DEAR DR. FOX: There are several points that are continually overlooked by those who take an anti-Trap-Neuter-Release (TNR) position. Most caregivers of outdoor cats want nothing more than for each cat to have a loving family of his own. But if we don't take the first critical step in halting an outdoor cat's ability to reproduce, we are fighting an uphill battle. The other reality is that "a loving family of his own" is not possible for every outdoor cat.

While there are times when feral cats can be socialized, it is unrealistic to expect shelters (or people) to have the resources of space or time to allow for this. In the time it takes to socialize one feral cat, countless more could have gone through TNR, significantly reducing the overall number of wild cats. The insistence that caretakers adhere to detailed definitions of appropriate levels of colony care is not reasonable. If the laws already in place in so many states were adhered to (licensing of pets, prohibition of cats roaming at large, illegality of pet abandonment), we would not face this problem.

The only alternative to TNR is to catch and kill, and that option is never going to get endorsements from compassionate people. Rounding up and killing healthy outdoor cats who have become more comfortable with an "alternative lifestyle" (outdoors with little human contact instead of the social structure we have tried to define for cats) runs counter to the definition of a civilized society.

People who do not accept feral cats for who they are and the lifestyle they choose demean them. Those who turn the other way and make no attempt to help these cats demean them. Caretakers who responsibly practice TNR and respect the feral cats' distrust of humans but acknowledge their definition of a quality life are doing anything but demeaning them. -- K.L., Virginia Beach, Va.

DEAR K.L.: I appreciate your concerns about feral cats and those who oppose TNVR -- Trap-Neuter-Vaccinate–Release. Your argument is convincing from the point of view of considering "the lifestyle they chose." But these cats have no real choice in the matter and follow innate survival instincts that include predation on wildlife. And, when they become sick or injured, they must still fend for themselves. In my opinion, this is a tragic situation that is caused by irresponsible people letting their un-neutered cats out and feral cat populations becoming established. Capturing and euthanizing a few for the greater good may still be the most humane and ethical response to this nationwide problem, along with public education and better enforcement of laws prohibiting owners from allowing their cats to roam free.

DEAR DR. FOX: I have an 8–month-old Shih Tzu puppy who likes to eat only poor-quality dog food. If I buy the food recommended by our vet, she turns her nose up at it. I purchased different brands of canned food to see if she would eat it, and the one she prefers is Gravy Train beef and bacon. After doing research online, I found out that Gravy Train is considered a very poor-quality food. I mixed her Iams food in with the Gravy Train and she wouldn't eat it.

I talked to my vet about her finicky tastes, and he told me to put the high-quality food in her bowl and quit stressing over it: "She won't starve."

I want her to be healthy. How can she go 24 hours without eating? Help! -- J.P., Lancaster, Pa.

DEAR J.P.: If your dog checks out in perfect health with the veterinarian, then the picky eating issue is probably psychological.

Many dog food manufacturers conduct palatability tests on certain ingredients that amount to a corporate goal of triggering the equivalent of food addiction -- regardless of the nutritional value of the main ingredients. For details, see my book, "Not Fit for a Dog: The Truth About Manufactured Cat & Dog Foods."

Try making a gravy of the poor-quality food your dog prefers and the good food. Then back off and leave the dog alone. The more you fuss or stand there monitoring the dog, the more anxious she will become. If she refuses to eat, put her food bowl away, and offer it to her later. The food should not be chilled.

(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 enjoy your column and often find interesting things that apply to humans as well.

One thing I have been curious about for a long time is spreading tooth decay. There have been reports that a mother kissing her baby can transfer saliva that can give the child dental caries (decay), especially if the mother has untreated cavities. The reports say sharing a spoon can also spread this.

Many people kiss their pets. Some people might use a used dinner spoon to scoop out wet cat food. And I have some great pictures of a relative's German shepherds with their heads in the dishwasher licking the plates. Do you think that pet cavities might be caused from interacting with humans in this way? I was not able to find the original study for the child/mother cavity information. -- S.G., Sandy Hook, Conn.

DEAR S.G.: Basically, saliva heals, and the exchange of oral, fecal and body-surface bacteria is an essential part of any infant animal/human developing a healthy bacterial flora. The infant comes in contact with this bacteria when interaction with the mother and through contact with others and the soil.

These good bacteria play vital roles in immunity, disease and allergy resistance, digestion and other physiological processes. The bacteria is currently being investigated with some surprising findings, even indicating dysbiosis -- a dysfunctional "microbiome" bacterial population in the guts -- plays some role in obesity and depression.

Certainly if the microbiome is not yet well developed in an infant, the introduction of harmful bacteria, as from a shared spoon with a parent, could be problematic.

My book "Healing Animals & the Vision of One Health" explores such connections and more in an integrative approach to wellness. We should be concerned especially with the continued, wholesale use of antibiotics by the livestock industry and harmful pesticides by industrial agriculture.

DEAR DR. FOX: I have two Persian cat brothers who were purchased together as kittens. They will be 3 years old in November. One of them has a problem: For almost a year now, he will not use the box when pooping. He continues to go on the carpet. He didn't have this problem before, but it has become an everyday thing. He never urinates outside the box, and he seems to know when he poops on the floor that he has done something wrong, because he runs and hides for a while.

