Medicating & Assist Feeding Your Cat

Getting medication and sometimes food into our cats are important skills. Even if our veterinarians show us how in the office, they often make it seem so easy - but once we get home it's a completely different experience. Here Carolina and I (Laurie) share important information about medicating and assist feeding your cats, and the methods we use to accomplish those feats. It wasn't all roses, and it usually results in some emotional trauma (more for us than our cats!), perhaps a mess to clean up, or a wasted, soggy pill. We all have to start somewhere. Hopefully these tips will make it easier.

Let's get started -

Obviously, the easiest method is to get your cat to eat the pill. For tablets and small capsules, this is the raw feeding equivalent of a pill pocket. Thank you, Carolina, for this tip!
 
Meat Pocket
Cut a small piece of meat that is small enough to be bite-sized, but big enough to snip a “pocket” into it with shears (or use a knife if you’re handy with them, I am not). Put pill in pocket, feed to cat - not as part of the meal, you need to ensure kitty eats it. If this method doesn't work, you may need to pill your cat.
 

Medicating with Liquids
For liquids, use the same techniques as for pilling. It is still best to follow the medication with water.


Pilling Kitty

Never pill a plain pill. I always put tablets into a #3 size empty gel cap (example: NOW size 3 empty gelatin capsules), and though it makes it a little slippery, I coat the pill with something, usually a bit of butter. Wet capsules can get stuck in the throat.
 
Pills should NEVER be given alone and dry. Think of your own experience swallowing a pill. It is not just uncomfortable, it can cause physical damage. Strictures are usually not reparable in cats, and over time dry pilling can cause scarring and restriction of the esophagus (to the point a cat must be put on a liquid diet).

If you are using your finger or a piller that doesn’t have a water chaser, to prep for giving the pill, have a little dish ready with a bit of something for them to lap up. Bone broth, meat broth (made for the cats with nothing added, just plain broth), “meat juice” if they like that (what separates from meat during thaw), a little tuna water… whatever works for your cat. Once you’ve gotten the pill down, they need to drink something to wash it down!

Use praise. LOTS of praise. Before, during, and after. Praise your kitty, tell her what you’re doing and why. Tell her WHAT a good girl she is, how much you love her, and don’t stop talking. Calm, sweet, loving, dotted with lots and lots of praise.
 
The main ingredient is confidence. It takes practice, but it won’t be long before you can approach your kitty wherever she is, hold her head, pop the pill in, and it’s over and done with before she realizes it happened. Take a big deep breath, or a few of them. Think “I can do this!” And just go for it. Worst case, your cat spits the pill out and you must try again. But this does NOT hurt your cat, and you will NOT harm your cat.

If you are still nervous, sing, even if you don’t sing. It calms both of you down. Just pick a tune you know, kitty doesn’t care if you sing in key. And sing the stuff you’d talk to her, if you don’t know the words to a song. Kitty doesn’t care if it rhymes or even makes sense.  I no longer need to sing to pill, but I do need to sing trying to get a few of them to do other things (like scuffing them into a crate to go to the vet. I have quite a few still semi-feral cats). I usually sing to the Monty Python Lumberjack song. “You’re a kitty cat and you’re ok! You need this pill so you can play and play…”


Pilling a Cat - Video demonstration by Carolina

Pilling a Cat - Laurie's Method
 
Important notes before we begin:

I am right-handed. If your dominant hand is the left, the point is to use your dominant hand for the work (getting the pill in, using the syringe, or swiping the food) and the other hand to control the cat’s movement.

You can use a piller rather than your finger. Unlike Carolina who is comfortable with a piller, I’m a spaz with one. I use what I feel in the cat’s mouth wtih my finger to know where the pill is. Yes, the cat usually chomps my finger, but rarely do they break skin. If you use a piller, best to use one with a water chaser as demonstrated by Carolina in the video, above.
 
The Process
 
When putting something in a cat’s mouth, it is their natural reaction to back away. Use this to your advantage. Sit behind your kitty, knees bent, butt on your heels, legs in a V shape. Use this position to “hold” kitty in place. There’s nowhere to back up, and your legs help hold the cat in place.

I use my left hand (my non-dominant hand) to hold the head, thumb on top of head, the rest of my hand under the chin, head “cupped” in my hand. You are not hurting your cat: hold firmly! I can manipulate where the head is this way. I have the pill (or if you prefer, a piller) in my right hand (holding the pill with my thumb and index finger). I push the mouth open with my left index finger. Locate the back of the mouth, where the upper and lower jaws hinge together. With your other hand (holding the pill), locate the back of the mouth with your middle finger, so you’re ready with the pill.

Hold the head tilted up with your left hand, it makes this easier.

I push at the hinge of the jaw, into the mouth, with my left (non-dominant hand) index finger. Push firmly. The mouth will open. (I’m already holding the pill in my right hand in the correct position, at the back of the mouth, ready-to-go). I push the pill in from the right side at the back of the mouth with my right (dominant hand) index finger. I stick my finger in the mouth, guiding the pill ALL the way to the back of the mouth, over the hump of the tongue. I push quickly. Just get it over that hump, you'll feel it. Remove finger immediately. Yes, my finger usually gets chomped. It doesn’t hurt much, skin is rarely broken. I have been using my left hand to prevent the cat from thrashing the head around, and my body and legs hold the cat in position, though there may be some wiggling.

