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Pilling Raphael and other tales of horror

post #1 of 13
Thread Starter 
Hello everyone! So, it's been a while since i was last here...since March, according to the thingy on top there. I've been a busy girl, and while I've been away, Raphael thought it would be a fun idea to stop eating, need to be rushed the the emergency vet (from hell) and contract a borderline case of Hepatic Lipidosis and also Pancreatits (the pancreatitis caused the FHL, because it hurt and made him lethargic, so he went an estimated 18-20 hours without eating anything).

So, he's eating again, and until the pilling episode, he was acting chipper and normal again. He's transitioning to a special diet, and that's going ok. But the doctor put him on Denamarin, which apparently only comes in pills. The doctor, apparently ignoring my concerns about getting medicine into my extremely fractious little dude, also gave me metronoidazole in pill form.

Well, when Raphael meets pill, all sorts of disaster break loose.

First, he jerked himself around while I had the pill gun in his mouth, and stabbed himself with it. Then he scratched his own face somehow during the scuffle, not to mention giving my husband a nice set of shallow scratches and me a couple puncture wounds. He screams. He foams at the mouth. He will not be scruffed and burritoing him worked long enough to get ONE pill in him, but wasn't about to fall for it again. The second pill ended up all over me and the floor and his face. And then he proceeded to drool relentlessly.

So, this other vet is apparently a complete moron (my regular one is in Israel at the moment), I guess my question is multi-faceted:

1. Has anyone else dealt with either pancreatitis or hepatic lipidosis? I know they're both reversible, and these are both slight, early cases. I also know that the treatments are pretty wide-ranging and there's really no magic bullet.

2. How do you get a pill in a cat that will just have none of it? He was semi-feral, has calmed down in his old age, but is apparently ready to release his inner feral when he sees the pill gun.

3. Has anyone ever heard of injectable suspensions of either of these drugs? Raphael, being the weirdo he is, will take injections, but he won't take pills and liquid is only very slightly easier to get into him.

Thanks guys!
post #2 of 13
What about pill pockets or a liquid med.
I used that for Coco.
Her bp med was compounded and she takes it.
post #3 of 13
Metronidazole is so bitter tasting that as you have found out most cats will fight tooth and nail to avoid tasting it again.

You can get it compounded in a fish paste at most pharmacies. Then administer orally with a syringe. Even with this method, the cats seem to still be able to taste the bitterness and they don't enjoy it.

Foaming will still happen unless you're lucky and they swallow quickly.
post #4 of 13
Did you have him wrapped in a towel during this process? One of my cats was a total tiger, but wrapped in a towel (only head showing), I was able to pill her without too much difficulty.

However, this was before "pill pockets." I haven't used them, but my vet told me that she had to pill her own cat, and the pill pockets are amazing. The cats just scarf them up. They're made by Greenies, and my boy loves his Greenies treats so if I ever have to pill him, that's what I'll try. I notice that they're sold at almost all vets' offices, so they must know that they work well.
post #5 of 13
I have to laugh about the pill pockets, because I tried them once too and really thought I had struck the mother load of pilling solutions.

The pill being administered was the dreaded Metronidazole and I was having a terrible time with a bengal boy who was not having any of that bitter stuff. He must have been related to Linda Blair because he could spin his head around better than she ever could.

Enter the pill pocket........

He greedily munched down the first one. Problem solved, right?

wrong.......

When it was time for the next pill, he wouldn't go near the pill pocket, he acted like it was toxic waste. I thnk he chewed it too much and got some of the pill in his mouth. Either that or he's much smarter than I give him credit for.

Not saying it's not worth a try though! My results may not be common.
post #6 of 13
I can not use pill pockets with Coco anymore because she bit into a Baytril pill once.
Now she will not touch the pill pockets.
The liquid bp med she takes.
It is tuna flavored so maybe that would work for your cat.
post #7 of 13
Quote:
Originally Posted by lionessrampant View Post
Hello everyone! So, it's been a while since i was last here...since March, according to the thingy on top there. I've been a busy girl, and while I've been away, Raphael thought it would be a fun idea to stop eating, need to be rushed the the emergency vet (from hell) and contract a borderline case of Hepatic Lipidosis and also Pancreatits (the pancreatitis caused the FHL, because it hurt and made him lethargic, so he went an estimated 18-20 hours without eating anything).

