DEAR DR. FOX: Thank you for always having a wonderfully informative and impeccably honest column about our pets! I wish there were more vets with your mindset -- unfortunately, that has not been my experience.

Over the years, there have been times when I've had to let my pet go without a suggested treatment. My nearby vet charges $38 just to stop in and say "hello." I once went in to have nails clipped ($10), and I walked out because the "hello" charge was four times the cost -- it would have cost close to $50.

In another incident with the same vet, I was there for a basic shot. The dog (a longhaired minidachshund) had a small lump/cyst on his back about the size of a quarter. The quoted price to operate was close to $800. I just couldn't do it. About a year later at another visit, I was taken care of by the vet who owned the business. After taking care of an ear problem, the vet was horrified by the size of the cyst, which was the size of a tangerine. I explained that I just couldn't afford the $800. He looked sincerely dismayed and displeased at the quoted amount. He said he could do it for $350. He agreed to $150 down and an installment plan.

A quote for Willie's teeth cleaning and extraction was $850. Shocked, I went home and called five other vet places in the nearby town, and the prices ranged from $450 to $850 for identical work. In my complaining to other seniors, everyone suggested I try All Creatures, a clinic about 20 miles away from me. My friends said it provides good care, is inexpensive and is up on the latest information. So I called, describing yet again the potential needs for his teeth. The girl quoted $65 for everything (anesthesia, checkup before and $5 for the meds after)! I was certain that she didn't understand me; I thought $65 for each tooth -- no, it was for everything. I paid in full immediately -- no long-term debt.

A few years later, when my beloved Willie got Cushing's disease, the vet was obliged to tell me it was time to let him go. He was so kind during my torrent of tears. He said, "Why don't I let you two have a little time together? I'll be back." It was invaluable to the healing process! -- V.G.

DEAR V.G.: Your letter will be appreciated by many readers and will alert veterinarians to the serious problem of increasing veterinary service costs, inconsistent charges for treatments and animals in need not receiving appropriate professional care because the owners are financially challenged.

My advice to readers who are in financial difficulties is to do what you did -- shop around and get price quotes in writing. If possible, ask for referrals from pet owners and your local humane society/animal shelter.

There are no simple solutions to the rising cost problem, as I emphasize in my new book, "Healing Animals and the Vision of One Health," where I stress the importance of good nutrition, preventive dental care (especially for smaller dog breeds) and annual veterinary checkups -- which do not need to mean more vaccinations and costly tests. When checkups become too costly, animals suffer the consequences by not being taken in until they are seriously ill, which means greater animal suffering and financial expense.

FINDING A HOLISTIC VETERINARIAN

The best medicine is prevention, and a holistic, integrative approach to companion animal health calls for a revision of vaccination protocols, of feeding highly processed commercial pet foods and of overmedicating -- especially with so-called preventive medications like those sold to keep fleas and ticks at bay. There are effective -- and cheaper -- alternatives available that pose far less risk to animals' health and to the environment.

For further information, contact a holistic veterinarian in your area. A searchable list can be found at www.holisticvetlist.com. Veterinarians wishing to learn more are encouraged to become members of the American Holistic Veterinary Medical Association at www.ahvma.org.

U.S. PET SPENDING TOPS $50 BILLION FOR FIRST TIME

Americans spent a record $50.96 billion on pets in 2011, according to the American Pet Products Association. Pet services spending increased the most, from $3.51 billion in 2010 to $3.79 billion in 2011, a nearly 8 percent escalation. The veterinary care category saw a modest bump, from $13.01 billion in 2010 to $13.41 billion in 2011, though that number includes money spent on pet insurance, which totaled approximately $450 million.

(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 DrFoxVet.com.)

DEAR DR. FOX: In a recent column, you stated that crating a dog is mean and cruel. I have a 2-year-old Maltese-mix whom I adopted from an animal shelter about a year ago. She has extreme separation anxiety and chews, scratches and barks uncontrollably when she's left at home alone, indoors or out.

Her vet recommended crating her while I go to work with a pillow from my bed, the TV on and her Kong toy filled with peanut butter. She spends six hours a day in her crate. We occasionally monitor her behavior with a webcam, and, judging by her behavior, this has been successful. She is calm, quiet and appears comfortable in her crate. Yes, I could have gotten her doggie Prozac (as you suggest in your column), but I believe that natural, humane ways of treating anxiety are better options than medicating an animal.

My doggie had a rough life before coming to us and had been in several shelters. She has a happy life now with a family who loves her and makes sure she is comfortable when we have to be away from her. The fact that you say crating is mistreatment is downright offensive. As a veterinarian, I would hope you realize that, for some dogs, crating is a healthier and safer way of treating separation anxiety than medicating or rehoming an animal.

Your column on crating was rude, small-minded and lacked professionalism. I am sending a copy of this letter to my local paper -- which carries your column -- in hopes that it will no longer. -- A.R.

DEAR A.R.: You took offense at what I consider an offense to dogs -- crating all day (for six or more hours) is inhumane treatment. It sets up a condition of learned helplessness. For puppies and older dogs who must drink more water because of kidney problems and then need to urinate more frequently, prolonged caging can be extremely stressful.

Clearly you are not a frequent reader of my column; otherwise you would not feel such discomfort over my concerns about this issue and blow up with self-righteous indignation! I have often stated that crate training to help dogs become house-trained and feel secure is a useful practice, but pups should be taken out periodically to be fed and walked and should not be confined all day.