As soon as I’ve removed my finger, I hold the mouth closed, and keep the head tilted up (and now your dominant hand is available to help). If you let the head down while pilling, tilt it up again. Holding the mouth closed prevents them from spitting it out, and tilting it up has gravity helping do the work. I hold the mouth closed until they swallow. If they resist swallowing, just stroke the throat gently with your right hand while still holding the head firm with your left. Or you can tilt the head all the way up and blow a gentle puff of air on the nose. As soon as they swallow, you’re done! Praise the heck out of her, and offer the liquid to drink.

Assist Feeding

IF YOUR CAT IS NOT EATING, IT IS UP TO YOU TO GET ALL THE NUTRITION SHE NEEDS INTO HER. Cats' livers are NOT designed to deal with processing fat stores. Without food, your cat starts to release fat and “eat” her own muscles. This fat can flood the liver causing a liver disease called hepatic lipidosis, or “fatty liver” and this IS life-threatening. It also makes your cat not want to eat, and the primary resolution is food. This is not treatable with a medicine. Food IS the medicine.

Assist feeding notes:

When to assist feed. As discussed above, a cat not eating can cause liver disease. Overweight cats are particularly at risk. When a cat has not eaten for 24 hours, or only "picked" at food over a 24 hour period, you need to begin assist feeding. Of course, a vet visit is warranted to discover the cause of the problem. Walking away from food is a sign of nausea in cats, and needs to be addressed and managed. But getting the nutrition your kitty needs into her will help support her best health, no matter the cause. It's important to note that without food, cats often develop acidic tummies, and the cycle of nausea perpetuates itself without food.

What to assist feed. If you need to assist feed your cat, as your cat is already in distress, it is best to continue to use the food you are currently feeding to minimize GI upset. The exception is kibble. Then we recommend using baby food or plain poached chicken breast. Thus, if you feed raw, continue to use that - though if you feed ground with bone, you will have to make a batch substituting eggshell for bone so you can put the food through the syringe. To use eggshell as the source of calcium, use 1/2 teaspoon (3.1 grams) of very finely ground eggshell powder for each one pound (450g) of meat/organs. If using commercial raw, in the U.S. there may be a Rad Cat distributor near you. This is the only commercial raw that is ideal for a syringe as it uses eggshell, not ground bone. If you want a very plain diet, you can use ground meat balanced with eggshell and taurine (1/32nd tsp of very finely ground eggshell powder per ounce (28.35g); for larger batches, one-half teaspoon per pound (450g), and to one of the syringes each day add 250mg of taurine). This can be done with raw or cooked meat. If you feed homecooked, we recommend you assist feed your homecooked food.

Many vets will tell you or encourage you to use prescription food designed to be used in a feeding tube, this makes it easy to use in a syringe. But if your cat has not been on a commercial diet recently, this is likely to cause GI upset, and there really is no need for this. For those new to raw and concerned about using raw when kitty is sick, please read our article Why You SHOULD Feed Your Immune Compromised Cat Raw Food. Having your kitty feel unwell from food simply because it was designed to be used in a syringe makes no sense. The vets that are not anti-raw tell you to keep feeding your cat raw. If YOU feel more comfortable feeding cooked, that's fine. Then cook the food you would feed, just make sure to use eggshell calcium instead of bone. Of course, food made with EZComplete fur Cats works very well in a syringe once prepared for it. When my cats are ill and need to stay at the vet, I take prefilled syringes with raw food, and they assist feed those rather than the canned Rx they would use. And thus my cats don’t get stomach upset from food they are not used to eating. If your vet won’t do that, fill them with baby food. Or poach chicken thigh. By including some fat, this is just as high calorie as the a/d. The a/d has 183 calories per 5.5 ounces, it isn’t a particularly "high calorie" food.

Prepare the food for the syringe. If assist feeding raw or homecooked, you’ll have to run it through the blender with some water. If you feed raw with bone, you will have to make food using eggshell as a substitute for ground bone. See above.

I use a knife to load the syringe from the top. Carolina uses a spoon.  We both prepare as many syringes as we're going to feed in one sitting before we start.

How Much Food?

For the feeding, start by giving a small amount per plunger push: 1ML to 2ML are good amounts to start with until you get the hang of it. I usually give 3ML in one squirt.

For the day. One of the biggest assist feeding mistakes is not getting enough food into your cat. You need to get all of the daily nutrition your cat needs into her. It is best to work up to the full daily quantity by starting with at least half of her daily need on day one. Day two, target three-quarters. On day three, you should start getting her full daily need.  If you are unable to get ALL the food your cat needs into her, please get a feeding tube. Feeding tubes save lives and are completely underutilized in cats. They are a quick procedure with a light anesthetic, and usually very well tolerated by cats, and even most sick cats can manage the procedure. You vet is the best judge of how your cat will handle the procedure. Whether for three days or three weeks, feeding tubes reduce the stress on both of you and ensure your cat gets the nutrition she needs.

