How to Administer Oral Medications

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Background

Veterinarians routinely prescribe medications, either in a liquid oral form or a tablet form. With either one, the goal is for your pet to receive the medication as easily as possible in your home. It is important that you give your pet the medication as directed by your veterinarian and for the entire time prescribed. Many health conditions may not improve without proper medication.

Terminology: “oral liquid” and “oral syrup” are interchangeable terms, but “pill” and “tablet,” strictly speaking, are not. A pill is perfectly round (spherical), and virtually no medications are made this way anymore because they can roll into awkward locations or be lost altogether when accidentally dropped. Tablets are round in one dimension and flattened/biconvex in the other, a familiar shape for medications in both human and veterinary medicine. They may be circular (most common), oval, or even triangular in shape. Capsules are hollow, closed-ended tubes that contain the medication in powdered or granular form.

Getting Started

Equipment/materials needed for oral liquid medication:

  1. Medication

  2. Syringe (if liquid)

Equipment/materials needed for tablet or capsule medication:

  1. Tablet splitter (if each dose is less than a full tablet)

  2. Food or “Pill Pocket”

  3. A syringe with 3 to 5 mL of water

Troubleshooting Beforehand

If is usually acceptable to give pills or capsules hidden inside a small bite of food, even if the medication is to be given on an otherwise empty stomach. Most dogs will take medication hidden in a small piece of food such as cheese, peanut butter, or canned dog food. There are also commercially available treats with a hollow center specifically meant to hold tablets or capsules (e.g., Pill Pockets®). Some dogs may find the tablet and spit it out. Cats often are much more clever (or discriminating): they can smell the medication and will often not take it in food.

If your pet shows resentment to receiving medications this way, stop the procedure and call your veterinarian for further advice. There may be other treatment alternatives, such as compounding, where the medication is transformed into a meat- or fish-flavored syrup or chewable tablet that most animals will take willingly. Do not cause risk to the health of your pet (no veterinarian likes to hear “It takes three of us and a wrestling match, but we’re getting the medication in,” because the stress may cause serious harm to the pet). Do not put yourself in harm’s way or allow yourself to get bitten.

Always give your pet water to drink or a small amount of food to eat after the tablet has been given (a “chaser”). This helps ensure that the medication will travel to the stomach. Without doing this, some medications will get stuck partway down the throat and can cause sores as the medication sits and dissolves against the wall of the esophagus. If your pet won’t willingly drink or eat, you can use a syringe to give a small volume (3 to 5 mL) of tap water, as described below for liquid medication.

If your pet has vomiting or diarrhea after medication administration, or what you feel may be an intolerance to the medication or other adverse effect, call your veterinarian. The medication your pet is receiving may have to be changed.

Procedure

Oral Liquid

  1. Fill the oral syringe or bulb with the desired amount of medication. Usually, there is a special top on the liquid bottle that allows you to easily attach a syringe. Once attached, hold the bottle upside down and draw out the liquid into the syringe. Some liquids are very thick and sticky, others are watery. You can draw more than you need, then squirt the extra back in the bottle. Look to be sure you have the right volume of liquid without any large air bubbles. Once you have the syringe filled to the right amount, turn the bottle back over, remove the syringe, and recap the bottle.

  2. Allow your pet to keep his/her mouth closed throughout this process.

  3. Insert the tip of the oral syringe into the corner of the lips on either side of the mouth. It is not necessary or desired for the mouth to be open.

  4. Hold the head pointing slightly upward (chin elevated), and squeeze the plunger gently to administer the medication into the cheek pouch over a period of 3 to 5 seconds. Often this is accompanied by licking movements of the tongue as the pet swallows the medication.

  5. Keeping the head elevated (lift the pet’s chin) helps ensure that the medication trickles to the back of the mouth and is swallowed, not dribbled out the front of the mouth.

  6. The cheek pouch approach is preferred over prying the mouth open and squirting the medication into the back of the mouth, because keeping the mouth closed is more comfortable to the pet, and it is less likely that a vigorous squirt will hit the back of the throat, causing gagging or coughing.

  7. Instead of this approach, you may try placing a small amount of medication on the food and see if the pet will eat it. This should be done just as an attempt, because some pets will not eat food that has medication sprinkled on top.

Tablet

  1. If the medication must be cut in half, place the tablet in a tablet splitter (available at your local pharmacy) and cut directly in half. Place half of the tablet back into the medication vial.

  2. For dogs, try placing the medication in a small piece of cheese, peanut butter, or canned food. Give the dog a piece of food that does not have the medication in it. Next, give the food with the medication in it, followed by another non-medicated piece. Ensure your dog did not spit out the tablet and that it is not caught in the lips.

