Getting Your Cat to Take Medication
Safety
Handling medications
Some medications are toxic or can be absorbed through human skin so sick, elderly or women of child-bearing age may be affected by handling medications designed for their cat. Other examples include - thyroid medications (eg Methimazole, Carbimazole, Telmisartan), Steroids (eg Prednisolone), antibiotics (eg metronidazole), immune modulating drugs (eg cyclosporine), chemotherapy agents (eg Chlorambucil, Cyclophosphamide). People with allergies to antibiotics like penicillin should avoid contact with certain antibiotics.
It is best practice to always wear gloves or wash hands after handling medications or get someone else in the household to dose your cat if you are unsure about the risks of a medication.
Can I divide tablets or crush tablets and granules?
Always check first with your vet before crushing or dividing tablets because some tablets are not designed to be cut up - the reasons for this are:
Should I give WITH or WITHOUT FOOD?
There are lots of reasons why a medication may be designed to be given either with or sometimes without food.
Always follow specific instructions as not only will it make the drug more effective it will reduce the risk of side effects for your cat.
"WITH FOOD"
When a medication says it "needs to be given with food" there are many potential reasons for this:
If we know for sure that a cat is hungry enough to eat after medication then you may feel happy giving their medication in a tasty bit of food and then simply following with your cat's usual meal. Most of the time however, it's not that easy! Often sick cats, older cats and pickier eaters will not reliably eat a meal when you serve it. For pick eaters it can be helpful to allow them only 1-2 mouthfuls of their food first to check their desire to eat and then follow with any medication before allowing them to finish their meal.
A reduction in appetite can be a good marker for unwellness so if your cat is not eating always contact your vet before giving any medications that are meant to be given with food.
"WITHOUT FOOD"
Some medications need to be taken on an empty stomach in order for them to take effect.
For example, those that are designed to coat the lining of the stomach itself (eg Sucralfate a drug used for gastritis and suspected ulceration of the stomach). Your cat may be prescribed a pain killer (eg Buprenorphine) that has to be squirted directly under the tongue or in the cheek pocket. This drug gets absorbed through the lining of the mouth so it is important that no food is given within 5-10 minutes of dosing so that it has a chance to absorb without interference.
HOW TO GIVE MEDICATIONS
Should I put the medication directly in the food?
I always recommend that cat owners avoid hiding medications in a cats usual food wherever possible for the following reasons:
If you must put a medication straight into some food (eg powders or liquids) then try these tips:
How NOT to give medication that needs to be given WITH FOOD
All too often owners tell me that they just place the medication on a mound of food. Most cat medications are tiny doses so if you use any more than a half teaspoon amount of food you are leaving an awful lot to chance. Of course there will be exceptions but this is the least effective way of giving a cat medication in my experience.
The main reason for this logic is simple - how will you know your cat actually got all the medication?
Drugs only work if you can get them into the patient. It makes life a lot more difficult for you and vets trying to assess whether a treatment is doing what it should if we can't be sure they are actually getting it!
Many cats will cleverly eat around the medicated food.
We all know cats that are "grazers" or just will not eat all their food in one go - for most medications the therapeutic effect comes after a taking a full dose at one time. You can appreciate then that half or a third of a dose now and a bit more in over 15 minutes time is unlikely to have any beneficial effect whatsoever.
Even for cats that eat all their food immediately it always gets moved about the bowl so much that most of the medication may be left behind as bowl remnants.
Of course you also risk other cats in the household/neighbourhood eating it instead
Disguising vs Direct dosing Medication
Direct dosing can be a quicker and more confident way of dosing your cat with medication if you are physically able to do this. Busy people often prefer to direct dose so that they can relax knowing that a medication has been given. It is a particularly good way to get medication down if there are multiple cats in the household and they like to swap bowls at mealtimes.
International Cat Care has awarded certain medications an "Easy to Give" award which means the pharmaceutical companies have made an effort to produce a formulation that is palatable and practical for owners and their cats. One of the advantages of having a vet that thinks like a cat is that they are aware of which medications these are. The added benefit of having a cat vet in charge of a business is that we can choose to stock these medications above others and so do so wherever possible. That said, unfortunately many drugs we use for treating illness in cats only exist in a human formulation so these can be very bitter or have minty/fruity flavourings added which doesn't exactly appeal to cats. I would never advise putting a tablet in a cat's normal wet/dry food as a lot of the time this just wets and dissolves the tablet and imparts the nasty taste into the food which can lead to an aversion with the food itself.
Link to How to use a towel when cats become nifty with their claws.
