Does anyone know about cat antibiotic dosing?

[randall]

Hi all, seeking your sage advice once again:

I have a cat who has been prescribed half a pill of antibiotic every day. When I got the pills from the pharmacy, it turns out they are big pills, even when cut in half.

In the past, I have had perfect success "pilling" this cat, but the pill was about one quarter the size of this one. So just a few minutes ago, while I was able to pop this bigger antibiotic pill into the cat's mouth, the cat excelled at getting that pill out of her mouth, repeatedly and, finally escaping my grip, pill ended up on the floor -- so she hasn't gotten her dose yet today.

My question is this: Would it be okay for me to divide the half pill into two parts, and give her one part at a time, separated by hours? When I gave her the littler pills before, she still ran away once she'd swallowed the pill and I let her go. Then it would take her several hours to forget what a creep I had been and be relaxed around me. So I don't think I can get 2 pops in her mouth separated only by minutes.

Does a daily antibiotic only work if the max dose hits the body all at once every day? Unfortunately, I can't reach the vet or the pharmacist today to ask them.

I have yet to despair of getting the larger size half-pill down her throat later today. But she is much more willing to take pills if they are smaller pieces.

Thanks if you can help!

[booktigger]

I'd speak to the vet, some tablets can be cut, some can't.

[randall]

Thanks for your reply, which caused me to look up the drug -- Stomorgyl -- on the internet, which I am so glad I did!

The instructions I have are all in Italian, so I didn't bother to pick through them, and instead just took the vet's instructions to dose the cat every day with half a pill.

On the internet, the instructions in English say not to break or crush the pills -- but I am going to go with the vet's instructions, because I really have no choice. This is a small cat. It appears the reason for the "don't break" instruction is that the pill is a composite, and there is no guarantee that a spilt pill will contain equal doses of both elements of the medicine.

Also, it does say to wash one's hand's thoroughly upon administering (glad I saw that -- will give pill wearing gloves) and to be especially careful to keep away from eyes, the cat's and mine. Triply glad I saw that.

Finally, it appears that a common reaction among cats to this medicine is foaming saliva, because the pill is very bitter tasting. It is coated with something red -- which I think is meant to take the bitterness away. But given how difficult it was for me to get the cat to swallow the pill, all the red coating on the first dose I attempted had come off by the time she spit it out on the floor.

I have since read on the internet that sometimes coating this pill with butter and then putting the pill in the freezer to harden that butter will make the pill go down much more easily and lessen the chance of foaming.

I am going to perservere with giving her a half-pill each day because the diagnosis for the cat is stomatitis, and this treatment is being given to prepare her for full dental surgery to remove all her teeth in about 10 days. Otherwise, she will not eat anything -- which is why she ended up at the vet. She was spitting out all her food, in pain. She was also given an injection of steroids to make it possible for her to eat, but they will wear off and the pain will return unless the stomatitis is treated directly with tooth removal. But first, the Stomorgyl is suppsed to sanitize her mouth and throat and clear it of infection to make it possible for safe surgery -- or that is my understanding.

Will let you know how things go...

[meriad]

would it not be easier (and safer for your hands) to ask the vet for a different antibiotic?

[randall]

I have considered asking for another medicine. But from my online reading, it does seem that Stomorgyl is the standard anti-bacterial preparation for stomatitis cases in advance of dental surgery, and it does not come in another form (not even an injection). On the Italian cat forums, I have found archives of discussions where people ask for help about finding a substute for this medicine, or a trick for giving a cat these pills. Some have already asked the vet, and the vet has told them to persist in getting the pills into the cat. People frequently suggest to a desperate owner that they crush the pill and mash it with anchovy, and then force that into the cats mouth. Or quickly follow a butter-coated pill with hairball remedy paste or wet food to get the cat to keep swallowing.

This evening I prepared a butter coated red pill, and used gloved hands to get it into the cat's mouth, and clamped the mouth shut. She resisted quite a bit, and had some success it half-spitting it out, but I kept getting it back into her mouth, and she eventually appeared to be swallowing, several times. I finally had to let her go (she ripped one of the gloves!), but I even got a flashlight to look under the bed, where she was hiding, to make sure she hadn't subsequently spit out the pill. Couldn't see anything remotely resembling a red half-pill among the dust bunnies under the bed. And two hours later, I was extremely relieved she had shown no signs of foaming at the mouth.

BUT?

Just a few minutes ago, I happened to spot, in the crack between the sofa cushions, THE NOW-PINK HALF-PILL. She had spit it out, right under my nose, and I missed it.

