Our cat has a condition that requires him to take a pill every day, and he has always loved getting it wrapped in cheese. But one day he flat out refuses. And the next. And the next. What do you do?
Some people give up, which for obvious reasons is a bad idea. “I’ve been in the emergency and critical care department for 23 years,” says Tufts veterinary technician Michelle Damon. “It’s very upsetting when you hear about owners discontinuing medications for their pet because it has become too frustrating. Then the pet has major medical setbacks. It’s really sad.”
Another bad idea is persisting at the same failed tactic. “You can’t keep trying the same thing,” says the head of the Tufts Animal Behavior Clinic, Stephanie Borns-Weil, DVM. “Once a cat has been sensitized, he will not spontaneously return to his previous behavior. He is not suddenly going to blink.” You also shouldn’t try to force the pill down your pet’s mouth. Either the cat or you can get hurt. And a cat bite can leave you with a bacteria-laden wound that ends up requiring antibiotics. Fortunately, there’s a variety of workable solutions to choose from.
A new approach
When a cat starts refusing to take his pill, it’s often because he tasted it on the last try, Dr. Borns-Weil says. If you have always wrapped it in cheese, for instance, he may have inadvertently bitten into the pill through the food. Especially if you use a pill splitter to cut a pill in half for the correct dosage, the doctor notes, the cat may have tasted the pill ‘dust’ at the cut end. The molecules released when a pill is split can taste “really nasty” to a feline, she says.
Whatever happened to change a newly unwilling cat’s behavior, “he isn’t going to forget that you tried to ‘poison,’ him,” the doctor says. “A negative association has been made, and his trust is gone.”
The solution is to create a new ritual that he won’t associate with the turn-off of the old approach. You want the new ritual to have positive associations for the cat. With the bitter taste of the pill in mind, Dr. Borns-Weil says there are plenty of options.
1. Coat the pills in butter. “That can sometimes lock down those stray molecules that taste bad,” the doctor says.
2. Buy empty gelatin capsules at the drug store and give the cat his pills in those. Just the change from the cheese (or whatever else you were doing) might be enough.
3. Try a pill shooter, a little plastic plunger that can shoot the pill past the tongue so the cat doesn’t taste it.
4. Give the pill in wet food. It’s smellier than dry kibble and may mask the odor of the medicine.
5. Buy edible pill pockets — little treat pouches that hold the pill during swallowing.
6. Ask a compounding pharmacy if the medicine in the pill your cat takes can be made into a liquid that has the flavor of fish, chicken, beef, or malt — whatever the cat likes.
7. Find out from your vet if the medicine can be obtained in transdermal form and applied topically to the cat’s ear. It doesn’t work for all drugs, but in some cases it’s a viable option.
8. See if the pill can be given as an injection, which a cat likely won’t mind. An injection could take the place of a couple of weeks’ worth of pills.
Sometimes, Dr. Borns-Weil says, you don’t have to change the way you prepare the pill but just something about the ritual. For instance, she says, if the cat becomes sensitized to the sight or sound of the pill splitter, you can split all the pills for a week behind a closed door rather than splitting one a day right in front of him. “That’s a way of avoiding the scary predictor,” she says.
Veterinary technician Damon changed up the ritual when her own cat, 7-year-old Yeti, started to refuse the life-saving heart medicine he had been taking since he was a kitten. She stopped rolling the pill in cheese and now quickly pops it into his mouth with her hand. But she only does it after he comes over to her on his own and allows her to pick him up. She makes the interaction his choice rather than chasing him and rendering it stressful. She then gives him a piece of cheese right after — as long as he first “gives paw” and then spins, tricks she taught him with a clicker when he was much younger. He likes the interaction.
“For the little bit of quick pilling,” Ms. Damon says, “he knows he’s going to get something positive. I keep petting him and talking to him as we go through it, and he purrs the entire time.
“The predictability of the new routine is really key. They need that so they can depend on an outcome; he knows that if he does his part, I’ll do mine. I sit in the same chair to give him the pill every day. It has gotten to the point that if I’m working at the computer and I forget it’s time for the pill, he’ll come to me.”