If you have a cat at home chances are really good that sometime in your cat’s lifetime you will need to medicate them, especially as they transition into their senior years. Sometimes cats can be challenging to pill or medicate, but there are some techniques that will make medicating them easier, less stressful, more effective and healthier for them. Here are some important things to know and follow when medicating your cat.

Why Dry Pilling and Dry Swallowing is Bad For Cats

Have you ever taken a pill without water? Ouch, it’s not fun. Well the same goes for cats. Without chasing a pill down with water or liquid afterwards the pill can get lodged in the throat and irritate the lining of the esophagus. Dry swallowing can cause a pill to go down painfully and slowly, and can even damage the delicate tissues lining the esophagus. Dry pilling can cause choking, gagging, reflux, heartburn, esophagitis, esophageal injury and strictures, and even cause aspiration. There have been case studies where dry pilling certain medications (including Clindamycin and Doxycycline) have resulted in severe injury to cats and in some cases, even death when these cats were dry pilled. One study noted that “After five minutes 84 percent of capsules and 64 percent of tablets are still sitting in the esophagus,” when dry swallowed. (Journal of Feline Medicine and Surgery, Volume 8, Issue 6, Dec. 2006: 412-419) Another study that appeared in a veterinary journal found that following dry swallows, “No pills were in the stomach at 30 and 60 seconds, and only 6 percent of the pills were in the stomach at 90 seconds. At 5 minutes, only 36 percent of the pills were in the stomach. For wet swallows that were followed by 6 ccs of water, 90 percent of the pills were in the stomach.” (Journal of Western Internal Medicine, 2001, Sept-Oct: 15: 467-70)

Dry pilling with no water or liquid following the pill can do serious damage to the lining of your cat’s esophagus. Not only can it cause irritation and discomfort, but it can also cause painful ulcers to develop. Some medications cause more damage than others. For example, the antibiotic Doxycycline can be especially irritating and painful if allowed to come into prolonged contact with the esophagus. It can actually cause erosive esophagitis when given without water or liquid.

Remember when pilling your cat to always syringe some water into your cat’s mouth after the pill. You never want to “dry pill” your cat. You wouldn’t like to take a pill without drinking some water, right? They are no different.

Here are some important things to remember when pilling your cat that will make the experience of pilling better for you and your cat, and healthier for them too.

Ways to Make Pilling Easier and Better For Your Cat

1. Never “dry pill” a cat or force a cat to swallow a pill dry – This can cause uncomfortable and serious damage to your cat’s esophagus.
2. Always follow pilling with water or liquid – Using a 1 cc or 3 cc size syringe (you can get syringes from your vet), place the syringe into the side of your cat’s mouth at a 45-degree angle and drop several drops of water or liquid onto their tongue following the pill.
3. As an alternative to water, use tuna juice, meat broth, or juice from a cat food packet– Use a flavorful, tasty alternative to water that your cat will like and deliver it using a syringe, using the same method noted above. You can also use the juice from a canned cat food can.
4. Feed your cat their favorite food after pilling – Just after pilling your cat, feed your cat their favorite canned or wet food (ideally not dry) or use Gerber’s baby food,  chicken or turkey flavor. You can also give them canned tuna**. Following the pill with some cat food will be positive for them and less stressful than using the syringe.
5. Use treats after pilling – If your cat loves kibble and like treats like Temptations™, you can follow their pill with a treat to help the pill go down, but again, because kibble is dry it is better to give them something with more water content to make the pill go all the way down.
6. Use Greenies™ Pill Pockets” when pilling – Greenies™makes two great pill pocket flavors for cats—salmon and chicken—and many cats love the flavor making pilling much easier! But a whole Greenie can be too large and difficult for most cats to swallow. So break the Greenie into two or more cookie pieces and if the pill is larger than cut the pill in two or three pieces; wrap the dough around each pill part and feed them the Greenies. To make it even easier, give the Greenie with the pill just before feeding time when your cat is hungry, then follow their pilling with canned wet food to help it go down. Plus it will make pilling a positive experience for them.
7. Coat the pill with a little butter, L-Lysine or vitamin paste – This can help the pill go down more easily. I use L-lysine (builds immunity for herpes cats), Vetoquinol Nutri-Cal Oral Gel or Vetoquinol Laxatone, which I always have readily available. Then syringe a little water following the pill.
8. Use a Pill Popper or Pill Pusher– Sometimes these devices make pilling easier and more effective, but again, be sure to follow with a syringe of water in small amounts. Insert the tablet into the rubber tip, open the cat’s mouth, and gently insert the popper into the mouth, then follow with water or a tasty liquid or canned food.
9. Crushing a pill and mixing it into wet food – This is an option, but it can be tricky when the cat either doesn’t like the flavor of the pill and as a result won’t eat the food, or doesn’t eat all of the food therefore not getting the entire medication. Cats can be very suspicious when they smell anything slightly different or unappetizing to them.
10. Avoid your cat vomiting up the pill – The objective is to get the medication into the stomach as quickly as possible. Once it is there the chances are good your cat will not vomit it back up. But if the pill is lodged in their throat or esophagus, they may vomit it up because it’s uncomfortable or painful.
11. Ask if your pill medication comes in a “coated” form for better taste – Methimazole, commonly known asTapazole®, a medication that treats hyperthyroidism in cats, is available in a coated pill form called Felimazole, which coats the very bitter, terrible taste of the methimazole pill making it much easier for your cat to take. See if a coated version of the medication is available, this will help and make a difference.