So back to square one. I will try again tomorrow morning. It's too late now (I don't want her to start foaming at the mouth at night. If it goes on for more than 2 hours, I need to take her to a vet.)

But if Thursday is a bust, I am headed to the vet on Friday. The cat is not in pain, because she had a steroid shot, so she is eating. But if she is going to have her teeth extracted, I need to get it done soon, because I must go away for the entire month of May, and I want her to have recovered from this surgery.

[Janey]

Hi there, giving cats pills can be a pain, if you find it difficult and look on the internet there’s You Tube videos which can help then it does become easier. I’ve had to give load of pills to my oldies over the years and I had one particular cat who I used to think had taken her thyroid med only to find it later as you did. If you can disguise it in a bit of food or treat such as Webbox or cheese, great. If not, then it helps to creep up behind your cat when e.g. they are sleeping so they aren’t fully aware and it’s straight down the hatch is less stressful making sure it goes to the back of the throat then like you did keeping the mouth closed, and tickle under the chin helps the cat’s reflex to swallow. Keeping calm when you do it and loads of praise and a treat after helps a bit too lol. Best of luck!

[randall]

It really is the size and hard-coating of the pill that is the problem. This cat has allowed me to give her other pills -- and even with this pill, I can manually open her mouth and poke in the pill, and she lets me grip her face for a minute or more before totally stressing out.

With other pills, if she keeps them in her closed mouth, they soften, and she's tempted to swallow. With this one, it's hard-coated, because the actual pill is so bitter. So she is able to push it around inside her mouth, or just clamp on to it.

I really did think I had gotten a half one down her earlier this evening. And I still don't know what will happen if I do get it down her. Other people report really alarming, copious foaming. One person described it as if "my cat swallowed a jar of bubble bath." Apparently the "trick" is keep the pill intact as possible, cover any exposed parts with butter (to prevent the bitterness from reaching the tastebuds) and follow it up, if possible with food or water, to make sure it descends all the way to the cat's stomach.

I'm not giving up yet, but this seems to require more than good pilling technique -- about which this cat is already patient and trusting. And if there is an injectible drug that will work, it would be much easier.

[Kay]

Sounds to me as if a slow release ab injection might be the way forward here - they are not , I believe, as effect as a daily pill, but much better than a pill down the side of the sofa

[randall]

Thanks. I am concerned that if she gets surgery, the conditions for it are optimal. These strong pills are meant to clean out her mouth infection to make tooth extraction safe and effective, I think. To prevent recurrance or complications. So I'm not sure there is an equally good substitute that can be injected.

If I can get a pill down her tomorrow, even if she fusses, and if she doesn't have a foaming reaction that frightens the heck out of me, I think I can make it work for 7 days. But if tomorrow is a disaster, I better to talk to the vet.

[jillyvillyvoo]

Hi I have had to pill my wee cat before she passed away for years with various methods and ftenfound her wee pills around the house! However I recently rescued a cat from cat protection who also needs pills every day. They informed me that they use the jars of princes salmon paste (very cheap) for the cats they cant pill, a tiny bit to coat it. It works! Thankfully as I have a very grumpy madame who will not allow you to stroke her never mind pill. Never misses her pill every morning and she is on them for life so I wish I had known this year's ago as I tried everything with my last cat. Good luck.

[randall]

Thank you. I will be buying some sort of fish paste this afternoon. I have also found some unused, sterile suppository plungers here in the house, still wrapped in plastic. The half pill fits into them, so I am thinking about using that as well, to get the pill well down the cat's throat. Will watch several videos online to see if I think I can do this without injuring the cat.

The immediate problem at the moment is that the cat is hiding under the bed most of the time now. She is depressed and listless, and obviously lost her trust in me. I have not been able to get near her this morning. We'll see how the afternoon goes.

The longer term problem is how quickly this cat would heal from surgery, and whether she will need medications every day following the surgery for the foreseeable future. I must travel for most of May, and when I have traveled in the past, I have simply left the cat in my office, and the landlord of the office -- who adores animals -- feeds her every day. But she hides from him (it's a multi-roomed office, with many crawl spaces under things or behind things), and my landlord often doesn't even see her when he arrives for the feedings. Even if she does come out of hiding, she would never let him close enough to touch her, let alone scoop her up to give her a pill.

Full dental extractions for stomatitis are, at best, curative 80 percent of the time if done right, but there is a big question about whether her mouth will have healed by May 1 if the surgery is not done until April 10 or so.

