DEAR DR. FOX: Earlier this year, our golden retriever was diagnosed with ehrlichiosis. We were prescribed a pretty expensive routine of drugs and monthly vet visits, and we are not really getting any results. We cannot afford to give her all of the meds the doctor has prescribed. She is currently getting prednisone, Denamarin and Renavast.

We are supposed to be giving her more of the Denamarin and Renavast than we are, but it's already adding up to $300 a month. Are there any cheaper alternatives, or do you think we are fighting a losing battle? We have to force-feed her most days, but once and a while she will eat on her own. I do not know what to do anymore. We don't want to lose her, but things are getting financially problematic for us. -- J.H., West Fargo, N.D.

DEAR J.H.: This disease, transmitted by ticks such as the brown dog tick, can be treated when an early diagnosis is made. But treatment is a challenge when this tick-transmitted infectious organism that enters and multiplies in certain blood cells has proliferated too invasively into the dog's tissues and organs.

Fever, lameness, loss of appetite, abdominal pain, enlarged spleen and lymph glands, bleeding from the nose, eye discharge and swelling of the extremities are early signs of infection, which can be confirmed by blood serum tests.

Regrettably, your dog is in the chronic stage of this disease, which could lead to blindness, kidney failure or collapse from internal bleeding. Have you had a frank discussion with the attending veterinarian about your financial concerns? Some equitable solution may be forthcoming if you are open. A less costly treatment trial with one of the tetracycline drugs may be worth consideration. Above all, your dog's comfort and quality of life need to be considered when there is no relief from the chronic, complex consequences of this disease.

PET FOOD INDUSTRY REVOLUTION/EVOLUTION

Pet Products News International reports that, according to the GfK Group (a Germany-based global market research company tracking business in 11,000 United States pet stores), sales of grain-free pet foods have jumped some 28 percent over the past year.

More than $1.4 billion was spent on this kind of pet food for dogs, and some $322 million for cats in 2012. While this is a small fraction of the annual $21 billion-a-year pet food market, it is a significant change in consumer choice and demand, driving market availability. Much of this has to do with the pet obesity epidemic and other documented health problems in dogs and cats associated with high cereal content diets. (For details, visit DrFoxVet.com.) It is an issue of special concern for cats, who are obligate carnivores and cannot process cereals and other sources of starch, unlike most dogs.

I have long advocated a reduction of soy products in dog foods and their elimination from all cat foods. Pet owners should check the ingredients of grain-free pet foods that may use high-carbohydrate substitutes, such potato and pea flour, as a binder in dry foods.

I have also been a long-time advocate of organic farming. According to the Organic Trade Association, organic pet food sales are growing at nearly three times the rate of similar organic, USDA-certified human food sales. This is noteworthy because of documented animal health and environmental concerns about genetically engineered crops and foods. Some pet food and pet treat manufacturers are even including a "No GMO" or "GMO-free" label on their products.

These market trends indicate the power of informed consumers voting with their dollars to support a more healthful agriculture and human food industry, of which the pet food industry is a subsidiary. It's time for a revolution, since the catalysts for many changes are the diet-related health problems being seen in dogs and cats fed conventional manufactured pet foods.

(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: For 2 1/2 years, my dog weighed 49 pounds and took heartworm medicine for dogs weighing from 25 to 50 pounds (Sentinel once-a-month tablets). Last week, she weighed 51 pounds, and I was told to increase to the 50 to 100-pound tablet. This seems like overkill, but the vet made a big deal out of it. Though she was covered just fine at 49 pounds, she's no longer safe since she gained 2 pounds.

What are your thoughts on this? -- M.K., Virginia Beach, Va.

DEAR M.K.: You raise an important question. I had the same conundrum with one of my own dogs and decided to feed her less and exercise her more when she crossed over from a svelte 47 to 52 pounds, which meant I could keep her on the smaller dose of Heartguard's ivermectin.

It is important in all states where there is a winter kill of mosquitoes to take dogs off this preventive medication and have a blood titer test done to make sure they are clear before resuming medication the next spring.

There are concerns that the heartworm parasite is developing drug resistance in some states, especially in the Mississippi River delta, so extra vigilance and not missing the monthly preventive medication are called for at this time.

DEAR DR. FOX: Do you recommend deworming cats? One of the three from a litter, now 9 months old, vomits after every meal. The other two are fine. -- J.V., Winston-Salem, N.C.

DEAR J.V.: Please avoid the temptation to make your own veterinary diagnosis, and take your cat to see a veterinarian if you believe your cat has worms because you have actually seen them. Cats and dogs who sometimes vomit or have loose stools are too often given over-the-counter worming medications by their owners, which, more often than not, cause more harm than good and are a waste of money because worms were not a problem. But this is not to ignore the fact that most kittens and puppies need worming with the right medication once the kind of worms they have are identified.

Similarly, people will buy various flea sprays, drops and pills whenever they see their pet scratching, making a wrong diagnosis -- cats and dogs scratch themselves intensely for reasons other than fleas -- even with fatal consequences for cats when given anti-flea preparations meant only for dogs.

