# Struggling with heart cat and medication



## ALR (Apr 16, 2014)

I dont want to highjack the other thread but I am getting desperate. 

Bubble is a heart cat that needs to take 3 meds a day. Most of these meds are easy to give in treats of food. But one of them, Clopidogrel, is a human med and tastes bad to most cats. It took me a long time to find out what works but eventually found that mince beef is a winner. 

This worked for 3 months then Bubble became uninterested in the beef. I started putting the med in a gel cap and directly in his throat. Although this involves running after him and waiting for him to get out from under furniture. 

We had our first appointment with the cardiologist and I was very impressed with him. But he advised finding a less stressful method to give Bubble his meds. Basically Bubble has a Congenital Heart defect (not HCM like my vet thought). His case is severe because his heart is enlarged. Bubble went into heart failure in June which is when we realised he had a heart problem. The cardiologist thinks that Bubbles heart failure was trauma induced (he was injured and went missing for 6 days). 

So we have to be careful about not stressing him otherwise his heart can get worse. After this Ive been trying to give the meds in treats again and tried a few different meats and the only thing that worked was prawns! I know prawns are not ideal but the cardiologist said if its a small amount, its ok as long as he takes the med. 

But the prawns gave Bubble a bad stomach and now I have to find something else. Also I have to sear the meat in a pan to seal the meds in because he opens it by licking it with his tongue! Once he finds the meds he walks away and I cant give him any other treats after that. 

Sorry for ranting but I dont know what to do anymore.


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## rox666 (May 22, 2012)

Does he like cheese? Most of mine like cheese so I often just put a tablet in a bit of soft cheddar and that works. Or, ccc posted a link earlier today for this cheesy flavoured paste that looks useful and I'm going to invest in some during my next zp order:

Gimpet Cheese Paste with Biotine: Great Deals on Cat Pastes & Cat Treats at Zooplus

There's pill pockets as well (link below, again, courtesy of ccc):

GREENIES FELINE PILL POCKET Easily Administer Cat Medication 45 Ct CHOOSE FLAVOR | eBay


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## Soozi (Jun 28, 2013)

Is there any way that the medication could be injected intramuscular? I know this sounds ridiculous but it could prove to be easier than pilling him.
As mentioned above cheese might be a good option as he might not smell the meds as much. Cheese is the only human food that my cat shows any interest in! Might work?


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## Ragdollsfriend (Feb 13, 2014)

I haven't given my kitties any heart medication but I have some experience with other meds of a nasty taste. I used to crash tablets into fine powder (with a wooden handle of my biggest kitchen knife) and then mixed it in well with a small portion of fish flavoured wet food (fish was my cat's fav). Other times I bought a Sheba dome with chicken as it had lots of nice clear gravy and mixed the finely crushed pill with a bit of that. When I needed to give only small tablet then I use to push that piece into a chuck of Thrive treat and offer to my cat. I had to vary the methods as she learnt fairly quickly what I was up to :laugh:


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## OrientalSlave (Jan 26, 2012)

Have you tried Lick-e-Lix? I managed to hide Max's meds in it for a while.

Subcutaneous injections are easier than intramuscular.


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## AFKMatrix (Jun 18, 2014)

Thanks OrientalSlave for the lick-e-lix tip as I have to give my boy some meds and this is another good option for it!!

I hope the suggestions from the others help you out ALR and you find something that works!!


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## ALR (Apr 16, 2014)

Thanks for all your responses.

I've tried cheese but it doesn't work. He's not very food oriented although he eats all the cat food I give him so not fussy either. If I put the Clopidogrel in his food though, he won't eat it. 

When I checked with people on the feline heart forum, this is not unusual. The tablet taste really bad to a cat so if they get even a lick of it, they don't like it. 

That's why I thought the gel cap would be a good solution. I've tried the webbox stick but he's not interested. The lick a lix worked after a lot of coercion once but it was a lot of work. 

I think he knows when he gets the meds and ignores all treats I've bought him some mince turkey and some chicken. I'll try those tonight and see how it goes.


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## Soozi (Jun 28, 2013)

OrientalSlave said:


> Have you tried Lick-e-Lix? I managed to hide Max's meds in it for a while.
> 
> Subcutaneous injections are easier than intramuscular.


