Administering Medicines

For most veterinary treatments it is important that medicines are given correctly. In the hospital, trained staff give medicines and it is important to ensure that you are able to continue to give the medicines once your cat has been sent home. If you have any doubts about how to give the medicine your pet has been prescribed, ask your vet or nurse to show you.

 

General information

 

To be most effective treatments have to be given regularly and for a sufficient length of time. If medicines are not given correctly active ingredients may be lost, or poorly absorbed, which reduces the dose that the patient receives.

There are two elements to medicine administration:

Ensuring effective administration of treatment

Ensuring safety of both the patient and the personnel involved in the procedure. In almost all cases it is far easier to administer treatment effectively if there are 2 people to help - one to restrain the cat and the other to give the treatment. However, it is possible for experienced owners to give medication by most routes to a reasonably co-operative patient.

Oral treatments (by mouth)

Many medicines are designed to be given by mouth - largely because this is a convenient route for owners to administer at home. Oral medicines can be given as tablets, capsules, liquids and pastes. Most medicines given by mouth enter the stomach but pass through into the intestine before they are absorbed into the blood. The presence of food in the stomach helps absorption of some drugs but prevents others from entering the body. The timing of administration of oral medication in relation to feeding can be critical. 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 should be used 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 stomach acids - the coating is dissolved in the stomach and the drug released once the tablet is in the intestine. Tablets are often put into food, but often the cat simply refuses to eat the food containing the tablet. The tablet can be hidden in a tasty morsel (or specially designed treat) and given to the animal to eat. 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. It is far more effective to give the tablet by hand (See table 1) so that you can be sure the cat is receiving its medication regularly.

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 eg liquid paraffin in the lungs can cause severe pneumonia.

Topical (on skin) administration

Topical application of medicine can be used to treat specific areas or as a simple way of applying medication to a patient which will then be absorbed through the skin to affect the whole animal. 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 eg corticosteroids put onto the skin can cause signs of Cushings disease. Most animals, particularly cats, will lick off any topically applied medication they can reach. 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 not uncommon in 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 table 2) 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 skin is very sensitive, so only treatments specially made for use in this area should be put into the ear canal. Drops or creams can be used effectively (See table 3). Before giving medicines into the ear it is important to check that the tympanic membrane (ear drum) is intact as many drugs can damage the middle ear if they are able to cross this barrier.

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 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 means of washes or shampoos. Remember when treating skin lesions that the area being treated may be sore to touch, so be gentle and ensure that the patient is adequately restrained. In many cases a combination of topical and systemic treatment is used eg shampoos and antibiotic tablets.

Topical treatment for systemic effect:

The advantage of administering medicines by this route is that they do not have to pass through the gastrointestinal tract and so this method is effective for drugs that would be destroyed in the gut.

Flea treatment

Some of the topically applied flea treatments are absorbed through the skin and then enter the blood stream. Spot-on treatments are dropped onto an area of the coat that the animal cannot reach when it grooms ie the back of the neck. The active ingredient is absorbed through the skin and enters the blood, fleas ingest the drug when they next bite.

Heart treatment

Nitroglycerine cream is used to manage heart disease and is more commonly used in cats than dogs. It is applied as a cream on a hairless area of skin (usually the inside of the ear pinna) from where it is rapidly absorbed and enters the blood.

Pain relief

Sticky patches containing some forms of analgesics (pain killers) are now available. These can be applied to hairless areas of skin in the recovery from anaesthesia and slowly release small doses of the drug over several hours. This gives the patient a pain free recovery from surgery, without the need to keep re-administering medication.

Remember that drugs can be absorbed even more easily through human skin so gloves should always be worn when handling topical treatments.

Administration of tablets

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 administering the medicine takes the correct dose of tablets in their right hand.

The patient should be approached from the side and the left 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.

A finger of the right hand can be used to press down on the lower incisor teeth to open the mouth.

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).

The patient should be watched closely immediately after medicine administration to ensure they do not spit the tablet out again.

Ocular (Eye) administration of treatment

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 held apart.

The person applying the eye drops opens the bottle or tube and holds the treatment in their right hand.

They use the thumb and forefinger of their left hand to hold the eyelid open (if necessary).

Hold the bottle or dropper above the eye and gently squeeze so that the correct amount of medication falls into the eye - take great care not to touch the surface of the eye with the bottle as this can contaminate the treatment 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.

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.

Aural (Ear) administration of treatment

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 ear flap is lifted by the handler, or person administering drops, to expose the ear canal.

The ear canal must be cleaned to remove any discharges or previously applied medication before putting in new treatment.

The nozzle of the treatment applicator is passed into the ear canal and drops or cream are squirted 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.

 

If in doubt about anything, call us! 0117 977 3230 or 0117 964 0113.

 

 

 

 

 

 

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