Pilling a Difficult Cat

Ashton just finished fourteen straight days of medication, and she may be the most difficult cat to administer pills ever in the family. I have given literally thousands of pills to all of my hyperthyroid cats over the years, but medicating Ashton without traumatizing her is nearly impossible.

one-eyed brown tabby cat, the difficult-to-pill cat

The problem with Ashton is she doesn’t like to be restrained or held in any way. After her recent dental, I brought home liquid medications for her, and wrestling her into taking them traumatized not just her, but the other cats, too. When both Pierre and Ashton hid and didn’t come out for dinner, I knew something had to change.

Ashton needed to take her medication willingly, and that meant hiding from her that she was taking it at all.

The first step was to switch from liquid medication to pills, which are easier to disguise for a food-driven cat like Ashton. Then I had to find something to hide the pill in. There are several products on the market specifically meant to hide pills. For Ashton, I chose chicken flavored Pill Pockets, because Ashton loves chicken, but you can’t hide a pill in actual chicken. If your cat is partial to a flavor that they don’t offer, there are other pill pastes and wraps. They important thing is to find a flavor your cat likes.

Pill and disguise

The key to successfully pilling a cat while hiding food inside anything is not using too much stuff around the pill. If there is, cats seem to chew it off and spit the pill right out, So for this pill, I broke the pill pocket in half and knead that around the pill so that it wasn’t too thick. Every time I do this, it doesn’t look like it’s going to be enough treat to cover the whole pill, but it is.

Combining pills into treat

Next, I give the empty half of the pill pocket as a treat. Ashton can smell the chicken flavor and waves her paw to ask for it. Since she is eating raw and only gets freeze-dried treats most of the time, this is pretty exciting for her.

one-eyedbrown tabby cat waves paw

After that, I offer the treat wit the pill hidden inside. Can you tell Ashton is right-pawed by the way it’s nearly always her right paw she waves when asking for her treat?

She eats the treat without ever realizing there was a pill in it. I sometimes worry that my sigh of relief will give me away to her when she does eat it!

one-eyed tabby cat takes pill hidden in treat

Once she has eaten her pill, Ashton gets another treat. This is important to make sure she isn’t hiding that pill somewhere in her mouth. Ideally, after you give a cat a pill, you should syringe some water into her mouth to get her to swallow, but since syringing anything into Ashton is so difficult, we make do with additional treats to ensure she swallows.

By this time, Pierre has figured out that Ashton is getting something he isn’t, and he wants treats, too. That’s part of the reason I usually have extra pill pockets on hand for this process!

one-eyed tabby cat takes pill hidden in treat as gray tabby cat looks on

Does this look like the face of a cat who knows she just got medicine? Not a bit, and that’s exactly the way we want it to stay.

one-eyed brown tabby cat licks lips with tongue

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Center of Attention

Ashton: You were trying to take a photo of Newton doing something back there instead of paying attention to me?

one-eyed brown tabby cat sits in front of orange tabby cat

Ashton: What were you thinking!?

one-eyed brown tabby cat with eears back

Take Back Leftover Veterinary Drugs this Saturday

During spring cleaning, I think I discovered that I am a veterinary prescription drug hoarder.

Pierre was prescribed an appetite stimulant and then started eating before they were all used. Ashton was prescribed liquid meds and I have to get pills instead. And so on. Pretty soon, we end up with all kinds of leftover medications.

one-eyed brown tabby cat with pharmaceutical drugs

The next logical question is how to get rid of them. Flushing unused medications down the toilet or drain is a bad idea. Water treatment plants are really meant for treating human waste, not for eliminating pharmaceuticals. That means medications flushed down the toilet are going into the environment, where they can sicken or kill wildlife. Drugs thrown into the trash end up in landfills, and those can seep into the environment, too.

The US Geological Survey has already found levels of drugs like antibiotics, hormones, and contraceptives in 80% of the rivers and streams tested in part of a nationwide study.Other studies have shown that fish and other wildlife can be adversely affected by pharmaceuticals, even after the medications are expired.

Drugs were found in 80% of US rivers and streams

This Saturday, April 29th, there are drug take-back events across the US to allow you to safely dispose of your medications without endangering the water supply. You can locate an event near you on the US Drug Enforcement Administration’s web site US Drug Enforcement Administration’s web site.

