Capromorelin for inappetence and weight loss in dogs and cats — LIKELY

In dogs and cats with inappetence or weight loss (including chronic kidney disease patients), does the ghrelin agonist capromorelin vs placebo increase food intake and body weight?

Shelf #258 · gate-verified and displayed under the developer's blinded-trial rule

LIKELY: Capromorelin stimulates appetite in dogs and produces weight gain in cats with unintended weight loss, in randomised, masked, placebo-controlled trials in each species. In dogs (Zollers 2016, 244 enrolled; 177 in the effectiveness analysis), owner-judged appetite success at day 3 was 68.6% on capromorelin vs 44.6% on placebo (P = .008), and mean body weight rose 1.8% vs 0.1% (P < .001) over 4 days. In cats, the anchor named for this topic (Wofford, published online 2017, journal 2018) is a safety study only — it makes no efficacy claim — and the feline efficacy evidence is Wofford 2025: in 176 cats with chronic kidney disease and ≥ 5% unintended weight loss, mean body-weight change at day 55 was +5.18% on capromorelin vs −1.65% on placebo, a treatment effect of +6.81% (95% CI 4.21–9.42, P < 0.0001). Diarrhoea and vomiting were the commonest adverse reactions in dogs; hypersalivation was the signal adverse event in cats. Drafted Nov 10, 2026 (VetMed build, topic #258); all figures from abstracts fetched and verified at drafting.

Zollers 2016 (dogs): appetite success 68.6% on capromorelin vs 44.6% on placebo; weight +1.8% vs +0.1%

Prospective, randomised, masked, placebo-controlled multicentre clinical study (4 days)

Who: Dogs: 244 client-owned dogs reported by owners to be inappetent for at least 2 days, enrolled in a prospective, randomized, masked, placebo-controlled study (177 cases in the effectiveness analysis) — capromorelin oral solution 3 mg/kg daily (n = 121) or placebo oral solution (n = 56) for the effectiveness population. Owners evaluated appetite at day 0 and day 3 ± 1; success was defined as improvement in appetite at day 3.

Result: Capromorelin improved appetite compared with placebo: 68.6% treatment successes (95% CI 59.7, 76.3) vs 44.6% (95% CI 32.2, 57.8), P = .008. Mean body weight increased in capromorelin-treated dogs compared with placebo (1.8% with 95% CI 1.3, 2.3, vs 0.1%, P < .001). Adverse reactions occurring in > 5% of either group were diarrhea and vomiting. The record concludes capromorelin oral solution is an effective treatment for stimulation of appetite in dogs.

Watch out: The primary endpoint is the owner's judgement of appetite over only 4 days, and the placebo success rate was high (44.6%) — inappetence often improves on its own or with attention. The trial shows short-term appetite stimulation, not treatment of the underlying cause of inappetence and not survival or disease outcomes.

Zollers B, Wofford JA, Heinen E, Huebner M, Rhodes L. A Prospective, Randomized, Masked, Placebo-Controlled Clinical Study of Capromorelin in Dogs with Reduced Appetite. J Vet Intern Med. 2016;30(6):1851-1857. PMID: 27859746. Registry ID: none in the record. MeSH: Animals · Appetite · Appetite Stimulants · Body Weight · Dogs · Female · Male · Piperidines · Prospective Studies · Pyrazoles · Receptors, Ghrelin

Wofford 2025 (cats): capromorelin gave +5.18% body weight vs −1.65% on placebo in CKD cats with unintended weight loss

Randomised, masked, placebo-controlled multicentre clinical field trial (55 days)

Who: Cats: 176 client-owned cats with existing chronic kidney disease and unintended weight loss of 5% or more, in a randomized, masked, placebo-controlled, multicenter clinical field study — randomised 2:1 to capromorelin or vehicle placebo orally once daily for 55 days (effectiveness population n = 112). Changes in body weight and safety parameters were monitored throughout.

Result: Body weight increased progressively with capromorelin and decreased on placebo. In the effectiveness population, mean change in body weight from day 0 to day 55 was +5.18% (95% CI 3.45–6.91) with capromorelin and −1.65% (95% CI −3.82 to 0.55) with placebo; the treatment effect (capromorelin minus placebo) was +6.81% (95% CI 4.21–9.42, P < 0.0001), representing +0.25 kg (95% CI 0.15–0.35). Hypersalivation was observed only in the capromorelin group (P < 0.0001); for all other adverse events there was no significant difference between groups (at least one adverse event in 96/118 [81.4%] capromorelin cats and 41/58 [70.7%] placebo cats, P = 0.3650).

