Several varieties of Diamond Naturals dog food have been recalled since April. Of the 14 people who have been sickened, at least five have been hospitalized with salmonella infections. According to the Centers for Disease Control and Prevention, there has been a nine-state outbreak linked to Diamond's pet food. The dog food was produced at a single manufacturing plant in South Carolina. In Food Safety News, reporter Mary Rosthschild writes, "How many dogs may have been sickened was not mentioned in the CDC report. In some recall notices, Diamond Pet Foods has claimed that no dog illnesses have been reported. Those recall alerts from the company did not reveal that human cases of infection were being investigated."

Now, as a precautionary measure, Diamond has expanded the recall. Pet owners with questions about recalled dog and cat food may contact Diamond Pet Foods at 800-442-0402 or visit www.diamondpetrecall.com.

In my opinion, while the manufactured pet food industry surveillance system may have helped prevent a major food-borne disease epidemic in this instance, it is the inhumane ways in which factory-farmed animals are raised, handled and processed that need to be addressed and changed, as I document in my book, "Healing Animals and the Vision of One Health." Harmful bacteria thrive under such stressed animal conditions.

DEAR DR. FOX: In May 2009 we adopted an abandoned cat that our friends found in a box giving birth. A home was found for the kittens, and we took mama cat. We immediately took her to the vet, who spayed her, gave her shots and performed a complete physical exam. The vet estimated the cat was about 10 months old. She weighed 6.5 pounds, and her tests indicated she was very healthy.

We named her Jackie Paper and took her back to the vet for a checkup in June 2010. She presented as a healthy cat, except that her neutrophil level had dropped from 7,000 to 1,350 (the normal range is 2,500 to 8,000). The vet suggested we have her retested. We did so one month later, and her level dropped even more, to 957. At that point, the vet tested the cat for feline leukemia and the corona virus -- the results were negative for both. A few weeks later, new tests indicated her neutrophil levels had increased to 1,408. The vet thought she might have had some temporary condition that she was getting over.

Jackie's neutrophil levels go up and down for no reason we can explain. And, with one exception (February 2011), her levels remain below normal. The vet consulted with other vets, set up a blog and researched the possible causes, but neither she nor any other vet has come up with a plausible cause for Jackie's condition. We had a bit of hope early in the summer of 2011 when one consulting vet suggested a probable bacterial infection and prescribed Orbax. The cat loved the medicine, but, unfortunately, her neutrophil level dropped from 1,940 to 1,540 during the four months she was taking the medication.

We're at a loss as to what to do. The vet and her consulting vets suggest a bone marrow biopsy, but we hate to put the cat through that if, in the end, there's nothing we can do to help her. Can you suggest any probable causes for her condition or any medications or food that would boost her neutrophil level? -- B.K.K., Alexandria, Va.

DEAR B.K.K.: As you have no doubt learned, neutrophils are white blood cells produced by the bone marrow and play a vital role as part of the immune system defense mechanism to fight infection and inflammation.

Feline viral infections can result in neutropenia (low white blood cell counts). It is my opinion that your Jackie Paper may have a viral or bacterial infection that is not showing up in blood tests. Alternatively, she could have a congenital bone marrow defect or have been treated for ringworm prior to you adopting her with a drug such as griseofulvin that damaged her bone marrow neutrophil production.

Since the antibiotic treatment did not help improve her neutrophil count, we can probably rule out a chronic bacterial infection. I would give her supplements to help boost her immune system functions such as coenzyme Q10, Resveratrol, fish oil and a good multivitamin and multimineral supplement such as Platinum Performance Plus. Short-term treatment with recombinant human granulocyte colony-stimulating factor (G-CSF) may be beneficial. I would question doing a bone marrow biopsy. Ask what treatments might be subsequently prescribed, depending on what is diagnosed.

Cats do not respond well to invasive procedures. If your cat were mine, I would wait and see, especially since she is showing no other signs of illness. A prior infection from which she recovered could have brought on her neutrophil anomaly, and, provided her health is maintained with good nutrition and a stress-free environment, she may live happily for many years.

Some normal cats may have low neutrophil counts (between 1,800 and 2,500). As a precaution, I would avoid giving your cat any further vaccinations or anti-flea drugs.

DEAR DR. FOX: We have a male Westie who turned 10 in July. We feed him Science Diet and Bil-Jac dry food. We also mix in 1/4 of the tin of Cesar's wet food.

