My 16 year old cat came down with symptoms that included vomiting and stopped eating and drinking over the September 27th and 28th weekend. I called several vet clinics on the following Monday morning, including "The Cat Hospital". No one answered at The Cat Hospital, the booking program at Atlas Urgent Care was taken off-line due to high demand and I couldn't call until after 12:00 pm. I called several other veterinary offices in the area and no one was accepting new clients, my previous veterinarian would not take on this pet. I was told to call PetMedic Urgent care in Freeport by at least one of these clinics and was able to find it's webpage. They also had an online appointment booking page and I was able to book the first available appointment for 12:30. I traveled from Sidney to Freeport and they were able to assist me right away. Standard chemistry and cbc with differential was performed that indicated an infection or inflammation that involved the liver, elevated liver enzymes, elevated bilirubin, as well as elevated neutrophils. They also suggested an ultrasound to find out if there were any tumor masses in the liver or biliary obstruction. They had a sonographer coming in that afternoon for another patient and they offered to have her done as well. I stood by for the rest of the day in order for them to do the ultrasound and get a preliminary diagnosis. They found biliary partial occlusion with an inflamed liver, pancreatitis, and IBD. They sent us home with an antibiotic, prednisolone, and was told to follow-up with my veterinarian or contact them. I tried again to take her to my regular veterinarian, but they decline saying they were gradually phasing out the business for retirement. I had taken my other cats there but, this cat had not yet been seen before by my vet., They recommended The Cat Hospital or a veterinary service in Winthrop. This time, I was able to get through to The Cat Hospital and make a follow-up appointment with them for Friday of that week. I sent them the laboratory and ultrasound results from Petmedic Urgent Care via email. The appointment went well, they showed me how to give subcutaneous fluid IV fluids, gave me three transdermal meds to administer to her ears, and provided another tablet to help improve her liver condition. More lab tests were performed checking her liver enzymes and a more specific test for pancreatitis was performed. All results were abnormally elevated. There were two other medications they did not have on hand which she had me order through "Chewy". One of those was Mirtazapine, a tetracyclic antidepressant known to stimulate appetite. I administered these meds as the vet had instructed. The ones from Chewy were started on Tuesday, four days from the initial visit on the Friday before. Her next appointment was the next day on Wednesday. She still was not eating at this point but, she was drinking some. Her follow-up enzymes had gone down by at least half and the test for pancreatitis was back in the normal range. She still wasn't eating on her own, I had been feeding some food with a syringe which was provided by Petmedic the week before. The vet had given her her SubQ fluids and the antibiotic pill for me and I gave her the transdermal meds once back home. No changes in medication had been indicated by the vet. She started to exhibit ataxia, lethargy, and limpness later on in the evening. The Cat Hospital was closed, leaving me no other choice but to call the Emergency clinic in Lewiston. I explained what had been going on with my cat from the beginning and I told them I was concerned about the mirtazapine. They told me to bring the cat to them but, I was unfamiliar with the Lewiston area. It was also getting late at night. They said I could either wait until the next morning to go to my own vet the next morning or bring the cat to them. I decided to wait which turned out to be the wrong decision. She died in my arms after gasping for air at approximately 3:30 am the next morning, Thursday October 9th. Upon reviewing the side effects of this medication on-line, I discovered that cats have been known to have tachycardia severe enough to cause death. She showed signs of difficulty breathing, tremors, ataxia, dilated pupils, disorientation, and extreme lethargy. These are all signs of mirtazapine overdose. I also discovered on-line that there was an antidote called cyproheptadine. The vet from The Cat Hospital had instructed me to give the full dose of this medication. The on-line instructions are as follows: Use caution when giving mirtazapine to cats with kidney, liver, or heart disease. The drug is metabolized more slowly in cats with kidney disease, which can lead to higher drug levels. She knew the cat had a compromised liver. I was providing care myself at home that should have been in a cat hospital. If I had known fully what to look for or what to do or had even left her at a reputable hospital. read more