That is a common discussion on the feline IBD list. Some struggle so much with oral meds, and I have a cat that is very difficult to pill.  And forget it when you have a vomiting cat trying to give anything oral.  Injections literally saved Bo's life.  I remember August 2007.  Bo was so sick - vomiting and nauseous.  We had been to the vets several times but just couldn't get food down, let alone medications.  He vomited them, drooled them...etc.  On top of that he was completely stressed out and was fighting us.   I was getting worried about HL. The vet was going to be off on Friday so I kept calling over and over on Thursday to tell her we needed a different plan. I was lucky that she called me after hours and we came up with a plan for the backup vet the next day - injections.  We were kind of scared because we had never given an injection before.  But didn't figure there was a choice because we didn't want Bo to die.  So, a single Vetalog injection to quiet things down (given by the vet) and injections of famotidine and dolasetron at home.  He finally started his recovery and we tapered off the injections.  When Bo became sick again in December of the same year, following his exploratory surgery we used the same combination of drugs, and added prednisolone compounded into little tuna chews.  We tried pepcid that way but he wouldn't touch it.  We did eventually learn to give him pepcid as a pill but it took a long time to get there.  He takes the pepcid daily and continues to get the pred chews EOD. 

On the other hand, or cat Cougar is just a sweet thing to pill!!

Jenny November 19th, 2009 03:16:51 PM

Thank you for a great article.  Very timely for me right now.

With my cats, I have had pretty good "luck" getting the meds down orally.  But it can be tricky, popping that pill in and/or getting it in the mouth via pill popper syringe.  And liquids?  Another story...lol...

I now have one 21 year-old-kitty who may need antibiotics. (Waiting blood tests.)  It has always been difficult to get meds into her, and esp. now.  When the vet said she may need antibiotics by mouth, I thought, "Oh no. Not going to work."  I was the one who had to ask about injections.  And they are available, subcutaneous (sc).  

Easier for me and no stress on my kitty. And for sure, the medication will be getting into her! 

Hey, so many of us are sent home with sc needles and bags of water to give to our cats, what is the big deal with NOT giving injectable meds more often?  I DO hope the pharmaceutical companies make more medications available in injectable form.    

Ronnie November 19th, 2009 03:58:30 PM

We were fortunate enough that Jerry didn't mind our proven method of manually putting pills down the back of his throat. :-) Later, as the meds increased during his hospice care, liverwurst worked best. The stinkier the better. Thanks for this new option, never thought about asking if meds were available in other more easily administered forms.

Another great post for your client audience! We'll be linking to this one in our ongoing discussion about how to get dogs to take meds.

tripawds.com November 19th, 2009 04:10:41 PM

This was timely for me, too.  I just talked to my mom about the latest drama for her disaster dog.  The poor thing is having trouble maintaining weight, and her skin condition seems to be getting worse.  Since she already takes several pills a day for epilepsy and allopecia, the vet suggested a special diet to address the weight/ skin issues.  I was impressed by what a thoughtful solution it was.

Posey November 19th, 2009 04:58:22 PM

Very timely for me, since I have a cat who was just put in Actigall. Any recommendations for getting pills into cats? I wish everything was available as a subq injection!

Sarah November 19th, 2009 08:52:09 PM

A plea to vets: stock at least a small supply of non-chewables in the commonest prescriptions, for the dogs who won't touch chewable pills! Chewables are big and hard to hide in cheese or liverwurst, plus the dog can still smell them. I've had two such dogs now. My current dog is almost impossible to dose; I may have to ask my vet to let me try the sub-q route, because he is really good at sniffing out anything you add to his food, and he gets really upset if you try to force things down his throat.

Susan Rosenau November 19th, 2009 09:27:41 PM

Sarah, Cougar is on actigall/ursodiol.  I purchase capsules from a regular human pharmacy and give him 1/6 sprinkled over his food. He has never had any problems with taking it that way, so I have never had it compounded.

Jenny November 19th, 2009 09:37:17 PM

"Any recommendations for getting pills into cats?"

I'll second the question.  We've done it but it takes two of us and it's not pretty.  The cat loves Greenies pill pockets and some other wrappings but is also quite adept at eating around the pill itself.

Will November 19th, 2009 10:25:13 PM

My cat has IBD shading into lymphoma and is on pred and leukeran. No way to pill this demon! And he picks the pills out of cream cheese, which worked for a while

What works now?

Putting the thankfully small pills in empty unflavored gelatin capsules - I got a 1,000 of the size 4 for about $18 - and putting THAT into cream chese in a ball just slightly bigger than the capsule.