Determining the daily food requirement.  As to how much to feed of the course of a day, the math is straightforward. 5ML is one teaspoon of food. Three teaspoons are a tablespoon. So each 15ML syringe is one tablespoon, and that is approximately one half-ounce of food. If your kitty eats 4.5 ounces a day, that means over the course of a day, your cat will need to be fed nine 15ML syringes of food. You can feed one every hour to hour-and-a-half. You can feed two every few hours, and one at the end of the day. You can feed three meals a day of three syringes. Whatever works best with your schedule.
 
Where to Feed. I assist feed in a bathroom. It’s closed, warm, and easy to clean up. And if for some reason the cat gets away from me, I can more easily corral them again.

Assist feeding is messy – more so when you’re still new to it. Have lots of paper towels handy!


Assist Feeding - Carolina's Method

Please note, this video was made before Carolina transitioned her cats to raw food. Now when any of them need assistance eating, Carolina prepares their regular raw food (raw meat + EZComplete fur Cats) to use in the syringe. (I use the same). She uses her Magic Bullet to blend with water into a consistency easy to use in the syringe. I use my small food processor. As food made with EZComplete fur Cats is moist, it doesn't require much water using the Four Paws Easy Feeder syringes featured in the video and discussed here, as you control the width of the tip by where you cut it to create the opening in the cone on the feeder syringe.

Carolina found the BEST syringes: Four Paws Easy Feeder. No rubber, so they never stick. Easy to clean. They’re large enough to be useful, but not so large you can’t handle them – and we both have small hands. Best, you cut the syringe tip to the width you want it, which makes syringing raw food SO much easier. The pack comes with one food syringe with a cone shaped feeding tip and one liquid syringe. I cut the long thin part off the liquid one, and thus I get two food syringes. Carolina finds the tip on that to be too thick - and it is a wide opening, so best to use the cone syringe as a beginner. The syringes are 15ML each. That is half an ounce of food. When assist feeding, it is often best to feed more frequent smaller amounts. But it sure is helpful to be able to feed an ounce at a time (two 15ML syringes). The syringes the vet gives you are meant to be used with a feeding tube, and are very limiting both in terms of how much food you can feed (they're usually 10ML at most) at one time, and the opening is very small, so it's difficult to get food through it.

In this video, Carolina demonstrates how to assist feed using a cat bag. This works to settle and calm the cats, reducing the stress of assist feeding. It also restrains the cat, so you are free to use both hands. It is stressful to assist feed a struggling cat. ...Though as we've found, you may find that after a few meals, your cat realizes she feels better, and settles down (often after initially objecting just on principle).  But this is Carolina's first time assist feeding Lucky (though Carolina was already experienced with assist feeding when this video was made). My Lazlo was the first cat I ever had to assist feed, and at first, of course, he hated it and fought it. But as I got better at it, and he realized he felt better with food in his tummy, he quickly became cooperative and purred throughout - as you can see Lucky is almost enjoying her food, here. Carolina and I think it's important to note: while this is the first time Lucky was assist fed, she is calm and not struggling. Our cats are so sensitive to us, if we approach it with fear and trepidation, we can expect them to object. Approaching it calmly, with love, gentleness and confidence, they respond, as Lucky does.

Assist Feeding - Laurie's Method

The instructions for assist feeding are exactly the same as pilling, only you’re not putting a pill in the mouth, you’re putting the tip of a feeding syringe. And instead of aiming for the throat, tilt the head up with your left hand, so it’s easy to point the tip of the syringe at the roof of the mouth. By pointing at the roof of the mouth, you can be sure you’re not going to make your cat accidentally inhale food.

 
Finger Swiping
 
This can be used for small amounts of food, but it isn’t very efficient. I use this to get slippery elm bark powder “paste” into my CKD cat. I used to use the slippery elm “syrup,” which seems to work much better for nausea than straight slippery elm bark powder. But now I’ve a CKD cat that needs this basically daily, I find it easier to just finger swipe a paste into his mouth – and by replacing water with the George’s Distilled Aloe Vera Juice (now labeled “drink”), he needs less of the paste to be as effective as 3ML to 5ML of the syrup. The usual directions for the paste are one-quarter teaspoon of slippery elm bark powder and one-half teaspoon of water. Stir and let thicken. But now I replace the water with George’s Aloe – and he doesn’t need all of it. I’ve reduced it to 1/8th tsp slippery elm bark powder and one-quarter teaspoon of George’s aloe vera.

Have the paste handy. Follow the instructions for pilling, only rather than holding a pill to put in the mouth, you’re putting a blob of aloe paste on the end of your dominant hand finger. Rather than push a pill all the way into the back of the mouth, you're just “wiping” the paste into the back of the mouth. Open her mouth with the index finger of the hand holding the head as instructed in the pilling section above, and quickly wipe that blob of paste (or food) that's on your other finger into the back of the mouth. No need to push it anywhere. Close the mouth with the left hand, hold the head tilted up, wait for kitty to swallow. Repeat as necessary to get most (or even all) of it in. If you only need the smaller amount paste to help your kitty’s nausea, you should be able to get it done in one or two swipes.