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Entyce® Cat Owner Feedback Page

 

 

Ron Hines DVM PhD

 

When I last checked in May of 2019, Entyce (capromorelin) was not FDA-approved for use in cats. To the best of my knowledge, that is not because the FDA knows something negative about the use of this medication in cats. Aratana Therapeutics (NASDAQ:PETX), the producer of this medicine, is a small, newly-formed company. The company is not expected to post its first profit until 2020. Securing FDA approval for a medication is a very expensive and time-consuming process. A company cannot suggest on its label that their product can be used in a different species unless it furnished the FDA with expensive studies that confirm it works in that species.

Capromorelin’s effects appear similar in humans, rats and dogs, I see no reason, as yet, why this drug might not have worthwhile applications in cats as well as dogs. In fact, the company stated in one presentation that capromorelin's effects on cats were similar. (ref) But cat process certain medications differently than dogs - particularly those that are modified or eliminated by their livers. So I would still be quite cautious in off-label uses in cats until we understand this medication better. The following are some people who took the time to written to me about their experiences using Entyce in their cat to stimulate its appetite. One thing is already clear, most cats hate the tast of the product:

 

 

June 11, 2019

I  wanted to share my experience with Entyce for my cat, Emma.  She gradually stopped eating over the course of a few days.  Several vet/specialist visits later we found out she has a sarcoma on her mesenteric root. It is inoperable, radiation is impossible, and chemo is not effective. We are at a point of keeping her comfortable as long as possible. To help her eat, she was prescribed Cerenia and 0.5ml Entyce a day. Her first couple of weeks of the Entyce were tough for her.  She definitely foamed at the mouth and continued to do so up until recently now that we are rounding her 3rd week on it.  If she takes it fast enough and I follow up with a treat there is very little foaming. She does not like the taste at all. It does stimulate her appetite. The Cerenia then helps the food stay down. I would like to take her off of the Entyce because it is such an ordeal to give it to her (she runs as soon as she sees the syringe) and I feel bad that it is so tough for her, but I am afraid she will stop eating again. She has become more like herself this past week than she has been since she first became ill. My husband did notice some off behavior when she first began taking the Entyce - she would go to her water or food bowl and after eating/drinking some she would lay her head right into the bowl. That was very odd but stopped after the first couple of doses. I have noticed some constipation but that could be the Cerenia.  

Thank you,

A. T.

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May 9, 2019

My 9 lb. cat, Annie, was prescribed Entyce (.03 ml once daily) as an appetite stimulant. She had been recently discharged from an overnight stay at the emergency animal hospital for respiratory distress. She had not eaten anything for 2 days when I took her to my local vet for a recheck. The vet prescribed Entyce, but did not tell me it was off-label or the side effects [sometimes] associated with it. When I gave Annie her first dose, she started drooling [and] foaming at the mouth profusely. She seemed very disoriented and weak. I thought this was happening because it tasted terrible and that she was still reeling from being poked, probed and x-rayed so much in the past few days. It took her hours to somewhat recover from it.  I tried again the next day. Same results. She acted like she was given poison. [ ] I contacted ARTANA, the drug manufacturer, to report Annie's adverse reaction. They quickly responded and asked for more details and contact information for my vet. Shortly after, I received an email from my vet saying that if I return the bottle they will give me a full refund. This got me thinking and I researched this medication online. It is NOT FDA approved for cats, only DOGS.  It can be used for cats, but off label. I was not advised. I was shocked and angry that no mention was made of the possible side effects that Annie suffered. [ I suggest you] use this medication with extreme caution. There are other safer, proven appetite stimulants on the market for cats. [ ]

Annie's Mom

 

April 23, 2019

Hi,

I came across your website when researching whether or not to give my cat Entyce (as prescribed by her vet as a last resort appetite stimulant). Our 4 year old cat was diagnosed with cancer that originated somewhere in her bile duct. She had a surgery to bypass/re-route the bile duct in order to also obtain a biopsy, and ultimately determined that the mass was cancerous and had spread to her lymph nodes. She had been on prednisolone and had a great appetite for 3-4 months until she suddenly vomited one night and never fully regained her appetite. We tried a variety of appetite stimulants and ultimately decided to try Entyce. She is a small cat (about 5 pounds) and reacted very negatively to Entyce - she seemed to get very drowsy and almost had seizure like reactions where she would be trying to fall asleep but suddenly start jerking and biting. While it passed after a few hours, it had minimal effect on her appetite. We stopped it after the seconds dose as it was not effective and had extremely bad side effects for her. Hope this can help another cat owner in the future.