The capsule hides the taste and he doesn't even notice the.

Natalie November 19th, 2009 11:25:35 PM

Many apologies for the sloppy typing!

Natalie November 19th, 2009 11:26:50 PM

I kinda don't get it but think it comes back to handling one's own pets who should be accustomed to being wrangled by an owner.  I've yet to have a cat or dog I couldn't pill although there's always an initial period when I have to find out what works best for each pet; however, that pill's gotta go down that gullet and, in my house, is going to go down that gullet and I'm gonna know it did before I release.  They learn that and then it all gets easier over time as "resistance is futile" around here!

Restraining a cat...  Here's my starter version.  Bag the cat.  Some bag options: Mesh, grooming bag, vet bag.  I prefer a simple mesh bag with openings at both ends because it's easier to put them in head first than butt first.  Then use a heavy over-sized towel to wrap, burrito, the cat.  Essentially you tuck the limbs in close in a natural position, close to the body, and wrap tightly so the limbs can't move (the bag is most helpful in keeping those front paws from popping out).  Cradle the cat in one arm like a baby and shift the cat to your lap (cross legged on the floor works best with the cat in the "well" surrounded by your legs.  Put one hand over the cat's face (they are more cooperative if they can't see) with a thumb on one side of the face and finger on the other, grasp upper jaw with that thumb and finger and tilt head back to open mouth.  Use other hand to pry lower job if necessary (over time they will usually just let their mouth open.  (I grasp pill between thumb and first finger and use third finger to pry if needed.)  You should now be in a position to drop the pill directly to the back of the throat.  Drop in pill, instantly close mouth and hold it closed,use small syringe to shoot in a small amount of water on one side of mouth without allowing jaws to open (there's plenty of space between the teeth for water to go in), stroke throat to encourage swallowing if water alone didn't get the job done.  Do not release mouth until you see the throat action related to swallowing.  The first few times, a cat will try to tell you they are choking, etc., etc. and you must not fall for it!  It may take an hour the first few times but I can now do this in under 20 minutes with a newbie and under 5 with my long term critters.  Most of my dogs AND cats will sit in my lap and allow me to tip their head back to drop in the pill because they know I'll resort to this method if they are uncooperative.  Resistance is futile!

This method works for small dogs too.  Suck it up mommies and daddies, those pills need to go down those gullets :)

PJB November 20th, 2009 01:57:05 AM

At the Hospital where I work, getting the pills down is a constant complaint.  We always ask what the owner thinks would be better pills or liquid and 90% of the time they tell us pills and then they can't get the pills down, so we switch to liquid and it seems like people have problems with this too.  I thought these owners were just crazy until one of my dogs got ehrlichia and had to get 8 pills a day.  Of course this dog hates treats, would pick around them mixed in anything so I just had to shove them all down her mouth.  Not fun for either of us but we got the job done.  Sometimes you just can't be afraid to make your pet a little mad. 

DNS83 November 20th, 2009 07:50:20 AM

I'm also big on offering the rare stinky treat so cats and dogs will get used to this as a future pill vehicle. Some cat owners especially appreciate the Greenies pill pockets since their cats seem to love them whether they're hiding something or not. 

Dr. Patty Khuly November 20th, 2009 08:10:47 AM

I take pills twice a day. Mommy tried cream cheese & pill pockets. I growled at her and said, "no way"! I am usually a sweet girl, but that made me growly. She got a pill shooter and that works great. Someone suggested bagging a kitty. That sounds very traumatic to me. Mommy has never held me down. She uses one hand on top of my head to gently pull up on my mouth (thumb & 1st finger over fangs) and puts the shooter all the way in my mouth and shoots at the back of my throat. Usually I don't even need to swallow. It goes straight down. Now here is the important part: pay attention. I always get treats afterwards! Why is this important? Mommy has sometimes forgotten my pill. Because of the treats, I will remind her. I come when Mommy calls me to get my pill, because I know there will be treats! Some days I even sit on the kitchen table and wait, because I know there will be treats! Treats are very important! Mommy doesn't shoot water down my throat because my fountain is nearby. I usually go there after my treat. I find it very important to get my treat first.

My woofie brother likes his pills in kielbasa. I think that may also be a kind of treat.

