How to Give Your Cat Pills

by Dr. Ko⁽¹⁷⁶⁾ Red Star

So, you and your cat are back home after a visit to the vet. You have two bottles of medication in your hand and instructions to medicate your cat three times (eek!) per day. You aren't quite sure how your cat will feel about this plan. You anxiously glance at your kitty, now curled up comfortably on the couch. Kitty opens one eye which boldly stares back at you ... the look in kitty's eye is unmistakable. It says, "just you try to medicate me, Human. By the time you've made your last futile attempt, YOU will be the one needing a visit with the doctor and some medication." But, don't panic! There are lots of tricks available to help you medicate your cat in an effective, relaxed, and danger-free manner!

Sneaky Tricks:

? Pill Pockets

Pill pockets work best for food motivated kitties
They come in two tasty flavors, salmon and chicken
Pill pockets are hollow, soft treats into which you place the tablet or capsule and then ‘mush' the opening of the pill pocket closed so that the medication does not fall out
Disadvantages to pill pockets are that cats that are not food motivated are unlikely to voluntarily eat them
Another disadvantage is that if your cat accidentally bites into the pill pocket and tastes an unpalatable medication inside, they will be unlikely to ever be fooled by pill pockets again! Also, some cats will learn to eat all around the pill, consuming just the pill pocket and leaving the medication behind.

? Flavored Chews

For long term medication options, flavored chewable treats are a very pleasant option
Medicated chews need to be compounded by your veterinarian's compounding pharmacy, and do tend to be more expensive than the regular drug
Compounding flavored chews works best for medications that are not particularly strong tasting and unpleasant, otherwise cats may still detect the taste of the medication and reject the chew treat (ie. many antibiotics cannot be successfully made into flavored chews)
To figure out what flavor your cat prefers before ordering a large quantity of medicated chews, ask your veterinarian to try non-medicated samples: generally flavored chews come in varieties such as tuna, chicken, liver, shrimp, seafood medley, and beef

? Flavored Liquids

Flavored medications in liquid form also need to be specially compounded by your veterinarian's compounding pharmacy, and are also available in a variety of flavors palatable to cats
Many people find liquids easier to administer to their cats than pills

? Liquids (non-flavored)

Many medications come in liquid form as well as pill form
Liquids are not necessarily any more tasty in comparison to their pill counterpart (most are sweetened for human consumption and are banana or cherry flavored – since cats cannot taste sweetness, all that they taste is the flavor of the medication itself), but many owners find liquids easier to administer than pills
Ask your veterinarian if there is a liquid form of the medication they have prescribed if you are having trouble giving your cat the pill form
Keeping the liquid in the fridge (unless the medication specifically cannot be kept at such a cool temperature) may help decrease the distastefulness of the medication and make it less unpleasant for your cat to swallow

? Clear Gel Capsules

Many medications have very strong, unpalatable tastes - when these medications are prescribed in tablet form they can be particularly unpleasant, and often chalky, for cats to swallow
Particularly when a medication is being administered long term, placing tablets into clear, flavorless gel capsules can be an excellent idea – your cat will likely resent the entire procedure much less if it does not involve an unpleasant taste that makes he or she salivate for ten minutes afterwards
Clear gel capsules can typically be obtained at your veterinarian's office, and if they are not routinely kept in hospital, then they can likely order some in particular for you
Some tablets may be too large to fit inside the gel capsules, so you may want to purchase a pill splitter at your pharmacy in order to cut up the tablets into halves or quarters that will fit more easily into the gel caps
The drawback to using gel capsules is that they start to dissolve as soon as they touch moisture – ie. as soon as they are inside your cat's mouth!
So, the key here with gel capsules is to ensure that you have your pilling technique finessed and to always have extra water syringes nearby so that you can flush the capsule down with more water if needed (ie. if the capsules becomes ‘stuck' to your cats tongue or roof of the mouth)

Pilling Techniques & Steps:

? Step I: Organize Supplies

It is essential to everything you need prepared and ready to gobefore you approach your kitty to administer their medication.
- Have your pills ready on your right side (or if you are left-handed, have them on your left side).
- Have your syringes filled with water ready alongside the pills.
It is IMPERATIVE that you administer water to your cat to help him or her swallow their medication.
- It is unfair and unsafe to assume that cats can swallow their medication without the help of water, and this is a topic that is all too often neglected when educating owners on how to medicate their cats.
- Studies have proven that cats that are forced to ‘dry swallow' their medications do not successfully swallow their medications all the way down the length of their esophagus – in fact, after 5 minutes post dry swallow, only 36% of cats had the pills in their stomachs.
The esophagus is a very thin, delicate tissue, and it is not protected from caustic substances by a thick mucus layer as the thick, tough stomach walls are.
This means that when medications dissolve within the esophagus, as they do when cats are forced to dry swallow them, the esophagus is vulnerable to sustaining serious and painful injury from the dissolving medication.
Unfortunately, your cat cannot alert you to the fact that this is happening, and that they are experiencing painful ‘heartburn,' but it is the reality of forcing them to swallow medications without water – most cats will simply withdraw after being pilled, and many owners assume that this is a result of the stress of the pilling event, and do not recognize it as an expression of pain.