Our dog has scabs all over his underside. This is the third bout in 10 years. Our vet told us to bathe him twice a week with KetoChlor medicated shampoo and scratch the scabs off. I have been doing that, and I try to remove all the scabs each time, but they just seem to be coming back. He has started licking his front paws to the point where he has licked the hair off.

Should I change his dog food and give him some sort of medication? Would you please tell us what we could do to get rid of the scabs and stop the licking? -- S.S., Benbrook, Texas

DEAR S.S.: Your dog may have a food allergy or nutritional deficiency, either of which can result in secondary bacterial or fungal infection of the skin.

I would gradually transition, over five to seven days, onto a corn- and wheat-free diet. Give him a few drops of fish oil in his food, working up to a teaspoon daily. His condition may show gradual improvement within a few months. If not, then additional supplements (such as zinc, selenium and vitamin B-complex) may prove beneficial. Try a weekly bathing with human Selsun Blue medicated shampoo for one to two months.

Considering his age, there could be other health issues that need to be addressed, notably poor thyroid activity.

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Universal Uclick, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

Visit Dr. Fox's website at www.twobitdog.com/DrFox.)

DEAR DR. FOX: I have a 14-year-old husky/shepherd mix. Last July she developed a bump on her right leg that has now become an open sore that she licks constantly. I have applied antibiotic ointment and covered it with clean dressings. But she chews the dressing off and licks the wound. This does not allow the area to dry and heal. The open sore does not smell, weep or look inflamed or infected. She runs and walks without any problem. She continues to eat normally and acts normal. However, she does sometimes shake, but she does not seem to be in pain.

Since she is 14, I do not want to pay for any heroic measures, but I will not let her suffer. I realize you cannot see what I see, but would like to know if there are some basic things I can do to help heal her open sore. I read online that some dogs get cancerous mast cell tumors. If this is what she has, I would do only comfort care. She is a great dog, and I will care for her until it looks as though she is not able to enjoy her daily runs and the love of our family.

Thank you for any help you can offer. She trembles when we go to her local vet, and I have not taken her for a checkup for this reason. We get her shots through local clinics offered in our area on a yearly basis, so she is up-to-date on all her shots. -- T.Z., Rockville, Md.

DEAR T.Z.: I fully respect your decision not to engage in "heroic measures," considering your dog's age. But you owe it to her to have the bump on her leg examined by a veterinarian. You may find one who does house calls, which would be much less stressful for your dog.

Without knowing if the swelling is a form of cancer or simply a fibrous inflammatory growth called a granuloma, you really don't know what might be best for your dog. It might be easily removed surgically, which would put an end to her constant licking. Early examination and removal often stops a diagnosed cancer from spreading. Clearly, the fact that she is licking it means she is experiencing discomfort, so the best solution to improving her quality of comfort is a thorough veterinary examination.

You speak of a plurality of shots being given every year to your old dog. This is outrageous and is tantamount to malpractice. For details on canine and feline vaccination protocols, check my website, www.DrFoxVet.com

DEAR DR. FOX: I have had cats since 1972. They all lived from 13 to 20 years of age. They all came from our local Humane Society. My only dog was 16 when he passed.

I have suffered a stroke and had two knee replacements. I am now in a wheelchair and did not want a kitten because I wouldn't be able to train it properly. But I've been without a companion animal for three years, and it's been difficult living alone.

Our local Humane Society had a special running before Christmas on older cats. I felt strong enough, and I now have in-house help, so I adopted a 3-year-old cat. The previous owners used this Humane Society for their veterinary needs, so I have all of his health records.

He's not overweight. I try to play with him for 30 minutes in the morning and again before bedtime. My only concern is that he eats only Purina dry food. I have tried chicken, pork and fish in various cooking methods -- he smells it and just walks away.

I've had several cats over the years, and I believe they've all had long lives because I fed them a good variety of food. A good friend advised me of that in 1972 with my first cat, and he lived to be 20 years old.

Have you ever heard of a cat refusing chicken? What should I do? -- S.D., St. Louis

DEAR S.D.: Considering that you have in-home help, I think it is good that you have given a home to an abandoned adult cat. The best interactive toys for you in the wheelchair are laser lights and lures tied to the end of a long cane.

