Making syringe meds less traumatic — one squirt?

[Biomehanika]

Moose has been on liquid compounded doxycycline for stubborn but mild chlamydia related conjunctivitis for 12 days now and he has just over two weeks left (28 day course).

I was getting away with mixing it in with a bit of Churu type treat and wet food, and giving him his proper dinner right afterwards, and he would eat it very begrudgingly but I could tell he hated the taste and that it was a struggle for him. He is now refusing it that way completely (wasted a whole dose but luckily I think they include extra) so I’ve had to do the dreaded direct syringe method for the past three nights.

The dose is .45 ml, so quite small. Is it safe if I give him it all in one squirt (as long as it’s from the side of the mouth onto his tongue and not directly down his throat, of course)? I tried to do it in two-three rounds to make sure he swallows properly and stuff because I’m terrified of aspiration when giving meds this way, I’m not very experienced with this stuff, but the poor little dude hates it so much. He starts trembling and gets quite scared, especially when I need to get it in his mouth and squirt it multiple times. I know it must taste horrible and I want to make it as non-traumatic as possible since we still have quite awhile left. Is .45 ml in one squirt okay??

 

[AbbysMom]

Absolutely. My cat gets :5 ml of Prednisolone and it gets squirted into the side of her mouth all at once. I find it Works best to approach her from behind And hold her head. It’s a slight learning curve but she and I got used to it.

 

[IndyJones]

Squirt it into the cheek works best in my experience and use a plastic eyedropper or narrow syringe.

 

[neely]

I find it Works best to approach her from behind

This is exactly what I do. I come from behind and crouch down on the floor also holding his head.

Just out of curiosity, can you get it flavored to make the taste somewhat more palatable? I know a lot of times they still don't like it but every little bit helps.

 

[Biomehanika]

This is exactly what I do. I come from behind and crouch down on the floor also holding his head.

Just out of curiosity, can you get it flavored to make the taste somewhat more palatable? I know a lot of times they still don't like it but every little bit helps.

Oop, sorry I thought I mentioned that but I guess I forgot! The compounding pharmacy did make it flavoured, fish flavour, but it doesn’t help much and still tastes awful I guess, though I do think the shaking is probably more so because he’s scared of the process more than the taste. He has however been totally fine five minutes or so later, it’s just during and directly after that he seems so upset, but ofc I don’t want to push my luck.

AbbysMom TY! That is what I’ve been doing but it’s definitely a learning curve. When you say into the side of the mouth do you mean onto the tongue, or into the cheek pouch? I am not sure I’m skilled enough to do cheek pouch yet when he’s kind of wriggling around and stuff but I could try.

 

[fionasmom]

Giving Liquid Medication to Cats | VCA Animal Hospitals

Can Moose be put into a purrito or would that be more stressful for him? Is there any very highly flavored food that might disguise the taste, especially if he is allowed to have fish? I use the various treat pouches for products like Miralax which are flavorless, but I find that they do not disguise taste sufficiently.

Working from behind is almost always recommended as was mentioned as opposed to trying from the front. In my experience with cats who fight taking medication, it has become a moot point as to whether it goes more toward the cheek pouch or the side of the mouth between the fangs and back teeth.

 

[Biomehanika]

Squirt it into the cheek works best in my experience and use a plastic eyedropper or narrow syringe.

Trying to figure out exactly what this means as I’ve never done it before. I assume between the cheek and molars, right at the back, almost sideways?

Giving Liquid Medication to Cats | VCA Animal Hospitals

Can Moose be put into a purrito or would that be more stressful for him? Is there any very highly flavored food that might disguise the taste, especially if he is allowed to have fish? I use the various treat pouches for products like Miralax which are flavorless, but I find that they do not disguise taste sufficiently.

Working from behind is almost always recommended as was mentioned as opposed to trying from the front. In my experience with cats who fight taking medication, it has become a moot point as to whether it goes more toward the cheek pouch or the side of the mouth between the fangs and back teeth.

I think a purrito would be more stressful for him. He isn’t a fan of being held or handled much so I don’t think he likes feeling constrained, it’s something we’ve been working on because I’ve been trying to teach him to have his teeth brushed. He was a feral street baby so was not socialized with people at all until he got rescued at about 6-7 weeks old after his mom died, spent about a week alone on the streets and was the hardest of his siblings to trap, so he is a very cautious cat and runs and hides the second he senses something is up. I think he trusts me for the most part but I’ve only had him for just over two months now so I don’t want to ruin the progress we’ve made.

Scrumptious Catto (which is basically churu) is his favourite thing on the planet, and he was eating the meds in that for awhile but now refuses even when the ratio of treat to med is huge, so I’m not sure anything else would change his mind now and I am wary about trying because I don’t want to run out before the 28 days of doses are up. The compounding pharmacy is a few hours roundtrip away and I’m actually without a car for the next two weeks or so, so getting more meds should I end up wasting more dosages would be a nightmare right now.

He does let me syringe dose him from behind quite well though, it’s just after the first squirt that he really starts to panic (which is why I wanted to confirm if giving the entire .45 ml in one go was safe).

 

[silent meowlook]

Just remember to make the entire experience last only a couple of seconds. When done, just walk away. Don’t try to comfort or apologize to him.

 

[Biomehanika]

Just remember to make the entire experience last only a couple of seconds. When done, just walk away. Don’t try to comfort or apologize to him.

