Saturday, May 14, 2016

Medicating Your Cat: A Veterinarian’s Tutorial

There’s a fun little cat-themed meme that’s been circulating online over the past ten or twenty years. In one of its many iterations, a cat owner explains “how to pill a cat in 13 easy steps” and concludes that it might be best to keep a hamster instead.

While you’ll never find me backing any plan to keep hamsters over cats, I don’t disagree that some cats are a nightmare to medicate. This discomforting reality is especially apparent when you consider how easy it is to get a dog to swallow a pill. Wrap it in peanut butter and –– voilá! –– you’ve done the job. But cats? … Not so much.

Not that all cats are difficult to give meds to. Indeed, I’ve found that plenty of cats are surprisingly easygoing on this issue. Open their mouths with the tip of a syringe and they’ll down every drop. Place a pill on their tongue and they’ll swallow it quick. Got a powder, pill or elixir you want to mix into their food? No complaints.

But these are only the outliers. The majority of felines will give you a run for your money when it comes to accepting the administration of meds. They’ll spit up the pill, drool out the liquid, and turn their nose up at a “contaminated” food bowl. (“What, do you think I’m really that stupid?”)

Then there are those who won’t even let you get close enough to offer the offending item. After one or two rounds, they’re smart enough to hide out until you get tired of looking for them. Alternatively, they may well truck out the teeth and claws to let you know –– definitively –– that they’re not going to comply (and that you can keep your stupid human tricks to yourself, while you’re at it).

Fortunately, there are some tricks of the trade that people like me (vets, vet techs, pet sitters and other pet professionals) have developed and mastered that might well be of use to the wider cat-owning public. To that end, here’s my personal “how-to” guide for your consideration:
#1 The traditional pilling method

Hold the top of your cat’s head with your non-dominant hand, just as if you were holding a baseball. In so doing, crook your fingers and thumb underneath her cheekbones. Next, crane her head back so that it’s pointing up. You’ll notice her mouth will open as you do this. This is usually just enough of an opening for you to pop a pill in with your dominant hand. (I sometimes just drop it in so I don’t risk the wrath of those teeth.)

Now you simply close her mouth gently and wait for her to swallow. You’ll usually know she’s done this when she licks her nose. At which time you can release your hold on her head and hope to God she doesn’t spit it back out somehow.
#2 The traditional liquid medication method

Hold the top of your cat’s head as for the pilling method. Instead of craning her head backwards, though, simply insert the tip of the syringe into one of the corners of her closed mouth. Slowly depress the plunger on the syringe, waiting patiently for her to swallow bits of it as you go. If you’re doing it right, you’ll see her throat “gulping” as she takes her meds.

Administering a liquid may sound like it’s an easier process, but I happen to be a big believer in the greater simplicity of pills for medicating most cats. Cats do differ, however, so it’s always worth trying to medicate with a liquid when pills prove difficult. And sometimes it’s true that cats will respond well to some liquids and pills and poorly to others so ask your veterinarian whether most cats tend to prefer the pill or liquid versions of the meds he or she prescribes.
#3 Handling the resistance

A significant percentage will inevitably resist. They do NOT want that nasty stuff in them and they’ll be sure to let you know this with as many of their “tools” as they have to before you’ll understand and internalize their position on this subject.

My approach to these patients is to first find out how badly they’re willing to hurt me. If I conclude they’re not terribly serious about making me go away (i.e., they’re not threatening to actually bite me), I’ll wrap them in a towel, burrito-style, and try my usual tactics for pills and elixirs. If they’re especially tough, I’ll enlist additional help to hold as I medicate or vice-versa.

Using a pilling gun or some other such tool may be necessary here. These pilling tools allow you to remain outside the clutch of those feline teeth, meanwhile allowing you to get deeper down into the oral cavity with the pill itself.
#4 Reigning in the regurgitator or drooler

Some cats are masterful rejecters of pills and liquid. Somehow, they actually manage to bring up the item as if it’s nothing more than a wayward bit of offensive kibble. Or they’ll spit out the stuff in a stringy dribble of drug-tinged drool.

I’m not a fan of these patients' reluctance. It makes it almost impossible to administer anything to them orally. For these, I employ the next two tips:
#5 The pill disguise

It’s always a good idea to try something like those commercially available “pill pockets” for tricking your gulper into taking his meds but beware: most cats will start off taking the secreted pills, only to figure it out and, unbeknownst to you, start spitting them out behind your bed or under your sofa.
#6 Alternative approaches

Some conditions are treatable through other means. Treatment with radioactive iodide, for example, can cure cats of hyperthyroidism, thereby relieving you of drug delivery detail forever (at least for treating her thyroid disease). Others are amenable to treatment via subcutaneous injection. (Believe it or not, almost all cats prefer subcutaneous injections to pills and liquids.)

Alternatively, some medications can be formulated as a gel that can be absorbed through the skin. This “transdermal” approach is one many compounding pharmacies will prepare for their animal patients whose unwillingness to take medication makes treatment otherwise impossible.
#7 Start early

The one thing I will say in favor of having to medicate sick kittens under eight weeks of age is that these babies tend to grow up into easier to treat cats. Young kittens who must be medicated frequently during their socialization window (between 2 and 7 weeks of age) will almost inevitably learn to tolerate such ministrations and carry this easygoing aspect of their personalities into adulthood.

So those are my tips. Now it’s your turn: What do YOU do when it comes time to medicating your cats?

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