It is often better in the short term to dose essential medications directly into your cat because you want to be sure the dose has gone down. Often it can be continued until your cat is feeling better enough that they have regained their usual appetite but in the longer term it is less stressful all round if you can transition your cat into a medicating regime that involves voluntarily taking the medication. Let's face it we are most likely to continue with a treatment if our cats are compliant at taking it without the need to restrain or force it upon them, but if all my disguising suggestions fail, then direct dosing may be the only option. You can always try again at a later stage to disguise the medication. What we don't want is a cat that is already unwell and suffering from a reduced appetite to be put off eating even more because they suspect that every meal may be laced with nasty tasting medications.
NB: Always follow any directly dosed medications with a syringe of 1-2 ml water - especially for certain medications that can predispose to oesophageal ulceration. We wouldn't take tablets/capsules without washing them all the way down into the stomach where they are intended.
Link to Tools: Fingers or Pill givers
Disguises for Tablets
NB: You may have to break the tablets into 2 pieces to get them to fit into the gelatin capsules or into the putty and stick treats - always check with your vet it's safe for you and your cat to do this first. Wear gloves or wash hands after handling medications.
Tiny Gelatin Capsules (Gel Caps)
Tasteless, dissolvable capsules that are great for disguising nasty tasting tablets as heir temporary moisture-proof barrier reduces the chance of the tablet coming into contact with your cat's tongue and is a super way of dosing cats on multiple tablets either directly down their throat or by coating in the treats below.
Disguising in Treats
The number one thing you need to gain first is TRUST! The key is to always be sure they like the treats first! If it's not love at first sight with the treat, then be sure to make them at least familiar with it by putting a small amount with their usual food first so they get used to the taste, smell & texture alongside something they know and trust first. When they are accepting the treats readily, only then should you start to lace them with medication.
Commercial Treats I recommend for hiding tablets:
Soft, "squishable" putty-like treats that can be rolled into balls around the tablet.
Semi-soft sticks - use a kebab skewer or one prong of a fork to bore a hole down the centre of a 1cm piece of stick, taking care not to burst the seal round the outside of the stick as it will lose its shape and fall apart. Insert the tablet pieces
* again remember to try small balls of these soft treats first without any medications in to introduce your cat to it gradually & gain their trust.
Handling medications
Some medications are toxic or can be absorbed through human skin so sick, elderly or women of child-bearing age may be affected by handling medications designed for their cat. Other examples include - thyroid medications (eg Methimazole, Carbimazole, Telmisartan), Steroids (eg Prednisolone), antibiotics (eg metronidazole), immune modulating drugs (eg cyclosporine), chemotherapy agents (eg Chlorambucil, Cyclophosphamide). People with allergies to antibiotics like penicillin should avoid contact with certain antibiotics.
It is best practice to always wear gloves or wash hands after handling medications or get someone else in the household to dose your cat if you are unsure about the risks of a medication.
Can I divide tablets or crush tablets and granules?
Always check first with your vet before crushing or dividing tablets because some tablets are not designed to be cut up - the reasons for this are:
- Slow release medications have a special coating that delays absorption so by breaking or crushing a very large dose is released at one time and this can be very dangerous (eg once daily thyroid medications)
- Protective coatings on some medications reduce side effects and ensures the medication bypasses certain areas of the gut before being absorbed (some antibiotics and certain liver supplements).
- Uneven distribution of the medication within the tablet so a half a tablet may not necessarily contain half the dose.
- Toxicity to people is a risk with some medications so crushing/dividing tablets increases exposure to the side effects of these drugs to owners and is not advisable (eg chemotherapy drugs, thyroid medications etc)
Should I give WITH or WITHOUT FOOD?
There are lots of reasons why a medication may be designed to be given either with or sometimes without food.
Always follow specific instructions as not only will it make the drug more effective it will reduce the risk of side effects for your cat.
"WITH FOOD"
When a medication says it "needs to be given with food" there are many potential reasons for this:
- Reduction in stomach ulceration - Many are to be avoided if vomiting or diarrhoea is seen - this is because some drugs can cause stomach ulcers and the risk is increases when given on an empty stomach (particularly those from the aspirin family also known as NSAIDs - which for cats usually means products containing Meloxicam)
- Reduction in oesophageal ulceration - by disguising some medications and then following with a meal it reduces the risk of the medication irritating or becoming lodged in the oesophagus (the muscular tube that connects the mouth to the stomach). This risk applies in particular to two antibiotics used in cats (Clindamycin and Doxycycline). A meal works best at physically moving any medication all the way down into the stomach but if a cat will not eat afterwards then you may need to syringe 2-5ml of water down after each dose.