Thanks. This is exactly what I try to do, but unfortunately the meds have to be immediately followed with his (very watery) wetfood dinner due to doxycycline possibly causing serious damage to the esophagus if it sits in there too long, so I do need to at least make sure he starts eating before backing off and giving him some time to decompress. I guess the upside is he also sees it as me giving him food for going through the ordeal, which may work as some positive reinforcement for the whole thing over time.

 

[daftcat75]

Betty gets ondansetron and gabapentin twice a day. She used to happily take as many capsules as I wanted to dip in Hills A/D and put in front of her. She no longer goes for that method anymore. Now I powder up her ondansetron and mix it in a spoon with her liquid gabapentin before pulling both up into a 5 mL syringe. Her gabapentin dose is 1 mL. I use the larger syringe because it can pop the entire 1 mL in one quick squirt. I have a bottle of unmedicated chicken flavored oil (which is more almond flavored because that's the carrier oil base.) I wanted to run a few flavors and formulations past her before I got the gabapentin compounded. She wasn't impressed. But I still use the unmedicated oil to dip the tip of the syringe in. This way the first thing that touches her lips when I'm asking her (because I don't force it) to "pop a smile, crocodile". I do my best to aim it down towards her tongue rather than back towards her throat. But she's not a fan and squirms happen. We did have some snarfles the other week which I assume was some aspirated liquid. But like you or me, as long as it isn't an oil, an aspirated liquid can be coughed back up. Her snarfles eventually cleared up within a few days. (It started on a Friday afternoon, and I wasn't trying to spend $1000+ at the ER. I gave it the weekend and it was much better by Monday.) For Betty's morning dose at 5am, I tell her, "when you're done with the pout, come snuff me out." She will pout for a few minutes and then she comes back to bed with me and lays in her usual spot draped on my shoulder and chest like her own furry pillow to my face. For her evening dose, she won't let me go back to work until I've spent some time fussing her up. For both doses, I put a treat and a kibble (which may as well be a treat to her since she doesn't get very many of these in a day) by her fountain. She knows where they are and will happily eat them in her own time. Sometimes directly after the post-dose pouting and sometimes not until after her gabapentin nap. She often likes to take a nap after her dose (probably waiting for that sweet pain relief to kick in) before she starts on her post-meds meals.

All of this is to say that yes, you can give the 0.45mL dose all at once. And that, as long as it isn't an oil, and as long as you aren't repeatedly making this mistake, he should be able to recover from a rare aspirated dose the same as you or me when something goes down the wrong passage.

 

[AbbysMom]

In my experience with cats who fight taking medication, it has become a moot point as to whether it goes more toward the cheek pouch or the side of the mouth between the fangs and back teeth.

Yes, our goal is just to get it in her mouth without shooting it straight down her throat/lungs.

 

[Biomehanika]

Well, last night went much more smoothly than usual, but tonight he figured out that he can scoot his butt forward and kick my syringe arm with his back legs!! Which he did just as I was pressing on the syringe, causing me to squirt some or all of the dose through his mouth and onto my shirt! I have no idea how much of the dose was wasted so I gave him just a little bit extra… hopefully it wasn’t the whole thing and it won’t effect his treatment…

I think I will attempt a partial purrito tomorrow night and see how that goes. Or give it one more go normally and if he is still fighting me like he did tonight, attempt at the purrito… But he is at least not trembling afterwards anymore, or at least hasn’t the past two nights.

 

[Biomehanika]

Ooookay the purrito is a big win so thank you fionasmom , I don’t wrap him tightly in it but enough so that he can’t kick my arms and it has made things much smoother the past few nights.

I have one concern though.. the trembling has returned but it starts when he’s eating his wet food now. And it is happening at EVERY wet food meal (3x per day) so with or without the meds beforehand. By trembling I mean shivering… the same nervous shivers he gets at the vet… it’s barely visible but I can feel it if I pet him and they stop within a minute or so once he’s done eating. It does *not* happen when he gets his dry food a few hours after his meds and the wet food isn’t so cold to cause shivers or anything… at first I was worried this was a bad side effect and was gonna contact the vet freaking out (lol) but instead of getting ahead of myself I’ve really been observing this closely the past few days and I now believe it’s totally psychological, as if it were a side effect of the meds it should happen at other times or at least when he’s eating dry food too, no? The shakes stop right when he stops eating wet food. He is basically totally normal the rest of the time BUT he is definitely a little more nervous of me because I’m the evil medicine lady lol. But besides that he’s high energy, good poops, happy boy, nothing else off except that when he eats his wet food he trembles!? But not his dry food!? It’s so weird….Do you think it’s possible he is associating the medication/syringe dosing process with his wet food and now gets nervous while eating it??? I *was* giving him the meds in his wet food/Chruru previously, and it is basically the first thing he sees after getting syringe dosed…. I had thought the meal immediately after the meds would work as some sort of positive reinforcement, but maybe it’s had the opposite effect. Any thoughts?? Or has anyone experienced/heard of anything like this before??

 

[fionasmom]

Chelsea, the FHS/SCL cat that I had to purrito, did not have any reaction aside from the complete indignation that goes with someone doing something that they don't want done. Your theory about his association with the food and dosing could be correct though. It does seem that if this were a drug reaction that it would either continue or happen at other times of the day.