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Tuesday, April 5, 2011

Cats who refuse to be pilled may take emotional toll on owners

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When it comes to giving pills to pets, dog owners tend to have it easier. Put the pill in a little bit of peanut butter or cheese and most dogs will think they’re getting a treat and won’t argue with the owner.

When it comes to cats, it’s usually not quite that simple. Rumor has it there are some cats who will allow their owners to pill them easily, but if my personal experience and that with veterinary clients is any indication, they’re few and far between.

There are several options for pilling a cat, from quickly shoving the pill deep into the cat’s mouth to using a pill gun to pill pockets to crushing up the pill and mixing it with a small amount of food (caution: the latter may not be appropriate for all types of medication, check with your veterinarian to be sure).

Many medications are also available in liquid form, which may make dosing easier for some cat owners. Some can even be compounded into tuna or chicken flavored liquids. Another option may be transdermal delivery: the medication is compounded into a cream that is rubbed on the inside of the cat’s ear.

And of course, there’s always the ever popular kitty burrito method (although I’m sure cats would disagree about its popularity).

In theory, all of these sound great. But there are some cats who simply won’t cooperate. And unless you’ve had one of these cats, you may not understand the emotional toll this can take on the owner.

I recently talked to a friend whose 16-year-old cat was diagnosed with hyperthyroidism, and needs to take medication twice a day to regulate thyroid function. She can’t pill the cat, he won’t take pill pockets, and he refuses to take the liquid form of the medication in his food. She tried the transdermal version, to no avail. She kept trying, for several weeks. At this point, the cat runs from her whenever he sees her coming. He no longer sleeps on the bed with her, or sits next to her when she reads or watches tv. The bond between the two of them is completely broken. My friend is stressed and upset, and so is her cat.

The cat is not a candidate for radioactive iodine treatment, nor is he a good candidate for surgery. The medication is the only viable option to control his disease. My friend is at the end of her rope: she feels like she’s killing her cat because she can’t medicate him, and most of the time she feels like she doesn’t even have a cat anymore since he wants nothing to do with her.

I told my friend that she has another choice. Making a treatment decision can also mean choosing not to treat. She can choose to stop giving her cat the medication, and restore the relationship with her cat. She will need to understand what will happen physiologically to a hyperthyroid cat with no treatment. She will need to accept that this will most likely shorten her cat’s life. She will need to monitor her cat closely for even subtle changes, and she will probably eventually need to be ready to make the euthanasia decision.

She’s afraid to tell her vet that she wants to stop treatment. Understandably, this may not be a popular decision with some vets. Vets are trained to heal and cure. But most vets also understand that they’re not just treating their patient, they’re treating the bond between patient and owner. And when treatment interferes with the bond to the extent it did for my friend, shouldn’t they discuss this alternative with their clients?

I had to make this choice with Buckley, and I was fortunate that I had my vet’s complete support when I decided to stop treating her restrictive cardiomyopathy. She was on multiple cardiac meds, and for several months, she happily took them with pill pockets. Once she started to refuse the pill pockets, the only way I could have gotten the meds into her was through force.

Buckley was the kind of cat who, at a mere seven pounds, needed multiple veterinary assistants to restrain her to get anything done. I don’t think she ever had an exam that didn’t require at least mild sedation. There was no way I could have pilled her, nor would I have wanted to put a cat with heart disease through the twice daily stress of it. I also knew that she would come to dread contact with me, and I knew I couldn’t have handled that.

I made the choice to stop her heart medications knowing full well that it would shorten her already much too short life even further. But I also knew it was the right decision for her, and for me. She lived for another month after I stopped her meds, and except for the last few days of her life, her quality of life was good.  If anything, our bond became deeper, knowing that our time together was limited.

If my friend chooses to stop treatment for her cat, she will most likely shorten her cat’s life, too. But what she will gain, in my opinion, far outweighs what she will loose. She will get the loving relationship with her cat back.


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