YOUR END-OF-YEAR DONATIONS: AVOIDING CORRUPT CHARITIES

There has been much talk in the news about various charities, designated as nonprofit organizations, from those claiming to help war veterans to international disaster relief, that prove to be scams with little or no funds ever going to help the designated causes. Always make sure your donations are tax-deductible and go to a registered 501(c)(3) charity. For some guidance in this domain, visit charitywatch.org and charitynavigator.org. Also find some links to reputable nonprofit organizations on my website, DrFoxVet.com.

When it comes to animal and environmental protection organizations soliciting your support, some of the large ones are already well-funded by corporations and their spin-off charity branches or foundations. They may be limited in their effectiveness by conflicts of interest and by the need to maintain high executive salaries and slush fund travel expenses and other perks, some playing shell games with their accounting and accountability.

Remember, small is beautiful, and small, local groups and chapters of reputable larger nonprofits (such as the Audubon Society) are easier to support if you want to monitor your donations and not just send out some conscience money to feel good. Small organizations include your local animal shelter and humane society -- not to be confused with the Humane Society of the United States -- and wildlife rehabilitation and environmental education centers. Some larger nonprofits, such as the Animal Welfare Institute, Union of Concerned Scientists and Earth Island Institute, are reliably transparent. One must be especially cautious with those soliciting funds to help nonprofit organizations abroad. Find out if your donations are tax deductible and what percentage goes to actually help rather than paying for overhead expenses.

(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 articles in my local newspaper, and one in particular caught my attention.

I will try to make this as brief as possible:

I owned two cats, both indoor-only. One cat was domesticated when I got her; the other was a feral kitten someone found and gave to me. She was still young enough to tame, but even after age 4, she was still not very trusting.

Both cats got their yearly exam and shots, including one for feline leukemia. A few months after Lovely got her annual shots, I noticed that she was limping. I examined her right leg and found a large mass on her upper shoulder -- she has long fur, so it wasn't noticeable except by feeling. I took her to my vet, who did a needle biopsy and gave me some pain meds for her. The next day, after giving her the meds, her whole personality changed -- she hid all day and came out only at night.

The lump was cancerous, and her leg would have to be amputated. Trying to get her to the surgeon that morning was terrible -- she fought and tried to bite me. Finally, we were able to get her there. The surgeon told us that her personality change may be permanent and the stress of losing the leg would possibly make it worse. He also mentioned that the leukemia shot may have caused the cancer and that it may have spread to other organs. We made the painful decision to put her down.

After asking another vet and my own vet, they admitted that the leukemia shot would, in some cases, cause cancer at the site of the injection in the upper shoulder.

Please advise other owners of indoor cats that this shot is not necessary. When my other cat, Lady, was due for her shots, my vet, after all we went through, was still going to give her that shot; I said, "No!" -- A.M., Naples, Fla.

DEAR A.M.: According to veterinary literature, cancer (specifically fibrosarcoma) developing at the vaccination site is extremely rare, but it does occur. As a precaution, until nasal or oral vaccines are developed, the proper vaccination protocol for cats is to inject the vaccine as low down as possible on a hind leg. Amputation is then more feasible and less crippling than having to remove the cat's entire shoulder area and foreleg, as was the case with your poor cat.

I am surprised that your cat was vaccinated in the shoulder region. Certainly, the pain would have changed her personality. Also, the pain medication could have made her more fearful, as could the traumatic trip to see the veterinarian.

Send this reply to the veterinarian to change the vaccination protocol: inject a lower hind leg; do not prescribe feline leukemia vaccinations for indoor cats; separate giving rabies vaccinations from other vaccines for which blood titers can be conducted to determine if they are really needed.

A new protocol, which was suggested several years ago, of vaccinating in the tip of the cat's tail has been confirmed as being effective and safe by Dr. Julie Levy and her team at the University of Florida School of Veterinary Medicine.

DEAR DR. FOX: Amos is the sweetest, most loving cat we have ever had. He is intuitive and answers us when we talk to him, and he stays with us constantly. We adopted him in 2007, and he's now about 10 or 11 years old. He is a real joy, the center of our family and is admittedly spoiled rotten. He has had no real physical issues except with some of his teeth that had to be pulled about two years ago.

We were wondering: Why does he get up every morning at exactly 4:20 a.m. without fail? Daylight saving time does not seem to throw him off. He starts to meow up and down the hallway, then jumps on our bed to complete his mission. My husband, like any dedicated pet owner would do, gets up and plays with him, feeds him and then he promptly takes a good old-fashioned "cat nap." We have tried everything, such as closing the bedroom door, playing with him late at night, making sure he has kibble and water, but he is relentless until we get up.

We read in your column that some cats are calling for companionship from other cats when they cry out. Could this be the case, and is there anything we can do? He is such a joy and we get a kick out of his habits, but we could use a little more sleep. -- F. & P.S., Winchester, Va.

DEAR F. & P.S.: There's a time clock in your cat's brain that you clearly cannot reset. You may have found the only solution other than trying to ignore him.

When his brain says it's early to rise, it is telling him to go out to hunt and interact with other cats on their predawn roaming in the wild.

Adopting a younger cat may be the best solution. Providing your cat with a substitute for your husband to play with and race through the house while you both enjoy a less interrupted sleep could help all parites. Check my website, DrFoxVet.com, for the important steps you are advised to take when introducing a new cat into your home.

(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.)