If you need to dispose of medications other times of year, you can:

Call your city or county government’s household trash and recycling service to ask whether a drug take-back program is available in your community. Some counties hold periodic household hazardous waste collection days, where over-the-counter and prescription drugs are accepted at a set location.
Ask your pharmacist whether he or she knows of any medicine disposal programs in your area.
Find a local, independent pharmacy in your area who participates in drug disposal through the disposemymeds.com.
Locate another site in your area accepting drug disposals through the National Association of Boards of Pharmacy drug disposal locator.
Ask your veterinarian. Only vets with state or federal authorization to collect medications for disposal can take back medication, but your vet might know of one.

If there aren’t any drug take-back events in your area, you can purchase special postage-paid packages from your local pharmacy that send medications back to a medical waste company. Some medications are ineligible for this program, so read the fine print before you purchase.

You can use most of these same resources for disposing of human medications, too, except your veterinarian is not likely to be able to help with unused human medications.

Let’s keep things that don’t belong in the trash out of it, including medications.

Reference and further reading

US Environmental Protection Agency, Contaminants of Concern Including Pharmaceuticals and Personal Care ProductsContaminants of Concern Including Pharmaceuticals and Personal Care Products
US Geological Survey, Pharmaceuticals, Hormones, and Other Organic Wastewater Contaminants in U.S. Streams
US Department of Justice, National Take-Back Initiative

Feline Tooth Resorption

When I shared that Ashton was going to have a tooth pulled, it was surprising how many friends commented about cats having teeth removed, too. What’s up with all these cats losing teeth? Feline tooth resorption.

Tooth resorption, where the cat’s own body begins to break down a tooth, happens more often than you would expect. It is one of the most common diseases in domestic cats, with about 29% of cats having at least one resorptive lesion.

What is feline tooth resorption?

Tooth resorption happens when odontoclasts, cells in the cat’s mouth, gradually destroy the tooth by digesting it at a cellular level.

Holes – or lesions – form in the outermost layer of the tooth, sometimes starting in the root, and other times in the visible of the tooth, called the crown. Because tooth resorption can be hidden beneath the gums, you may not be able to see when tooth resorption begins.

The only way to detect below-the-gumline lesions on teeth is with x-rays. Your veterinarian can only see this kind of resorptive lesion after it spreads upward into the crown. Sometimes the holes in the crown of the tooth are visible on examination, and other times, a cat’s gums become inflamed and will cover the area of the tooth with the lesion.

Ashton’s gums were inflamed around her damaged tooth, and the gum seemed to be stretching up to try to cover her tooth, as soon below.

Resorptive lesion on tooth. Photo courtesy Bay Hill Cat Hospital.

What her inflamed gums were hiding was a tooth that had a huge hole in the side. Look at the x-ray image that shows what was hiding under the gum. Doesn’t that look like it must have been painful?

Radiograph showing tooth resorption courtesy Bay Hill Cat Hospital

If left long enough, tooth resorption will destroy the tooth entirely, until nothing remains above the gumline. Ashton’s same premolar on the other side of her mouth was completely gone, as seen in this image.

X-ray of tooth completely destroyed by tooth resorption courtesy Bay Hill Cat Hospital

Signs of Tooth Resorption

Once the lesions above the gumline can be painful to your cat. Cats are good at hiding pain, so it may not be obvious. Signs that could mean tooth resorption include:

Difficulty eating or dropping food outside the bowl
Chewing with only one side of the mouth
Bleeding from the mouth
Excessive salivation
Overall withdrawal or change in mood
Bad breath

Ashton never misses a meal, so the only clue we had at home there could be a problem was her terrible breath. It’s a good thing we knew what her regular breath smelled like so we could tell when there was a change. It meant the vet needed to take a look at her teeth!

one-eyed brown tabby cat with mouth open wide

What causes tooth resorption?

The exact cause of tooth resorption isn’t understood. Researchers have a list of conditions that happen around teeth with resorption, but they have not been able to establish whether these conditions cause resorption or whether they are an effect of it, including an acid pH and the fact that there are more vitamin D receptors in the tissue around the teeth.

Some cats, especially purebreds like Siamese and Persian, are more prone to tooth resorption, so there is a genetic component to the tendency for the condition. Plenty of mixed-breed cats, like Ashton, get tooth resorption, too, so genetics isn’t the only factor at work.

How do you treat tooth resorption?

Tooth resorption is progressive. You can’t stop or reverse it. Once it is detected, the only treatment is to extract the tooth.

Veterinarians don’t yet have an adequate way to prevent tooth resorption. Brushing your cat’s teeth at home with toothpaste meant for cats is a good way to detect issues with your cat’s teeth and gums early so you can bring them to your vet’s attention.