Topical medicines – how to administer them

It is important that any medicines prescribed by your veterinarian are given correctly. In the hospital, trained staff give medicines so it is important to ensure that you understand how to continue giving the treatment properly to your cat when they are at home. If you have any doubts about how to give the prescribed medicine to your pet, ask your veterinarian or a nurse to show you.

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To be effective, most treatments must be given regularly and for the right length of time. If medicines are not given correctly the active part may be lost or poorly absorbed. This reduces the dose that the patient receives and may delay recovery from illness or lead to early recurrence of disease.

There are several important elements to giving medicine:

• Ensure treatment is given correctly, ie the patient receives the correct dose, at the times requested by your veterinarian.
• Ensure the safety of both your pet and anyone helping with the procedure.
• Ensure medicine is stored correctly and handled according to instructions supplied. All medicine that is unused should be returned to your veterinarian to ensure correct disposal.
• Any untoward effects of medicines should be reported to your veterinarian. Adverse effects are rare, but possible.

Topical treatment (onto the body surface) can have a local effect on the ears or skin, or it might be absorbed through the skin to enter the blood stream and have effects elsewhere in the body.

Treatment of ear disease

The inside surface of the ear canal is just a special type of skin. However, this is a very sensitive area, so only treatments specially made for use in the ear should be used. Drops or creams can be used effectively.

Treatment of skin disease

To be effective, a topical treatment must make contact with the skin directly, so hair should be removed from the area and the skin surface cleaned to remove grease, previously applied medication and any build-up of crusting or secretions. Your veterinarian will be able to advise you on this.

Most topical skin treatments come as gels, ointments or creams. Creams or ointments are massaged gently over the skin surface until they are absorbed into the skin. Some medications can be applied in the form of washes or shampoos, but this is less common in cats than it is in dogs. Remember when treating skin problems that the area being treated may be sore to touch. Be gentle and ensure that the pet is comfortable, and pain is being managed effectively. In many skin diseases, a combination of topical and systemic treatment is used, eg shampoo and a course of anti-inflammatory or antibiotic pills.

Topical treatment for systemic (whole body) effect

Some drugs can enter the body through the skin and affect organs and tissues far away from the site of original application. Remember that drugs can be absorbed very easily through hairless human skin too, so gloves should always be worn when handling topical treatments and always wash your hands after handling medicines.

Spot-on treatments for parasites such as fleas are applied onto an area of the skin that the cat cannot reach when it grooms itself, usually the back of the neck. The active ingredient is absorbed and enters the lipid layer, spreading through the entire skin surface. Fleas or other parasites receive a dose of the drug and are killed when they next bite the cat.

Nitroglycerine cream may be used to manage heart disease in cats and is applied as a cream on a hairless area of skin (usually the inside of the ear flap). It is rapidly absorbed, entering the bloodstream and affecting blood vessels throughout the body.

Sticky patches containing powerful pain killers can be applied to hairless areas of skin and slowly release small doses of the drug over several hours or days.

Topical (on the body surface) application of medicine can be used to treat specific areas, such as patches of skin, or as a simple way of giving medicine to a patient because some drugs are taken up through the skin into the body. A lot of drugs are readily absorbed through the skin and if given frequently, or for prolonged periods, could build up in the body, causing side effects. For example, steroids put onto the skin regularly and in high doses could eventually cause signs of steroid overdose. This is why it is important to follow your veterinarian’s instructions carefully.

Most cats will lick any medication on the skin if they can reach it so this may need to be prevented by using dressings, Elizabethan collars or other protective devices. Sometimes, applying the medication before feeding is enough to shift your cat’s attention away from the treated area. Your veterinarian will advise you on this.

• Find a quiet time, when you are not rushed as this will be less stressful for your cat.
• Have your cat at a comfortable working height. Try placing or encouraging your cat onto a table or raised surface. If the surface is slippery, put a carpet tile or non-slip bathmat down so that your cat feels more secure.
• A second person can sometimes be helpful to gently hold and praise your pet while the ear medication is being applied.
• Hold your pet’s head steady and lift their ear flap open to expose the opening of the ear canal.
• You can use some damp cotton wool to gently clean any discharge or debris from the outside of your cat’s ear. Never stick anything down your cat’s ear canal like cotton buds.
• Insert the nozzle of ear treatment into the entrance of the ear canal and apply the amount your veterinarian has recommended.
• Massage the base of the ear to disperse the medication around the ear canal. This will feel like a tube of cartilage just behind your cat’s jaw.
• Most cats shake their heads as soon as they are released. Some drops will come out (along with debris such as ear wax) but provided the correct technique has been used, enough will remain in the ear to have the desired effect.
• Remember to praise and reward your cat so that they build a positive association with having their ear treatment applied.
• If you are concerned about your cat’s reaction or your ability to administer ear medications, ask your veterinary team for assistance or consider referral to a positive reinforcement animal trainer with experience in cooperative care training.

In many cases, a missed dose is corrected by giving the dose as soon as you remember and then giving the following one when it would have been due anyway. This applies to most topical treatments. Intervals of 1-2 hours either side of the specified time are unlikely to make much difference. However, because some medication should not be repeated too soon, it is always best to check with your veterinarian what you should do. If it is not possible to contact your veterinarian, then the safest course is to skip the missed dose and just give the next one when it would have been due.

Always contact your veterinary practice for advice if you have any concerns about your pet’s treatment. Sometimes the dosing may need to be altered, or an alternative drug may need to be used. If you are concerned stop the treatment in the meantime and immediately contact your veterinarian for advice.

No, your other cat needs a veterinary check-up first. It could be a different condition that just looks the same, or your other cat could have individual problems that require a different approach.

It depends on the problem and the policy of the cattery. Most reputable catteries can cope with routine treatment for problems such as arthritis, heart conditions and skin conditions. Experienced catteries can also handle more complex medical conditions such as the daily injections and treatment for diabetic animals. Speak to both your veterinarian and the cattery in plenty of time to make sure they are happy to apply your cat’s topical treatment while you are away.