I might have got that wrong but when my last cat was awaiting chemo for lymphoma I had to inject her in the scruff a few times the vet showed me how and I did it at the surgery (with very shaky hands) but they said I could really inject her anywhere!!! Assumed that meant in the muscle but probably not! It was easier to inject her than it was to pill her in her case.


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## ALR (Apr 16, 2014)

I am not sure I'd like to inject him. It probably is easier than sticking something down his throat though. But I'd like to exhaust all options first.


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## rox666 (May 22, 2012)

I guess that if it is long term medication then maybe IM wouldn't be the best option - although I could be completely wrong, I just assume there would be a risk of muscle damage. I think you probably need to try and find a few different oral options so that you can swap them around so he doesn't get wise to it or just bored of the same thing.


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## ALR (Apr 16, 2014)

I wish I was good at popping the pills in his mouth. I've seen a number of videos they make it look easy. 

But Bubble anticipates me and I don't always have the heart to get him and do it.


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## Soozi (Jun 28, 2013)

I use this for Liddy as it works very well as water can be put in the chamber and it's quick! I feel less nervous using it as I know I can keep my fingers!


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## ALR (Apr 16, 2014)

I've got one of those. I had no idea you could put water in them (duh!). That's a very good idea. I tried to use it once but it was a bit fiddly. I was trying to hold Bubble still with one hand and trying to get my fingers through the scissor thingie. 

I think I might try again with some water this time


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## Ceiling Kitty (Mar 7, 2010)

Soozi said:


> I might have got that wrong but when my last cat was awaiting chemo for lymphoma I had to inject her in the scruff a few times the vet showed me how and I did it at the surgery (with very shaky hands) but they said I could really inject her anywhere!!! Assumed that meant in the muscle but probably not! It was easier to inject her than it was to pill her in her case.





rox666 said:


> I guess that if it is long term medication then maybe IM wouldn't be the best option - although I could be completely wrong, I just assume there would be a risk of muscle damage. I think you probably need to try and find a few different oral options so that you can swap them around so he doesn't get wise to it or just bored of the same thing.


Will have been subcutaneous injection - quite easy to do and well tolerated by most cats. Intramuscular injections are more fiddly and can be sore.

I'm not personally aware of an injectable form of clopidogrel though - at least not in the UK.

This is a common problem with clopidogrel - it even mentions it in the formulary:



BSAVA Formulary said:


> Clopidogrel: tablet formulations for humans are film-coated, which needs to be broken for appropriate dosing in cats. Many cats dislike the taste of the tablets when the film-coating is broken.


If you're finding it really difficult, you could talk to the cardiologist about trying aspirin instead. They may prefer to use clopidogrel, but it might be worth an ask. Clopidogrel is more effective than aspirin; but maybe aspirin will be better than nothing at all.


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## Soozi (Jun 28, 2013)

Thank you for the heads up Shosh! I now know the difference! the meds I had to inject were two mixed together in the hyperdermic to help my cat's breathing. Sadly she only managed one Chemo treatment and just completely went downhill she never had the second chemo.


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## Soozi (Jun 28, 2013)

ALR said:


> I've got one of those. I had no idea you could put water in them (duh!). That's a very good idea. I tried to use it once but it was a bit fiddly. I was trying to hold Bubble still with one hand and trying to get my fingers through the scissor thingie.
> 
> I think I might try again with some water this time


You fill the chamber up (only half way) and as you press the plunger the water helps the pill go down you must get it the back of Bubble's throat. My OH always holds Liddy while I do the deed!


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## ALR (Apr 16, 2014)

I must admit it does sound a bit scary and if hubby helps me it would be a lot better. I've been doing it solo because I'm home first. 

I'll try the new treats I got him first because I want him to forget the past horrid experiences of us trying to put meds in him. But if the treats don't work, I'll have to start using this.


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## Soozi (Jun 28, 2013)

ALR said:


> I must admit it does sound a bit scary and if hubby helps me it would be a lot better. I've been doing it solo because I'm home first.
> 
> I'll try the new treats I got him first because I want him to forget the past horrid experiences of us trying to put meds in him. But if the treats don't work, I'll have to start using this.


It's amazing what you can do if you have to though! Once you get the hang of the plunger it is very easy! saves your fingers too! Since using the piller I haven't had any pills come back up or spat out.


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## ALR (Apr 16, 2014)

Shoshannah said:


> If you're finding it really difficult, you could talk to the cardiologist about trying aspirin instead. They may prefer to use clopidogrel, but it might be worth an ask. Clopidogrel is more effective than aspirin; but maybe aspirin will be better than nothing at all.


