Giving medicines to your cat

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, i.e. the patient receives the correct dose, as and when needed.
• Ensure safety of both the patient and the personnel involved in the procedure. In almost all cases, it is easier to administer treatment effectively if an assistant is able to help: one person restrains the cat and the other gives the treatment. However, it is usually possible for experienced owners to give medication by most routes to a reasonably co-operative and obedient cat.
• Ensure medicine is stored correctly and handled according to instructions supplied.
• Any untoward effects of medicines should be reported to the veterinary clinic or hospital. Adverse effects are rare, but possible.

Many medicines are designed to be given by mouth – largely because this is a convenient route for home treatment. Oral medicines can be given as tablets, capsules, liquids and pastes. Most medicines given by mouth enter the stomach and pass 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 be important when you give oral medicines in relation to feeding and you should follow any specific instructions your vet gives you.
Direct oral administration of medication obviously involves dealing with the animal’s mouth. This may be a real problem in aggressive patients and alternative routes of medicine administration (or mixing of medication with food) may be needed if there is a significant safety risk.

Tablets and capsules

Tablets are made from compacted, powdered drug (usually mixed with something like chalk to make the tablet the right size, and often with a flavour to make it more palatable). Capsules contain powdered drug inside a gelatine case – once inside the gastrointestinal tract the gelatine dissolves to release the drug. Some tablets 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 released once the tablet is in the intestine.
Tablets are often crushed and put into food, but the fussy cat may refuse to eat the medicated food. Keeping the cat slightly hungry before tablet administration and offering the powdered tablet disguised in a small amount of especially tasty food, may get round this problem. The rest of the meal is given only once the medication has been taken. You can buy special treats to hide tablets in, or else you can improvise using, e.g. soft cheese.
This can work quite well but if an animal bites into the tablet they are likely to spit it out and will be reluctant to be fooled by the same trick again. The most certain way is to give the tablet directly into the mouth (see below: “Oral administration”). If the tablet is swallowed you know the whole dose has been taken.

Pastes

Drugs mixed into pastes can be particularly useful for use 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. Some of these medications can be smeared onto an area of fur for the cat to lick off while grooming.

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 flavoured 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 e.g. liquid paraffin in the lungs can cause severe pneumonia.

Topical (on the body surface) application of medicine can be used to treat specific areas, such as patches of skin, or as a simple way of giving medicine to a patient because some drugs are taken up through the skin into the body. A lot of drugs are readily absorbed through the skin and if given frequently, or for prolonged periods, can build up in the body, causing side effects. For example, steroids put onto the skin can eventually cause signs of a condition called Cushing’s disease.
Most cats will lick off any medication on the skin if they can reach. it This should be prevented by the use of dressings, Elizabethan collars or other protective devices.

Topical treatment for local effect

Ocular (eye) treatment

Eye conditions are quite common in domestic pets and are often best treated by topical therapy. Eye treatments come as drops or creams/ointments. Drops can be easy to apply to the eye (see below; “Ocular administration”) but are washed out quickly and may need to be given many times daily. Ointments and creams persist in the eye for longer and some only need to be given once daily.

Aural (ear) treatment

The inside surface of the ear canal is just a special type of skin. However, this is a very sensitive area, so only treatments specially made for use in the ear area should be used. Drops or creams can be used effectively (see below; “Aural administration”).

Skin treatment

To be effective, a topical treatment must come into contact with the skin. If necessary, hair should be removed from the area to which the treatment is being applied. The skin surface should be cleaned to remove grease, previously applied medication and any build up of crusting or secretions.
Medication for topical application can be mixed with oily or water-based carriers to produce gels, ointments or creams. Creams or ointments are massaged gently over the skin surface until they are absorbed into the skin. Alternatively, application may be by means of washes or shampoos. Remember when treating skin problems that the area being treated may be sore to touch, so be gentle and ensure that the patient is adequately restrained.
In many skin diseases, a combination of topical and systemic treatment is used, e.g. shampoo and a course of antibiotic tablets.

Topical treatment for systemic (whole body) effect

One advantage of giving medicines by the topical route is that they do not have to pass through the gastrointestinal tract. This makes it a useful way to give drugs that would be destroyed by acids in the stomach. Some drugs can enter the body through the skin and affect organs and tissues far away from the site of original application.