  3. Tablets may also be placed in Pill Pockets, a hollow, semimoist treat designed to hold medication. Be sure, if you are using these or a treat (cheese, peanut butter, other), that your hand that touches the tablet does not touch the treat. Some dogs and many cats have a sufficiently sensitive sense of smell that they will detect the smell of medication on the outside of the treat that came from you touching the outside of the treat with powder or residue from the tablet.

  4. For dogs that will not take the medication in food, place one hand on the top of your pet’s nose/mouth (your right hand if right-handed). With the other hand, open the mouth and place the tablet on the farthest point of the back of the tongue using your index finger. Quickly remove your hand; shut the mouth and hold closed. Gently squirt a 5- to 20-mL (1 to 4 teaspoons) syringe of water into the cheek pouch (as described above for liquid medications) to encourage the pet to swallow. You may also rub your pet’s throat to encourage him/her to swallow. Again, check the mouth, lips, and floor to ensure your pet has swallowed the tablet and not spit it out.

  5. For cats, begin by “administering” a treat that the cat likes very much, like a small amount of canned tuna. Take a small pinch of tuna between your left thumb and forefinger, and place your right hand behind your cat’s head, using the thumb and forefinger of your right hand to stabilize the upper jaw. With your left hand, open the mouth and place the tuna on the farthest point at the back of the tongue with your index finger. Quickly remove your hand. Cats quickly understand that this type of handling equals tasty treats (like tuna), so repeat this once or twice with tuna, then administer the medication tablet or capsule in the same way, then once more with tuna. Afterward, you can gently squirt a 5-mL (1-teaspoon) syringe of water into the cheek pouch, encouraging your cat to swallow. You may also rub your cat’s throat to encourage him/her to swallow.

  6. Pill Poppers may also be used to aid in the medicating of pets as a last resort. Pill Poppers are a thin, rigid tube that contains a plunger (to be pressed by your thumb) and a rubber tablet holder at the tip. To use a Pill Popper, begin by placing the medication in the rubber tablet holder at the tip. You should then hold your pet’s head as described above. Insert the Pill Popper into the mouth, directly toward the back of the tongue. By depressing the plunger with your thumb, the tablet will pop out of the rubber holder and into the back of the throat, where it is swallowed. Be sure to follow the tablet with a syringe full of water as described above, ensuring the medication is swallowed.

  7. Some kinds of medications may also be crushed and sprinkled on top of food, if needed. (This should be the last method used; many pets will not eat food that has medication sprinkled on top.) To crush a tablet, you can use a mortar and pestle or place it between two spoons and apply pressure to break it into small fragments and powder. Alternatively, pharmacies also sell handheld tablet crushers. Not all medications should be crushed – be sure to ask your veterinarian or a pharmacist before trying this method.

Afterwards

Pets are clever and many times they do not understand that medications are intended to help them. Often, pets find a way to avoid taking medication. If they do, you must change the method used to medicate your pet, ensuring he/she is receiving the entire dose.

Your veterinarian may request to see your pet for a recheck during treatment or once the medication has been finished. You should call and schedule your appointment, and be sure to bring the medication with you to confirm that what you are giving and what the veterinarian thinks you are giving are the same thing. If the medication is to be given long term, remember to request refills in plenty of time so that you do not run out of the medication.

Always keep medication out of the reach of children. Ensure that all caps or lids are closed well, and wash your hands after you administer the medication.

Frequently Asked Questions

What if I cannot medicate my pet?

It is very important that your pet receives the medication as directed. If you cannot give the medication, call your veterinarian. Your hospital may help you medicate your pet or may change medications.

Should I feed my pet when I give the medication?

Some medications should be given with food; others should not. Ask your veterinarian what is best when you receive the prescription.

Should I wear gloves to medicate my pet?

Most medications are safe and can be administered without protection; however, gloves must be worn with some medications. Ask your veterinarian if you should wear gloves with your pet’s prescription.

How should a liquid medication be stored?

Many liquid medications should be stored in the refrigerator, at least after water is added to a powder to make a solution. Make sure you know the proper storage conditions for each medication

 

Oral syringe (in right hand) is slipped into the cheek pouch at the corner of the dog’s lips, while the head is held slightly elevated (left hand).

Placing medication (or tuna or other tasty treat) in a cat’s mouth. The right hand is holding the upper jaw while the left hand is both pushing the lower jaw down (opening the mouth) and dropping the treat or medication into the mouth (thumb and index finger).

 

Source: From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved

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