I have tried everything: picking it up and putting it in the box; scolding him when I catch him and then gently bringing him over to the box; changing the litter to a different brand; cleaning the boxes every time one of them uses it. I have three different boxes. Neither cat covers what they do in the litter box, whether it is urine or poop. They scratch around the box or even on the wall, but not the litter. Must be a Persian thing.

I would appreciate any help you can give me. -- D.R., Newtown, Conn.

DEAR D.R.: According to other people who have Persian cats, not covering excreta does seem to be a problem with the breed. Persians have long fur and "feathers" around their hindquarters, which can get matted with cat litter, not to mention the litter getting trapped between their paws. This can be a deterrent for the normal covering-up behavior. Try a litter like Purina's Yesterday's News (recycled newspaper pellets) that I have found to be less cat-adhesive than many others.

Many cats choose to defecate outside of the box because they are constipated and they associate the pain of evacuating with being in the box, so they develop a litter box aversion. Feeding your cat moist food and a teaspoon of pumpkin or mashed butter beans may help soften the stools. You can also try the mild and tasty pet laxative Laxatone.

(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 have a 7 1/2–year-old pit bull/terrier-mix. She is a rescue dog. We adopted her when she was 12 weeks old. These last two years or so, it seems like her stomach gets upset easily. Often, she doesn't eat and just lies around. Sometimes I give her Pepto-Bismol, and sometimes she will eat a little of a certain grass that makes her vomit, then she is ready to eat.

Daily, I give her boiled chicken, green beans, dry food, her multivitamin (half of an adult tablet) and garlic juice, which she gets only in the morning. I can't figure out what is upsetting her stomach so often. I have caught her eating bunny and squirrel poop in the yard, but she doesn't get an upset stomach every time.

She loves raw pasta. I give her maybe 12 pieces of the no-yolk kind a day. The only other thing she will get is Pup-Peroni when we leave the house as positive reinforcement. Is there anything else I could add to her diet to cause her to not want to eat the poop?

My other question concerns her anal glands: I have to take care of them once a month like clockwork, and they are usually full. You mentioned something about an allergy or intolerance. The dry food I purchase is Purina One with lamb, rice and soft morsels in it. Is that why she can't release her anal glands on her own? -- G.S., Cedar Hill, Mo.

DEAR G.S.: If you are giving your dog the garlic juice on an empty stomach, this could be the problem. I would cut out this supplement and the snacks and transition her onto my home-prepared diet (available on my website, DrFoxVet.com). Also try my buckwheat dog treat recipe.

Many manufactured pet foods contain various food industry byproducts and other ingredients not always indicated on the label. Food hypersensitivity/allergy can manifest is chronic ear and/or anal gland disease. I would certainly avoid any manufactured food that contains GMO (genetically modified) ingredients such as corn and soy. Consider transitioning her onto a raw food diet such as Bravo or some of the whole-food and organic dog foods listed on my website.

The poop eating may indicate a nutritional deficiency, so she may benefit from a daily teaspoon of brewer's yeast and a probiotic supplement in her food. You can use live bacteria-rich organic plain yogurt or kefir as a backup.

DEAR DR. FOX: I have enjoyed your column for many years. You often get letters from people dealing with their cats who have symptoms of feline urinary syndrome. I had a cat who displayed those symptoms and, though no stones ever needed to be removed, I drove to the emergency hospital late at night on more than one occasion because I believed he would not live until morning.

I came across a book about cats and vitamin C, and the vet who wrote it suggested giving sodium ascorbate to cats for FUS. Sodium ascorbate, as you would know, is vitamin C buffered with salt for easier digestion. The book even gave recommended quantities based on the cat's weight. I gave my 12-pound cat 1/8 teaspoon mixed into his moist food every day for the rest of his life, and he never had any more problems with FUS. I found a vet who, when I told her I was giving my cat sodium ascorbate, responded, "Good idea, keeps the urine nice and acidic."

In learning about human natural medicine, I learned that for either diarrhea or constipation, bran flakes are effective. When my cat was straining to defecate and I took her to the vet to get checked out, the doctor said that one can treat a cat the same way as a human for constipation. I bought some bran flakes and now I mix a teaspoon in with my cat's moist food every day. Stools are softer and leave her body easier.

I really hope these natural and inexpensive treatments don't die with me. I don't hear veterinarians these days prescribing these simple "cures" found at any natural food store. -- D.S., St. Louis

DEAR D.S.: I hope that veterinarians and cat and dog owners will take note of your personal testimony of the benefits of such natural products for some serious health conditions in companion animals.

Vitamin C is a natural acidifier, which can help dissolve and prevent struvite crystals/calculi but may not be of benefit when animals have oxalate or other kinds of urinary tract-blocking calculi. Veterinarian Dr. Wendell Belfield was one of the first, I believe, to recognize these and other benefits of vitamin C for companion animals.

Bran can be effective, but I prefer psyllium husks, presoaked in water. When animals are on a dry food diet and don't drink enough water, bulk laxatives can aggravate constipation.

(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.)