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1Clear out junk files and repair common Windows errors2Scan for outdated or missing drivers - takes under a minute3Repair Windows errors before they cause bigger problemsAn appetite stimulant is a category of treatment, not a diagnosis. When a cat eats less or loses weight, the cause decides whether a stimulant has any role at all. In the United States, the FDA identifies two prescription products for unintended weight loss in cats: Mirataz (transdermal mirtazapine), an ointment applied inside the ear, and Elura (oral capromorelin), a liquid taken by mouth. Elura is specifically labeled for cats with chronic kidney disease (CKD). Neither medicine finds or treats the illness behind a poor appetite, and neither should be started without a veterinary examination.
Why a cat stops eating
Reduced appetite is a symptom with many possible sources. The FDA’s consumer guidance names kidney disease, dental disease, and stomach or intestinal problems as conditions associated with weight loss. The 2022 ISFM consensus guideline on feline care adds several contributors that a caregiver can easily miss:
- Nausea, which can make food unappealing even when the cat is hungry
- Pain, including pain from arthritis, dental lesions, or injury
- Dehydration
- Anemia
- Fever or other signs of infection
- Side effects of a current medicine or treatment
The FDA puts the stakes plainly: “Weight loss is often the first sign of illness in cats.” (U.S. Food and Drug Administration, consumer article on FDA-approved drugs for cats.) A stimulant can make a cat eat more while the cause is still active. That is why veterinarians treat the appetite problem as one part of a larger assessment.
What a veterinarian is likely to do first
The ISFM guideline says appetite stimulants may help maintain calorie intake in hospitalized cats, but they do not replace diagnostic work-up or correction of contributing problems. A typical sequence looks like this:
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- Physical examination, including the mouth and teeth, abdomen, hydration status, and body condition.
- A history of when the change started, how much and what the cat is eating, vomiting, litter-box changes, and any new medicines.
- Diagnostic tests selected for the suspected causes. The veterinarian decides which tests are needed.
- Treatment of contributing problems such as nausea, pain, or dehydration.
- Only then, if appropriate, a discussion of an appetite stimulant. Where intake stays inadequate, the guideline also discusses nutrition support, including feeding tubes.
The two prescription options
Both products are available only by veterinary prescription in the United States. Their labeled uses differ, and the right choice depends on the individual cat’s diagnosis, other conditions, and other medicines.
Mirataz (mirtazapine transdermal ointment)
Mirataz is applied to the non-hairy inner part of the ear, where it is absorbed through the skin. The U.S. label regimen described by the FDA is a 1.5-inch ribbon once daily for 14 days, alternating ears. A veterinarian or trained veterinary staff member should demonstrate the application. The FDA advises the person applying it to:
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- Wear disposable gloves.
- Wash hands after handling the medicine.
- Keep the cat separated from people and other animals for two hours after the dose, to reduce unintended exposure.
The FDA advises caution in cats with liver or kidney disease, because kidney disease may slow mirtazapine clearance and increase drug exposure. The label also gives monitoring thresholds after treatment: contact the veterinarian if food intake drops dramatically (more than 75%) for several days, or if the cat stops eating for more than 48 hours. These are label-specific instructions. They are not permission to wait 48 hours before calling in every situation.
Reported adverse effects include ear-site reactions, increased vocalization or hyperactivity, and vomiting. In the Mirataz field safety study, 115 cats received Mirataz and 115 received a vehicle control. That figure describes the safety study sample, not an efficacy comparison with Elura.
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- Supports Appetite & Eating Habits: If your cat sniffs at food and walks away, low B12 may be part of the problem. Supplementing with methylcobalamin, the active form of B12, helps restart normal fat and protein metabolism—restoring healthy hunger cues and interest in meals
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Elura (capromorelin oral solution)
Elura is labeled in the United States to manage weight loss in cats with CKD. The FDA explains that capromorelin mimics ghrelin, a naturally occurring hormone that stimulates eating, and can increase eating and weight gain. The label specifies once-daily oral dosing based on body weight. For cats routinely fed meals, the label says to offer food 30 minutes after the dose. Dosing must come from your veterinarian and the product label. Do not calculate a dose from a general article.
The label carries several cautions:
- Do not use in cats with acromegaly.
- It may raise serum glucose for several hours. Its use in cats with current or past diabetes has not been evaluated and may not be appropriate.
