Tips and tricks for administering oral medications

You step away from your horse after fighting to administer a dose of oral medication and realize you’re coated in half of what he should have swallowed. It’s frustrating to have to go through this same effort twice a day for a week. Your veterinarian emphasized the importance of getting all the medication down to help your horse fight an infection, but it’s proving easier said than done.

“Surely there has to be a better way to do this,” you think. “I have to be smarter than my horse!”

From antibiotics and anti-inflammatory tablets to anti-ulcer pastes and deworming medications, we ask our horses to consume a variety of products deemed important for their health. Fortunately, there are tricks to getting even the most refractory patient to take his medicine. After more than three decades of performing equine veterinary work, I have found, through trial and error, a number of successful strategies to help you with this process.

Oral Paste

Always administer oral medications before feeding your horse, and check that his mouth has no food or debris in it before getting started. Rinse it out if necessary. Otherwise, medicine can get caught in hay, grain, carrots, or horse cookies, where it’s more likely to be spit out.

Have everything ready to go before haltering your horse. Don’t give him time to anticipate the dosing. Keep calm so your body posture doesn’t reveal anxiety or nervousness, as horses are exquisitely sensitive to body language.

When medicating with a syringe of paste, try not to give a difficult horse much, if any, warning. For starters, don’t let him see the syringe. Hide it behind your back or in your jacket and, once alongside his head, bring it up under his chin slowly. He can’t see it there. Then, with your finger in the corner of his mouth, slide the tip of the syringe in.

It helps substantially if you have practiced this maneuver previously using first your finger, then carrots. Once he accepts those approaches, administer a syringe full of something tasty, such as applesauce. In fact, Ray Randall, DVM, of Bridger Veterinary Clinic, in Montana, suggests syringing your horse regularly without ­medication—just something pleasant and tasty. It’s all about desensitizing him to the process, so he won’t be afraid. This takes time, practice, and patience.

Give yourself every advantage by using a syringe that fits your hand well; this will make the process more efficient. Some people cannot work the plunger on a full 60-cc (2-ounce) syringe. In those cases you might need to use a 35-cc syringe and give the dose in two or more parts. To make administering a thick paste easier, cut the catheter tip or nozzle off the syringe.

Once you’ve inserted the syringe of medicine into your horse’s mouth, slide it as far as you can to the back of the tongue. While pressing on the plunger, massage his tongue back and forth with the tip of the syringe—tongue movement forces him to swallow the medication before he can spit it out. Keep his head somewhat elevated while massaging his tongue. Positive reinforcement after each treatment can help mitigate fights over the next administration. Have a reward ready—either a favorite treat or a bucket with tasty food in it.

If you have a particularly stubborn horse, get someone to help you. The more your horse resists, and the longer he gets away with it, the more ingrained that behavior becomes. Some horses need a lot of restraint; for others, less is more. However, never tie your horse’s head when administering medication. This could result in a violent reaction that is dangerous to you and your horse. Don’t stick your hand through the halter, either. Give his head freedom to move, and follow his motion. Take your time, stay calm, and be patient.

“Sometimes the problem is the person giving the medication,” says Randall. “Get someone else to administer it to your horse. While it may be hard on your pride, the point is to get the job done as easily as possible.”

In some cases you might have to make a paste out of pills. You can mix water and medication in a cup or in the plastic syringe case for a 60-cc syringe; the syringe fits well into that case, making it easy to withdraw all the fluid-medication mix.

Some pills dissolve more readily than others. Some tablets should not be dissolved or crushed, because they need their outer coating to withstand digestive juices and to release active ingredients at an expected rate. For tablets that can be pulverized (ask your veterinarian about this), however, crush or grind them in an electric coffee grinder or with a mortar and pestle. Then you can add an appealing substance that helps with delivery—applesauce, small amounts of yogurt, baby food (such as carrot puree), molasses, or Karo syrup.

When selecting such substrates, it’s important to remember the needs of horses with insulin dysfunction, equine metabolic syndrome (EMS), or pituitary pars intermedia dysfunction (PPID, formerly known as equine Cushing’s disease). Choose nonsugary components, such as unsweetened applesauce, to mask the medication’s taste. Avoid using products that contain molasses or Karo syrup, including beet pulp with molasses. Low-sugar yogurt is usually safe to use in small quantities.