? Step II: Methods of Restraint

♦Kitty Burrito Technique♦

It is important to know that frequently ‘less is more' with cats when it comes to restraint and physical manipulation.
- The more practice you get at administering medications to your cat, the easier it will become. So have patience, and remember that practice will make perfect.
- As you become more proficient at this task, the less stressful the event will be for your cat, the less protestation they will make, and as a result it will become even easier to accomplish.
Occasionally owners are anxious about restraining their cats and ensuring that their kitty cannot escape while they are administering their medication(s).
- One method of restraining your cat effectively and in a manner that does not increase his or her stress level, is by making a ‘kitty burrito.' (Ultimately, it is best if minimal restraint is used, but during the learning curve, it is acceptable to ensure that your cat cannot escape from you and further complicate the process.)
To use the ‘kitty burrito' technique, follow these steps:
- Place a towel on the floor in front of you.
- Place your cat on the towel so that they are lying down (upright), facing away from you.
- Wrap the towel around your cat just like you would wrap a present or a burrito, leaving your cat's head uncovered, but both forelimbs snugly tucked inside the towel.
- Place your feline 'burrito' on the floor between your knees facing away from you.
Cats enjoy feeling snug and secure, and wrapping them in a towel will decrease the amount of struggling they will do.

♦Minimal Restraint Technique♦

If not using the ‘burrito' technique, simply ensure that your cat is facing away from you, and then approach your cat from behind.
- This can be done while your cat is on a table, or on the floor, but generally speaking it is easiest when accomplished sitting on the floor with your cat.
Place one hand on your cat's chest so that they do not run away while you are getting organized.
- The reason you want your cat to be facing away from you is because this way they have nowhere to back into (because they will back into you), and with one hand lightly on their chest, they cannot run away either.

? Step III: Opening Your Cat's Mouth

♦My Favorite Technique♦

Gently tilt your cat's head upward:
- Place your left hand (that was previously on your cat's chest) under their chin and apply slow and steady pressure in an upward motion.
When your cat is looking up at you, place your right index fingertip between your cat's lips and you will be able to feel a gap between their upper and lower jaws where there is a space between their teeth
- The space is just behind their canine teeth and in front of their premolars.
- If you poke your finger in this small space, your cat will automatically open up their mouth.
When your cat opens their mouth for that split second, with your right hand (which has the pill ready), pop the pill as far back into the throat as possible.

♦Traditional Technique♦

Many people prefer the standard cat pilling technique.
- With your left hand grasp your cat's upper jaw and gently pull their head (and upper jaw) upward.
  - Your thumb is placed on the right upper jaw while your index and middle finger hold your cat's left jaw.
  - Your fingers should be just behind your cat's canine teeth when grasping their upper jaw.
- With your right hand pick up your cat's pill between your thumb and forefinger, and then placed your middle finger on the front aspect of your cat's lower jaw.
  - Your middle finger is used to pry your cat's jaws apart by placing it on your cat's lower incisors - cats' incisors are small and dull, so you will not be injured by this maneuver.
- Apply gentle but steady pressure on your cat's lower jaw until their mouth is open.
- With your cat's mouth open, quickly drop the pill as far back as you can to the base of the tongue.
The traditional technique requires a bit more physical manipulation, which is why I prefer the previous technique ("My Favorite Technique").

♦"Traditional" and "Favorite" Techniques with Pill Popper♦

Many people are hesitant when it comes to the "dropping the pill down to the base of the tongue" part of pilling their cats, and understandably so! If you fear for the safety of your fingers, or your kitty is simply a pro at preventing you from placing the pill far enough inside their mouth, then the pill popper may quickly become your favorite new acquisition.
- The pill popper is a long, thin plastic tube with a rubber tip on one end and a stylet inside of it.
- Place the pill inside the rubber tip.
- Use either technique to open your cat's mouth, and then gently insert the pill popper into your cat's mouth and push the stylet.
  - The stylet handle is on the opposite end of the pill popper from the rubber tip and, when pushed, it pops the pill out of the rubber tip and into your cat's mouth.