Tiki the Cat November 20th, 2009 08:35:15 AM

Timely post for me as well.  I just had my skittish boy in for a dental and he had a tooth removed so now he's on clav. 

fostering has taught me how to pill quickly and efficiently, but Eli spent the first six months of his life being medicated, so our issue isn't getting the pill in the throat, it is getting the pill and the cat in the same room!!  He's so wary of me that nothing works for long.  I got the pill pockets and was quite hopeful when I got dose #2 down him so easily, but after that he said NO WAY! and I've had to grab him and mandhandle him.  I am fearful that by the time the script is up, I won't see him for a few weeks.  Not much can be done about that though..

Connie November 20th, 2009 11:23:05 AM

"our issue isn't getting the pill in the throat, it is getting the pill and the cat in the same room!!"

That's our problem.  If the pill is supposed to reduce anxiety, having to stage an extraordinary rendition to give it each time didn't compute.  Given no other choice we would do it but alternatives are much preferred.  I can give shots, I've done it lots with humans, one bird, many cats, and countless rats.

Will November 20th, 2009 02:11:49 PM

Sarah - I agree with Tiki the Cat that restraining is not ideal.  However, I've not had much luck with pill shooters.  If you can get the cat to do one of the treat methods already described, that would probably be easiest.

When I volunteered at a shelter, I was taught to try to get the cat calm and then sneak the pill into her mouth before she could guess what I was doing.  Sneaking the pill into the mouth entailed bringing it up from the side/ back so the cat didn't see it coming head on and then popping it into the back of the throat.  There is a small space between the last tooth & the corner of the mouth - that's where I'd push the pill in & then down.  You may have to gently hold the mouth closed and massage the throat until kitty swallows.  I was taught that if kitty licks her nose, it's a good sign that she swallowed the pill, but it wasn't always foolproof.

PJB's burrito method works when the cat is difficult and trying to claw you, but if you can get the cat to take the pill calmly, it makes everyone happier.

I've had great luck with pill pockets for my male cat.  He's an angel about taking pills that way, but my female is obstinate.  I typically try to sneak the pill into her mouth while petting her, but sometimes she spits it out.  Then, I try holding her & pushing the pill in.  I haven't had to burrito her yet, but that would be the next step.

Posey November 20th, 2009 02:42:50 PM

Tiki, You remind me of my Bubba who would take pills that way except I didn't even need a pill shooter.  Unfortunately, not all your cousins are so cooperative :(

Will, I can sympathize.  I had a cat on phenobarbitol eons ago and I always wondered whether the effect was worth the fight in getting it down her but it turned out it was because she became more easily pilled over time.  I really think they begin to realize there's a relationship between the meds and how they feel.

My guys don't like the pockets and treats just aren't enough to persuade them.  I gave up on liquid because I can never tell just how much really went down and how much got spewed.  I tried one of the fist pill shooters and it didn't seem to work well but maybe those have improved.  I've been tempted to resort to shots on a few occasions but, so far, pilling is still the easiest for me.

PJB November 20th, 2009 03:17:30 PM

PJB,

You haven't met nearly enough animals! All of mine are rescues with issues.

First time feline Katie was at the vet they just tried to give her ears a look... she levitated two feet over the exam table and went back nearly over the vet's head, then curled up in a snarling ball on the floor. And her attitude went downhill from there.

Her brother Gus (he's the mellow one) and his vet have an understanding: Gus will cooperate for as long as he can manage and the vet won't handle him after that.

Fortunately, Gus loves salmon cream cheese. If I make the ball just the right size, he picks the whole thing up in one lap of his tongue. It didn't work when the taste of the meds was bleeding into the cream cheese but works fine now that the med is protected by the capsule.

Natalie November 20th, 2009 03:46:36 PM

It's not only the issue of getting the medication down the animal's throat... sometimes different preparations of the same active ingredient are better tolerated than others.

Case in point, a dog I adopted has a seizure disorder and has been on Phenobarbitol and Potassium Bromide (KBr) since she was about 4 months old.  We got the KBr from a compounding pharmacy, in capsule form.  She is easy to medicate as far as getting the pills down - the problem was that the KBr made her vomit.  I struggled with this for years, the best solution I came up with was to give the KBr at bedtime, separately from any other meds and with a small snack.  Even then, I could give it no more than 2 days in a row - if I went 3 days, she would not only throw it up but would continue to vomit for several hours.   At this point she had stabilized to having 1 or 2 seizures every 5 or 6 weeks, and since this was a big improvement on the 3 -4 seizures per week she used to have, I figured that was the best we could do.

