By Teresa Garden, DVM
Dogs and cats can develop anorexia (no appetite) or dysrexia (decreased appetite) for many reasons. Usually it is because of diseases such as cancer, kidney disease, liver disease, heart failure, and inflammatory bowel disease. Pain from pancreatitis, GI ulcers, bone fractures or joint inflammation can decrease appetite. Acute infections can also lead to anorexia. Psychological stress can cause anorexia.
We know from human medicine that decreased appetite and food intake will negatively impact the patient’s outcome. The same is true for our pets. We all need to eat to live and especially to heal. Decreased appetite leads to delayed wound healing, decreased immune response, and decreased strength. Eventually weight loss will occur if the situation is not remedied. As pet owners, we often equate not eating to a decrease in quality of life and well-being of our pet.
When are appetite stimulants beneficial to pets? They are often employed when a pet is recovering from an acute illness or injury. Examples would be gastritis or hemorrhagic diarrhea. Recovery from orthopedic surgery would be another instance where these medicines could be helpful. Dogs and cats treated with antibiotics, pain medicines or sedatives will sometimes have diminished appetites and could be helped by appetite stimulants. They are often used in animals recovering from trauma. Veterinarians have found appetite stimulants helpful when transitioning a patient from their normal food onto a prescription diet. Prescription diets are part of treatment protocols in treating diseases such as allergies, IBD, kidney disease, pancreatitis, and bladder stones to name just a few. Patients battling chronic diseases such as cancer, heart failure, kidney disease, and IBD may benefit at times from the use of appetite stimulants. It can help them to take medicine and supplements more readily as well as maintaining muscle mass. Appetite stimulants can mitigate the effects of vomiting and nausea associated with chronic disease and chemo therapy.
Entyce (capromorelin) is the only FDA approved appetite stimulant for dogs. It is available as an oral flavored solution and is given once daily. This drug mimics ghrelin (the hunger hormone) to trigger the feeling of hunger. It can treat acute and chronic conditions that cause anorexia. Entyce must be used with caution in cases of liver dysfunction and kidney insufficiency. Adverse reactions are few but may include vomiting, diarrhea or hypersalivation. Entyce is a prescription drug and as such is available only through your veterinarian.
Mirataz (mirtazapine transdermal ointment) is the only FDA approved appetite stimulant for use in cats. Mirtazapine was originally marketed as a human antidepressant medication. It had the unwanted side effect of causing people to gain weight so it quickly fell out of favor! But it can be a life saver for cats. Mirtazapine increases appetite and reduces nausea and vomiting. Studies have shown it to be 80 to 90% effective in helping diseased cats gain weight. It can be used to help cats with chronic kidney disease, IBD, neoplasia, hyperthyroidism, liver disease, and pancreatitis. Mirataz (the transdermal form) is easy to administer and provides a more constant blood concentration. The transdermal medication is applied to the inner ear flap once daily. It is important to wipe off any remaining residue from an earlier dose to avoid drug accumulation. Mirtazapine is also available in a pill form or can be compounded into an oral liquid. The oral medication may be given daily or every 48 or 72 hours depending on the dose and the individual case being treated. Side effects include vocalization, hyperactivity, and vomiting. This, too, is a prescription drug available only through veterinarians.
Hemp products and CBD oil may also be employed to stimulate appetite and decrease nausea and vomiting. Some of our patients at Animal Health & Healing with IBD, kidney disease, and cancer have benefited from the addition of these products to their treatment protocols. Hemp products are available in pill or chewable form. CBD oil is a liquid and can be mixed with food.
Appetite stimulants should only be given to your pet with the knowledge and consent of your veterinarian. It is imperative to have an exact diagnosis before prescribing an appetite stimulant. There are conditions, such as obstructive diseases, where the use of these medicines are actually contraindicated and could be detrimental to your pet’s health. But many of our older pets suffering with chronic wasting diseases can enjoy an approved quality of life when appetite stimulants are used as part of their overall treatment plan.
Dr. Teresa Garden is chief veterinarian/owner of Animal Health & Healing, a full-service holistic and conventional veterinary practice in the Maplewood/Richmond Heights area. 314-781-1738.
www.AnimalHealthandHealing.com.