Pilling can be dangerous

The following is a summary of a very interesting article that appeared in one of the vet journals entitled “Evaluation of the Passage of Tablets and Capsules through the Esophagus of the Catâ€. It is from a paper presented at the 2001 American College of Veterinary Internal Medicine Forum.

I have always been concerned about the issue of pilling cats with a dry pill with no water or not in liquid form. Have You ever tried to swallow a pill dry without any water? Just think how terrrible this must feel to a cat whose esophagus is so small.

Study: 30 cats were used. Fluoroscopy was used to evaluate the pill/capsule passage at 30, 60, 90, 120, 180, 300 seconds. Cats given dry pills by standard pilling methods as opposed to those given the same medication in liquid form.

The study was evaluating how long it took for the pill to get through the esophagus into the stomach of the cat.

Study results: For the dry pill swallows: (can you imagine having to swallow tablets or capsules with no water, hurts just thinking about it) at 5 minutes ONLY 36% of the pills were in the stomach.

For the liquid medication all medication was in the stomach by 90 seconds.

"The main concern with this information is that if tablets and capsules sit in the esophagus for a prolonged period of time, this can cause damage to the tissues in this area. This damage can lead to esophagitis, which can lead to nausea, vomiting and megaesophagus. At times, the esophagus can also respond by developing an ulcer or stricture. The latter is a very serious complication requiring aggressive therapy, preferably with balloon dilatation.

My cat will be on methimazole for the rest of her life. She literally runs to the refrigerator for her tuna flavored liquid medicine making for a much more enjoyable relationship with her. The “bond†between pet and pet owner is very important and a traumatizing experience like pilling everyday can cause a permanent break of this trust or “bondâ€.

Many of you may not be aware of the option of having tablets or capsules made into tasty liquid forms to facilitate administration. The list of flavors depending where they are made up is long and includes Tuna, Sardine, Salmon, Beef, Bacon. etc. Keep the quantity small 1ml or less for ease of administration and make sure that you use a reputable pharmacy that has done all of the proper testing (stability, compatibility). You can ask to see stability data before using a pharmacy so that you can have peace of mind of knowing that what you are giving your pet is medication that is of proper quality and accurate strength and that the flavorings being used are not diluting or ruining the efficacy of the medication being given.

There are human pharmacies out there that will do this but vet meds are not their specialty and they don't have access to vet meds. There are many sources out there to get this done at.

Hopefully this information will be useful and help to save some of our animal companions from painful esophagitis and humans from the hassle of pilling and traumatizing beloved pets.

My cat is also on methimazole, twice daily. I'm fortunate that he has learned to swallow pills rather quickly without an issue. After he swallows it, I feed him. That way, the process of eating and swallowing food can move the pill along. I have also heard of people who give their cat a syringe full of water after giving the pill to ensure that it goes all the way to the stomach.

I would disagree with your statement about human pharmacies, however. Pharmacies that specialize in compounding are generally very familiar with pet medications. I used to work at a compounding pharmacy, and they kept a variety of substances on hand to create tuna, liver, etc. flavored gels that could be fed to the cat. They also create transdermal gels, which are applied to the ears (usually). Most good pharmacies can order medication if they don't normally keep them in stock. Fortunately, methimazole is used for people as well as cats, so I haven't had an issue with this.

use a pill gun and you will have no problem whatsoever

Mizcat, could you please quote your source? I would like the name of the Journal, the date of publication, and the author.

I want the info so that i can see the article for myself, but also because when quoting or summerizing someone else's work its important to give proper attribution. True, many times at thecatsite people will reference an article without attribution but this is a big article, with a lot of summerizing, and relatively new information.

Thanks

This was sent to me as an abstract from an associate doing research on a similar subject and sent it on to me. So I don't know all the background of it but there is a paper that was written with similar results that was published in another study by JP Graham (American Journal of Veterinary Research 2000)."

I thought the abstract was extremely interesting, but you are right I should have found out all of the details when I received it and given proper attribution. Since it was from a paper presented at the 2001 American College of Veterinary Internal Medicine Forum I thought it was legit.

Cloud_shade I think the feeding wet food or a syringe of about 5 or 6ml's of water after the pill would help move the tablet out of the esophagus and into the stomach much quicker. Thank you for the good advice.

Has anybody tried those gel medicines you put on the ear?