Then last summer when I had her at the clinic for a check up, my vet mentioned that they had started carrying KBr in a suspension.  I had considered trying a liquid formulation before, but really thought it would make no difference.  But I tried this liquid KBr anyway....

and it's a miracle!  She has not vomited since we switched and I can just put it on her food.  Best of all, (and I'm assuming this is because she is finally getting the dosage she needs) she has not had a seizure since we switched!  We've been able to reduce her Phenobarb by 30%, she is less ataxic, and it has been FOUR MONTHS since her last seizure!! 

I am kicking myself for not trying a different formulation years ago - but I am SO GRATEFUL for this!  Same active ingredient, but just the formulation made all the difference in the world.

Barb November 20th, 2009 03:54:45 PM

And speaking of stinky treats... try Braunschweiger.  It's a soft, stinky meat paste - VERY messy, we put it into a big syringe either with a catheter tip, or just cut the tip off - and squirt out a little as needed.  We use it mostly for the "ultimate" treat for high distractions/difficult exercises or as a real jackpot.  But many animals go so crazy over it they will snarf it down pills and all.

Barb November 20th, 2009 04:07:28 PM

A number of years ago, I had a little poodle with congestive heart failure (among other things) who was on a handful of pills twice a day. She was a miserable little bugger about taking them. No matter what I hid them in, she'd find them and spit them out. I got away with chunky peanut butter briefly, but then she started eating the peanut butter and still managing to separate the pills from the chunkies. So I'd pill her, and she'd fight and struggle, which was stressful and dangerous given her heart condition, but she couldn't *not* take the pills because that was dangerous too. It had me in tears more than once, just out of overwhelming frustration.

The dogs I have now are simple- I just chuck the pills in their food bowls and they scarf them down without a thought. Gluttons. The only exception has been antibiotics in capsule form, but those go down easy in cream cheese or peanut butter or whatever.

One of my cats was diagnosed this week with hyperthyroidism. I didn't even consider medication, to be honest. I'm going straight for the radioiodine treatment. Having to pill a cat twice a day for the rest of his life is something I'd really prefer to avoid if possible.

Katie November 20th, 2009 06:28:55 PM

"You haven't met nearly enough animals!"  LOL, I am all too familiar with the levitating cats and the hissy/snarling/spitting/lashing out balls of cat furor!  I've had cat scratch fever more times than I can count.  My wonderful Bubba was a long hair but liked being trimmed to short hair/nearly no hair once he developed respiratory problems (less cleaning needed and he preferred to clean himself and be trimmed rather than be groomed with long hair).  As good as he was, one time I clipped his skin with the clippers and he drove a fang all the way in behind my thumbnail; reminded me of the concept of bamboo shoots and torture.  I've had a multitude of cat scratches and bites but this one was wicked and left a scar that requires me to keep that nail trimmed to avoid problems with the scar tissue (which also has to be trimmed).  Historically, I end up with the cats who can't be placed because they're alleged to be vicious.  I'm generally a very happy camper to get them from feral insane to half feral and house broken and anything after that is gravy (and I usually get quite a bit of gravy) but even "wild" cats need meds sometimes :)  Wrangling the cats to the vet and while at the vet is a whole other thing!

PJB November 20th, 2009 07:19:57 PM

Ronnie - a lot of the clients I work with turn down the injectables because they're more expensive. 

anna November 20th, 2009 08:48:41 PM

I've found that what works best for my pill picky terrier is to treat my other two dogs with chunky peanut butter for doing some obedience/freestyle/agility behaviors. The picky dog gets very upset that she's not getting any peanut butter. Then I sneak the pill in the peanut butter and she chomps it right down. j

Julie November 22nd, 2009 08:01:23 AM

PJB, sometimes it isn't a matter of getting the pill down a cat's throat.  As mentioned we could get the pill in, but when you have a very sick cat and he vomits, or froths, up his meds it just doesn't work.  He was so sick he couldn't even keep pepcid down.  Also, as for restraining him, you take a very sick cat that is already really stressed and add restraining him and can only make things worse.  I just won't do that to him when injections are available.   

Jenny November 22nd, 2009 10:24:55 AM

Jenny, I called my method a "starter version" for a reason.  It isn't a cure all, just a very effective method for me and mine.  If you find injectables more acceptable, that's wonderful.  However, I don't see much difference between restraining for a pill and restraining for a shot.

PJB November 22nd, 2009 02:08:59 PM

I have a cat with HCM and she gets meds twice a day.  Initially it was a problem but now I flip her over on my lap, open her mouth and pop the pill in.  On a good day, it goes straight down and her swallowing reflex kicks in and all done.  Occasionally, she'll resist but my new cat sitter taught me to just just a syringe worth of water into her mouth after the pills gone it. 

