Hiding pills in food or a treat. This doesn't work for all pills, or for all cats for that matter. For this to work, the pill can not have a strong odor or bitter taste, and the food or treat must be something that your cat likes so much that they will eat even when it is 'tainted' by a pill. For this, you can use any cat food or people food as long as it is not a food that will make them sick. The only people foods you need to avoid is anything with garlic or onions in them since those are toxic to cats, chocolate, or anything with lactose in it since most cats are lactose intolerant. Anything else in a small amount is okay to use. Kind of the "a spoonful of sugar helps the medicine go down" philosophy.
Probably the easiest way to hide a pill in a treat is to purchase a "Pill Pocket" or something similar. This is a soft treat with a hole in the center. You place the pill inside the treat, smush it closed over the pill, and pretend that you are just giving a normal treat to your cat. If your cat is a big treat eater, and they don't tend to chew their treats, this will work very well. You can also try this using a piece of cheese, lunch meat, hamburger, or anything that is small, that you can hide a pill inside of and that your cat will be likely to inhale without chewing.
If this doesn't work for your cat, then the next thing is to grind the pill up into a fine powder using either a mortar and pestle, two spoons, a hammer, a pill grinder, or anything that will achieve the desired result. You can then mix the pill powder in a small amount of a very tasty cat or human food that your cat normally goes crazy over. Just make sure that your cat eats all of the food, or they won't get all of their medicine, so don't use a large amount of food. Also note that some medication do not taste very well and some cats have the ability to smell it in their food, causing them to avoid eating whatever food the medication was placed in.
Pilling by hand
Okay, so your cat is too smart for the pill in a treat method, or the pill is just too nasty tasting (such as with Baytril or metronidazole - very nasty tasting meds). So, you decide to try giving the pill by hand. There are a lot of cats that will actually tolerate this well. You can either give the pill as is, or you can also try lubricating it with a little butter, margarine, or cream.
If your cat is fairly docile, then you may be able to administer the pill by yourself with no help. There are four ways to hold your cat by yourself to give the pill. The first method involves holding the top of your cat's head by placing your thumb on one side of the upper jaw and your fingers on the other side. Tilt your cat's head back gently until their nose points toward the ceiling, which should cause your cat's jaw to open slightly. The second method involves scruffing your cat firmly and tipping their head back until the nose points toward the ceiling. This is for slightly less cooperative cats. The third method involves putting your hand under your cat's chin with your thumb in one cheek, and your fingers in the other, and pushing in gently until your cat opens their mouth. The fourth method is only for cats that like to be held on their back. This involves cradling them on their back like a baby, but with their head and neck in an upright position, and just using your hand to open up their mouth.
Once you have found a method of restraint that works for your cat, the next step is to use your ring finger and littler finger to open your cat's mouth further, and then use your thumb and forefinger to place the pill as far back in your cat's mouth as possible. Quickly close your cat's mouth, and hold it closed. You can encourage swallowing by one of three methods; gently rubbing your cat's throat, blowing in your cat's nose, or have a syringe of water ready to go, and dribbling it into the side of your cat's mouth immediately after placing the pill.
So neither treats nor hand pilling will work for your cat. Don't give up yet. This is what they invented pill poppers for. Pill poppers look like a long fat syringe that you can place a pill inside of. You can then use the pill popper to get the pill into the back of your cat's throat without having to risk getting bitten and sticking your fingers in there.
For this method, you can also do it with only one person, but about the only effective methods of restraint are holding the top of your cat's head, or scruffing your cat. When it comes to restraining your cat's head, you want to place your non-dominant hand around their skull and have your thumb and point finger behind their eyes and behind their cheekbones as shown in the pictures below.
Once you have control of your cat's head, using your dominant hand, take the pill popper with the pill already placed in it, and use it to open your cat's mouth by pushing it into the side of your cat's mouth just behind the canines where there is an area with no teeth (as demonstrated in the picture above). Once in, quickly but gently push the pill popper to the back of your cat's mouth, push the pill in, and then repeat the methods to stimulate swallowing.
A few additional pointers
Some cats may require two people to restrain. The second holder is most effective if they can hold your cat's two front feet to keep them from batting at you, and their arms along your cat's body to further help immobilize them. A towel wrapped securely around your cat may also help, but it may also further stress your cat out. If your cat has their front nails, consider trimming them before you start pilling them. Even if they go outside, the nails will grow back in a few weeks. Even the back nails can scratch you pretty well when pilling, wouldn't hurt to trim them also.
Speed is of the essence
The faster you go, the less your cat will fight you. You may want to practice on a different cat in the home without the actual pill before you go to pilling your cat.
60% of dry pilling results in the pill sitting in the esophagus for several minutes to hours before it travels down to the stomach. We highly recommend either syringing water or some type of flavored liquid such as chicken broth or tuna juice down your cat after pilling them to make sure they swallow the pill. This is primarily critical if you ever have to give your cat a doxycycline pill. Doxycycline pills are highly prone to causing esophageal strictures, which is why we no longer use them at All Feline Hospital. However, while other medications are not as bad, they can still cause a fair amount of irritation, so it's best to flush them down with something, even food will work.