♦Notes on All Three Techniques♦

It takes practice to gain the confidence required to pop the pill all the way to the base of the tongue in your cat's mouth!
- It is normal to feel slightly skittish about sticking your fingers so far in there, but the more you practice, the less frightening it will seem, and you will quickly come to appreciate why the pills must be placed all the way back there; they will not be spat out!
So don't worry if pilling your kitty doesn't come naturally at first ... both you and your cat will grow accustomed to the routine with time and practice.

? Step IV: Water to Swallow the Pill

Now that the pill is successfully (hopefully!) at the back of your cat's mouth, place your left hand back underneath their chin and apply gentle upward pressure .
- Your cat's jaw must remain parallel to the floor because if your cat gets their head down, they can spit out their pill more easily.
- With the lower jaw held gently closed, and their head parallel to the floor or slightly upturned, pill expulsion is less likely to occur.
With your right hand, grasp the filled water syringe, and gently place the tip between your cat's lips.
- The syringe tip does not actually need to be forced into the oral cavity between your cat's teeth.
- Simply depress the plunger gently with the tip of the syringe resting on the lower lip, and your cat will do the rest and swallow it, rather than allow the water to dribble all over their impeccable fur!

♦Notes on Water Administration♦

My personal preference is to use 3 ml syringes.
- Some people prefer the 1 ml syringes rather than the slightly bulkier 3 ml syringes.
The syringe tip which is placed between the lips should always be small and unobtrusive.
- If the tip is bulky, your cat may resist its presence.
- Syringe tip shape, length, and width may vary somewhat depending on the brand and size of the syringe.
One of my favorite tricks is to use teat canulas on the ends of my water syringes!
- Teat canulas are meant for cow udders.
- Teat canulas are thin, flexible, elongated plastic tips that can be placed on the ends of the syringes … they are smaller, longer, and softer than the tips of the syringes, so they make great extension tips for giving water or liquid medications orally to cats!
I generally administer the entire syringe-full of water when giving pills, even if my kitty has already swallowed the pill down after the initial depression of the plunger.
- It is far better to administer a little more water than necessary than not quite enough!
It's essential that you have enough water-filled syringes present in case you need extra!
- Sometimes even the best of pill administrators flub up, so it's handy to be near a water bowl with which you can refill your syringes in case the first pill was expelled and a new pill needs to be given!
You can encourage your cat to swallow the pill by using your right hand to gently stroke your cat's throat - this stimulates the swallowing reflex.

? Step V: After the Pilling Procedure has been Completed

After your cat has successfully swallowed the pill(s), give lots of praise, cuddles, and some of their favorite treats, so that they make a positive association with the event.
In time, it is possible that your cat may even come running on cue (or, at the very least, won't run away!) when they hear the medication cupboard being opened, or the pills rattling in the pill vial, because they know that there will be tasty treats coming their way post-medication!

Common Kitty Medicating Mistakes:

? Pills

Do NOT mix your cat's medication into their food for several reasons:
- Many medications taste unpleasant, and typically the flavor of the medication in your cat's food will simply turn them off of a food that they previously enjoyed.
- Putting the pill in food or crushing it and mixing it into food is a very unreliable manner of medicating your cat, unless you are then immediately syringing it as a slurry into your cat's mouth.
- If you have other pets in the house, they may end up ingesting the medication and it may not be safe for the other pets in your home.

? Liquids

Do not EVER place your cat in dorsal recumbency in order to administer liquid medications – ie. do not cradle your cat like a baby in order to syringe liquid into their mouth!
- This position makes it difficult for cats to swallow properly, and makes it very easy for them to aspirate the administered liquid into their lungs, instead of swallowing it down their esophagus.
- I have seen cats suffer from aspiration pneumonia as a result of liquid medications being administered in this manner.
Administer liquid medications the same way you would administer the water post-pill placement.
- Push the plunger slowly and gently, allowing your cat ample time to swallow the liquid.
- Keep your left hand (or your right hand if you are left-handed) under their chin in order to keep it closed, and ensure that the jaw is parallel to the floor so that they do not spit or drool out the liquid.

To read this article at www.catdoctorko.com please click here.

The information provided in this article is for educational reference purposes only. It is not intended to be a substitute for the advice and care of your veterinarian, nor medical diagnoses or treatments. All questions regarding your cat's health should be discussed with your veterinarian. © 2011 K & J Ventures Inc. All Rights Reserved.

Article submitted Tuesday, June 28, 2011 & read 241 times.

Dr. Ko is a licensed Veterinarian who works exclusively with cats. She is a passionate believer in the importance of preventative medicine and educating cat owners about its benefits for their cats. It was this ideal which was the motivation for the creation of the Cat Health Store website - http://cathealthstore.com which is a free information resource and online store for cat owners everywhere!

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