- Reduction in nausea - some medications can cause nausea in people so we advise giving with a snack or meal (eg Metronidazole antibiotics)
- Maximize absorption - The uptake of some drugs need food to enhance their absorption (eg Lufenuron an oral flea product)
If we know for sure that a cat is hungry enough to eat after medication then you may feel happy giving their medication in a tasty bit of food and then simply following with your cat's usual meal. Most of the time however, it's not that easy! Often sick cats, older cats and pickier eaters will not reliably eat a meal when you serve it. For pick eaters it can be helpful to allow them only 1-2 mouthfuls of their food first to check their desire to eat and then follow with any medication before allowing them to finish their meal.
A reduction in appetite can be a good marker for unwellness so if your cat is not eating always contact your vet before giving any medications that are meant to be given with food.
"WITHOUT FOOD"
Some medications need to be taken on an empty stomach in order for them to take effect.
For example, those that are designed to coat the lining of the stomach itself (eg Sucralfate a drug used for gastritis and suspected ulceration of the stomach). Your cat may be prescribed a pain killer (eg Buprenorphine) that has to be squirted directly under the tongue or in the cheek pocket. This drug gets absorbed through the lining of the mouth so it is important that no food is given within 5-10 minutes of dosing so that it has a chance to absorb without interference.
HOW TO GIVE MEDICATIONS
Should I put the medication directly in the food?
I always recommend that cat owners avoid hiding medications in a cats usual food wherever possible for the following reasons:
- Wet cat food is 80% water and powders and tablet surfaces start to dissolve in water which then imparts a horrible taste to the food.
- Cats develop aversions to things so if they smell or taste something horrible it may make an association with the food.
- Some cats are teetering on the edge of turning their nose up at their usual food and some just seem to eat a food out of habit. If you then lace this food with something that smells or tastes strange then that may be the only excuse they need to stop eating it. You often need to use something far tastier of your cats own choosing!
- Some medications are palatable and designed with cats in mind such as those awarded the "Easy To Give" logo. Others are designed for humans so are generally sweet with either fruit/mint flavouring. There are a few medications that lose their bitter taste when stored in the fridge (eg the contents of Clindamycin antibiotic capsules) but many medications prescribed for cats are not readily accepted by them.
If you must put a medication straight into some food (eg powders or liquids) then try these tips:
- Use oily fish - the oil is more likely to coat the powder and act as a barrier to the taste buds and the strong fishy flavour may help drown out any nasty tasting medication. For cats that don't like fish you could use the gravy from some wet food, see below for some other options for hiding liquids/powders.
- Never put more than half a teaspoonful of food down with the medication.
- Try warming the food slightly first so it smells tempting before you add the medication (heating medications may affect their efficacy).
- If you have tablets then I would strongly advise that you do not put these directly into wet food but use a gelatin capsule or other disguise listed below.
How NOT to give medication that needs to be given WITH FOOD
All too often owners tell me that they just place the medication on a mound of food. Most cat medications are tiny doses so if you use any more than a half teaspoon amount of food you are leaving an awful lot to chance. Of course there will be exceptions but this is the least effective way of giving a cat medication in my experience.
The main reason for this logic is simple - how will you know your cat actually got all the medication?
Drugs only work if you can get them into the patient. It makes life a lot more difficult for you and vets trying to assess whether a treatment is doing what it should if we can't be sure they are actually getting it!
Many cats will cleverly eat around the medicated food.
We all know cats that are "grazers" or just will not eat all their food in one go - for most medications the therapeutic effect comes after a taking a full dose at one time. You can appreciate then that half or a third of a dose now and a bit more in over 15 minutes time is unlikely to have any beneficial effect whatsoever.
Even for cats that eat all their food immediately it always gets moved about the bowl so much that most of the medication may be left behind as bowl remnants.
Of course you also risk other cats in the household/neighbourhood eating it instead
Disguising vs Direct dosing Medication
Direct dosing can be a quicker and more confident way of dosing your cat with medication if you are physically able to do this. Busy people often prefer to direct dose so that they can relax knowing that a medication has been given. It is a particularly good way to get medication down if there are multiple cats in the household and they like to swap bowls at mealtimes.
International Cat Care has awarded certain medications an "Easy to Give" award which means the pharmaceutical companies have made an effort to produce a formulation that is palatable and practical for owners and their cats. One of the advantages of having a vet that thinks like a cat is that they are aware of which medications these are. The added benefit of having a cat vet in charge of a business is that we can choose to stock these medications above others and so do so wherever possible. That said, unfortunately many drugs we use for treating illness in cats only exist in a human formulation so these can be very bitter or have minty/fruity flavourings added which doesn't exactly appeal to cats. I would never advise putting a tablet in a cat's normal wet/dry food as a lot of the time this just wets and dissolves the tablet and imparts the nasty taste into the food which can lead to an aversion with the food itself.
Link to How to use a towel when cats become nifty with their claws.
