If they are lucky, most cat and dog owners will only have to give their pet a routine worming tablet and some flea treatment a couple of times a year. The less fortunate may have the unenviable task of administering medication on, in and all over their pets more regularly. Tablets can appear to be the size of marbles and capsules the size of bullets compared to the size of the pet's mouth. The veterinary surgeon confidently explains how to give them - Just pop it down his throat and rub his neck until he swallows.

This is usually easier said than done!

Oral Medications

Whichever method is chosen to administer treatment, it is important that the entire dose is given, and that both the animal and the owner remain unharmed.

The most efficient way to give oral medication is by direct administration - straight into the pet's mouth. By doing this, it is known that the correct dose was definitely administered, and at the correct time. Animals that need daily medication will soon get used to it, they may not like it, but they will tolerate it, especially if rewarded with a treat afterwards. Animals on intermittent or short courses of treatment may never get used to it, which can be stressful for both animal and owner alike. Finding alternative ways to give medication to a reluctant patient will certainly make life easier.

Tablets and Capsules

By far the easiest way to give a tablet is in food. However, some tablets may need to be given on an empty stomach, in which case you will need to use 'the direct approach'. The veterinary surgeon will explain if this is the case. Greedy dogs may swallow it along with the food, none the wiser. Some dogs - and cats in particular - are less likely to be fooled, usually eating everything but the bit of food with the tablet in.

The next option is to create a powder from the tablet¹. Crush the tablet between two spoons, or a pestle and mortar. Mix the powder evenly into the food, which should disguise the taste of it very effectively. However, even after all this, there are still some pets that will refuse to eat it.

Capsules can be given the same way as tablets. Rather than crush them, the capsule is made up of two sections fitted together and will quite easily pull apart to release the powder².

In Water

Tablets that can be crushed and capsules opened, could be dissolved in a small amount of water and given orally as a medicine. Unfortunately not all tablets will dissolve in a liquid however finely you crush them.

Tips and Tricks

• Pill-givers - these are commercially available plastic devices to make giving tablets easier and safer. They have a syringe-like barrel and plunger, and at the other end of long narrow shaft are two plastic claws. The pill-giver is placed in water and the plunger withdrawn to suck up water to fill the barrel. The tablet is then placed in the claws. The idea is that by using the pill-giver you can reach the back of the animal's throat without putting your fingers in the mouth. By slowly depressing the plunger, it will allow the water to push the tablet of the claw, as well as forcing the animal to swallow.

• Titbits - hiding a tablet in a small piece of cheese, chocolate³, banana or butter, although generally not recommended, can often be too much of a temptation to refuse.

• Pets may start to associate getting a treat with medication. It is sometimes wise to offer a treat without medication, then offer a medicated one, and then again an unmedicated treat to reduce the association. Varying the type of treats used is advisable too.

• Pill-biscuits - commercially available biscuits with a hole in them. Insert the tablet in the hole and hopefully the animal will be so keen to eat the biscuit the tablet won't be noticed.

• Hunger - don't give pets any food before the tablet is due. If the animal has constant access to food, then remove it a couple of hours before the medication is due. A hungry animal is more likely to eat food even if they can taste the tablet.

• A spoonful - rather than offering a full meal, offer only a small amount with the tablet in. This makes it more likely that the pet will eat it, rather than eat around it. Once that has been eaten then offer the rest of the food.

Medicines

Medicines that don't need to be given on an empty stomach can be mixed in food. However if the pet will not eat the food then the only option left is 'the direct approach'.

The Direct Approach

The pet should be approached from the left. On large dogs, the upper jaw is grasped just behind the level of the canine teeth and the head pulled upwards until the mouth falls open. Don't put fingers directly into the mouth, by using the lips to protect the fingers, the dog is less likely to bite down, as doing so will mean biting their own lips. With cats and smaller dogs, tip the head back by grasping the cheekbones (zygomatic arches) and tipping the head backwards until the mouth opens slightly. A finger of the right hand can be used to press down on the lower incisor teeth to open the mouth. The tablets are placed at the back of the tongue, or dropped into the back of the mouth and the jaw is allowed to close. Keep the mouth shut until the animal has swallowed. Gentle stroking of the throat area can encourage the pet to swallow. Dribbling a small amount of water into the side of the mouth will also stimulate swallowing. The pet should be watched closely after administration to ensure they do not regurgitate the treatment, shake it out of their mouth or flick it out with their tongue.

