Oral medications – how to administer them

For most veterinary treatments it is important that medicines are given correctly. In the hospital, trained staff give medicines and it is important to ensure that you are able to continue to give the medicines once your cat has been sent home. If you have any doubts about how to give the medicine your pet has been prescribed, ask your veterinarian or a nurse to show you.

To be effective, most treatments have to be given regularly and for the right length of time. If medicines are not given correctly the active part may be lost or poorly absorbed. This reduces the dose that the patient receives and may delay recovery from illness or early recurrence of disease.

There are several important elements to giving medicine:

• Ensure treatment is given correctly, ie the patient receives the correct dose, at the times requested by your veterinarian.
• Ensure the safety of both your pet any anyone helping with the procedure. In almost all cases, it is easier to administer treatment effectively if you have someone to help: one person restrains your pet and the other gives the treatment. However, if your cat is reasonably co-operative many owners can give medication by most routes.
• Ensure medicine is stored correctly and handled according to instructions supplied. All medicine that is unused should be returned to your veterinarian to ensure correct disposal.
• Any untoward effects of medicines should be reported to your veterinarian. Adverse effects are rare, but are always possible.

Many medicines are designed to be given by mouth – largely because this is a convenient way for owners to treat their pets. Oral medicines can be given as pill, capsules, liquids and pastes. Most medicines given by mouth go through into the intestine where they are absorbed into the blood. The presence of food in the stomach helps absorption of some drugs but hinders the absorption of others. It can therefore it is important to follow any specific instructions your veterinarian gives you about timing of treatment in relation to feeding.

The most certain way of giving a pill is to put it directly into your pet’s mouth. At least this way you know whether or not your pet has swallowed all the medication.

Many medications also taste unpleasant so if your cat has had treatment before they may be even more reluctant to wait around for another dose. Cats do not like to be restrained for any reason as they like to be in control of a situation. If cats have not been used to being handled and examined as kittens it can be very difficult to give pill effectively. Give pills in treats/food at mealtimes when your cat is hungry. Check with your veterinarian whether the pill or medication can be split or crushed before mixing with food. Some medication can’t be given with food and some cats will not eat if they detect the medication. So, ask the veterinary staff to show you how to administer pills or liquid, or check out this YouTube video on how to give your cat a pill: www.youtube.com/watch?v=pSxjeAMuTEI.

There are soft-ended ‘pill givers’ which can be used to give pill – these can be purchased from veterinary clinics, where staff will advise on how to use them. If your cat is very wriggly you might find it helpful to wrap them gently in a towel for administration of pills, but do not struggle with your cat as you will both end up stressed! If you really can’t give treatment to your cat, ask your veterinarian if there is an alternative medication. Never just stop giving medication without talking to your veterinarian about it first.

Medicines can be delivered in many different forms and if you are struggling to get your pet to accept one type ask your veterinarian if your pet’s treatment can be given another way. Even for medication that is given by mouth there are many different formulations:

Pills and capsules

Pills are made from compacted, powdered drug (usually mixed with something like chalk to make the pill the right size, and often with a flavor to make it more palatable). Capsules contain powdered drug inside a gelatin case – once inside the gastrointestinal tract the gelatin dissolves to release the drug. Some pills have special coatings to protect the drug from the action of acid in the stomach – the coating is dissolved in the stomach and the drug is only released once the pill is in the intestine.

Pastes

Drugs mixed into pastes can occasionally be useful in cats. The sticky paste is smeared onto the tongue and the cat is unable to spit it out so has no alternative but to swallow. It may be possible to smear the paste on to an area of fur and get the cat to lick it off, but this is not a very reliable way of ensuring your pet has the correct dose.

Liquid formulation

Liquids can be very tricky to administer effectively to cats unless they can be mixed with food. If they are mixed with food, it is important to ensure that the medicine is thoroughly mixed in and that the patient eats all the food containing the medication. Some liquid medications taste unpleasant so need to be mixed with quite a large volume of strongly flavored food to disguise them. Animals will often refuse to eat contaminated food or eat around bits of food containing the drug if it has not been mixed in well. Liquid medications are usually administered directly into the mouth using a syringe. It is very easy for cats to refuse to swallow liquid medications and to dribble it from their mouths. When giving liquids by mouth, great care must be taken, to ensure that the patient swallows the medication and does not breathe it in. Oily medications, eg liquid paraffin in the lungs can cause severe pneumonia.

With a bit of practice many owners can give their cats a pill straight into their mouth. Ask your veterinarian to show you how to do it if you are unsure and watch a video online until you are confident you know what you are doing. It is much easier if you have someone to help you hold your cat.

• The handler restrains the patient in a sitting position on a non-slip surface so that it feels secure (preferably with its back to a corner). It is often easier to restrain cats at a working height so place a towel or blanket on a table. If a cat struggles a lot or tries to scratch it may be necessary to wrap it in a towel.
• The person administering the medicine takes the correct dose of pills in their right hand.
• The patient should be approached from the side and the left hand used to grasp the top of the muzzle firmly but gently.
• The upper jaw is grasped just behind the level of the canine teeth and the head pulled upwards until the mouth falls open.
• A finger of the right hand can be used to press down on the lower incisor teeth to open the mouth.
• The pills are placed at the back of the tongue and the jaw is allowed to close.
• The mouth should be held shut until the patient has swallowed (gentle stroking of the throat area might encourage the patient to swallow).
• The patient should be watched closely immediately after medicine administration to ensure they do not spit the pill out again.

In many cases, a missed dose is corrected by giving the dose as soon as you remember and then giving the following one when it would have been due anyway. Intervals of 1-2 hours either side of the specified time are unlikely to make much difference. However, because some medication should not be repeated too soon, it is always best to check with your veterinarian as to what to do. If it is not possible to contact your veterinarian, then the safest course is to skip the missed dose and just give the next one when it would have been due.

Always contact your veterinary practice for advice if you are worried about anything relating to your pet’s treatment. Some pills can make cats sick – the dosing may need altered or else an alternative drug may need to be found. Stop the pills meantime and immediately contact your veterinarian for advice.

No, your other cat needs a veterinary check-up first. It could be a different condition that just looks the same, or your other cat could have individual problems that require a different approach.

It depends on the problem and the policy of the cattery. Most reputable catteries can cope with routine treatment for problems such as arthritis, heart conditions and skin conditions. Experienced catteries can also handle more complex medical conditions such as the daily injections and treatment for diabetic animals. Speak to both your veterinary surgeon and the cattery in plenty of time to make sure they are happy to manage your pet while you are away.

It is likely that you will have to administer medicine to your pet at some point in its life. If the need arises speak to your veterinarian and ask for extra help if you do not feel confident to give pills to your pet. Your veterinarian would much rather work out the best way to treat your pet properly rather than have you struggle and risk your pet not getting the proper treatment.