I have talked to him about aspirin. I want to keep trying the clopidogrel for a bit longer. Bubble is at risk of blood clots because the blood in his heart is moving slowly from the top left chamber to the bottom one. Basically the left valve doesn't work properly (Mitral valve dysplasia).

Aspirin would be easier but it is less effective and so far I've been able to give him the clopidogrel every day - at the cost of my patience and sanity. I didn't mind it that much but now I'm worried about stressing Bubble so I need to find the right balance (somehow).


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## Ceiling Kitty (Mar 7, 2010)

Soozi said:


> You fill the chamber up (only half way) and as you press the plunger the water helps the pill go down you must get it the back of Bubble's throat. My OH always holds Liddy while I do the deed!


You can put water in pill givers?! 

Well knock me down with a feather, I never knew that. I've always used a separate syringe of water. Duh!


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## Paddypaws (May 4, 2010)

Do give the gel caps another go too.....they are at least tasteless, whereas if the cat tastes a bitter medicine it can froth at the mouth unpleasantly and REALLY get determined not to take it again.
I normally try and pill my cats just before I feed them, hoping they are interested enough in the food I put down in front of them to distract them away trying to spit the pill out.


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## Cats cats cats (Feb 4, 2011)

Just skimmed this thread so apologies if this has already been asked and answered but have you considered transdermal medications ? Many medications can be made up into a gel applied to the ear  I have recently had cause to look into this and put my vet onto these people.....

Vet Specials | Vet Specials Medicines | The Specials Lab

Who were apparently very helpful 

Another thought is injections, I am currently injecting one of my cats and although admittedly, I was TERRIFIED at first , it is so so so much easier than pilling 

Maybe the specials lab could make your medicine into an injectable ?

I feel for you as I have a heart kitty too and know how stressful it is xxx


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## GingerNinja (Mar 23, 2014)

My attempts at using the piller (with/without water) was abysmal 
I actually found it easier to pill without it. 

I hope you have some success with the new treats for bible as everything I have used has already been mentioned on this thread 

ETA I meant bubble, not bible!!


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## MaineCooner (Jun 26, 2011)

Shoshannah said:


> If you're finding it really difficult, you could talk to the cardiologist about trying aspirin instead. They may prefer to use clopidogrel, but it might be worth an ask. Clopidogrel is more effective than aspirin; but maybe aspirin will be better than nothing at all.


I'm not sure what meds the OP's cat is on but I have to give clopidogrel (plavix) as well as aspirin to my heart cat.

I also tried the raw beef mince meat ball trick to hide the plavix until she went off it big time. However, changing from regular mince to very low fat steak mince did the trick and she was prepared to eat the mince balls again. Lamb mince as a nice change also worked. I buy the mince, make up the meat balls individually and place them into small vol au vent casings which then go in an old ice cream tub in the freezer. I take out one a day and defrost as necessary. Worth a try perhaps?


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## MaineCooner (Jun 26, 2011)

One other tip to get the OP's cat back on meat balls. If the cat's taking a diuretic like furosemide, it's probably also taking a potassium supplement like kaminox. Now, kaminox is very tasty and my girl will literally suck it out of the dropper. Smear the meat ball in a little kaminox and watch the appetite increase, hopefully.


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## huckybuck (Jan 17, 2014)

I know it's not ideal because quite salty but you only have to use a tiny amountwe used to wrap the tablet in a small piece of parma ham or similar.


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## ALR (Apr 16, 2014)

I tried both mince Turkey and mince beef last night. The mince turkey worked really well. The beef he wasn't keen on but he managed to open the beef and found the pill in the middle!

He knows there is a pill so he doesn't just eat the treat, he'll chew it until he gets to the pill then spit it out. 

I think eventually I'll have to use the piller. But I'll wait until the weekend when hubby is here so I can get an assistant. 

I've looked at the Vet Specials but I'm a bit scared at the mention of 'unlicensed medicine'. I wouldn't like an injection because I'm worried about formation of abscess and even cancer, unless we definitely need to inject. But the idea of a spot on sounds good in theory or simply changing the flavour of the medication, I'm not sure about the 'unlicensed' part and what are the risks I'd be taking.