- Use with caution in cats with heart disease, severe dehydration, or liver dysfunction.
- It can cause transient decreases in heart rate and blood pressure lasting up to four hours after administration.
In the 56-day field study, 176 client-owned cats with CKD and at least 5% unintended weight loss were enrolled: 118 received Elura and 58 received vehicle control. The label lists vomiting, hypersalivation, inappetence, and behavior change among reported adverse reactions. These are results from a study population. They are not predictions for any individual cat.
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Comparing the two prescription options
| Feature | Mirataz (mirtazapine transdermal ointment) | Elura (capromorelin oral solution) |
|---|---|---|
| Formulation | Topical ointment applied to the inner ear | Oral solution |
| Labeled context | Manages undesired weight loss in cats | Manages weight loss in cats with chronic kidney disease |
| Labeled regimen (U.S.) | 1.5-inch ribbon once daily for 14 days, alternating ears | Once daily by body weight; food offered 30 minutes after the dose for cats routinely fed meals |
| Who applies or gives it | Veterinarian or trained staff demonstrates; caregiver applies under instruction, with gloves and a two-hour separation | Given by mouth as directed by the veterinarian |
| Conditions that call for caution | Liver disease and kidney disease (slowed clearance) | Acromegaly (do not use), diabetes history, heart disease, severe dehydration, liver dysfunction |
| Reported adverse reactions | Ear-site reactions, increased vocalization or hyperactivity, vomiting | Vomiting, hypersalivation, inappetence, behavior change; transient decreases in heart rate and blood pressure; increased serum glucose |
| Field study size (safety) | 115 Mirataz, 115 vehicle control | 176 cats with CKD: 118 Elura, 58 vehicle control, 56 days |
| Label instruction for monitoring intake | Contact the veterinarian for a drop of more than 75% for several days, or no eating for more than 48 hours | FDA recommends monitoring food intake during treatment; the label-specific threshold is not stated in the sources reviewed here, so follow your veterinarian’s instructions |
No source reviewed establishes that one medicine works better than the other. Choosing between them is a clinical decision that depends on the cat’s diagnosis, kidney and liver status, and how the medicine can be given.
Safety limits and what not to substitute
- Do not give human mirtazapine. The FDA states that human mirtazapine used in cats is extra-label and has not been proven safe and effective in cats for that use. The smallest human tablet strength it cites is 15 mg, which is far above typical cat doses, so tablet splitting is not a workable substitute for veterinary direction.
- Be cautious with compounded transdermal products. The FDA warns that some transdermal products compounded from bulk mirtazapine are unapproved animal drugs.
- Cyproheptadine is not an approved alternative. The ISFM guideline describes it as not approved for use in cats.
- Other putative stimulants are not equivalent. The guideline notes that several have not been assessed for efficacy or may have significant side effects that outweigh benefits. This includes vitamins, steroids, and over-the-counter “appetite booster” supplements.
Where oncology guidance fits
The 2026 AAHA oncology guideline lists capromorelin and mirtazapine as options for hyporexia (reduced appetite) in feline and canine oncology patients. It also says to treat nausea first if it is suspected as the underlying cause. This is guidance for supportive care within cancer treatment. It is not a general dosing plan for every cat with poor appetite.
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When to call your veterinarian
Do not wait for a stimulant to work or for a label threshold to be reached. Contact your veterinarian promptly if your cat:
- Skips meals or eats noticeably less than usual
- Loses weight without a clear reason
- Vomits, drools, becomes lethargic, or hides
- Shows signs of pain, such as reluctance to jump or changes in grooming
- Is already on a medicine and stops eating after starting it
Cats that stop eating can deteriorate quickly, so arrange same-day contact when your cat has eaten nothing for a day or more, or if you are worried about any sign above.
Keeping a feeding record
The FDA recommends monitoring food intake during Elura treatment, and a written log helps the veterinarian judge whether the plan is working. A digital kitchen scale is one optional way to record portion amounts consistently. A scale does not stimulate appetite, is not a veterinary device, and cannot replace an examination. Note the amount offered, the amount eaten, vomiting, and changes in water intake.
Regulatory scope
The product statements above describe U.S. FDA-approved labels. The sources reviewed do not establish current licensing, availability, or prescribing rules in other countries. If you live outside the United States, ask your veterinarian which products are legally available where you are.
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