Do transdermal medicines work?

Dear Dr. Barchas, My four-year-old cat has been diagnosed with asthma. I have to give her a pill every day to keep it under control,...

Dear Dr. Barchas,

My four-year-old cat has been diagnosed with asthma. I have to give her a pill every day to keep it under control, but it seems like each day, the pill is harder to give.

I have heard that medicines can be made into a cream that can be rubbed onto pets’ ears instead of given by mouth. Is this true? Do the creams work?

Brandon, Kansas City, KS

You are not the only person who has trouble medicating his pet. In fact, giving pills to cats is legendary in its difficulty.

A few tricks may ease the process. If your pet’s medicine can be given with food, the easiest way is to slip it into a favorite healthy treat. However, this works much better for dogs than for cats. And it doesn’t work in every dog.

Some cats will accept pills if they are crushed into a powder and mixed with a small amount of the cat’s favorite wet food. Offer the mixture before breakfast or dinner, when your cat is hungry. After she has consumed the pill, she can have her meal. Again, this trick is not guaranteed to work. And, if it interferes with your pet’s medically necessary feeding schedule or special dietary needs, it is not an option.

Some pharmacies (called compounding pharmacies) can reformulate medicines into palatable (that is to say, tasty) liquids or treats. This practice is somewhat controversial, in part because quality and methods are not consistent among different pharmacies. However, if your pet otherwise will not take her medicine, compounding is worth exploring. Talk to your veterinarian about whether compounding your cat’s medicine is appropriate for her circumstances.

Finally, some pharmacies can produce gels or creams with medicine that can be rubbed onto the skin. This method is relatively new, and little is known about the absorption and effectiveness of giving medicines this way. For that reason, some experts are opposed to the use of these so-called transdermal gels, at least in cases where they have not yet been tested. Nonetheless, your veterinarian can provide more detailed information about your pet’s specific medicine, and whether a transdermal gel might be worth trying.

Medicines that are compounded into palatable formulas or transdermal gels typically cost much more than the equivalent pill. But the expense may be worthwhile if it saves you the misery of fighting with your pet over her medicine each day.

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