Author Topic: The Dangers of Pilling  (Read 180 times)

Offline Pookie

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The Dangers of Pilling
« on: August 24, 2017, 11:16:31 AM »
I posted about esophageal stricture in the IBD section, but there's a very important part of that article that I wanted to bring to attention.  It discusses the dangers of pilling cats, and how critically important it is to follow ANY medication (liquid or pill) with a chaser, e.g. broth, pureed canned food, or water.

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Administering pills and capsules is probably the most common way our cats might get esophagitis, which can lead to actual esophageal stricture. Here is the key point: you MUST make sure every single pill or capsule is cleared out of your cat’s throat. You can’t skip even one time. Cats’ anatomy is such that they simply don’t clear pills out of their throats on their own with “dry” pilling, and so they are especially prone to damage caused by pills. This article cites a study about the dangers of dry pilling, http://catinfo.org/pilling-cats-and-dogs-and-erosive-esophagitis-compounded-flavored-liquid-alternatives-transdermal-medications-pill-pockets/.

Cats were tested to determine how long it takes for pills without a “chaser” to clear out of the throat. Here is what it said: “After 5 minutes 84% of capsules and 64% of tablets are still sitting in the esophagus.” [It is important to note that gelcaps are even worse than tablets in clearing out of the throat.] Certain categories of medications, including antibiotics, can cause the most damage if they aren’t cleared out of the esophagus. There are case studies in veterinary research websites about cats that have died from a single dose of certain medications such as clindamycin or metronidazole. And how many of our kitties are prescribed antibiotics such metronidazole at some point? Here is a summary of the article: If you can get your cat to voluntarily drink something liquid like bone broth or eat something semi-liquid like canned food pureed with a lot of water, use that. If your cat will tolerate syringed water after pilling, use that – see the pilling instructions http://www.ibdkitties.net/how-to-pill/. If the best you can do is to get your cat to eat his regular food or even a cat treat afterwards, do that. The point is, do something!!!

One of the ways many vets try to avoid the dangers of esophagitis and esophageal stricture is to prescribe liquid medications. The vets might think, as my local vet did, that they have avoided the dangers of pilling and the problem is solved — no need to clear liquids out of the throat. This is not true! You must follow the same instructions for clearing meds if you are using compounded liquids. Liquids are in fact safer – you can’t kill your cat with a single dose if you fail to follow the clearing instructions – but your cat can develop esophagitis and esophageal stricture from liquid meds. Gracie did. The vets from the Colorado State University Veterinary Teaching Hospital (CSU VTH) have done a lot of research on this subject. By chance, that is where my local vet referred us when Gracie started having trouble. Our wonderful internal medicine vet there gave me a long lecture about clearing liquid meds. When I got back home, I repeated this all to my local vet, wondering why she had never told me about it – and she said she just plain didn’t know.

While the article is focusing on IBD cats, and cats with esophageal issues, it also offers some good advice that may prevent esophageal problems that could result from using pills or liquid medications:

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1) NO PILL OR CAPSULES EVER, even if chased with water. Try to get your medications compounded into liquid or transdermal form. If this is impossible, for example with certain new and proprietary meds like Cerenia, convert your pills into liquids. Put the pill (broken into pieces if necessary) into a dosing syringe – just pull the plunger out and drop the pill in. Then suck up enough water to dissolve the pill and let it sit for half an hour to an hour, while the pill dissolves, and shake well. This may take some experimentation – some pills must be crushed a bit to do this. Capsules are easier. Suck up the water first and put your finger over the end to hold it while you remove the plunger. Dump the capsule contents into the syringe. Replace the plunger and shake.

2) Use transdermal meds for everything you can.

3) If you can get your cat to eat her meds blended in her food, do that – it’s safer. Be super careful with any syringed liquids (meds,
water, food when necessary) to avoid aspiration. Any cat with an esophageal stricture is at high risk for aspiration pneumonia.

4) If you must use liquid meds, religiously chase them with water, food, or something. See the catinfo.org article for suggestions.

5) NO DRY FOOD, EVER. No treats either.

Personally, I learned the hard way how pilling can harm a kitty.  My IBD girl was on certain medications, and one day I came home to find pink bile all over the house.  A pill must have stayed in her esophagus and dissolved there, and she'd been vomiting until there was nothing left to bring up.  I can't imagine how much pain and discomfort she must have been in.  Unfortunately, no vet (and I'd been to several) had ever told me to administer food or water/broth after pilling, even when they demonstrated how to do administer the medication.  So I just didn't know.  And I didn't know transdermal meds or liquid meds even existed, nor were they ever suggested to me.  So I wanted to emphasize this part of the article for those who may not read it.

Finally, Dr. Pierson has a great article on her website about pilling cats.  Incidentally, that's how I learned about the problems with pilling.  I was on her site learning about raw feeding and saw the link to pilling.  It was eye-opening for me, that's for sure.  Then again, everything on her site was eye-opening to me.

This is a MUST READ if your pet is receiving medications:

http://catinfo.org/pilling-cats-and-dogs-and-erosive-esophagitis-compounded-flavored-liquid-alternatives-transdermal-medications-pill-pockets/

P.S.  I would imagine these dangers apply to dogs as well.
« Last Edit: August 24, 2017, 11:32:30 AM by Pookie »
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Offline DeeDee

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Re: The Dangers of Pilling
« Reply #1 on: August 24, 2017, 11:56:52 AM »
I always give medicine with a meal--even if I have to make an extra small meal while on the meds because some meds are more than 2x a day.
"In order to really enjoy a dog, one doesn't merely try to train him to be semihuman. The point of it is to open oneself to the possibility of becoming partly a dog." Edward Hoagland
"Thorns may hurt you, men desert you, sunlight turn to fog; but you're never friendless ever, if you have a dog."

Offline DeeDee

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Re: The Dangers of Pilling
« Reply #2 on: August 24, 2017, 12:00:57 PM »
 thumbsup1
"In order to really enjoy a dog, one doesn't merely try to train him to be semihuman. The point of it is to open oneself to the possibility of becoming partly a dog." Edward Hoagland
"Thorns may hurt you, men desert you, sunlight turn to fog; but you're never friendless ever, if you have a dog."

Offline Lola

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Re: The Dangers of Pilling
« Reply #3 on: August 24, 2017, 03:02:42 PM »
DEFINITELY good info, Pookie!!! 
Everything you NEED to know about caring for your feline. www.catinfo.org

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