PJB, I don't need to 'bag' her to pill her and in fact, I have never bagged a cat in my life.  Although it sounds really traumatic I have wrapped many a cat in a towel to avoid getting shredded hands well trimming nails and that seems to calm them down.

Shannon November 22nd, 2009 07:22:27 PM

LOL.  I love those of you who are trying to pick a fight because I was willing to share an effective method in response to a couple of people who asked who to restrain a cat to pill him/her/it.

Shannon, goody for you.  Me too.  I've had to "bag" a cat twice.  Generally, my cats will sit, head tip back, pop in pill, off to get their own drink of water.  Sometimes, towel wrap and baby hold; although the bag is often tempting because it ensures those front paws don't pop out and reduces the chances of injury.  However, I WILL bag if needed because the meds are important and I won't make excuses for not getting them down the cat's throat.

BTW, none of these measures for difficult (actually, just plain good old fashioned independent) cats is really traumatic for the cat.  What's traumatic for the cat is being sick and picking up on the silly "traumatic" displays by the owners.

PJB November 22nd, 2009 11:33:45 PM

PJB I think that your the one trying to pick a fight.  People express concern that bagging a cat would be traumatic and you turn it around and say its because of silly traumatic displays by the owner.  This is a forum where people share ideas and opinons.  Your's aren't the only one's that matter.  And by the way, I'll excuse the 'goody' comment as a typo but if it wasn't it would have been rude.

Shannon November 23rd, 2009 06:27:40 PM

Actually I don't need to restrain for an injection at all.  Sometimes we are lucky enough to do them without the cat even expecting it, and there is barely no reaction.  That is generally the way we do it with Bo's pepcid as well since he does take that nightly.  But for the injectiosn I've done that a few times while they are simply walking around.  But even with Bo who we usually try to prepare first, he takes the injections with no fight, and no problem at all.  We usually place him on the kitchen island. I hold him in place so he doesn't flop on his side and at the same time kind of push his fur up on the sides to increase the scruff. He purrs through this whole thing because he is getting attention from both of us and then my husband gives the injection. Sometimes there is a slight reaction if the injection stings, but a few "good boys" and pets and he purrs right away.   This is much less traumatic then bagging a cat, and as I said, he vomits the meds when he is sick so pilling him isn't an option anyway.  No use pilling a cat if they can't keep the meds down.

Jenny November 23rd, 2009 10:17:21 PM

In the post it wasn't clear...Bo's pepcid is a pill now.  As he is stable now, there is no problem giving him this one pill.  His EOD pred remains as a tuna chew because it is easier for all of us. 

Jenny November 23rd, 2009 10:23:11 PM

Shannon: "PJB I think that your the one trying to pick a fight. People express concern that bagging a cat would be traumatic and you turn it around and say its because of silly traumatic displays by the owner. This is a forum where people share ideas and opinons. Your's aren't the only one's that matter. And by the way, I'll excuse the 'goody' comment as a typo but if it wasn't it would have been rude."

Express away.  If you choose to direct the comment to me individually, I may consider that rude and be snide in response to that rudeness.  It wasn't a typo and I certainly don't need your forgiveness.

PJB November 23rd, 2009 11:28:57 PM

PJB

This isn't the first time that you've insulted me.  Keep them to yourself.  We're not in elementary school anymore.  It is possible to express opinons without being rude about others.

Shannon November 24th, 2009 06:40:04 AM

Shannon, Not the first time you've insulted me either so take your own advice before dishing it to others.

PJB November 24th, 2009 10:49:32 AM

Here is my sucess story w/ treats.  Red tailed hawk w/ a nasty squirell bite on it's toe.  It affected the extensor tendon enought that the toe could not/ would not open of it's own volition.  Bird was on I think batryl which tastes aweful.  The normal method is to cast and use a flexable hose on a syringe to inject it down the throut.  This would be OK on a bird kept tethered, but I wanted to free loft her to reduce the chance of bumble foot, and I had to keep her fat to help her fight the infection.  Well the combination of a fat bird and being cast every time she came to the glove was making her very reluctent to come to the glove.  The solution was mouse bellies.  I injected the baytrel into a dead mouse and fed her the mouse.  Worked like a charm, once I figured out the correct mouse size.  To small and the liquid squeezes out the injection hole, to large and the bird prefers to eat in two bites, and gets no medicine.  Once I got the mouse size figured it worked great:)

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