Every day that I cannot get this Stomorgyl half-pill swallowed by her pushes back the soonest date she can have the surgery.

I have lots of questions for the vet, and I will probably take my office landlord with me to discuss them.

[jillyvillyvoo]

Get that paste on them and I think will be your best friend again. A tip for you, make the paste with tablet stick to a blanket or similar surface, that way when it's getting smelled and licked it doesn't get pushed around the floor and most likely will get scooped up on her tongue in one swoop. I would try this before the other method as I had a similar thing from vets to give pills to my other cat, FAIL!! She really did not like me for that.

[randall]

I appreciate your advice, and will let you know how it goes, but one of the features of stomatitis is that the cat is wary of eating anything. She now has to be tricked and coaxed into biting into her favorite foods, because the pain has been significant. She will sometimes stare at her food bowl for minutes before approaching it. Once she has had a painful experience eating from the bowl, I have needed to find a new location for the bowl because she associates her usual spot with pain now.

In the past I had a cat who loved yoghurt, and I put every pill I gave him in yoghurt and he lapped it up on his own. Unfortunately, this cat will not eat yoghurt, even plain without a huge pill hidden in it, and ran away at an offer of salmon just the other day, because she was too wary of a "new" food.

I have been able to get her to eat short little strips of boiled chicken and turkey. That is it. And when she is through, she runs under the bed. She is having a very rough time, psychologically as well. I will get the anchovy paste and see if she licks it off my finger. If I am able to catch her, just about my only hope of getting this large pill swallowed is to manually get it down her throat.

[booktigger]

If using paste for tablets, just check the ingredients, a lot have onions in them, which can cause health issues in cats.

[randall]

Thank you for your sound advice. I actually forgot to buy the paste when I was in the store! But if do buy some, I will check the ingredients for sure.

I have an appointmet to go to the vet tomorrow. I will probably be able to take the cat (she is not easy to catch on schedule), but even if not, my landord is coming with me so we can ask the vet lots of questions. The vet only speaks Italian and mine is not quite good enough for a situation this complicated, with such important consequences, so I hope we can find some good answers for the cat tomorrow.

[jillyvillyvoo]

The princes at paste is recommended and used by cats protection where I got my recent rescue cat from.

[randall]

I am in Italy (and so is the cat!) so our choices for paste will be pretty limited. I am afraid anchovy paste -- the most likely available -- would be too salty. She is already thirsty from the steroid shot given to her.

There are pet stores here, so I can probably find hairball or vitamin pastes specifically for cats.

But what I am really hoping is that tomorrow the vet will agree to give her antibiotics via injection. She only needs 7 days worth of antibiotics.

[Crewella]

I really hope you manage to find a good alternative, but just in case - I always pop pills 'down the hatch' by tilting the cat's head right back and dropping or pushing the pill as far back as I can - right at the back of the tongue, then keeping the cat's head upright whilst stroking the throat to encourage them to swallow. As soon as I release them I give them their favourite treat, hoping to make them swallow again and also to try to distract them from any thoughts of hawking the pill back up again!

I hope she's able to have her operation - my Grumpy Nellie had all her teeth removed due to similar issues and was much, much better afterwards.

[randall]

Thanks. Tooth removal is still an option, but not right now.

I took the cat back to the vet's office, where there is a rotatatng staff of vets, and this time the same vet who had seen my cat in January was on duty. Upon examination, he said that the cat's oral inflammation was less than what he had seen in January, which he had told me then was mild. He felt an operation would not only be premature, but that the cat would benefit from more precise testing to determine if she had the type of disease that is responsive to full dental removal. He didn't see any problem with waiting until June for anything as involved as surgery.

He gave her an antibiotic injection, and within a few hours, the cat was behaving more normally -- sitting next to me, dashing about a bit. Her eyes are brighter and more alert. This is a complete change from the depressed cat that she was yesterday. She is now harassing me to give her more food and let her go outside.

I'm actually glad I was unable to give her the Stomorgyl pills, because it caused me to take her back to the vet. I think I may have been too directive with the first vet, having read so much on the internet about how tooth removal was the best course, and then wanting to get it done quickly before my going away next month. But as I read more and more on the internet, I became very concerned about how much post-operative time might be needed for full recovery, and how a significant number of cases were not improved by tooth removal, necessitating a lot of hands-on care, which I wouldn't be here to give.

So I'm satisfied that this is the most protective course for her now, and that the vet knows what he is doing for this cat. I'll follow up if there is any interesting news. Thanks again!

[Crewella]

That's good, I'm so pleased she's feeling better.