Once dogs get used to being crated and no longer fight to get out, the door can be left open so they can come and go as they wish. This gives them control over their environment and greater self-confidence, and it serves as a den for security, which helps them cope with separation anxiety. I would advise you try this for your dog and let me know how she responds. You should place a pee pad a few feet from her open crate (preferably scented with a little of her urine) so she can relieve herself when she needs to. Leave a radio or TV on since the sound of the human voice is reassuring for many home-alone dogs.

DEAR DR. FOX: I have read your support for animal hospice. How does someone get involved in that? Over the years, I have had wonderful veterinarians who are willing to teach me certain things for my "hands-on" care of a terminally and/or elderly pet, saving stressful trips to the veterinarian and adding additional important time with the family. I know not every pet owner is comfortable with some things, so hospice should be available, with someone to go into the home and help care for a pet during his last days, keeping him as comfortable as possible. -- G.W.

DEAR G.W: I appreciate your interest in helping provide hospice care for dying animals. Often the veterinary profession leads the way for the human medical profession, especially in the domains of euthanasia, controlling zoonotic (animal-to-human) diseases and promoting the One Health concept. But I am glad to say that in many states, human medical services now include in-home hospice care -- my family being one participant with my late father-in-law. It did not take long before some enterprising veterinarians started offering similar in-home services for people who were able to provide the care needed for their end-of-life pets.

If you want to help in some way, call veterinary hospitals and your local animal shelter. Preferential selection for an assistant who has a human nursing background or veterinary nurse/technician qualifications, plus considerable experience working with people helping them cope with the pending death of their loved ones, would be expected. Just having a sympathetic heart for this kind of work is not an acceptable qualification for a job on the cutting edge of responsible medical care and human emotion. Additional details about hospice care for animals is posted on my website, www.DrFoxVet.com.

BUYER BEWARE: AVOIDING GENETICALLY DEFECTIVE PETS

The Universities Federation of Animal Welfare, a science-based organization in the U.K., has developed an excellent website profiling the most prevalent genetic defects in pets, which can impact their welfare and health. The website, www.ufaw.org.uk, currently contains descriptions of more than 70 conditions in some 90 varieties of domestic animals sold as pets, including dogs, cats, horses, rabbits, guinea pigs, pigeons and goldfish. More than 50 conditions in 47 breeds of dog are included. This will be a useful resource for people looking to purchase a specially bred animal, and it should help serve as a resource to facilitate the elimination of genetic disorders from animals whose health and welfare could be in jeopardy.

(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 DrFoxVet.com.)

DEAR DR. FOX: Do you think rabies vaccinations are necessary? I have always given my dog the shots every three years, but since the last one, I have been avoiding all immunizations. I am trying to be more holistic with her.

My boyfriend said he never gave his dog any shots, and he fed her only the cheapest dog food. She lived to be 18 years old. My town is having a free rabies clinic in a few weeks, so I need to know before then. -- M.B., Scranton, N.J.

DEAR M.B.: The law is the law, and if your dog is ever lost and has no rabies tag or accidentally bites someone, you could be in deep trouble. Rabies vaccinations are mandatory in many communities across the U.S.

I, too, am concerned about adverse vaccination reactions. The American Veterinary Medical Association is working on a protocol for veterinarians to provide certificates for animals who are at risk of developing adverse reactions to the anti-rabies vaccination, and, therefore, should not be vaccinated.

At this time, you can have your veterinarian do a blood titer reading to determine if the three-year vaccine is still providing a high enough level of rabies protection to prove revaccination is not needed for your dog. A statement to that effect written by your veterinarian should satisfy public health authorities if the vaccination status of your dog is questioned.

DEAR DR. FOX: My vet recommended my cat, Bob, have a dental cleaning and an extraction of at least one tooth due to a resorptive lesion. We do not want to risk putting him under anesthesia because he has hypertrophic cardiomyopathy and an arrhythmia. He was diagnosed with asthma and is being treated with the Flovent inhaler.

Are the ingredients in PetzLife oral products safe for our cat to ingest? What are the results of using PetzLife on a resorptive lesion? We were told that the tooth would rot and eventually fall out, possibly causing a lot of pain and maybe an infection. Have you seen other cats with resorptive lesions use this product? Any other inforomation you could give me would be appreciated. -- C.W., Washington, D.C.

DEAR C.W.: This possible autoimmune disease, namely the tooth resorption, is a complication of stomatitis -- check my website and archives therein for more details: www.DrFoxVet.com.

In my opinion, your cat is at greater risk from anesthesia than from giving him a daily treatment of PetzLife oral care gel or spray. Simply follow the manufacturer's instructions, applying a small quantity to you fingertip and rubbing it on your cat's gums, making sure to get between the teeth and gumline to help your cat get used to this treatment. Remember, more is not better for any medication. This treatment will help reduce inflammation and infection, and it may actually help arrest further tooth resorption. Let me know if this turns out to be the case.

For his heart, and also to help his dental problem, get him used to a few drops of Nordic Naturals fish oil for cats, working up to about 1 teaspoon daily. Discuss with your veterinarian giving Bob benazepril and a CoQ10 supplement.

Many cats diagnosed with "asthma" actually have a food allergy. You may want to transition your cat onto organically certified, grain-free cat food. For details, visit www.felinenutrition.org.

A READERSHIP REQUEST

Many of you dear readers have written to me in the past, documenting how various dog and cat health issues have cleared up dramatically once your pet's food has been changed to exclude corn and soybean products. I would like to hear from other readers who have had similar experiences, sharing with me what the animal's condition was, what it was being fed and what kind of new diet facilitated its health recovery.

(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 DrFoxVet.com.)