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The effect of transdermal mirtazapine on the appetite recovery time in hospitalized cats with hepatobiliary disease : an ambispective study
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Efeito da mirtazapina transdérmica no tempo de recuperação de apetite de gatos hospitalizados por doença hepatobiliar: um estudo ambispetivo - A mirtazapina é um antidepressivo tetracíclico, utilizado em medicina veterinária como estimulante do apetite. Na Europa, o Mirataz® (Dechra), pomada transdérmica que contém mirtazapina e cujo uso está aprovado em gatos, é frequentemente utilizado em hospitais veterinários no combate à anorexia. Uma vez que este fármaco é metabolizado pelo fígado (tendo maior tempo de semivida de eliminação em gatos com disfunção hepática) e que a anorexia é um sinal clínico que aparece com regularidade associado à doença hepatobiliar, o presente estudo foi realizado de forma a explorar a eficácia da mirtazapina transdérmica em pacientes hospitalizados por doença hepatobiliar. Este estudo ambispetivo dividiu-se em duas fases. Numa primeira abordagem, foi realizado um ensaio clínico randomizado, de forma prospetiva, em gatos que se apresentaram no hospital veterinário com doença hepatobiliar e anorexia. Além do tratamento padrão da doença hepatobiliar instaurado em hospitalização, estes gatos foram divididos em dois grupos: o grupo MT: gatos que receberam tratamento com mirtazapina (Mirataz®), numa dose de 2 mg por gato, a cada 24 horas; e grupo C: gatos que receberam apenas tratamento sintomático. Gatos que morreram antes de retomarem o apetite foram excluídos. Na segunda fase, adicionaram-se dados retrospectivos de gatos hospitalizados por doença hepatobiliar. Destes, os que receberam tratamento sintomático adjuvante com mirtazapina foram adicionados ao grupo MT e os que não receberam tratamento foram alocados ao grupo C. No total foram incluídos 29 gatos: 15 do grupo de controlo e 14 no grupo da mirtazapina. Os gatos do grupo da mirtazapina recomeçaram a comer significativamente mais cedo do que os do grupo de controlo (p = 0.007) e passaram tipicamente menos tempo hospitalizados (p = 0.018). Apesar da diferença não ter sido significativa (p = 0.087), os gatos do grupo da mirtazapina tendencialmente ganharam peso durante a hospitalização, enquanto os do grupo de controlo perderam peso. Não se observaram reações adversas graves nos gatos tratados com mirtazapina. Estes resultados apoiam o uso da mirtazapina transdérmica em gatos hospitalizados por doença hepatobiliar, reforçando que, quando associado ao tratamento sintomático individualizado, aparenta reduzir o período de anorexia e o tempo de hospitalização, não estando associado a reações adversas graves
Mirtazapine is a tetracyclic antidepressant used in veterinary medicine as an appetite stimulant. In Europe, Mirataz® (Dechra) – a transdermal ointment containing mirtazapine approved for use in cats – has been frequently used in veterinary hospitals to manage anorexia. Since this drug is metabolized by the liver, with cats with hepatic dysfunction showing a longer elimination half-life, and anorexia is a well-known clinical sign of hepatobiliary disease, this study was designed to explore the efficacy of transdermal mirtazapine in hospitalized cats with hepatobiliary conditions. This ambispective study was divided into two phases. On a first approach, a prospective, randomized clinical trial was conducted on client-owned cats presenting at the hospital with hepatobiliary disease and anorexia. Beside the standard treatment for hepatobiliary disease, which all cats received, these cats were divided into two groups: the MT group: cats who received treatment with Mirataz transdermal ointment at 2 mg/cat once daily; and the C group: cats who received only the standard treatment. Cats that died before they restarted eating were excluded. Afterwards, retrospectively collected cases of cats with hepatobiliary disease were added to the dataset; from these, cats whose treatment plan included transdermal mirtazapine were added to the MT group, whereas those who did not were added to the C group. In total, 29 cats were included: 15 part of the control group and 14 part of the mirtazapine group. Cats in the mirtazapine group restarted eating voluntarily significantly earlier than those in the control group (p = 0.007), and spent less time hospitalized (p = 0.018). Although the difference was not significant (p = 0.087), cats in the mirtazapine group also showed a tendency towards weight gain during hospitalization, whereas those in the control group typically lost weight. No severe adverse effects were observed. These results support the use of transdermal mirtazapine in hospitalized cats with hepatobiliary disease, showing that, when associated with individualized symptomatic treatment, it seems to lower the anorexia period and hospitalization duration, while also not being associated with severe adverse reactions
Mirtazapine is a tetracyclic antidepressant used in veterinary medicine as an appetite stimulant. In Europe, Mirataz® (Dechra) – a transdermal ointment containing mirtazapine approved for use in cats – has been frequently used in veterinary hospitals to manage anorexia. Since this drug is metabolized by the liver, with cats with hepatic dysfunction showing a longer elimination half-life, and anorexia is a well-known clinical sign of hepatobiliary disease, this study was designed to explore the efficacy of transdermal mirtazapine in hospitalized cats with hepatobiliary conditions. This ambispective study was divided into two phases. On a first approach, a prospective, randomized clinical trial was conducted on client-owned cats presenting at the hospital with hepatobiliary disease and anorexia. Beside the standard treatment for hepatobiliary disease, which all cats received, these cats were divided into two groups: the MT group: cats who received treatment with Mirataz transdermal ointment at 2 mg/cat once daily; and the C group: cats who received only the standard treatment. Cats that died before they restarted eating were excluded. Afterwards, retrospectively collected cases of cats with hepatobiliary disease were added to the dataset; from these, cats whose treatment plan included transdermal mirtazapine were added to the MT group, whereas those who did not were added to the C group. In total, 29 cats were included: 15 part of the control group and 14 part of the mirtazapine group. Cats in the mirtazapine group restarted eating voluntarily significantly earlier than those in the control group (p = 0.007), and spent less time hospitalized (p = 0.018). Although the difference was not significant (p = 0.087), cats in the mirtazapine group also showed a tendency towards weight gain during hospitalization, whereas those in the control group typically lost weight. No severe adverse effects were observed. These results support the use of transdermal mirtazapine in hospitalized cats with hepatobiliary disease, showing that, when associated with individualized symptomatic treatment, it seems to lower the anorexia period and hospitalization duration, while also not being associated with severe adverse reactions
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária, Clínica, 2026, Universidade de Lisboa, Faculdade de Medicina Veterinária
Palavras-chave
Hepatobiliary disease Mirtazapine Anorexia Cats Doença hepatobiliar Mirtazapina Anorexia Gatos