Medicines can be given into the side of the mouth. There is a natural gap between the lower cheek teeth. Raise the pets head by stroking under the chin and tilting upwards. Lift the lip and gently insert the syringe tip or nozzle into the gap and slowly dribble the medicine in. Squirting fast can cause the animal to inhale the liquid causing pneumonia in severe cases. By keeping the syringe at a 90° angle to the length of the muzzle, then the liquid will dribble over the back of the tongue stimulating the swallowing reflex rather than down the throat with a risk of inhalation.

Restraint

With larger dogs, it is easier to have them in a sitting position, with cats and small dogs, it is often easier to lift them onto a table, or do it while they are quite relaxed, perhaps sitting on a chair.

If a cat struggles a lot or tries to scratch it may be necessary to wrap it in a towel. This involves placing the cat on a large towel and pulling it up around the neck, like a bib, and over the back, making sure all four feet are included. This still allows access to the mouth, ears and eyes.

Topical Treatments

'Topical' is a term used to describe medications that are applied externally. This can be on the surface of eyes, in ear canals, or onto the skin and coat. Protective gloves may need to be worn when applying some of these treatments, as they can also be absorbed through human skin.

Eye Drops and Eye Ointment

The application technique of both drops and ointment is very similar. The most important thing is that the nozzle never touches any area around the eye to prevent contamination of the tube and damage to the surface of the eye is avoided.

Most animals being approached faced on with a bottle or tube will automatically flinch back, as their first instinct is to smell the object. Equally an automatic defence mechanism to protect the eyes is to back off from any object approaching them directly. Taking into account these responses, the best way to apply eye treatment is to approach the animal from behind, so they cannot see what is about to happen.

Sit to one side of the pet. Stroke the pet's chin and gently tilt the nose upwards. It is usually possible to hold the eyelids open with the thumb and forefinger of the hand when doing this. Hold the bottle or dropper above the eye with the thumb and forefinger of the other hand and gently squeeze so that the correct amount of medication falls into the eye. Resting the hand on top of the animal's head will help to steady the hand and avoid touching the eye if the animal should suddenly move.

Aural Medication

The canine and feline ear consists of a vertical canal and a horizontal canal, which then connects to the eardrum (unlike human ears which only have a horizontal ear canal). In order to make sure the drops reach both canals, the vertical canal must be massaged after applying the drops.

As with the application of eye drops, the animal should be approached from behind so they cannot see the eardrops.

Sitting on the right hand side of the pet, cuddle into the pet. Using the left hand, lift the left pinna (earflap) to expose the canals. Keep hold of the flap at the base. Use a ball of cotton wool (not a cotton bud) to remove any discharges or debris before putting in new treatment. Apply the drops and then the vertical ear canal gently massaged from the outside to disperse the treatment. Swap sides and repeat with the other ear. Holding on to the pinna prevents head shaking, but doesn't hurt the animal.

Creams and Ointments

A cream is water-miscible, non greasy and easily removed by licking. An ointment is usually anhydrous, greasy, insoluble in water and more difficult to remove than creams.

These are one of the simplest treatments to apply. The biggest problem can often be preventing the animal licking the cream off as soon as you have put it on. By distracting the animal for ten minutes after application, it allows time for it to be absorbed by the skin.

• Take dogs for a quick walk.

• Feed your pet afterwards.

• Tempt them into a game with their favourite toy.

• Use an Elizabethan Collar⁴, unfortunately wearing these can often be quite distressing for the animal.

Spot-on Treatments

The most common types of spot-on treatments are flea and tick control products. Again, quite easy to use. They are applied directly onto the skin (not fur) at the back of the neck between the shoulder blades. This is an area that dogs and cats cannot reach to lick it off. Part the fur to expose an area of skin, and simply squeeze the contents of the tube onto it. There are specific instructions about bathing depending on which product is used, so the directions should be read thoroughly first.

Powders

Powders are messy and difficult to apply. In order to be an effective treatment, the powder needs to reach the base of the hairs and onto the skin. This is a problem in thick-coated animals such as Birman cats and Shetland Collies.