J. Z.

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February 23, 2019

My cat has had little interest in food since a bout with a rhinovirus she picked up at the adoption center when I adopted her at age 4. Prior to that illness, she was cited as having normal appetite. Her appetite has been limited for all these years, and she has been consistently underweight. She also has hypertrophic cardiomyopathy which even further reduced appetite later in life. She has been taking mirtazapine, one-eighth tablet, every three days. While the side effects of restlessness and vocalization are reduced noticeably they are present even at this lower dose and it has kept her eating.

At her last check up, Entyce was recommended as having fewer side effects. Mindful of her strong reaction to the full dose (1/4 tablet) of Mirtazapine, I first tried a dose a bit more than half that recommended. She seemed unusually quiet all morning, and her appetite was not stimulated. She ate less than usual. I gave her the full dose this morning, and she is lethargic and uninterested in food 1.5 hours later. I had been told her appetite should pick up within 15 minutes of the dose.

I will go back to mirtazapine tomorrow. I don’t like it’s [Entyce's] side effects, and really wish the Entyce would have helped her.

J.M., Sent from my iPad

March 24: I can add that I did try Entyce once more. I gave her nearly the fully prescribed dose. Just a couple minutes later, she vomited it all up.   I have not tried it with her since then.

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January 3, 2019

My 8 year old cat Patches has been given a tentative diagnosis of IBD or intestinal lymphoma. To keep his a vomiting under control he is being given a 1/2 tab of Cerenia (16 ml) as needed for vomiting and 1/4 tab of Metronidazole (250 mg) per day for diarrhea. He has no appetite nor does he drink water at this point. I have been syringe feeding him since December 18th in hopes that this would kick-start him wanting to eat on his own.  I discussed this with my vet and she suggested giving him Entyce. I gave him .06 with the included dose syringe and his immediate reaction was to start salivating quite heavily.  He did not show any interest in eating and unfortunately, 20 minutes later, he vomited everything I had fed him 2 hours before along with the Entyce. Tomorrow I will once again attempt to give him some Entyce but at a somewhat smaller dose.  Hopefully I will get a better reaction and Entyce will get him back to eating again.      

Thank you for your time.       

Patches Mom,  Sent from my Galaxy Tab® A

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Dec 28, 2018 Updated Jan 4, 2019

Our 17 year old cat, Astra, is showing her age and we want her to be comfortable in her final time. Lately she has lost interest in food after being a chow hound all her life. We have been giving her Cypro [cyproheptadine] for 6 months or so on a routine basis but its effectiveness [for appetite] has waned so our vet prescribed Entyce. Her dose was 0.4cc once a day. We just gave her the first dose and less than 10 minutes later she was at her food bowl, cleaned out a complete half meal and cried for more. She is a little hyped up too, so we will track her, but [we] will stop in a few days to see what she does without it.

The first time with good results but then her feeding fell off so we tried splitting it into two doses [of 0.2cc] but it was not as effective, then less effective with the usual full dose of 0.4cc so we stopped it.

C.G. , East Bay of San Francisco

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December 12, 2018

I'm surprised nobody else has mentioned this. My cat started wildly foaming at the mouth as soon as I gave it [Entyce]. After that subsided, he looked and acted completely miserable - slinking around with [his] tail down, dilated pupils, wouldn't purr. Finally he lay down for 20 minutes or so, completely motionless. [ ] Then all of a sudden he jumped up, went to his food [bowl] and gobbled voraciously for about a minute. This continued for a few rounds, at which point he moved to the water dish but just hunched over it, not drinking. For the next hour he was [] not himself and acted like he was in pain. Gradually and slowly he came around, but [it] gave me a huge scare.
Background info : [Entyce] was prescribed by [my] vet to stimulate a diabetes/insulin related loss of appetite. []

L. M. Washington State

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October 3, 2018

I started giving my 10-pound feline leukemia-positive cat, Smudge, 0.2ml of Entyce today in an effort to get her to eat canned food for the extra water it provides. She is takes raltegravir B-1 and B3 vitamins and Feline Interferon Omega to combat the feline leukemia virus. If one didn't know she was FeLV+, one would think she is completely healthy. Smudge is a picky eater; I have tried every canned and dry food that is made. She favors eating dry Purina kitten chow, but even then, it sometimes takes cyproheptadine to get her to eat. Even a small dose of cyproheptadine makes her sleepy and not all there. I hate the way it makes her feel, but she will eat after taking it. Her being, FeLV+, I don't have the luxury to let her not eat until she is starving. That's why I wanted to try the Entyce. The first day I gave her Entyce, within fifteen minutes, she ate one and a half ounces of canned Fancy Feast. However, it was only effective the first day I gave it.

