Visiting Veterinarian

Take two and call me in the morning

By Michele Gerhard Jasny V.M.D. - January 18, 2007

One of my favorite cartoons depicts a veterinarian's exam room that looks like it has been hit by a tornado, pictures askew, medical equipment strewn about. A freaked-out cat hangs from the drapes and a disheveled doctor sits dazed on the floor. His clothes are tattered, his arms scratched, but he's grinning ear-to-ear as he hands an incredulous owner a huge vial of pills. The caption reads "Great! Now just give her nine of these a day until they're gone." Medicating Spot, the spaniel, is a piece of cake...or at least a piece of cheese. Unless they are so sick they have no appetite, most dogs will swallow anything hidden in a sufficiently tasty morsel. Honestly, an animal whose idea of a yummy snack is raiding the litter box shouldn't be too hard to trick into taking a pill. Spitfire, the cat, is another story. She won't even eat cat food unless it's the right brand, right flavor, right temperature, on the right plate, with suitable background music.

So let's imagine Spitfire is sick and needs medication. Let your vet know right up front if you think that's a problem. I can't always tell based on her demeanor in my office. Spitfire may be a pussycat here but a tiger on her own turf. Conversely, some cats act aggressively at the vet, but are easy to handle at home. Maybe Spitfire isn't the problem, she's easy to pill. You're just not very good with this sort of thing. That's okay. We all have our strengths and weaknesses.

Let's try to make things easy. Can you crush medication and mix it in food? Check with your vet first. Many medications taste bad. Mash them in her Tuna Feast and she'll simply refuse to eat. If your vet approves, mix the medicine in a very small portion of food, say a teaspoon. Feed it before her regular meal so she is hungry and will eat it all. If you mix it in a full serving, and she only eats half, we won't know how much medicine she got. Another option is a commercial product called Pill Pockets. These tasty tidbits have a hole in the middle and come in a variety of sizes and flavors. Pop the pill inside, squeeze shut and voila! Spitfire eats the treat without noticing the pill. Many cats, however, are too discerning for such tactics.

Get help and close the door

Face it. You're just going to have to push it down her throat. Hopefully there are two of you humans. Pick a surface that is comfortable for both you and Spit, such as a rubber-backed bath matt (so it won't slip) on a counter. Each cat is different. Experiment. Work in a room where you can close the door and without a lot of hiding places. That way, if she bolts during your first attempt, you won't be chasing her all over the house or trying to fish her out from behind the washing machine for your second attempt.

Now, Person Number One, your job is to hold Spit and keep Person Number Two from getting scratched. Every cat is different. (Yes, I know I already said that.) Try and sense what makes her tense, what helps her relax. The hold I generally find most effective is putting one hand gently on each front leg at the cat's elbow, using my forearms to orient and confine the body and hind legs. Person Number Two, take Spitfire's head firmly in one hand and tilt it up. Don't be wimpy. Take a definitive grasp and point her nose right up at the ceiling. Straight up. If Spitfire were to sneeze, she should spray the ceiling, not the walls. If you have her head tilted adequately, her mouth should open slightly.

Place a finger on her lower incisor teeth and gently pry her mouth open. Drop the pill as far back in her throat as you can. Now, quickly, close her mouth. Relax her head to a normal position but keep her mouth held shut. Blow a little air in her nose or massage her throat. If the pill is far enough back, and you are firm, she should swallow it. You can dropper a little water into her mouth to wash it down. Buttering the pill in advance can also make it go down easier.

There. Good for you. You did it... or not. Two seconds later she deposits that pill back on the floor.

Maybe you should get a pet piller from your vet. It's a plastic plunger with a soft rubber gripper tip. Put the pill in the gripper, open Spit's mouth, push the plunger as far back her throat as possible, push the pill in. If you can get that pill over the hump of a cat's tongue, very few will be able to spit it out. There. Good for you. You did it.

Fussy about flavoring

Or not. If Spitfire is an inveterate pill-spitter-outer, talk with your vet about liquid medications. Sounds easier, you say. Why don't we always dispense liquids for cats? Only a few products come ready-made in liquid form, many of which are flavored for human children, not cats. If you think Spitfire hates pills, wait until you try to give her cherry-flavored antihistamines or bubble-gum flavored antibiotics.

If we have a specific medical reason for using one particular antibiotic or drug, rather than another, it may not come in liquid. We can have it specially prepared into a suspension by a compounding pharmacy, even flavored with something like fish or liver, but this takes time and costs extra. My other concern with liquid medications is that owners think if they squirt the medicine out of the dropper, they have successfully medicated the cat. Seems to me many cats end up wearing more of the liquid than they actually swallow. Still, liquid preparations often are a reasonable answer. Restrain Spitfire as described above. Work the end of the dropper into her mouth and squirt in the dose. There. Good for you. You did it.

Or not. Face it. Some cats are virtually impossible to medicate orally. Sure, you might get a few doses down but by day four, pill 12, forget it. We don't want you getting hurt. We don't want to give Spit post-traumatic stress disorder. We do want her to get better. Be honest with your vet. Don't be embarrassed. It doesn't do anyone any good if you meekly accept the medication and then don't give it. We have other options. If Spit is on multiple drugs, a compounding pharmacy may be able to combine them into one pill or one liquid. Some drugs can be administered in transdermal gels that are absorbed through the skin. You can hire someone to help you at home. Many of the freelance Island pet sitters have experience working in veterinary offices and may be more adept than you at medicating cats. Your vet may opt to use injectable medication, modify the treatment plan (for example, prescribing a once-a-day antibiotic rather than one that needs to be given two or three times), or discontinue nonessential treatments.

Medicating a cat is a lot like getting your children to listen to you. If you are too tentative, you will fail. If you are too heavy-handed, everyone gets upset and you still fail. Tailor the approach to the individual feline, take a committed but gentle approach, and go for it. There. Good for you. You did it....