With sickly feral kittens try to use your vets most effective but least invasive treatment available. Forcibly restraining kittens unnecessarily to medicate them can set back the taming process and sometimes make complete taming impossible. Along with any medical treatments remember to feed the most nutritious food possible. A healthy immune system can combat many ailments, but it needs premium quality food to feul the battle. Natural Balance, Petguard, Wellness, Nutro, Eukanuba are among the best for nutrition. Friskies and Wiskas are inferior, but the better of the grocery store brands. Stay away from grocery store brands when you have a sick cat. The moisture from wet food is much preferable to dry food. (Disclaimer: Keep a sick cat eating even if it only wants a less nutritious brand. Eating “something” is the most important thing.) Building a healthy immune response through a top quality diet can often heal a feral cat when you can’t handle her safely to medicate properly. Here are some of the simpler medical treatment options which don’t require stressful or traumatic restraint:

When safe-handling is impossible, forget about a flea bath! CAPSTAR pills crushed in food are a safe and effective flea treatment for cats and kittens 4 weeks and older. A half pill is the safe dose for 4-8 week old kittens. CAPSTAR does not require a prescription and can be purchased online at any of the PetMeds-type websites, or even some pet supply stores. CAPSTAR kills fleas in 3-6 hours at which time the cat/kitten may be brought anywhere without fear of risking flea infestation if you dispose of the old infested bedding. The pills can be crushed and sprinkled onto a small amount of a tasty food. They have no unpleasant taste. CAPSTAR has no residual effect so the cat/kitten must not be re-exposed to fleas. It does not kill eggs on the cat so follow up with a long-acting topical treatment when you can handle the kittens safely. Advantage, Revolution, Frontline, etc. continue working for one month). IF you find you CAN handle the kittens in time, a bath with Dawn dish-washing detergent kills fleas on contact. Sometimes a flea comb dipped in the soapy water is enough to comb out a few fleas. Put a soapy ring around the neck and anus at the start to prevent the fleas from escaping into ears and you know where. REVOLUTION has the benefit of also treating ear-mites and roundworms(see below).

REVOLUTION requires a prescription but will effectively treat Ear-Mites; (it also treats fleas and roundworms at the same time). Briefly handling of the cat/kitten is necessary to squeeze a small amount of the REVOLUTION liquid onto the cat’s skin between the shoulder blades. This can be done at the time of a vet exam or after the Spay/Neuter surgery. Other EAR MITE treatments require fourteen days of twice daily ear drops with a refrigerated product like TRESADERM. This is stressful and traumatic for fearful kittens. Cold ear drops twice-a-day for two weeks is not a good recipe for taming. Some say REVOLUTION needs two treatments, but in the right dose, it has worked well for us every time. The vet can clean and treat the ears with Acarex or Ivermectin to kill the mites when the kittens get their Spay/Neuter surgery if you can’t treat before then. Ear mites are contagious and uncomfortable, but not life threatening. If you find you must wait for a vet visit to get them treated the kittens will be ok to wait a bit, but treat a.s.a.p.

Treating eye infections can be very difficult but must not be neglected. Scarring and loss of vision is common with untreated Herpes Virus eye infections (Herpes is the R in the FVRCP vaccination). Make sure you have the correct diagnosis since treating with the wrong eye medication can be useless or even harmful. Let the vet prescribe the eye med since you could do harm with the wrong one. For example: if the surface of the eye has been harmed, a steroid ointment could cause permanent damage. If you are required to use the standard tubes of eye ointment (Terramycin, Vetpolymicin, etc.) or drops, remember that if the tip of the tube touches the eye, you may spread the virus to everyone else you treat with that tube. Ideally each patient has their own individual tube. If this is financially impossible, take your time and be extra careful. To undo the bad experience of being restrained and treated for the eye problem spend extra nurturing time with the kittens before and after treating the eyes with the proper eye ointment or drops. Terramycin ointment is said to be the most effective against Herpes however it also stings the most. If the eyes aren’t in too, too bad shape, the vet may agree that gentler drops and gentle cleaning may be enough rather than the irritating Terramycin. Antibiotics have no direct effect (read about Zithromax below) on viral infections like URI (Upper Respiratory Infection) but often vets will prescribe one to treat or prevent a secondary bacterial infection. This is usually easily mixed into food without handling the cat. Make sure you can follow the directions precisely or don’t treat the cat with ABs. Antibiotics are not a “hit or miss” medication to be played around with. Ask the vet if you’re not sure! Kittens with URI that are bouncing around and playing and most importantly eating normally, may not need an antibiotic at all. Zithromax (Azithromycin), has been found to be very effective for resolving kitten and adult Herpes eye infections. Although it is an antibiotic and we all know they can’t cure viral infections, vets are documenting that an Azithromycin course of treatment often resolves Herpes eye infections. Azithromycin can be compounded with flavors and stirred into food, avoiding the need to restrain the animal to treat it. It can be ordered with a prescription from and mailed to you if your vet or pharmacy doesn’t do compounding. The medicine itself is not perishable, so stick with the non-perishable flavorings. We use the “Roasted Chicken” and not the perishable “Tuna” which needs refrigeration. The success of this treatment for herpes is unexplained and “off-label” so your vet may not be aware of this seemingly miraculous if counter-intuitive treatment for Herpes eye infections. When eye ointment treatments are impossible, Azithromycin could save the day. It can also be used as the preventative treatment for a secondary bacterial infection. There is another drug Famciclovir which is sometimes used for a difficult viral or herpes eye infection.