B.B. Jackson, Tennessee

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July 8, 2018

Summary: My 16 year old cat, Gilbert had a rise in his Creatinine and BUN--kidney issues. He was put on a low phosphorus, low protein, renal diet.  He was eating the new renal diet very well, but suddenly stopped eating, totally, for 3 days. mirtazapine used to work, but did not help, nor many special foods and treats.  Although Entyce, by Aratana, is only approved in dogs, my vet tried it at about 60 percent of the dose recommended for a dog of Gilbert's weight. It worked great, with  soft stool as a side effect. Wrongly thinking more is better, we increased it to the full dosage for a 13 pound dog. His reaction, as only one individual cat, was deep depression, hiding, and one incident of involuntary head shakes.We dropped it back to 60 percent of the dog dose, the side effects, except soft stool immediately went away. He ate well at the lower 60 percent dose.  I  don't know what the long term side effects are of Entyce, but it was urgent and lucky Entyce was available to get Gilbert eating. He gained weight. After two weeks, and we aren't sure of when the need for it stopped, he is eating on his own, doing well, and I have a bottle on hand, in case. It is good 90 days from opening it.
If your cat needs it, I hope that it works as well for you. 

Neal, Nevada USA

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June 15, 2018

Gilbert is a 16-year-old cat living in the Las Vegas Nevada area. He sees a feline veterinary specialist. He has as history of elevated blood creatinine, BUN and SDMA (kidney problems) but had eaten well and maintained his normal weight of 13.1 pounds. His blood phosphorus level has remained within normal limits. He is not at all enthusiastic about eating the special kidney diet his veterinarian prescribed for him. On June 1, Gilbert stopped eating. Mertazipine, an appetite stimulant, dispensed by the vet did not help. His weight dropped to 12 lbs. Even his favorite flavor of Fancy Feast did not interest him. Gilbert’s owner succeeded convincing another veterinarian to sell him Entyce:

My vet in Las Vegas does not use Entyce. None of the 10 hospitals I called would provide it either. They didn’t want to use it for a cat but I insisted and gave full permission. The Entyce works. He came home and ate a 3-ounce can of renal diet. He is having some kibble now an hour later. I don’t see any side effect. There is an immediate burst of hunger that rapidly tapers [off].

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June 18, 2018

Gilbert is taking 0.3ml of Entyce every morning. It is working. I don’t see side effects. No depression, head movement, etc. He has gained 0.2 lbs since I last wrote. He is up to 13.3 lbs.  

June 19, 2018

Per my conversation with Dr. M, we increased his Entyce from 0.3ml up to 0.5ml. He ate renal food when we got home. At 0.3ml he wont eat renal food. He wants Fancy Feast at 0.3ml. I need a blood type test to consult with U of Penn. They need type A. I am testing this and creatinine and BUN. [the owner is considering a kidney transplant for Gilbert]

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June 20, 2018

His Creatinine has dropped from 2.7 on June 8, down to 1.9, now. 1.9 is close to the 1.7 it was back in November before his decline. Every third day he still gets 2 mg of mirtazapine. He still drinks a lot of water and urinates a lot
His differential blood count numbers have gone from low to normal in two weeks.

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February 2, 2018

We have a Main Coon cat, Bailey. We were given Entyce by our vet friend who had samples for dogs. She's an older cat who was diagnosed with fatty liver [disease] and, as a result, had completely lost her appetite. She was hospitalized for over a week with IVs and then we finally decided to start giving her Entice when we brought her home to help her continue eating on her own.
The medication has definitely help increase her appetite. She has more desire to eat and is eating more on her own - although not quite as much as we would like. She has started displaying some weird behaviors with head shaking and loss of coordination while walking, but we are looking into maybe a possible ear infection or other explanation. We have reduced her dosage starting last night, in case it was causing the side effects, but I notice she hasn't eaten as much today already.
We are hoping to be able to keep her on Entyce long enough so that she will not need it [anymore] and will be eating on her own, once her fatty liver condition has improved. I decided to email you since you said you would like information a pet owners using this on their animals, so let me know if you have any questions.

M. M., San Luis Obispo County, CA   Sent from my iPhone

February 13, 2018 update:

Bailey developed some head shaking and tipsiness that our vet thinks is related to an ear infection. So we discontinued Entyce for now. But I definitely feel that the medicine was a lifesaver for her. She was down to 4 lbs and would likely not be here without the medicine.

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