BTW: Gingerninja, you made me laugh calling him Bible. I told Bubble, he wasn't impressed


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## Soozi (Jun 28, 2013)

ALR said:


> I tried both mince Turkey and mince beef last night. The mince turkey worked really well. The beef he wasn't keen on but he managed to open the beef and found the pill in the middle!
> 
> He knows there is a pill so he doesn't just eat the treat, he'll chew it until he gets to the pill then spit it out.
> 
> ...


There is this piller on Amazon I have both types, the one I posted about yesterday and this one as I wasn't sure which one would be better! you might prefer this type! sorry the photo i






s a bit blurred!


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## ALR (Apr 16, 2014)

Is this one easier? I've been looking at videos it seems with the other piller, you can put a pill in a cats' mouth from the side and slide it down the throat. It looked simple but I'll have to try and see. I'm sending hubby the videos so that we can try at the weekend. 

Hubby took a picture of Bubble relaxing yesterday night. As you can see he's quite chilled:


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## Soozi (Jun 28, 2013)

ALR said:


> Is this one easier? I've been looking at videos it seems with the other piller, you can put a pill in a cats' mouth from the side and slide it down the throat. It looked simple but I'll have to try and see. I'm sending hubby the videos so that we can try at the weekend.
> 
> Hubby took a picture of Bubble relaxing yesterday night. As you can see he's chilled:


Can you post the link to the video please ALR? I have used the first piller twice but both times I have had my OH to hold her in place! I haven't tried the second piller as it looks bigger so stuck with the green handled one.


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## ALR (Apr 16, 2014)

It's this one.It's got both methods.: 




That poor cat!


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## Soozi (Jun 28, 2013)

ALR said:


> It's this one.It's got both methods.:
> 
> 
> 
> ...


If only it were that easy! Lol! The towel wasn't needed and the cat was a non wiggler! You will find a way that's best for you! The piller with water worked best for me but it's a matter of personal choice!


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## GingerNinja (Mar 23, 2014)

ALR said:


> BTW: Gingerninja, you made me laugh calling him Bible. I told Bubble, he wasn't impressed


It was predictive text on my phone 

Bubblelicious looks delicious :biggrin:


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## Soozi (Jun 28, 2013)

ALR said:


> It's this one.It's got both methods.:
> 
> 
> 
> ...


Another tip my vet gave me was when (if) you get the cat's mouth open is to aim to get the pill just past the rough part of the tongue as it's on the rough part that the pill will more often get stuck enabling them to spit it out.


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## chillminx (Nov 22, 2010)

It was impossible to pill one of my previous cats (RIP) directly, so this is the method I used successfully for the last 2 yrs of his life: Buy some Greenies Pill Pockets, break them in half and roll into little balls and then feed them (empty) to the cat as treats for a week. My cat usually gulped the half pill pocket down without biting it. 

After a week hide the clopidogrel tablet inside half a pill pocket easing it around the tablet completely. If the clopidogrel is too large to hide in half a pp, then divide the drug into two and use two halves of pill pocket. Put the pill pocket on a dish with a couple of empty balled half pill pockets. My cat used to scoff the lot and because he didn't bite into them he didn't notice the hidden tablet.

Pilling a cat directly down the throat can be a great solution if your cat will accept it. I always do the procedure before a meal - I have the food ready on the side to give it immediately afterwards. I use the second smallest empty gel capsules, as they are easier to get down the throat without sticking. I conceal it from the cat until I am ready to give it. I give the cat a few treats to lull him into a false sense of security (!) then wait until he's finished and pop the capsule down the throat. (I found using a piller was harder than doing it without.) 

Speed is of the essence, as is NOT giving him warning of what you are about to do! If he is a wriggler then get someone to help you. But if you do, it's best to sit the cat facing you on something like a kitchen table, where you can reach him easily, and have someone hold him firmly from behind. Much less stressful for the cat than picking him up to restrain him, or wrapping him in a towel etc. 

Onwards and upwards


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## ALR (Apr 16, 2014)

I've ordered a pack of Dreamies and was planning to put some pills in but I think I'd do what you do and get him used to it first. It sounds like a very good idea:thumbup1:

I might also order extra gel caps. I got a few from my vet and used the small one just for the clopidogrel. I'm not sure what size they are as I got mine from the vet - there's a size 0 and a size 1 on ebay. I don't want to put a big pill down his throat. Does the size of the pill matter? I'd think bigger pills are not pleasant. 