Flea treatment

Some of the topically applied flea treatments are absorbed through the skin and then enter the bloodstream. Spot-on treatments are dropped onto an area of the coat that the cat cannot reach when it grooms itself, usually the back of the neck/scruff area. The active ingredient is absorbed through the skin and enters the cat’s blood. Fleas or other parasites receive a dose of the drug when they next bite the cat and are killed.

Heart treatment

Nitroglycerine cream is used to manage heart disease and is more commonly used in cats than dogs. It causes blood vessels to relax, helping to reduce the workload for the heart. It is applied as a cream on a hairless area of skin (usually the inside of the ear flap) from where it is rapidly absorbed, entering the bloodstream and affecting blood vessels throughout the body.

Pain relief

Sticky patches containing powerful analgesics (pain killers) are now available. These can be applied to hairless areas of skin during the recovery from anaesthesia and slowly release small doses of the drug over several hours or days. This gives the patient a pain-free recovery from surgery, without the need for further injections. These pain-relieving patches are only currently used in hospitalised patients.
Remember that drugs can be absorbed very easily through hairless human skin so gloves should always be worn when handling topical treatments.

• 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 giving the medicine takes the correct dose of tablets in their dominant hand.
• The patient should be approached from the side and the other 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 naturally.
• A finger of the dominant hand can be used to press down on the lower incisor teeth to open the mouth a little more.
• The tablets 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. Licking of the nose indicates that swallowing has occurred.
• The patient should be watched closely immediately after medicine administration to ensure the tablets are not spat out!

• 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 handler grips the head of the cat from underneath. Now they can tilt the cat’s nose upwards using one hand (it may be possible for them to hold the eyelids open with the thumb and forefinger of the other hand when doing this).
• Alternatively, with one hand on the top of the head and another under the jaw the eyelids can be gently held apart and the head steadied at a suitable angle.
• The person applying the eye drops opens the bottle or tube and holds it in their dominant hand.
• They use the thumb and forefinger of their other hand to hold the eyelid open (if necessary).
• Holding the bottle or dropper above the eye, it is gently squeezed so that the correct amount of medication falls into the eye. Take care not to touch the surface of the eye with the nozzle as this can contaminate the contents and damage the eye.
• Resting the side of the hand against the muzzle whilst holding the applicator between thumb and forefinger helps to steady the applicator away from the eye and gives good control.
• When applying creams or ointments it may be necessary to trail the ‘worm’ of ointment against the lower eyelid to detach it from the tube.
• Keep the cat restrained for a few seconds to allow the treatment to spread over the eye surface – then allow them to blink before releasing them.

• The handler restrains the cat 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 handler restrains the patient from the side ‘cuddling’ it to them with a hand placed over the muzzle pushing the muzzle down and holding the head firmly against their body.
• The person giving the drops lifts the ear flap to expose the ear canal.
• The ear canal is cleaned to remove any discharges or previously applied medication before putting in new treatment. Use a large piece of dampened cotton wool.
• Do not insert cotton buds, instruments or small ‘twirled’ pieces of cotton wool into the ear canal. Only material easily visible at the surface should be gently wiped away.
• The nozzle of the treatment applicator is held next to the opening of the ear canal and drops or cream are applied into the canal. The nozzle is withdrawn and the vertical ear canal gently massaged from the outside to disperse the treatment (whilst the patient is still restrained).
• Take care as you release the patient as they are likely to indulge in vigorous head shaking.

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. This applies to most ear and eye treatments, and to many tablets. However because some medication should not be repeated too soon, it is always best to check with your veterinary surgeon as to what to do. Note that intervals of 1-2 hours either side of the specified time are unlikely to make much difference. If it is not possible to contact the veterinary surgeon, then the safest course is to skip the missed dose and just give the next one when it would have been due.

Always contact the veterinary practice for advice. Some tablets have a tendency to do this – the dosing may need to be altered or else an alternative drug may need to be found. Stop the tablets in the meantime.

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. If you used the same product, you would not anyway have enough to complete the course of the first cat’s treatment.

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.