Give the pet a thorough brushing to remove all dead hairs, getting right down to the base coat. Dog and cat coats are made up of two types of hair, a soft downy under hair and the longer, often wiry, 'guard' hairs, which is why applying powder can be tricky. Then 'reverse brush' the coat to encourage the hairs to separate and stand up. Cover the floor (or table) with newspaper and stand the pet on it. Rather than dusting the whole body in a single application, which is likely to be shaken off, do small areas at a time. Either place a small amount of powder into a cupped hand or onto a patch of coat and massage it into the fur to reach the base of the hair shafts and skin. Repeat the process until the entire coat is covered, avoiding the eyes and ears.
Do not let the pet try to lick themselves afterwards.

Sprays

There are two types of sprays - aerosol and pump-action. Animals are very often afraid of the 'hiss' of an aerosol spray, so a pump-action spray is a better option if it is available. Directions of application will vary depending on the type of treatment, but avoiding the eyes, applying in a well-ventilated room and not allowing the pet to lick the coat afterwards are the main points to remember.

Shampoos

There is one sure thing about shampooing a pet - the owner will usually get very wet!

Preparation is the key to making bath time as non-traumatic as possible - for both pet and owner alike.

• Read all instructions carefully before hand.

• At least three towels are needed - size dependant on the size of the animal being bathed (the larger the better).

• Prepare in advance any shampoos that require dilution before application.

• Have a jug of clean warm water available for emergency rinsing, in case the shampoo gets in the animals eyes.

• If possible, use a shower for bathing the pet, or a spray unit attachable to bath taps to ensure a constant flow of warm, clean water. It is vital that the pet is rinsed thoroughly afterwards, so they don't ingest any shampoo when cleaning themselves.

• If possible, enlist additional help!

Repeatedly check the temperature of the water during bathing, using the elbow as a gauge to prevent scalding. The normal temperature of a dog is 38.3 - 38.7°C and a cat is 38 - 38.5°C. Both are slightly higher than the body temperature of a human baby - 37.4°C, however the technique used for testing a baby's bath water is still appropriate.

The eyes and ear canals should be protected at all times. A ball of cotton wool can be placed in the top of the ear to prevent any shampoo getting in (but take care not to push it in too far). The eyes should be shielded by a hand, especially when bathing the head.

Wash the body before the head, as when the ears get wet it triggers a shaking response intended to protect anything from getting in them.

Cats can be particularly difficult to bath. One suggestion is to use a wire cat cage⁵. This allows the cat to be thoroughly soaked and rinsed without fear of escape, opening the carrier only to apply shampoo. However this does not allow protection of the eyes.

Before removing the pet from the shower or bath, place a large towel over the pet and allow them to have a good shake. Give them a rough towelling and allow them to shake again, then change towels and start to dry them properly, concentrating on the head and main body as those are the areas likely to lose most body heat.

Using a hair dryer can irritate the skin, particularly if the reason for bathing is due to a skin complaint, so it is better to allow the pet to dry naturally. However, in cold weather the pet needs to get dry as quickly as possible. Use the hairdryer on the lowest heat setting and don't aim the nozzle directly at the animal's skin, angle it so it blows the warm air across the coat.

Keep pets indoors in a warm room for an hour afterwards, to make sure they are fully dried off.

Brushing Teeth

Whilst brushing your pet's teeth is not strictly a medication, it is certainly classed as a necessary part of the routine health care of your pet along with worming and flea treatment.

More detailed instructions on oral hygiene are explained at How to Clean your Dog or Cat's Teeth, along with tips and technique.

Injections

Medication that needs to be given by injection will usually be administered in a veterinary centre by trained staff. However, there are some circumstances where treatment by injection needs to be given by the owner at home.

The most common reason for this would be if a pet has Diabetes Mellitus. Daily injections of insulin are required to maintain a stable blood sugar level.

A veterinary surgeon or qualified veterinary nurse will explain how to give injections, ensuring the owner is proficient in their administration and technique, before being asked to do them unsupervised at home.

Notes

• In cases of extreme difficulty with administration of medications, it may be possible to arrange an appointment with a veterinary nurse to give them instead.

• Tablets that need to be split usually have a 'score' down the centre, but it can still be tricky to halve them or even quarter them. A tablet cutter is available - this is a plastic box with a blade in the lid. If fits all sizes of round tablets, which are placed in a triangular frame and the box closed forcing the blade through the tablet, splitting it.

• Medication for animals should be treated in the same way as human ones. The directions should be followed exactly, storage conditions adhered to, courses of treatment completed, and medications should not be used on other animals unless advised by a veterinary surgeon.

• A veterinary surgeon or nurse should always be consulted about queries or worries regarding any treatment.