DEAR DR. FOX: I bought a Maltese puppy for my great-granddaughter. The dog is about 3 years old.

He was very difficult to train, as I've heard this breed is. He has now started to pee and poop in the house.

We take him out, but he still pees in the house. We keep him confined to the kitchen now because he has peed on the TV stand, recliner, coffee table, etc. I can't get rid of him because my great-granddaughter is so attached.

Any advice you can give us will be appreciated. -- P.S., Chesapeake, Va.

DEAR P.S.: Maltese terriers and other small breeds do seem to have a higher incidence of cognitive impairment when it comes to toilet training, especially compared to other breeds.

This urination activity in your home calls for some analysis. If he is straining and having difficulty or pain while urinating, your dog may have a urinary tract or bladder infection or stones. A veterinary checkup is then urgently needed.

If he is raising his leg and marking, this could be hormone-related territorial behavior. There's also the probability that it could be anxiety-driven if there is some cause for emotional stress in his environment. Ask yourself if he is anxious for some reason, and address that problem. Is he taken out frequently enough? Does he need more attention and physical activities?

It could also be a habit triggered by the residual scent where he has urinated before. Use an enzyme cleaner on all soiled areas. Let him out of his kitchen confinement on a long leash and harness for control. Pull him up short as soon as he sniffs and readies to urinate. Carry him outside and put him on a pee-pee pad already marked with his urine (or placed in the kitchen). Be sure to give lots of praise and a treat after he urinates.

Many small breeds are amenable to pee-pee pad training (which is a blessing for apartment living). Check out thepetloo.com for an indoor toilet system for small dogs.

DEAR DR. FOX: I have a 5-year-old domestic shorthair spayed female cat who started to compulsively lick her stomach and the backs of her legs. It got to the point where she had licked off most of her hair.

The vet said there was no way to figure out why she was doing this and wanted to put her on a behavioral medication. Before going this route, I tried changing her food from one with chicken as the main ingredient to one with no chicken at all. Within a week of the diet change, my cat had stopped the obsessive licking.

It has been about six months since the diet change. I have been observing her closely and have not seen any obsessive licking, but her fur is still very thin. It grew back a little, but not much.

Do you have any suggestions for anything I might add to her diet to help with fur growth, or is this how she is going to look from now on? -- J.K., Mount Rainier, Md.

DEAR J.K: I applaud your initiative and regret the limited scope of possible causes and treatments your veterinarian offered.

Hypersensitivity or allergic reaction to certain ingredients in the cat's diet and hyperthyroidism are two considerations to be ruled out before making a behavioral, anxiety or obsessive-compulsive disorder treatment decision.

It is quite possible that there is some ingredient other than chicken underlying your cat's malady. It could also be compounded by the beginnings of thyroid disease -- hyperthyroidism is very prevalent in cats who groom themselves excessively.

Fish oil, wild salmon and mackerel, or sardines rich in omega-3 fatty acids can do wonders for cats' dermal health, helping make for thick, lustrous coats. Always introduce any new supplement or food ingredient gradually, beginning with a minute amount mixed in with regular food. Also note that some cats are allergic to fish, so organic, free-range, grass-fed beef and butter can be good omega-3 sources.

(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: I lost my German shepherd/chow mix and my Great Dane/Lab mix to cancer within months of each other last year. I immediately adopted Buddy, a 4-month-old golden retriever/Lab mix, from a no-kill shelter because I love big black dogs, and I know they have a horrible time finding homes.

I took him to the vet because he had a sore on his back leg and one on his penis. I wanted to make sure that he did not have ringworm. (He didn't.) The vet looked at some skin scrapings under a microscope and told me that he had a bacterial infection. She prescribed cephalexin. Buddy got diarrhea almost immediately after taking the medicine. His stool wavered between soft and loose. I stopped the cephalexin and called the vet. The vet put him on PVD FortiFlora Canine. The next day, his vet was off duty, but another vet put him on metronidazole. The stools were firmer after five days, so I stopped the pills.

After 24 hours, the soft/loose stools returned. I put him back on the metronidazole for several days. I called the vet to renew the prescription, and this vet informed me that the normal dosage should have been four times the amount I had been prescribed, so she changed that for him.

He was perfectly fine until the cephalexin. One of the vets suggested he be examined again, but I am not sure what good this would do. I seem to get different answers depending on which vet I speak to that day. I gave Buddy probiotics all of this time. Can you help? -- K.W., Imperial, Mo.

DEAR K.W.: I am shocked that the veterinarian prescribed such a powerful oral drug as cephalexin rather than treating the skin infection with a topical ointment.

Clearly, the cephalexin wiped out some of the beneficial bacteria in your dog's digestive tract, causing dysbiosis or bacterial population imbalance. The corrective treatments prescribed were appropriate.

I would give your dog a good-quality probiotic twice daily, along with a prebiotic such as inulin (not insulin) and digestive enzymes. Herbal preparation of marshmallow root, chamomile, aloe vera and cramp bark may help alleviate the diarrhea. Glutamine, N-acetyl glucosamine, lecithin and montmorillonite clay or calcium aluminosilicate are all potential remedies for this kind of diarrhea.