Watch out: The effectiveness population (112) is smaller than the enrolled population (176), and adverse events were common in both groups — these are sick CKD cats, and the trial measures weight over 55 days, not kidney progression or survival. Weight gain is the endpoint the drug is for; whether it changes the course of CKD is not answered here.

Wofford JA, Milliken MacKinnon A, Heinen E. Capromorelin promotes weight gain in cats with unintended weight loss: a randomized, masked, placebo-controlled clinical trial. J Feline Med Surg. 2025;27(11):1098612X251379924. PMID: 41204815. Registry ID: none in the record. MeSH: Animals · Cats · Female · Male · Cat Diseases · Quinuclidines · Renal Insufficiency, Chronic · Weight Gain · Weight Loss · Piperidines · Pyrazoles

Wofford 2018 (cats, safety): capromorelin up to 60 mg/kg for 14 days and 6 mg/kg for 91 days — emesis and hypersalivation, no clinically relevant pathology differences

Two randomised, controlled safety studies with placebo groups (14 days and 91 days)

Who: Cats: two randomized, controlled studies — Study 1: cats (n = 6 per group) received placebo or capromorelin at 9, 15, 30 or 60 mg/kg once daily for 14 days, with postmortem examination; Study 2: cats received capromorelin 6 mg/kg (n = 8) or placebo (n = 4) once daily for 91 days, with growth hormone and insulin-like growth factor 1 measured. This is the Wofford cat study named as this topic's anchor (published online 2017; journal issue 2018); it is a safety study and reports no appetite or weight efficacy endpoint.

Result: Abnormal clinical observations were limited to emesis, hypersalivation, lethargy/depression, head shaking and lip smacking, which occurred more frequently in the capromorelin-treated groups than in the placebo group. There were no clinically relevant differences in clinical pathology test results between the capromorelin and placebo groups in either study.

Watch out: Safety at multiples of the clinical dose in small groups (4–8 cats per group) does not establish efficacy, and blinding is not stated in the record for these studies — no design word beyond randomised and controlled is claimed for this card. Efficacy in cats rests on the Wofford 2025 field trial carded above, not on this study.

Wofford JA, Zollers B, Rhodes L, Bell M, Heinen E. Evaluation of the safety of daily administration of capromorelin in cats. J Vet Pharmacol Ther. 2018;41(2):324-333. PMID: 29057482. Registry ID: none in the record. MeSH: Administration, Oral · Animals · Cat Diseases · Cats · Dose-Response Relationship, Drug · Drug Administration Schedule · Female · Growth Hormone · Insulin-Like Growth Factor I · Lethargy · Male · Piperidines · Pyrazoles · Sialorrhea · Vomiting

Synthesis: appetite up in dogs within days, weight up in CKD cats over 55 days — species evidence kept separate

Synthesis

Who: Synthesis of the cards above: Zollers 2016 (randomised masked placebo-controlled trial, dogs), Wofford 2025 (randomised masked placebo-controlled field trial, cats with CKD) and Wofford 2018 (randomised controlled safety studies, cats).

Result: Each species has its own placebo-controlled evidence and neither is borrowed from the other: dogs show a real but modest appetite effect over 4 days against a high placebo response (68.6% vs 44.6% success), and cats with CKD and unintended weight loss show a clear weight effect over 55 days (+6.81% treatment effect, P < 0.0001). The cat safety work shows the expected ghrelin-agonist signs (emesis, hypersalivation) without clinically relevant pathology changes at the doses and durations studied. None of the three studies measures survival or disease modification.

Watch out: All three studies are manufacturer-programme studies of the same product family (Aratana/Elanco ghrelin agonist programme, per the records' drug naming), durations are short (4–91 days), and the dog endpoint is owner-reported appetite — the LIKELY stamp reflects concordant placebo-controlled results in two species, discounted for those limits.

Synthesis of Zollers B et al. PMID: 27859746; Wofford JA et al. PMID: 41204815; Wofford JA et al. PMID: 29057482. Registry IDs as on the individual cards.

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