Using oral syringes repeatedly can cause the rubber on the plunger to become brittle or difficult to move. To avoid this, clean syringes well after each use, and lubricate the rubber parts with ­vegetable oil. You can also buy commercial syringes that don’t contain rubber parts and tend to function smoothly for longer. Keep a spare syringe available in case the one you’re using goes bad.

Small Tablets

Some medications come in small tablet form, such as pergolide (Prascend) for horses with PPID or the non-steroidal anti-inflammatory firocoxib (Equioxx). If a dose is only one or two pills, then core out a small piece of apple or carrot and slip the pill into it to be consumed readily. This is typically a more effective technique than combining tiny pills with the horse’s feed, where he could knock them out or eat around them.

You can find pill pocket treats for horses, similar to those designed for dogs. They come in various forms, from flavored coatings to products such as Standlee’s Horse Pill Carriers­—firm alfalfa-based treats with a center hole for pills.

Edible conduits like these are particularly useful for ensuring horses consume important medications, such as pergolide, every day. “Don’t bank on the horse eating it out of a bucket of feed,” says Randall.

Sometimes we do chores on autopilot and can’t remember whether we gave our horse his pill today or yesterday. To help avoid this scenario, prepare a week’s supply using human pill containers that denote days of the week.

Powders

Some oral products or medications, including phenylbutazone (Bute, a non-steroidal anti-inflammatory drug), thyroid replacement drugs, and electrolytes, come in powdered form to be top-dressed on feed. Others must be made into powders by grinding tablets to render them consumable. When grinding solid pills, be careful not to inhale the powder, especially when dealing with drugs such as Bute (used as an analgesic) or isoxsuprine (used to improve blood flow in laminitic horses). To be safe, wear a mask that covers your mouth and nose.

Mix the powder thoroughly with your horse’s feed. Some horses can pick out powder and push it aside. Applesauce is a good binder for holding powdered medication to grain or complete feeds. Making a wet mash of complete feed pellets and/or beet pulp also helps blend and disguise medication in feed.

A number of medications are available in powdered formulations made by different manufacturers. Each tastes different when top-dressed on feed. It is helpful to know which formulations horses are most likely to consume. Your veterinarian or other horse owners might be able to provide recommendations; ask your veterinarian to prescribe ­accordingly.

After your horse eats his powder-dressed feed, check that he’s consumed all the medicine and not just pushed it to one side of the bucket. You can place the feed bucket into another, larger container to catch dropped feed and meds and monitor what your horse has eaten. Or, hang the bucket in such a way that a horse can’t knock it over and spill medicine on the ground.

Liquids

Liquid medication is fairly easy to add to horse feed. One common liquid medication is the progesterone hormone Regumate, which veterinarians prescribe to suppress mares’ estrous cycles. Wear gloves when handling Regumate, because it can be absorbed through human skin and create havoc with women’s hormones. To give progesterone safely, purchase a box of 100 red top tubes (10 cc size) from your veterinarian and carefully fill each one with the measured dose for each day. (Most 1,000-pound mares need about 10 cc per day.) Store the tubes upright in the container in which they arrived. Then, all you have to do is flip off the red rubber top and pour the liquid onto the feed. You can wear gloves to avoid skin contact, although it’s possible to flip off the rubber top without contamination if you’re careful. You can rinse the tubes out—again, wearing gloves to be safe—when you’ve emptied them all and dry and refill them for another 100-day round of treatment. Be sure to label the tubes and lock these and other medications out of reach of children and animals.

Electrolytes

For those involved in distance sports, giving electrolytes intermittently throughout a competition is important, particularly in hot and humid climates. Many riders add the salt to a sloppy gruel they offer their horses at rest stops. But not all horses will eat a mash of beet pulp and/or alfalfa-based pellets if laden with salt. You might have to administer electrolytes by syringe. You can also find recipes for electrolyte cookies that horses enjoy; they get a dose of electrolytes while consuming a treat.

Appealing to the Taste Buds

Adding flavoring to feeds is a common strategy to get horses to take their medications. Various research groups have studied horses’ flavor preferences to determine which palatants they prefer most and have found they’re commonly partial to anise, apple, peppermint, fenugreek, banana, and cherry. Most horses don’t like citrus. Experiment with additive flavors to find your horse’s particular preference, and do so before the need to medicate arises.

The Bottom Line

Experience, common sense, and the above tips can help make administering oral medications to horses more palatable, safe, and successful. If you have any hesitation about the proper way to prepare or administer these medications, talk to your veterinarian.