A lot of feeding trials are conducted by cat-food manufacturers geared toward making cats prefer and become addicted to their products. Some manufactured dry foods are given a covering of an "animal digest" formula. This is all very well and good, but corn, soy, rice and other cereal grains have no place in proper cat food diets.

Try mixing some of the Purina chow with other brands such as Organix, Wellness and Feline's Pride. There are other excellent brands available that have either little or no cereal content and no soy, which, like the corn, is genetically engineered and can harm animals.

Be sure your cat is drinking plenty of water. This is a must for cats who drink little and are addicted to eating only dry cat food. You can try moistening your cat's dry food with warm water.

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Universal Uclick, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

Visit Dr. Fox's website at www.twobitdog.com/DrFox.)

DEAR DR. FOX: I am writing about my 4-year-old male papillon, Papi Lee. I was pleased to have him join me and my 3-year-old rescued female papillon. I have now had Papi Lee for two years.

A few months after I got him, I noticed that he started to stumble a lot. Initially, it just seemed odd, but I soon realized something was wrong.

After observing him for a few months, I took him to my vet. After several visits and a few hundred dollars, the vet found no problem with his inner ears, kidneys, blood and eyes. The vet could not offer an opinion about his problem.

In spring 2011, I was in Alabama visiting my family. I took Papi Lee to a vet there for an ear problem. While there, the vet said that he might have a growth or tumor on his cerebellum, but it would cost a lot of money to find out for sure. The tumor probably couldn't be removed.

Since then, I've been doing all I can to make my pet feel safe and happy. He has an excellent appetite and appears to be in no pain. His back end seems to curve forward when he walks or runs. He falls at the least provocation, but he gets right back up and continues to play. He has fallen off the bed and patio steps, and he stumbles around in the car unless I put him in his bed on the floor on the passenger side.

Since he is failing so quickly, do you think he'll just not be able to get up one day? -- V.A., Virginia Beach, Va.

DEAR V.A.: I did some canine neurology research and clinical studies in the past, and, without being able to examine your little dog, the best I can offer is an educated guess to help put your mind at ease.

Your dog most likely has a condition called cerebellar hypoplasia, where the part of the brain that helps control balance and coordination did not develop normally. One test is to cover his eyes with a bandanna. If he cannot walk at all and falls over, it is probably this developmental defect, which he compensates for visually. This condition is not painful, nor is it fatal.

If his condition is actually getting worse, another possibility is hydrocephalus -- water on the brain. Hydrocephalus is not uncommon in toy breeds. Your dog is probably too young for a brain tumor. Either way, you are doing the right thing. So long as he enjoys life and you keep him away from situations where he might fall and injure himself, his handicap is something you can all live with.

DEAR DR. FOX: My cat is 18 1/2 years old and in good health. He eats well, has good bathroom habits and seems to drink enough water. He is an inside-outside cat, but he can no longer climb the fence, so he does not leave our backyard.

He has had rabies shots every year. It's time for his shot, but I really don't want him to have it. I know other animals can come into the yard even if he can't get out. If he gets sick, he'll go to kitty heaven.

I have heard it is hard on older animals to keep getting shots. It seemed it was very difficult for him at the last shot, which is why I'm putting off this most recent one. I know rabies shots are important, but having it every year until now, can I just skip it this year? -- K.T., Sterling, Va.

DEAR K.T.: Since your cat is old and was adversely affected by the anti-rabies vaccination last year, I think you have legitimate reasons to avoid putting him at risk from another vaccination. But you need to check on the regulations regarding such vaccinations for cats in your municipality, since they vary. In some areas, cat owners are liable if they allow their cats to wander off their property without a valid rabies tag on their collars.

Discuss this issue and your concerns with your veterinarian, who may find it acceptable to write a letter stating that your cat has had prior anti-rabies vaccinations and his health might be jeopardized by giving further vaccinations.

It is also possible that the anti-rabies vaccination is not needed because your cat has adequate circulating antibodies, for which your veterinarian could run a blood test.

PET FOOD MANUFACTURER'S SECOND RECALL

Diamond Pet Foods took steps to recall a second variety of its dog food because of potential salmonella contamination. Visit www.diamondpetrecall.com or call 800-442-0402 for a full list of recalled products.

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Universal Uclick, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

Visit Dr. Fox's website at www.twobitdog.com/DrFox.)