** How to make your own tuna water – To make your own tuna water mix canned tuna with 2-3 cups of water. Mash it up and let it sit for 10-15 minutes. You can strain the water leaving only liquid, then syringe the tuna liquid after pilling. Or keep the mixture to let you cat eat a little after each pill episode. Always refrigerate it for the next use, and toss it after a few days. Then remake fresh again.

Alternatives to Hard Pills and Capsules

If you have trouble pilling your cat, some medications can be formulated into different forms that will make it easier to medicate them. Some medications that come in pill form are also available in liquids, transdermal gels, or chewable treats. Ask your vet if another form can be used for your cat’s prescription that is equally as effective. Often these medications will require a compound pharmacy to formulate the medication precisely for your cat’s size and weight.

If your cat is particularly difficult to pill and the experience is stressful for them, these options are worth looking into. Compounding the drug into a liquid or transdermal gel is only available for certain medications, but it may be worth asking your veterinarian. If available, your vet will contact a compound pharmacy to have the medication formulated based on your cat’s weight. A transdermal gel will be applied to the inside of your cat’s ear and then goes into the bloodstream. A flavored liquid medication will be syringed into your cat’s mouth or can be syringed on top of their wet food and mixed in. Something to keep in mind is compounded medications can be slightly higher in price, but they are often well worth it especially if your cat is hard to pill and accepts the liquid or transdermal medication easier. Avoiding stress is the name of the game.

1. Transdermal gel– Transdermal preparations are formulated into gels or ointments and are absorbed through the skin by rubbing onto the inside of the ear. Usually you have to alternate applying the dosage to one ear in the morning and the other ear at night to keep the medication evenly applied and distributed. I have done this for three of my cats for several years with the hyperthyroid medication Methimazole (Tapazole) and it’s made my life and their lives so much easier. But medications like antibiotics, steroids and behavior-altering drugs are often not absorbed properly through the skin and can be bad candidates for transdermal gels.
2. Compounded flavored liquid medications– Compound pharmacies like Costco and specialty compounders can compound the medication into flavored liquids. For really bad tasting medications like Flagyl and some antibiotics, you can ask for something really strong like “Triple Fish” or tuna flavor. But they also have more common and mild flavors like chicken and beef that may work just as well.
3. Medications given by injection– Sometimes you might be prescribed an oral antibiotic in pill form, but if your cat is especially difficult to pill, you could ask your vet if the injectable, long-acting antibiotic like Convenia would work as a substitute. Convenia is an antibacterial medication that lasts for up to two weeks, but can stay in the body longer, and is typically given for skin infections and sometimes oral infections or prevention of infection. But as with all medications, there are risks, and although Convenia is convenient, there are known risks associated with this drug. But most vets will agree they are minimal and rare. But it may be better to have your cat given the injectable antibiotic than risk not getting adequate antibiotic in pill form.

Cautions Syringing Water or Liquid Medications

There are some important things to remember and know about using a syringe to syringe liquids into your cat’s mouth.

• Don’t syringe more than 1 cc or a very small amount—a couple of drops—at a time, up to 3 ccs slowly is fine for pilling.
• Let your cat swallow the water first, before giving them more. Pause for some moments before syringing the next 1 cc into their mouth. Let your cat swallow slowly and take your time in this process.
• To syringe, place the syringe into the side of their mouth at a 45 degree angle then drop the water/liquid onto their tongue. NEVER syringe from the front squirting directly to the back of the mouth, and do not insert the syringe directly to the back of the mouth. Both can cause reflux, choking and even aspiration, which can be very serious.
• Don’t tilt your cat’s head back when syringing liquid. Her head should be level and looking forward, with her mouth slightly down, but never raise her head upwards when administering liquid. It’s extremely difficult to swallow with your head tilted back, try it sometime.

More Tips on Medicating Cats

• Read the prescription instructions completely before administering
• Understand dosing instructions and follow them precisely
• Don’t forget any doses, if you do, wait until the next prescribed dose
• Finish the medication as prescribed for the full durationof the recommended treatment; don’t stop mid-way unless your vet suggests it
• Some medications require shaking first to mix all the ingredients. If shaking the medication is required before administering—then shake thoroughly
• Be careful when administering liquid medication, do it slowly and don’t force it in all at once making your cat gag
• Store the medication properly following the label. Some need to be refrigerated at all times, and some need to be kept in a cool place. Be sure to follow the storage instructions
• If your cat has a reaction to the medication call your vet immediately or take them to a veterinary hospital, don’t delay
• After the medication is given, praise and reward your cat so the experience will be a positive one
• Remember to follow pill medication with water / liquids to avoid esophageal problems, discomfort, and ulcers
• Give your kitty a treat or their favorite wet food after medicating them to reward them and make medicating as positive an experience as possible

Here are some instructive videos for medicating your cat. Good luck!

How To Give Your Cat Medication

Teaching Your Cat to Willingly Take a Pill Using a Pill Popper

Applying Transdermal Medication to Your Cat

https://www.youtube.com/watch?v=uIvRwLKMMDs

How to Administer Liquid Medication to Your Cat

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