So, he's eating again, and until the pilling episode, he was acting chipper and normal again. He's transitioning to a special diet, and that's going ok. But the doctor put him on Denamarin, which apparently only comes in pills. The doctor, apparently ignoring my concerns about getting medicine into my extremely fractious little dude, also gave me metronoidazole in pill form.

Well, when Raphael meets pill, all sorts of disaster break loose.

First, he jerked himself around while I had the pill gun in his mouth, and stabbed himself with it. Then he scratched his own face somehow during the scuffle, not to mention giving my husband a nice set of shallow scratches and me a couple puncture wounds. He screams. He foams at the mouth. He will not be scruffed and burritoing him worked long enough to get ONE pill in him, but wasn't about to fall for it again. The second pill ended up all over me and the floor and his face. And then he proceeded to drool relentlessly.

So, this other vet is apparently a complete moron (my regular one is in Israel at the moment), I guess my question is multi-faceted:

1. Has anyone else dealt with either pancreatitis or hepatic lipidosis? I know they're both reversible, and these are both slight, early cases. I also know that the treatments are pretty wide-ranging and there's really no magic bullet.

2. How do you get a pill in a cat that will just have none of it? He was semi-feral, has calmed down in his old age, but is apparently ready to release his inner feral when he sees the pill gun.

3. Has anyone ever heard of injectable suspensions of either of these drugs? Raphael, being the weirdo he is, will take injections, but he won't take pills and liquid is only very slightly easier to get into him.

Thanks guys!
((This post turned out to be quite long, so bear with me))

Yes Me! eeerrr I mean Samson. I had to give him 5 meds/day 3 of which were pills including the metronoidazole & Denamarin.

I can *so* completely sympathize with you, giving Samson the pills was the most stressful part of all, left me in tears every time. He did the same thing, and still does, the head jerking thingy. Thankfully though he has never scratched me.

And yes he runs and hides when he sees the pill gun! I now hide it under my shirt when I go to pick him up or I have it ready close by hidden under magazine or something. But as soon as he sees it, he wants to run!

However, your kitty does sound worse than mine at accepting the pill gun. When you say he won't be burritoed do you mean he wont' accept being wrapped in a towel?

This is what the vet recommended for me and it works, but be prepared he will still do the head jerking thing, so you will have to have a very firm grip.

Place your thumb and middle finger on each side of his mouth at the corners of his lips. With your fingers gently pry his mouth open by squeezing inward against his teeth. As I'm holding Samson this way, I also have my arm, the one that his holding his mouth, wrapped around him pressing his body against me. In your case you will probably need your husband to hold Raphael, maybe with a towel under his neck & over his front paws.

I also use my hand to partially cover his eyes so he doesn't see the pill gun coming. And, I approach his mouth from the side sort of sliding it into his mouth sideways. Try to be as calm as possible...I know, not the easiest thing to do under the circumstances. Also, try to be as quick as possible. Stick the pill gun into his mouth "click it" and close Raphael's mouth right away, so he does not have time to chew and spit the pill out. Be patient, there are days where you are going to have to start over.

Also try to have that "I mean business attitude". Ever notice how at the vet, a complete stranger can just grab your cat and *easily* make him swallow a pill? Frustrating isnt' it? Well, anyways, my point is, if you can develop that same "no nonsense approach" it will make a big difference.

I also whenever possible, administer the pills to Samson, when he is very relaxed or even sleeping (don't worry he will wake up). I start by petting him etc. then I get into position and by the time he starts struggling in earnest, it's over. But you have to have a very firm grip on his mouth, not pressing against his lips but his teeth. It's difficult for the cat to really go anywhere when you're holding his mouth that way and Samson *hates* being scruffed as well!

Getting the Metrozone compounded into a liquid though is the best way, because with the liquid you can just shoot it right into his mouth. Not necessarily pleasant, but doesn't give him a whole lot of time to taste it. I have also squirted water into Samson's mouth afterwards to help get rid of the taste and also to make sure he was getting enough water. I don't know if it can be administered via a shot.

It's a long road to recovery, and I'm still assist feeding Samson, and he's on the Hills a/d feline/canine recovery food, which thankfully he likes, but your baby Raphael will get better!

Try practicing holding his mouth in advance so he gets used to the feeling a bit, if you can.

