What is the most effective way to give a cat a pill?

Looking through the comments on one of my past articles — “Would Heart Medication Have Saved My Cat?” — I found the following comment:

Could [you] write an article about the best techniques for successful pilling, please? I live alone and anticipate that some of my cats would be resistant. Even if some cats just won’t accept medication this way, it would be good to know how to try. I hope veterinary drug manufacturers are working on this problem and will develop more injectable or transdermal medications for cats. We would gladly buy them and pay more for them if need be.

I fear I’m embarking on a fool’s errand. Medicating cats is famously — even legendarily — difficult. In the best cases, giving medicine to cats is an unpleasant chore. In the worst cases, it can lead to destruction of the bond between owner and feline as the cat grows to resent the daily struggles. And, because cats are so smart, the level of difficulty of giving long-term medication tends to grow over time. Each day may be “easier” than the next (if the word easy can ever be used in this context), with the cat growing ever more suspicious and refractory to medication.

I recommend you avoid the struggle if possible. Most medications can be given with food (ask your vet whether this is the case for yours). Some cats will accept medications that have been inserted into Pill Pockets (cat treats that were designed for this). Others will accept medication that has been crushed and mixed into palatable wet food or tuna water. Sneaking medications into food or treats works best in hungry cats, so consider withholding food for several hours before medicating in this fashion.

For cats that are not easily tricked, liquid medications tend to work best. Some are widely available as liquids. Many pills can be crushed and mixed with water (or tuna water) and administered orally using a syringe or dropper.

I’m a strong proponent of compounded medications as well. The vast majority of medications are available through special veterinary pharmacies (known as compounding pharmacies) that can produce flavored liquids or chewable tablets that resemble treats. You may have local pharmacies that are qualified to compound your cat’s medication. If not, there are several mail-order compounding pharmacies with competitive prices that ship anywhere. BCP Veterinary Pharmacy and Roadrunner Pharmacy are two of the most reliable ones, in my experience.

Most compounding pharmacies also offer many medications as transdermal gels. This form of medication is applied to the skin, usually on the inside of the ear. The efficacy of transdermal gels is debated by many veterinary experts, and uptake of medications through the skin tends to vary from cat to cat. However, the gels seem to work quite well for conditions such as hyperthyroidism in which medication doses need to be adjusted to meet individual needs through regular testing and dosage adjustments.

Some medications are available as long-lasting injections that eliminate the need to give medications at home. Convenia is an antibiotic that lasts for a week after it is given at the vet’s office. Similarly, Depo-Medrol is a long-lasting form of cortisone. Remember, however, side effects from these medications can persist for the length of the medications’ efficacy. Depo-Medrol in particular can be risky — I have seen it cause diabetes in cats. Also, remember that all injections have the potential to cause injection site sarcomas. The benefits of these medications must be carefully weighed against the risks, but they may be appropriate in some instances.

As a last resort, consider the use of a pill gun. Pill guns are small plastic plungers with rubber tips. The tip holds the pill, and the plunger is used to deposit the pill in the back of the cat’s throat. This method is almost always easier (and safer — for you) than using a finger to pill a cat, cowboy style. However, as I mentioned above, it’s always better to avoid the struggle if you can.

Catster has a lot of dedicated readers who no doubt are experienced cat medicators. If any reader has additional suggestions, I (and I’m sure many others) would be interested to read them in the comments section.