For most veterinary treatments it is important that medicines are given correctly. In the hospital, trained staff give medicines and it is important to ensure that you are able to continue to give the medicines once your dog has been sent home. If you have any doubts about how to give the medicine your pet has been prescribed, ask your vet or a nurse to show you.
To be effective, most treatments have to 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 early recurrence of disease.
There are several important elements to giving medicine:
- Ensure treatment is given correctly, i.e. the patient receives the correct dose, as and when needed.
- Ensure safety of both the patient and the personnel involved in the procedure. In almost all cases, it is easier to administer treatment effectively if an assistant is able to help: one person restrains the dog and the other gives the treatment. However, it is usually possible for experienced owners to give medication by most routes to a reasonably co-operative and obedient dog.
- Ensure medicine is stored correctly and handled according to instructions supplied.
- Any untoward effects of medicines should be reported to the veterinary clinic or hospital. Adverse effects are rare, but possible.
Many medicines are designed to be given by mouth – largely because this is a convenient route for home treatment. Oral medicines can be given as tablets, capsules, liquids and pastes. Most medicines given by mouth enter the stomach and pass through into the intestine where they are absorbed into the blood.
The presence of food in the stomach helps absorption of some drugs but hinders the absorption of others. It can therefore be important when you give oral medicines in relation to feeding and you should follow any specific instructions your vet gives you.
Direct oral administration of medication obviously involves dealing with the animal’s mouth. This may be a real problem in aggressive patients and alternative routes of medicine administration (or mixing of medication with food) may be needed if there is a significant safety risk.
Tablets and capsules
Tablets are made from compacted, powdered drug (usually mixed with something like chalk to make the tablet the right size, and often with a flavour to make it more palatable). Capsules contain powdered drug inside a gelatine case – once inside the gastrointestinal tract the gelatine dissolves to release the drug. Some tablets have special coatings to protect the drug from the action of acid in the stomach – the coating is dissolved in the stomach and the drug released once the tablet is in the intestine.
Tablets are often crushed and put into food, but the fussy dog may refuse to eat the medicated food. Keeping the dog slightly hungry before tablet administration and offering the powdered tablet disguised in a small amount of especially tasty food, may get round this problem. The rest of the meal is given only once the medication has been taken. You can buy special treats to hide tablets in, or else you can improvise using, eg soft cheese. Many greedy dogs simply swallow the morsel whole and the tablet is easily given.
The most certain way is to give the tablet directly into the mouth (see below: “Oral administration”). If the tablet is swallowed you know the whole dose has been taken. This method is not suitable for aggressive dogs.
Many drug manufacturers make tablets designed to be tasty to dogs. Larger breed and greedy dogs such as Labradors usually take these well; smaller, fussier dogs may be more awkward.
Drugs mixed into pastes can occasionally be useful in dogs. The sticky paste is smeared onto the tongue and the dog is unable to spit it out so has no alternative but to swallow. This method is not suitable for aggressive dogs. With an aggressive patient, it may be possible to smear the paste on to the forepaws and get the dog to lick it off.
Liquids can be given directly into the mouth or mixed with food. If they are mixed with food it is important to ensure that the medicine is thoroughly mixed in and that the patient eats all the food. Some liquid medications taste unpleasant so need to be mixed with strongly flavoured food to disguise the taste. Animals will often refuse to eat contaminated food and may eat around bits of food containing the drug if it has not been mixed in well.
Liquid medications are usually given directly into the mouth using a syringe. It is very easy for dogs to refuse to swallow liquid medications and to dribble it from their mouths. When giving liquids by mouth, great care must be taken to ensure that the patient swallows the medication and does not accidentally inhale it. Oily medications, e.g. liquid paraffin, can cause severe pneumonia if they enter the lungs. It is best to have a veterinary surgeon or nurse demonstrate the correct method of direct liquid administration and to assess whether your dog is likely to let you do this at home.
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, can build up in the body, causing side effects. For example, steroids put onto the skin can eventually cause signs of a condition called Cushing’s disease.
Most dogs will lick off any medication on the skin if they can reach. it This should be prevented by the use of dressings, Elizabethan collars or other protective devices. Sometimes, applying the medication before feeding the dog or taking him out for a walk is all that is needed to shift the dog’s attention away from the treated area.
Topical treatment for local effect
Ocular (eye) treatment
Eye conditions are quite common in domestic pets and are often best treated by topical therapy. Eye treatments come as drops or creams/ointments. Drops can be easy to apply to the eye (see below; “Ocular administration”) but are washed out quickly and may need to be given many times daily. Ointments and creams persist in the eye for longer and some only need to be given once daily.
Aural (ear) treatment
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 area should be used. Drops or creams can be used effectively (see below; “Aural administration”).
To be effective, a topical treatment must come into contact with the skin. If necessary, hair should be removed from the area to which the treatment is being applied. The skin surface should be cleaned to remove grease, previously applied medication and any build up of crusting or secretions.
Medication for topical application can be mixed with oily or water-based carriers to produce gels, ointments or creams. Creams or ointments are massaged gently over the skin surface until they are absorbed into the skin. Alternatively, application may be by means of washes or shampoos. Remember when treating skin problems that the area being treated may be sore to touch, so be gentle and ensure that the patient is adequately restrained.
In many skin diseases, a combination of topical and systemic treatment is used, e.g. shampoo and a course of antibiotic tablets.
Topical treatment for systemic (whole body) effect
One advantage of giving medicines by the topical route is that they do not have to pass through the gastrointestinal tract. This makes it a useful way to give drugs that would be destroyed by acids in the stomach. Some drugs can enter the body through the skin and affect organs and tissues far away from the site of original application.