All of the above being said, it still won't be easy. It will still be quite a struggle. Lionessrampant, there were times when I would get Samson to give him his morning meds and he would look at me with such sad eyes, it would almost make me cry. But I would look back at him with sad eyes myself and explain to him that he needed the meds, that I didn't like to give it to him, but that for him to get better he needed it.

Hang in there and let me know if there is anything else I can do to help!
post #8 of 13
Thread Starter 
Quote:
Originally Posted by Shanynne View Post
((This post turned out to be quite long, so bear with me))

Yes Me! eeerrr I mean Samson. I had to give him 5 meds/day 3 of which were pills including the metronoidazole & Denamarin.

I can *so* completely sympathize with you, giving Samson the pills was the most stressful part of all, left me in tears every time. He did the same thing, and still does, the head jerking thingy. Thankfully though he has never scratched me.

And yes he runs and hides when he sees the pill gun! I now hide it under my shirt when I go to pick him up or I have it ready close by hidden under magazine or something. But as soon as he sees it, he wants to run!

However, your kitty does sound worse than mine at accepting the pill gun. When you say he won't be burritoed do you mean he wont' accept being wrapped in a towel?

This is what the vet recommended for me and it works, but be prepared he will still do the head jerking thing, so you will have to have a very firm grip.

Place your thumb and middle finger on each side of his mouth at the corners of his lips. With your fingers gently pry his mouth open by squeezing inward against his teeth. As I'm holding Samson this way, I also have my arm, the one that his holding his mouth, wrapped around him pressing his body against me. In your case you will probably need your husband to hold Raphael, maybe with a towel under his neck & over his front paws.

I also use my hand to partially cover his eyes so he doesn't see the pill gun coming. And, I approach his mouth from the side sort of sliding it into his mouth sideways. Try to be as calm as possible...I know, not the easiest thing to do under the circumstances. Also, try to be as quick as possible. Stick the pill gun into his mouth "click it" and close Raphael's mouth right away, so he does not have time to chew and spit the pill out. Be patient, there are days where you are going to have to start over.

Also try to have that "I mean business attitude". Ever notice how at the vet, a complete stranger can just grab your cat and *easily* make him swallow a pill? Frustrating isnt' it? Well, anyways, my point is, if you can develop that same "no nonsense approach" it will make a big difference.

I also whenever possible, administer the pills to Samson, when he is very relaxed or even sleeping (don't worry he will wake up). I start by petting him etc. then I get into position and by the time he starts struggling in earnest, it's over. But you have to have a very firm grip on his mouth, not pressing against his lips but his teeth. It's difficult for the cat to really go anywhere when you're holding his mouth that way and Samson *hates* being scruffed as well!

Getting the Metrozone compounded into a liquid though is the best way, because with the liquid you can just shoot it right into his mouth. Not necessarily pleasant, but doesn't give him a whole lot of time to taste it. I have also squirted water into Samson's mouth afterwards to help get rid of the taste and also to make sure he was getting enough water. I don't know if it can be administered via a shot.

It's a long road to recovery, and I'm still assist feeding Samson, and he's on the Hills a/d feline/canine recovery food, which thankfully he likes, but your baby Raphael will get better!

Try practicing holding his mouth in advance so he gets used to the feeling a bit, if you can.

All of the above being said, it still won't be easy. It will still be quite a struggle. Lionessrampant, there were times when I would get Samson to give him his morning meds and he would look at me with such sad eyes, it would almost make me cry. But I would look back at him with sad eyes myself and explain to him that he needed the meds, that I didn't like to give it to him, but that for him to get better he needed it.

Hang in there and let me know if there is anything else I can do to help!
Thanks for the tips. I'm trying to get good at using the pill gun at all by administering tiny treats to my more docile kitty, Gracie. I'm hoping that if I can develop the speed and agility with the thing, I can be quicker with Raphael.

Gracie, at the moment, is sort of like '?'

Does anyone know if this is hazardous to the Grace-meister?