If you see diarrhea, Fecal testing is usually the only way to know what treatment is needed.  While waiting for a diagnosis, feed a high fiber cat food like W/D to physically pus out as many of the parasites as possible.  Adding a tablespoon of unspiced canned pumpkin to the food can add fiber to regular wet food.  High fiber food may sometimes be enough to clear up a simple case of diarrhea but be ready to get a proper diagnosis and treat with meds if the diarrhea persists.

ROUNDWORMS – Most vets routinely give STRONGID as prevention even if diarrhea is not present in young kittens. It’s very mild and works very effectively. A repeat dose is required 14-21 days after the first treatment.  You can buy PYRANTEL PAMOATE without a prescription. It’s a similarly effective dewormer found in most pet stores and online.

COCCIDIA and GIARDIA are not treated effectively with either Strongid or Pyrantel Pamoate.

GIARDIA – Fortunately, this more difficult to treat parasite is less common. For this reason, testing for Giardia is usually an “ADD-ON” and not included in a standard fecal test. You can pay more up front or bring back another sample for testing if the first test shows nothing, but the diarrhea persists.  The very best treatment for Giardia in a cat that cannot be handled is Panacur Granules.

“The standard treatment for Giardia infection has generally been an imidazole, usually fenbendazole (Panacur) given at 50 mg/kg for 5-7 days.”

 (Barr et al., 1994; Keith et al., 2003)

That equates to one packet of granules, once a day for 5 days.

Resistance to a drug and therefore the dosing amounts change over time. Always research the latest information from a reputable veterinary website.

The Panacur liquid-suspension worked well for us before the tasteless granules came out, but its chalky taste is more difficult to disguise mixed into food.  Forget about using the Pancur powder altogether! A dog will gobble it up, but no cat that I’ve ever seen will touch it.

The very bitter drug, Metronidazol, or Flagyl works well, but nearly impossible to get into even friendly cats.  If a vet writes a prescription of Metronidazol to treat a feral cat, politely explain that you’ll need a more palatable medication and ask for the Panacur Granules.

COCCIDIA –  Not treatable with Strongid, Pyrantel, or Panacur but, it is included in the standard fecal test results.  There is a very effective medication called PONAZURIL that we’ve been diluting it for feral cats until this horse medicine became available dosed for companion animals. It’s tasteless and is easily disguised into a feral cat’s food. 20 years ago, it required only one treatment, but the single dose is being repeated in the past few years. There must be some resistance to the drug developing because it used to be a one-time silver bullet to knock out Coccidia.  Check for the latest treatment info on a reputable website! Old online articles never go away; even when they are hopelessly out of date.

Avoid ALBON if you can, the alternative medication for treating Coccidia. It’s unacceptable for cats that are difficult to handle. It’s a minty-flavored, bright shiny yellow liquid that requires prolonged treatment over 14 days.  If it’s all you have, by all means try to use it, but its flavor is hard to hide in food and kittens hate the taste of it even if you can squirt it down their throat. Treat with the much less-invasive PONAZURIL if at all possible.

There is now a reliable PCR test to diagnose Ringworm in 1-3 days which is dramatically faster than traditional fungal culture. However, getting a sample for the test from a fractious cat can be as difficult as administering any treatment. Just like the old test, you’ll still need plucked hair with follicles (minimum 10–20 hairs) and skin scrapings from the active border of suspect lesion.

That said, take heart if you have a fractious cat with ringworm that is just too hard to treat.

One of my professors told me, “It takes 21 days for Ringworm to heal if you treat it, and 3 weeks if you don’t treat it.” I found this to be true once treating two young feral kittens. One with sulfur dips and conifite lotion requiring repeated vet trips which terrified her. As a result, she was never comfortable being handled. Her sister was too feral for the vet techs to even handle for the treatments, and she healed on her own with good nutrition in the same amount of time. She is now a loving lap cat while her sister still hates being touched. One effective oral drug we’ve used, Itraconazole can be flavored at the Pharmacy and you can sneak it into the food for ferals. For years PROGRAM, a flea treatment, was being used to treat Ringworm but the recent vet literature says it doesn’t work at all. For hard to treat ferals, we recommend you target good nutrition to build a curative immune system response if a vet treatment is impossible. It does resolve in time.

There is an “off label” use for Cefovecin (Convenia™) which allows a one-time injection that provides 7-14 days of antibiotic treatment for cats. This means that a feral cat which is discovered to have an infected wound or needs teeth pulled at the time of TNR could get this one shot while still knocked-out for the neutering. This allows antibiotic treatment for many feral cats that previously went without antibiotics. It’s termed “Off-label use” because Cefovecin (Convenia™), has only been tested and approved for treating dermatological problems but doctors have found that it works for many other things AND has the 7-14 days of residual effect. Studies have shown that the only side effects (rarely seen) may be some nausea for a couple days but don’t last for the entire 7-14 days.

If your vet doesn’t understand the challenges of taming and building the kitten’s trust, there are many other vets who do, and will work with you to get the kittens to optimal health without using treatment methods that undo your hard work toward socialization. Ask around for a recommendation from one of the many groups working with feral cats.  In NYC, check here for “Feral-Friendly Veterinarians.”

The kittens AND YOU, deserve all the help and understanding you can get!!