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Medicating Feral Cats and Kittens

(Photo by Muhammad Mahdi Karim)
(Photo by Muhammad Mahdi Karim)
by Mike Phillips, NYC Feral Cat Initiative

Feral cats usually have sturdier immune systems than indoor cats, but when they do need medical treatment, the challenge for caretakers is to find ways to treat them without using stressful and traumatic restraint. Cats often break with illness from stress alone, so you want to make sure the method of treatment doesn’t hinder or delay recovery. Using the least invasive treatment available is always recommended for medicating feral cats, but when treating feral kittens during the taming process, you especially want to avoid treatments that require stressful physical restraint to administer. Forcibly restraining any kitten or cat for treatment can embed a fear of being handled that won’t easily be forgiven.

What follows are some of the more common conditions that feral cats and kittens develop, along with some simple treatment options.


You can forget about a flea bath when safe handling of a feral cat or kitten with fleas is impossible! A safe and effective flea treatment for cats and kittens four weeks and older is to add crushed Capstar to the cats’ food. For kittens four to eight weeks old, the dose is a half-pill. You do not need a prescription for Capstar, and you can purchase it online at any of the pet medication websites, or even from some pet supply stores. Capstar has no unpleasant taste and it kills fleas in three to six hours.

However, Capstar does not kill flea eggs that may be on a cat’s body, so it is important, when you can handle the cat safely, to follow up with a long-acting topical treatment such as Advantage, Frontline, or Revolution (which requires a prescription, but also helps treat ear mites and roundworms as discussed below). Apply one of these products to the skin between the cat’s shoulder blades and it will continue working for one month.

Capstar has no lasting effect, so a cat treated with it must not be re-exposed to fleas. For a follow-up treatment that does provide long-term flea control and that works well with adult ferals, you can use Program tablets, which are readily eaten when crushed in food and are an excellent noninvasive way to provide flea control to an outdoor cat when the dosing can be controlled for each individual cat. Program is designed to be the long-term followup to Capstar for flea control when handling the cat is not possible and administering oral medication in food is the only option.

Here’s another tip: If you find you can handle kittens, a bath with Dawn dishwashing detergent kills fleas on contact. Sometimes a flea comb dipped in the soapy water is enough to comb out a few fleas. Be sure to put a soapy ring around the cat’s neck and anus at the start of the bath to prevent the fleas from escaping into ears and you-know-where.

Ear MitesEar Mites

Ear mites are uncomfortable for a cat or kitten and they are contagious, but they are not life-threatening, so if you have to wait until a vet visit for a cat’s ears to be treated, it should be okay. As mentioned above, Revolution is an effective treatment that requires brief handling of a cat or kitten. It can be applied during a vet exam or after the cat’s spay/neuter surgery. Revolution should be administered two times (a month apart) for treating ear mites, but in my experience, one application will often killed all the mites.

Other ear mite treatments, such as Tresaderm eardrops, which also require a prescription and must be refrigerated, need to be applied to ears twice daily for fourteen days. This is stressful and traumatic for fearful kittens. Giving cold eardrops twice a day for two weeks is not a good recipe for taming. The vet can clean and treat the ears with Acarexx (ivermectin) to kill mites when the kittens get their spay/neuter surgeries if you can’t treat them before then.

Viral Infections

Treating viral eye infections can be very difficult, but this must not be neglected. Feline herpesvirus is one of the most common culprits, and scarring and loss of vision is common when it goes untreated. Make sure you take a cat or kitten with an eye infection to a vet so you can get the correct diagnosis and prescription, since treating a cat with the wrong eye medication can be useless or even harmful. For example, if the surface of the eye has been harmed, a steroid ointment could cause permanent damage. Remember too that if you are required to use eye ointments, such as Terramycin or Vetropolycin, or eye drops, you can spread the virus to other cats if the tip of the tube or dropper touches an infected eye. Ideally, each patient will have his or her own tube. If this is financially impossible, take your time and be extra careful.

Terramycin ointment is said to be the most effective against herpes, but it also stings the most. If the cat’s eyes aren’t in too bad a shape, the vet may agree that gentler drops and gentle cleaning may be a sufficient treatment option.

To undo their bad experience of being restrained and treated for an eye problem, spend extra nurturing time with kittens before and after you administer each dose.

Eye InfectionAntibiotics have no direct effect on viral infections like Upper Respiratory Infection (URI), but often vets will prescribe them to treat or prevent a secondary bacterial infection (read more about antibiotics and viral eye infections below). An antibiotic can usually be mixed easily into food, so you will not need to handle the cat. Make sure you can follow the directions precisely or don’t use antibiotics. They are not a “hit or miss” medication to be played around with. Ask the vet if you’re not sure about dosages! Kittens with URI that are bouncing around, playing, and most importantly, eating normally, usually don’t need an antibiotic at all to get well.

