George is an 8-year-old Maine Coon cat who's mom had rushed to the emergency room because he was having trouble breathing. Our team had diagnosed George with heart failure, and after two days of oxygen and medications, he was doing well.

We knew he was feeling well when he could breathe normal on room air and would growl when the nurse took his temperature, pulse and respiratory rate. It was time to go home.

I (Dr. Perry Jameson) went over with his mom his list of medications, what to watch for if he was not doing well, and when I wanted to recheck him. She was sent home with Lasix and Enacard for his heart and Plavix to prevent clots. All to be given by mouth.

She returned as instructed with George one week later. He was doing great. No trouble breathing, chasing the dog again and eating like a champ.

However, his mom did not look so good. She looked worried. When I asked why, she explained that George was not taking his medications well and she was concerned he would relapse soon. She showed me the scratches on her hands from the attempts to medicate him.

The words came out of my mouth before I realized I was saying them: "That's odd, we had no problem medicating him while he was in the hospital."

As the words left my lips, I realized most of his mediations were given by injection here, so of course he did not fight us. The ones we did give orally were by trained veterinary nurses who do this every day. I had sent him home with three medications to be given by mouth by his mother, an accountant.

She and her husband had struggled to give him his medications faithfully. He fought them every time. He started hiding from them. She was only getting them into him about half the time. Most of the day he was under the bed, scared to go near them, expecting a terrible tasting pill and not the rub under his chin he normal got.

It is difficult to give cats pills. They do not like to be forced to take anything they do not want to and they hate the taste of most medications. Here are a few tips I should have shared with George's mom:

Hide in food

My cat Mojo is hyperthyroid. He gets a medication called methimazole, which decreases his production of thyroid hormone. He has to get a pill every 12 hours. Our cats get mostly dry food and a tablespoon of canned food twice daily. If we put the pill in his canned food, he eats it.

This is the easiest way to administer medications. I have to make sure when he does not eat everything that another cat does not eat his medication.

Pill pocket

These are highly flavored treats. They are gooey, almost like caramel, and you hide the pills in them. I used them as training treats for my dog Flipper when we took obedience classes at the Charleston Animal Society. He would do anything for them. If they will not take a pill in food, this is the next step.

Force feed

If you cannot get them to eat the pill, you have to force them to take it, and this is easier said than done. For a compliant cat, here is how we do it: With your nondominant hand, grab the head with your thumb and middle finger at the back of the jaw. Lift the head so it is pointing up. The jaw should drop open. With your dominant hand, pop the pill to the back of the throat and quickly close the mouth.

Gently blowing on the nose while closing the mouth will promote swallowing. Rubbing the throat will promote swallowing, as well.

For bad tasting medications (like the Plavix I wanted George to take) coating with butter helps. This hides the pill's flavor, promotes salivation and acts as a lubricant to aid swallowing.

Pill gun

This is a hard plastic tube about six inches long with a soft rubber end. A pill is inserted into the rubber portion and this is used instead of your hand when administered as previously described. The pill gun places the medication in the back of the throat instead of your fingers.

If you are fortunate to have an assistant, they can wrap the cat in a towel. It is like swaddling a baby. For some cats, this comforts them; for others, it prevents them from using their claws to scratch you.

Other options

Then there are those cats that you just cannot give a pill at all. For these pets there are still a few options.

A compounding pharmacist can make the medication into a flavored liquid, like fish or chicken, that your cat may allow you to force feed. The medication also may be made into a chewable treat that your cat may take on his own. Finally, for those cats that will take nothing orally, some drugs can be made into an ointment that will be absorbed through their skin. This route does not work for every drug or cat, so you need to ask your pharmacist if the drug can be absorbed through the skin before trying.

Luckily for me, my cat Mojo will just eat his medication on his own. For George, wrapping him in a towel and coating the pills with butter worked. Every cat is different, so you and your veterinarian should come up with a plan to insure they take their medication and you are not scarred in the process.

Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs@postandcourier.com or veterinaryspecialtycare.com.