Avoid food with soy or grain. For more details, including my home-prepared dog food and treat recipes and a dog food quality scoring system, check my website, DrFoxVet.com.

DEAR DR. FOX: I am writing for your advice on food for my 16-year-old male cat, Chester. He's feeling the effects of his age with constipation and less-than-ideal kidney function (but not in the danger range yet).

The vet wants to put him on prescription low-protein dry food, either Iams or Science Diet. I'm not a fan of dry food or of those brands. Based on your column's pet food suggestions, Chester has been happily eating Evo moist food with pumpkin and fish oil added for several years.

Do you have any suggestions for alternatives to prescription low-protein food? Anything homemade? What is your opinion of giving constipated cats a laxative? -- M.S., McLean, Va.

DEAR M.S.: I would think twice about forcing an old cat onto a new, unpalatable diet he may loathe, which can make him suffer hunger pangs and a lowered quality of life.

While some of these prescription-only special diets can be beneficial, they are highly profitable and tend to be relied upon too much as the best remedy for various pet ailments.

I would never put a cat with kidney disease who likes moist, canned foods onto an all-dry diet. Low-protein diets are not advisable when the kidney disease causes more protein to be passed in the urine. Supplements such as fish oil (which your cat enjoys), potassium, vitamin D3 and a phosphate binder such as Renagel (under veterinary supervision) should help. The tasty product Laxatone and abdominal massage should help alleviate your cat's constipation.

UNIQUE VETERINARY CALENDAR

The 2013 Dr. ShowMore calendar is a "Calendar Girls"-style calendar featuring 17 holistic veterinarians from all over the world in tasteful, artistic, au naturel photographs with their beloved animals. The Dr. ShowMore project is part of the Center for Integrative Veterinary Care Inc., a nonprofit organization dedicated to education and outreach. One hundred percent of all proceeds will be donated toward veterinary student scholarships. The price, $15, includes shipping and handling. Visit DrShowMore.org to place an order.

(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: We first wrote to you about our dog Loki in 2008 after we had rescued him from the Animal Care & Control of NYC shelter. He was described as a 5-year-old collie mix. He was actually more like an 8-year-old Lab/pit bull mix, according to our vet. He was very anxious and seemed to be longing for a lost owner. Your response to us helped immensely.

Our reason for writing now is to ask how we can determine Loki's current quality of life. From our vantage point, he seems happy -- but he is blind, often confused and has been diagnosed with Cushing's disease. He is now probably about 13 years old. He weighs 90 pounds, but should weigh 80 pounds.

In 2010, Loki had a benign mast cell tumor removed. In February 2011, he was diagnosed with Cushing's. The next August, he went blind. After a thorough exam by our vet and a canine ophthalmologist, no cause could be found, but the condition -- bilateral optic neuritis and chorioretinitis -- was deemed irreversible and not treatable. It was surmised the pituitary tumor may have grown to impact the retinal nerves.

We do not want to give up on Loki. He responds to us with vigorous tail wags and eats your recipe for homemade food well. He knows his way around the house, but is totally disoriented outside. He is loved and pampered by the entire extended family.

Our vet prescribed tramadol tablets if it seems he has pain, but we really don't know. We have been mildly criticized for keeping Loki alive this long.

What is your opinion? Our vet is noncommittal. We value your suggestions and always appreciate your compassion for animals. -- J. & M.H., Poughkeepsie, N.Y.

DEAR J. & M.H.: Yes, I remember your earlier letter concerning Loki because that happens to be the name of an elephant with whom my wife, Deanna Krantz, became involved in India, resulting in an international controversy.

I regret that your veterinarian is behaving in a noncommittal way. I have had some bad experiences with dogs on tramadol, which can make them more anxious/agitated. Three or four drops of lavender oil on a bandanna may relieve some of your dog's anxiety. A daily full-body massage, like in my book "The Healing Touch for Dogs," an occasional buffered aspirin (with food) and a daily teaspoon of fish oil in his food may help alleviate inflammation-associated pain.

As long as he enjoys life, continues to cope with his loss of vision, feels secure and responds to all the TLC you can give him, I feel euthanasia may be premature. In some communities, there are veterinarians who do in-home hospice care supervision. Perhaps you can find one.

PRIORITY TOTAL PET CARE TREAT RECALL

Carolina Prime Pet Inc. is voluntarily recalling its Priority Total Pet Care All Natural Bullstrips in five-count packaging. This product has yielded a positive result for salmonella when tested by the Colorado Agriculture Department. No reported cases of illness have been related to this product. Priority Total Pet Care All Natural Bullstrips, which are made from bulls' penises, are sold in Safeway, Vons, Pavilions, Pak N Save, Randalls, Tom Thumb, Genuardi's and Dominicks stores.

Customers who purchased the recalled dog treats should discontinue use immediately, and return the items to the purchase location.

For further information, please call Carolina Prime Pet Inc. at 888-370-2360.

(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.)