It is often better in the short term to dose essential medications directly into your cat because you want to be sure the dose has gone down. Often it can be continued until your cat is feeling better enough that they have regained their usual appetite but in the longer term it is less stressful all round if you can transition your cat into a medicating regime that involves voluntarily taking the medication. Let's face it we are most likely to continue with a treatment if our cats are compliant at taking it without the need to restrain or force it upon them, but if all my disguising suggestions fail, then direct dosing may be the only option. You can always try again at a later stage to disguise the medication. What we don't want is a cat that is already unwell and suffering from a reduced appetite to be put off eating even more because they suspect that every meal may be laced with nasty tasting medications.
NB: Always follow any directly dosed medications with a syringe of 1-2 ml water - especially for certain medications that can predispose to oesophageal ulceration. We wouldn't take tablets/capsules without washing them all the way down into the stomach where they are intended.
Link to Tools: Fingers or Pill givers
Disguises for Tablets
NB: You may have to break the tablets into 2 pieces to get them to fit into the gelatin capsules or into the putty and stick treats - always check with your vet it's safe for you and your cat to do this first. Wear gloves or wash hands after handling medications.
Tiny Gelatin Capsules (Gel Caps)
Tasteless, dissolvable capsules that are great for disguising nasty tasting tablets as heir temporary moisture-proof barrier reduces the chance of the tablet coming into contact with your cat's tongue and is a super way of dosing cats on multiple tablets either directly down their throat or by coating in the treats below.
Disguising in Treats
The number one thing you need to gain first is TRUST! The key is to always be sure they like the treats first! If it's not love at first sight with the treat, then be sure to make them at least familiar with it by putting a small amount with their usual food first so they get used to the taste, smell & texture alongside something they know and trust first. When they are accepting the treats readily, only then should you start to lace them with medication.
Commercial Treats I recommend for hiding tablets:
Soft, "squishable" putty-like treats that can be rolled into balls around the tablet.
- Greenies Pill Pockets
- EasyPill Putty
- Vivitreats (designed for dogs but ok for cats)
Semi-soft sticks - use a kebab skewer or one prong of a fork to bore a hole down the centre of a 1cm piece of stick, taking care not to burst the seal round the outside of the stick as it will lose its shape and fall apart. Insert the tablet pieces
- Natures Menu treats
- Webbox Stix
* again remember to try small balls of these soft treats first without any medications in to introduce your cat to it gradually & gain their trust.
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Fridge treats I or my clients have found useful (in tiny quantities and only for the greater purpose of getting medication down!!)
Primula cheese
Fish paste
Cheddar
Marmite
Mayonaise
Tinned Tuna/Mackerel
Unearthed Pork Rilettes (Waitrose)
Disguises for Liquids
Fortiflora sachets
Webbox LickELix
Gravy from some wet food (many cats love to lick the gravy off the top of wet food)
Mash a 10p sized amount of wet food
Think Like A Cat
Presenting the Treats
Primula cheese
Fish paste
Cheddar
Marmite
Mayonaise
Tinned Tuna/Mackerel
Unearthed Pork Rilettes (Waitrose)
Disguises for Liquids
Fortiflora sachets
Webbox LickELix
Gravy from some wet food (many cats love to lick the gravy off the top of wet food)
Mash a 10p sized amount of wet food
Think Like A Cat
- Mix up the textures a bit and be creative and persistent. For example, you can use a liquid treat to coat a gelatin capsule but if your cat licks this off and then becomes suspicious of the capsule's texture they can refuse to eat it first time round. You can always try adding one or two other textures that they are already familiar with (eg Dreamies, or a couple of kibble from their preferred dry food) and that way the contrast in texture between the liquid treat and capsule is somewhat masked. My elderly cats have always been on multiple longterm medications but I've always maintained that they must be easy to give for the benefits to outweigh the effects on their quality of life. Sometimes I have to be super sneaky and hide tablet medications in a gelatin capsule, coat them in a liquid treat (eg LickELix) and then put a few Dreamies or a morsel of tuna/chicken in the bowl to confuse their suspicious tongues! Where there's a will there's often a way!
Presenting the Treats
- Use small ceramic saucer or dip bowl (Oriental spring roll dipping bowls are fab for this) - this way you avoid making a negative association with the cats usual food bowl - just in case they refuse to eat it!
- Rug/carpet/sofa - some cats are used to taking treats when hand fed or when they are put on the floor rather than from their food bowl so you may need to present the drug-spiked treat in this way. Try putting an empty treat down first and then following with the spiked one. Have a chaser treat to hand as if they think there's a third one coming they tend to gobble the middle one more quickly.
- Sandwiching two treats together can work well (eg Dreamies either side of the tablets within a Greenies tab pocket).