Interestingly, vets are finding that a course of treatment with the antibiotic Zithromax (azithromycin), can be very effective for resolving herpes eye infections. The success of this treatment for the viral eye infection is unexplained and “off-label,” so your vet may not be aware of this seemingly miraculous, if counterintuitive, treatment. When eye ointment or eye drops treatments are impossible to administer, azithromycin could save the day. It can also be used as a preventative treatment for a secondary bacterial infection.

Azithromycin can be compounded with flavors and stirred into food. The medicine itself is not perishable, and neither is the “roasted chicken” flavoring. The “tuna” flavoring is perishable and therefore the antibiotic with that flavoring will need refrigeration. With a prescription, you can get azithromycin mailed to you from VetCentric.com if your vet or pharmacy doesn’t do compounding.

Famciclovir is another drug that is sometimes used for a difficult viral or herpes eye infection.


Feral cats are susceptible to several different kinds of parasites, including roundworms, coccidia, and giardia. Because it is so common, all kittens should be given pyrantel pamoate for roundworms. This medication must be given twice, with the second treatment following two weeks after the first. Pyrantel pamoate can easily be put in the kittens’ food and they will gobble it up without detection. It is a very effective and safe medicine, but it will not resolve other parasites.

Diarrhea is often a warning sign that a cat or kitten may have a parasite in its system. Diarrhea can be very serious to kitten health and should not be neglected. An exact diagnosis can be difficult to get, but if diarrhea persists, take a stool sample to your vet for testing. The test for giardia is expensive and not usually run as a matter of course, so be sure to ask the vet about it. The routine treatment for giardia is a very bitter drug called Flagyl (metronidazole). It is impossible to disguise this drug in food. Panacur (fenbendazole) liquid suspension (not the powder) is a much better alternative for treating giardia in a feral cat or kitten. It has a chalky taste that gives you a much better chance of sneaking it into food. It is also a once-per-day treatment for only five days — much shorter than the bitter pill regimen.

For coccidia, traditionally, a long course treatment of minty flavored Albon (sulfadimethoxine) liquid has been prescribed. But, for feral cats, a much better alternative is a mostly one-time treatment (some vets repeat the treatment and doses will vary) of tasteless ponazuril, which is easily mixed into food.

Whenever a feral cat or kitten has diarrhea, feed a high-fiber cat food like Hill’s Prescription Diet w/d. If the cat has parasites, a high-fiber food will help push them out of the cat’s system. Adding a tablespoon of unspiced canned pumpkin to regular wet food is another way to add fiber to the diet. 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.


One of my vet tech professors once told me, “It takes 21 days for ringworm to heal if you treat it, and three weeks if you don’t.” I found this to be true when treating two young feral kittens for this fungal infection at the same time. One kitten was treated with sulfur dips and Conofite (miconazole nitrate) lotion that required repeated vet trips, which terrified her. Her sister was too feral for the vet techs to even handle for treatment. However, in the same amount of time, she healed on her own with good nutrition. She is now a loving lap cat, while her sister hates being touched.

One effective oral drug we’ve used, itraconazole, can be flavored at the pharmacy and you can sneak it into food. For years, Program, a successful flea treatment (mentioned above), was being used off-label to treat ringworm, but recent veterinary literature says it doesn’t work at all on this fungal condition.

For hard-to-treat ferals, if vet treatment is impossible, I recommend you target good nutrition to build a curative immune system response. Ringworm does resolve in time.

When a feral cat needs antibiotic treatment, a one-time injection of Convenia (cefovecin sodium) works well to treat a number of conditions for one to two weeks. This includes infected wounds. It is also a good choice for when a cat has teeth pulled. Convenia has only been tested and approved for treating dermatological problems with cats, so these and other uses are termed “off-label.” Studies have shown, however, that the only side effects, which are rarely seen, may be some nausea for a couple of days.

(Photo by Jake Remington)
(Photo by Jake Remington)
It is very important to keep a feral cat or kitten eating while it is undergoing any medical treatment. During this time it should be fed the most nutritious, premium quality wet food possible to help fuel the battle against the illness. Consider brands such as Natural Balance, PetGuard, Wellness, Nutro, and Eukanuba. Friskies and Whiskas are among the better grocery store brands. Keep the cat eating even if it only wants a less nutritious grocery store 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.

When a medical condition arises, if your veterinarian doesn’t understand the challenges of taming and building a feral cat or kitten’s trust by treating them the least invasive way possible, there are many other vets who do. They will work with you to get kittens to optimal health without using treatment methods that undo your hard socialization work. Ask around for a recommendation from one of the many groups working with feral cats. There is also a list of feral-friendly veterinarians in New York City available on the NYC Feral Cat Initiative website. The kittens, and YOU, deserve all the help and understanding you can get!