Some of the topically applied flea treatments are absorbed through the skin and then enter the bloodstream. Spot-on treatments are dropped onto an area of the coat that the dog cannot reach when it grooms itself, usually the back of the neck/scruff area. The active ingredient is absorbed through the skin and enters the dog’s blood. Fleas or other parasites receive a dose of the drug when they next bite the dog and are killed.
Nitroglycerine cream is used to manage heart disease in dogs. It causes blood vessels to relax, helping to reduce the workload for the heart. It is applied as a cream on a hairless area of skin (usually the inside of the ear flap) from where it is rapidly absorbed, entering the bloodstream and affecting blood vessels throughout the body.
Sticky patches containing powerful analgesics (pain killers) are now available. These can be applied to hairless areas of skin during the recovery from anaesthesia and slowly release small doses of the drug over several hours or days. This gives the patient a pain-free recovery from surgery, without the need for further injections. These pain-relieving patches are only currently used in hospitalised patients.
Remember that drugs can be absorbed very easily through hairless human skin so gloves should always be worn when handling topical treatments.
- The assistant (second person) restrains the patient in a sitting position on a non-slip surface so that the dog feels secure (preferably with the hind quarters directed into a corner).
- Small dogs may be easier to restrain on a table at waist level.
- The person giving the medicine takes the correct dose of tablets in their dominant hand.
- The patient should be approached from the side and the other hand used to grasp the top of the muzzle firmly but gently.
- The upper jaw is grasped just behind the level of the canine teeth and the head pulled upwards until the mouth falls open naturally.
- A finger of the dominant hand can be used to press down on the lower incisor teeth to open the mouth a little more.
- The tablets are placed or dropped at the back of the tongue and the jaw is allowed to close.
- The mouth should be held shut until the patient has swallowed. Gentle stroking of the throat area might encourage the patient to swallow. Licking of the nose indicates that swallowing has occurred.
- The patient should be watched closely immediately after medicine administration to ensure the tablets are not spat out!
- Give the dog lots of attention and a treat.
- The assistant (second person) restrains the patient in a comfortable sitting position on a non-slip surface so that the dog feels secure.
- Small dogs may be easier handled if sitting on a table-top at waist level.
- The assistant gently grips the head of the dog from underneath. They tilt the dog’s nose upwards using one hand. It may be possible for them to hold the eyelids open with the thumb and forefinger of the other hand when doing this.
- Alternatively, with one hand on the top of the head and another under the jaw the eyelids can be gently held apart and the head steadied at a suitable angle.
- The person applying the eye drops opens the bottle or tube and holds it in their dominant hand.
- They use the thumb and forefinger of their other hand to hold the eyelid open (if necessary) or to steady the head further.
- Holding the bottle or dropper above the eye, it is gently squeezed so that the correct amount of medication falls into the eye. Take care not to touch the surface of the eye with the nozzle as this can contaminate the contents and damage the eye.
- Resting the side of the hand against the muzzle whilst holding the applicator between thumb and forefinger helps to steady the applicator away from the eye and gives good control.
- When applying creams or ointments it may be necessary to trail the ‘worm’ of ointment against the lower eyelid to detach it from the tube. Alternatively, smear the required amount on to a gloved finger and then wipe your finger gently across the eyelids to spread the cream/ointment.
- Keep the dog restrained for a few seconds to allow the treatment to spread over the eye surface.
- Give the dog lots of attention and a treat.
- The assistant (second person) restrains the dog in a sitting position on a non-slip surface so that it feels secure (preferably with its back directed into a corner).
- It is often easier to restrain small dogs at waist height on a table.
- The handler restrains the patient from the side, ‘cuddling’ it towards them with one hand placed over the muzzle. The muzzle is pushed down slightly so that the nose points towards the floor – this opens up the ear canal better.
- The person giving the drops lifts the ear flap to expose the ear canal.
- The ear canal is cleaned to remove any discharges or previously applied medication before putting in new treatment. Use a large piece of dampened cotton wool.
- Do not insert cotton buds, instruments or small ‘twirled’ pieces of cotton wool into the ear canal. Only material easily visible at the surface should be gently wiped away.
- The nozzle of the treatment applicator is held next to the opening of the ear canal and drops or cream are applied into the canal. The nozzle is withdrawn and the vertical ear canal gently massaged from the outside to disperse the treatment (whilst the patient is still restrained).
- Most dogs 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.
- Give the dog lots of attention and a treat.
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 ear and eye treatments, and to many tablets. However because some medication should not be repeated too soon, it is always best to check with your veterinary surgeon as to what to do. Note that intervals of 1-2 hours either side of the specified time are unlikely to make much difference. If it is not possible to contact the veterinary surgeon, then the safest course is to skip the missed dose and just give the next one when it would have been due.
Always contact the veterinary practice for advice. Some tablets have a tendency to do this – the dosing may need altered or else an alternative drug may need to be found. Stop the tablets in the meantime.
No, your other dog needs a veterinary check-up first. It could be a different condition that just looks the same, or your other dog could have individual problems that require a different approach. If you used the same product, you would not anyway have enough to complete the course of the first dog’s treatment.
It depends on the problem and the policy of the boarding kennels. Most reputable kennels can cope with routine treatment for problems such as arthritis, heart conditions and skin conditions. Experienced kennels can also handle more complex medical conditions such as the daily injections and treatment for diabetic animals. Speak to both your veterinary surgeon and the boarding kennels in plenty of time.