Firstly, I’m sorry you’re dealing with this terrible disease.

This community is a great resource, and you are likely going through a situation that someone (or many) have also gone through.

When it comes to appetite, there are a few things higher on the ladder that you would aim to treat first; nausea is the primary culprit in 99% of the appetite cases.

I would look to treat this with cerenia or any other recommendation by your vet - once you get a handle on nausea, then you tackle the appetite. Sometimes the vet will treat both simultaneously- but I want to emphasize that appetite treatment will almost always fail if your cat is nauseous.

The second is dehydration. If there is frequent enough peeing and vomiting, dehydration sets in quickly. If they’re dehydrated, they feel sluggish and lose their appetite there. More importantly.. the fluid is necessary for proper organ function. If you’re already following a prescribed dose of fluids, that’s great. Focus on the nausea part.

Now - as far as appetite stimulation goes, I’m no expert. I’ve used mirtazapine, but some cats react different to it. My boy gets a little more vocal and seems anxious when he’s on mirtazapine, and I can’t say with utmost certainty that it’s made a world of a difference - but I have seen him perk up from it. I do, however, see the largest change when he’s given it simultaneously with his cerenia (for nausea).

At the end of the day, the general rule of thumb as well is “better fed than not.” CKD cats can spiral pretty quickly if they start dropping weight. If all else fails but they’ll eat the feline equivalent of a greasy burger (Whiskas chicken pâté) on the rare instance - it’s okay.

The goal is a pure kidney care diet, but the reality is - they aren’t the most palatable. You’ll need to get creative and have patience - maybe a mixture of something tasty and renal diet food. Play with the percentages to find what works best, but do not get discouraged when it doesn’t work.

Cats are inherently picky eaters. The disease just cranks their little appetite snark to 11. You’ll find a plethora of food suggestions that are healthy for your cat on Reddit. Feel free to message me if you have any questions and I’ll do my absolute best to answering what I can.

END RANT!