulants.