Veterinary Anesthesia & Analgesia Support Group
Practical Information for the Compassionate Veterinary Practitioner
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Long Term Medication Administration

 

 

  One of the greatrest challenges associated with chronic pain management is long term medication administration. Quality of life dictates that medication administration be performed in a minimally stressful way. The tips below are a compilation of methods that have worked for various patients with an emphasis on cat patients as they are the most difficult to coax into simple medication acceptance.
     
   
  1. Work with the owner to reduce their stress level about having to medicate their cat - owner stress predictably increasing patient stress related to the medication admin issue
    1. Feloway® or DAP® diffusers in the home may help reduce patient stress
  2. WHERE people do meds is very important to avoid having the "cat run when he sees me coming" scenario. Always have ONE place to do treatments (even if cat likes the meds in a treat/etc.).  Consider a closed small room with good light, and some place to have the patient where the owner can easily access the cat.
    1. Always have cat on a non-skid surface: bath mat, rug with non-skid base. Since many of these patients are geriatric, arthritic, and in pain, you should place a soft towel, fleece throw, cat bed, or a pillow on top of the non-skid surface to make it soft, warm, and cushy. The bedding can be warmed up in a dryer prior to its use.
    2. Bathroom, top of clothes washer/dryer. Then person can get a good view of mouth, holding head etc to optimize success.
    3. In a bathroom it can be helpful to use the sink as a "nest" making it harder for the cat to back away from you - put something soft, warm, and cushy in the sink.
    4. Big chair with cat in a corner
    5. If easier for owner to sit on floor with cat in/on lap - use a specific room, with door - where ONLY that happens.
    6. Use a “cat sack” (where head sticks out with zippers to access legs, etc). For home treatments, the cat bag is not only the signal that it's "vetlike" time, but keeps cat from backing up.  See: www.fourflags.com.
  3. Find a phrase you say when it's med time (or fluids time, or any "vet-like" time). This clues cat, and sets your own body language/communication.
  1. Direct pilling considerations:
    1. Make sure owners know that there are pill crushers/splitters (vet supply or human pharmacy)
    2. Crush tab and place in gel cap (available in flavored varieties ) if owner can manage direct capsule administration (eliminates the "taste" of the meds)
    3. Coat the tab lightly with butter, margarine, or vegetable oil to reduce the taste of the medication and facilitate its passage
    4. Coat tablets in a single layer of Kleenex - hides the taste similarly to a gel cap and more easily available. The Kleenex is easily digested.
    5. Pilling gun – place meds in pilling gun, then dipped in food before delivery
    6. Consider stroking the throat and giving either a small wet food meal or a water chaser after direct pilling to prevent having the medication hang up in the esophagus
  1. Crush tab or open capsule and mix with favorite cat food
    1. Caution!! Cats may develop a food aversion towards their support diets when owners mix in drugs. It may be wise to test drugs with some other diet first prior to mixing them in to medical diets.
    2. Crush tab or open capsule and mix with tuna fish or other favored NON-cat food including meat flavored baby food
  2. Crush pill, mix with butter, honey, or laxatone and rub on paws so cat licks if off.
  3. Take a three ml syringe without the needle. Cut off the tip (do NOT use your expensive surgical scissors. The pill or halves or quarters thereof can be placed into the syringe with the plunger pulled back. Stuff wet cat food into barrel to hold pill in place. Place to back of cat's mouth and "pop". Cost approximately 25 cents (more if you continually use you surgical scissors for preparation).
  4. Mix crushed meds with cat food can gravy; give through 3cc oral syringe. This often works great since cats commonly prefer the gravy. Take the gravy from canned cat food (either the cat's favorite one, or a brand with lots of gravy - Friskies Buffet Poultry, some of the fish flavors, and Whiskas Mealtime Kitty Stew) - mix crushed meds in - give with 3cc oral syringe (that way if there are small pieces of food they won't get stuck)
  1. Additional “treats” to hide pills in. This could be any treat that your cat likes/might like that you can hide the medication in. Even cats that dislike canned cat food may take their medications in a “treat”.
    1. Hide tab or cap in Pill Pocket: http://www.pillpockets.com/main.htm
    2. Hide tab or cap in Flavor-doh: http://www.flavordoh.com
    3. Have medication compounded in a cat friendly flavored liquid
    4. Have medication compounded in a cat friendly flavored chewy treat
      1. http://www.bcpvetpharm.com/products_vetchews.htm
    5. Friskies TENDER (not the crunchy) treats in the foil pouch. There are several different flavors, and they are slightly different shapes. The ones that work best for pills are the Poultry and the Salmon ones. Others are too flat to hold a pill/piece of pill. Only downside is they dry out and crumble if not kept airtight - so reseal the resealable bag, or transfer to something like a Tupperware airtight snack container.
    6. Use treat with crunchy outside and soft inside like Whiskas snacks and Pounce Hairball Treats. The pill/piece must be small enough to fit inside the treat. Carefully split in half with a sharp knife and place meds inside, then press closed. The crunchy outside helps disguise the medicine inside.
    7. Cheese Whiz processed cheese spread
  2. Use transmucosally absorbed drugs
  3. Obtain injectable version and have owner administer SQ using U-100 lo-dose insulin syringe (if medication is effective when delivered SQ)
  4. When ALL else fails, consider compounding in a PLO gel and attempt transdermal delivery (although the effectiveness of this method is questionable)
     
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Last modified: June 1, 2011 .