Raphael is eating on his own...had over half a can of the vet-approved food this morning. His pancreas is obviously not hurting him as much or at all, but I need to get his enzyme levels back to normal, so I MUST give him the meds. He was a very early, borderline case.
post #9 of 13
If he is back to eating OK, my suggestion would be to get a pill crusher, grind the pill down to powder form, then mix it in with his food. That's what we did with Willow when she was on Clavamox for a UTI. You can buy a pill crusher at the pet store, or just about any drug store should have them.

post #10 of 13
my dog has pancreatic insufficiency. She needs an enzyme in her food daily. She is fine but almost died. I would get the tuna flavoured liquid med for your cat. Any compounding pharmacy can take care of this..it saved my life for medicating my cat. I also used to put butter on the end of her capsule when I didn't have the liquid. Hope this helps...
post #11 of 13
Quote:
Originally Posted by Hesster View Post
If he is back to eating OK, my suggestion would be to get a pill crusher, grind the pill down to powder form, then mix it in with his food. That's what we did with Willow when she was on Clavamox for a UTI. You can buy a pill crusher at the pet store, or just about any drug store should have them.

This is a wonderful suggestion, that and pill pockets, and would work great for a cat that is eating, but when your cat refuses to eat, I think getting the pill compounded into a liquid is probably a safer bet to get him to ingest it!
post #12 of 13
Here's a couple of suggestions.

I very much recall how nasty Metronidazole is for a cat, the foaming and drooling (Taco used to get it as a kitten)

1. Check out this site: http://www.flavorx.com/vet/apothepet.asp
I had a peek at this site; it appears they sell special flavorings that many Vet clinics carry so that the clinic can compound up the medication into a whole variety of flavors (liquid) and on this page you can enter your postal code or zip code to find, I guess, a clinic in your area that uses this stuff.

2. Find a Compounding Pharmacy near where you live. They are wonderful. They can compound up the pill into a liquid form but at such a concentration that you barely have to give much at all. I used to do this with my CRF cat who got blood pressure medication. I had them make the concentration so strong (doesn't mean it tasted strong) so that I only had to give like 0.1 cc to give her the required dose. Not just any pharmacy or Vet clinic can do this; special training is required for a pharmacist to know how to properly compound. Do a search on Google for "Vet compounding pharmacies" including whatever city you live in. Also, some medications can be compounded into a transdermal GEL that you rub into the cat's inner ear flap. Not all can be done this way, but lots can; A good compounding pharmacist will be able to tell you if the meds you have to give can be made into this preparation. The reason some canNOT is because they simply wouldn't be absorbed well enough.

3. GELCAPS!!

These are a Godsend that I learned about when I had a CRF kitty who also had other health issues and she was on a LOT of daily meds. Depending on the size of the pills I had to give, I could sometimes put 2 pills into one empty gelatin capsule (gelcap) and therefore give both at the same time. They are awesome because you can put the most bitter tasting medication into it and the cat will never taste it. It's basically just an empty capsule, made with gelatin or some are made with vegetables (veggie caps, they're still clear). They come in various sizes, you can often get them at a health food store but sizes there are usually larger, for humans. I get mine online from iHerb.com

To give, I just get a little olive oil or the gravy from canned food, lube the end of the gelcap up a bit (the end that will go directly into the mouth), then quickly get it to the back of the throat. Always keep the head tilted up a little bit and then massage the chin/throat area, to encourage swallowing. ALSO - so important -- to prevent esophagitis (inflammation of the esophagus from the pill not going down and sitting there in the esophagus and causing painful inflammation), also squirt a little fluid (about 3-5 cc's), very slowly into the cat's mouth, to "chase it down."

here's some links you might find helpful about this all. this first one is written by a well respected Vet who's studies erosive esophagitis, it's very interesting...and she gives tips on getting meds into cats (liquid, transdermal gels, etc):

http://www.catinfo.org/pillingcats.htm

http://members.verizon.net/~vze2r6qt...es/gelcaps.htm

http://members.verizon.net/~vze2r6qt...lcaps.htm#size

http://www.torpac.com/Reference/unlinked_size_chart.htm --- this shows the actual size of the different sized gelcaps. I find it a little inaccurate, I find it shows them a bit larger than they actually are. I use a #1 for Taco's meds, and I've used a #3 for times when I have to give only a portion of a pill.

For a Cat I wouldn't use anything greater than a #1.

I know a Metronidazole pill is large so you might need a #0 for that one, unless you're not having to give the entire tab at once?
post #13 of 13
I'm here in Canada but I really like ordering my Gelatin Caps from www.iherb.com

Prices are good, shipping is fast (even to Canada):

http://www.iherb.com/ProductsList.aspx?c=1&cid=2192&p=1
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