Those videos make it look so easy. I'm hoping he won't be too stressed if I try the techniques on him.


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## chillminx (Nov 22, 2010)

Just to mention that Dreamies are not the same thing as Greenies Pill Pockets, Dreamies are hard and you cannot hide anything inside them. But perhaps you meant to say "Greenies" 

Greenies Feline Pill Pockets Salmon 1.6oz: Amazon.co.uk: Pet Supplies

Re: the gel capsules, size 0 and size 1 are quite large. I used size 3 which I bought in bulk off ebay. The capsules go up to a size 4 but that size is really small and not easy to fill if you are putting in powder. Though I did use them successfully for putting half a tab of Felimazole in.


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## ALR (Apr 16, 2014)

OMG I meant Greenies I'm having a brain freeze.

Thanks for the info on the gel capsules. I'd definitely get the size 3. If I can manage to get the clopidogrel in him, the rest is plain sailing


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## Ceiling Kitty (Mar 7, 2010)

ALR said:


> I tried both mince Turkey and mince beef last night. The mince turkey worked really well. The beef he wasn't keen on but he managed to open the beef and found the pill in the middle!
> 
> He knows there is a pill so he doesn't just eat the treat, he'll chew it until he gets to the pill then spit it out.
> 
> ...


Unlicensed simply means the drug has not been licensed for use in cats. It may be licensed in dogs, for example, but it may not be licensed for animal use at all (as is the case with the many human drugs used in veterinary medicine).

When a drug is licensed, it has official safety and efficacy trials carried out by the manufacturer, is marketed for the animal(s) targeted and comes with official manufacturer's recommendations.

If a drug is not licensed in cats, it doesn't mean no studies have been done. Most drugs have some kind of independent research papers looking at how well they work and how safe they are - that's how we know we can use them and what dose to use!

Clopidogrel is unlicensed in cats. It is a human medication. Compounding the medication into a liquid form (if that's possible for this drug) will carry no more or fewer risks than giving a tablet.


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## Soozi (Jun 28, 2013)

ALR said:


> OMG I meant Greenies I'm having a brain freeze.
> 
> Thanks for the info on the gel capsules. I'd definitely get the size 3. If I can manage to get the clopidogrel in him, the rest is plain sailing


If you are managing to pill Bubble on your own then you are not doing too badly at all!


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## ALR (Apr 16, 2014)

Well Bubble ate all his meds in pieces of chicken yesterday:thumbup:. I find that small pieces of meat is better that mince. The meat seals quickly once on a hot pan, but with the mince there are still gaps and he can still lick them open. 

I'm feeling more positive after yesterday. I managed to do all his meds within 15 mins and he ate it without fuss. This is a low stress method for Bubble so I'll try this method for however long it lasts and keep all the tips you guys gave me so I still have options. 

Shoshannah, thanks for the explanation on unlicensed meds. I might take a look at this if things don't work at all. I understand it's an expensive option so it might be a last resort. 

I sincerely want to thank all of you for your help on this. When I wrote this thread I was exhausted and I felt like I was failing Bubble. Your comments really helped me to keep trying.


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## Soozi (Jun 28, 2013)

ALR said:


> Well Bubble ate all his meds in pieces of chicken yesterday:thumbup:. I find that small pieces of meat is better that mince. The meat seals quickly once on a hot pan, but with the mince there are still gaps and he can still lick them open.
> 
> I'm feeling more positive after yesterday. I managed to do all his meds within 15 mins and he ate it without fuss. This is a low stress method for Bubble so I'll try this method for however long it lasts and keep all the tips you guys gave me so I still have options.
> 
> ...


Awww! Well done Bubble! such a good little man! I agree if you can get him to eat the meds it's less stress, maybe he's realised that too! LOL! onwards and upwards! He's a beautiful boy btw!:thumbsup:


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## carly87 (Feb 11, 2011)

ALR, I'd still suggest varying your methods so that he doesn't get used to/bored of the same one. That way, he'll eat his meds for longer.


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## ALR (Apr 16, 2014)

carly87 said:


> ALR, I'd still suggest varying your methods so that he doesn't get used to/bored of the same one. That way, he'll eat his meds for longer.


Oh definitely, I'm giving him the greenies without any pills in at the moment. I've also ordered some gel caps. I'll rotate the meat I'm giving him but I'm hoping I have a solid plan B if things don't work.


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