DEAR DR. FOX: I adopted two cats from the Humane Society 5 years ago. The brother and sister were kittens at that time. They were both neutered at 6 months. Two years later, my male cat had a complete blockage of his urinary tract. It cost almost $1,000 to get him back to good health. They are now both on Royal Canin Urinary SO dry food.

In the last week, I have noticed two occasions where one of them urinated outside of the litter box by my bed, on the bed skirt and on the carpet. I don't know which one it is, but I am suspecting it is my male cat. I like to keep my windows open slightly at night to allow fresh air in. But we have stray cats wandering in the yard at night, and my male cat gets very agitated.

Could this be his way of marking in response to the cats outside? I will be taking both of them to the vet next week to rule out any medical conditions that could cause this. -- M.C., Scranton, Pennsylvania

DEAR M.C.: You are not alone in having your cats disturbed by other cats outdoors. Seeing, smelling and hearing free-roaming cats outdoors can be very stressful to indoor cats who may begin to fight with each other and become stressed to the point of being motivated to spray-mark their indoor territories and even develop stress-related conditions, such as cystitis.

This is why, in addition to helping prevent the demise of wildlife from cat predation, all cat owners should keep their cats indoors if they do not have a cat-proof yard or patio. Municipalities should have laws prohibiting such irresponsible cat ownership with significant fines after a one-time warning. But it is difficult to find which homes free-roaming cats come from, some having no homes because they are lost or feral.

You will have to keep your widows and shades closed from early evening until morning. Use an enzyme cleaner where there are cat urine stains, and get some organic catnip to help calm your cats. Not all cats enjoy this herb, but many do. A quarter-teaspoon per cat should suffice early in the evening.

DEAR DR. FOX: Every weekend I read your column, and many times people talk about the desperation to find something to alleviate the side effects of their animals' allergies. I, too, have faced this with our 18-year-old poodle until our vet was informed about the new drug Apoquel. This is administered twice a day for two weeks, then reduced to once per day thereafter, and the dosage is decided by weight.

While there were minimal side effects, they were not serious, and they diminished once the dosage was reduced. Through time, they have totally disappeared. It has made an amazing difference in the quality of life for both my dog and myself.

Please mention this drug so other people can get the same relief from the never-ending turmoil associated with allergies. -- M.M., Palm Beach, Florida

DEAR M.M.: In my opinion, Apoquel (oclacitinib) from Zoetis, which was approved for use in dogs by the Food and Drug Administration in May 2013, should be used as a last resort because of potentially harmful side effects. Alternative treatments, including elimination and single-protein diets, and supplements should first be considered. In many cases, a transition onto an organic, GMO-free diet -- and balanced, raw food diets in particular -- can work wonders. But cases of allergic skin disease and atopic dermatitis can be devastating to both dogs and their caregivers. This drug can help in some, but not all cases.

The manufacturer states: "In clinical studies, the most common side effects observed in dogs treated with Apoquel were vomiting and diarrhea. Other reported side effects included lethargy, decreased or lack of appetite, skin irritation or infection and ear irritation or infection. Apoquel may increase the susceptibility to infection and demodicosis and may exacerbate neoplastic conditions. While most current therapies are broad-based agents, Apoquel is uniquely targeted to stop the itch and inflammation associated with allergic skin disease. It is a selective inhibitor of the Janus kinase (JAK) 1 enzyme, a protein that is integral to the signaling pathway that results in itching and inflammation. Its novel mechanism of action on the JAK enzymes is specifically designed to target the pruritogenic (itch-triggering) and proinflammatory pathways involved in the itch cycle, allowing control of the signs of allergic disease."

The company reports that the product was effective in 67 percent of dogs suffering from allergic skin disease and in 66 percent of those with atopic dermatitis. With careful monitoring for potential side effects after alternative treatments have failed, this drug may indeed be a small miracle for many suffering dogs.

(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: When my son was in grade school, he enjoyed the animals they had in his classroom -- a rabbit and a couple of gerbils. He's older now and wants a ferret. You don't write much about these kinds of small pets in your column, but my question is: Are there any alternatives to having a female ferret spayed? It seems extreme since we will only keep one, and she won't have a chance to breed. -- P.K., Norman, Oklahoma

DEAR P.K.: I rarely receive letters concerning cage and aquarium animals, be they rats, hamsters, lizards, parakeets or tropical fish. Part of the reason, I suspect, is that many people now find answers online -- some possibly from not the most reliable sources. Others just see the animals as cheap and replaceable, the more expensive ones being taken to "exotic" animal veterinary specialists.

In this category of animals, significant improvement in their care is called for; too many live solitary lives in impoverished environments. Many die prematurely, often before they leave the pet supply stores. Others, for various reasons, are set free, and if they do survive, they can harm the balance of nature (like in Florida with the python). For a detailed critique of this market industry, see veterinarian Charles Danten's book, "Slaves of Affection: The Myth of the Happy Pet."

I am also aware of the plight of many animals kept in schools, who lack proper care over weekends and vacations, and, as Dr. Danten emphasizes, even with the best teachers, the "educational experience" is primarily one of acceptance of animal confinement and exploitation. There are better ways to teach children respect for other living beings.

The American Veterinary Medical Association estimates that 748,000 ferrets are kept as pets in the United States. If they are not kept for breeding purposes, the females must be spayed; otherwise, they keep coming in to heat (mating breaks the heat cycle). This leads to a form of fatal anemia called irreversible pancytopenia. Males are neutered to reduce musky odors as well as to prevent mating. These are good examples of the welfare and health issues of taking in various species not adapted to conditions of domestication or captivity, which deprives them of basic social and environmental needs.

Research on a sex hormone-inhibiting, long-acting implant is progressing as an alternative to surgical sterilization. Side effects are yet to be determined. The harmful side effect of surgical neutering in both males and females is all too common, namely Cushing's disease (hyperadrenocorticism), which can mean chronic suffering and costly treatment. The hormonal imbalance caused by neutering is thought to be the cause, and this condition is not uncommon in neutered dogs.

While ferrets are adorable, intelligent, curious and affectionate animals, I would think twice about getting one -- and two is better than one for their social needs. Never purchase a purposely bred animal; instead, adopt from your local animal shelter.

DEAR DR. FOX: My 12-pound puppy has had diarrhea for at least five months. Our vet has tried special food like Hill's z/d hypoallergenic diarrhea powder. She's also been on prednisone and some antibiotics. At this point, I don't know what I can do anymore. She is otherwise a happy little puppy who seems to enjoy her life. Please, any help would be appreciated. -- S.S., Naples, Florida

DEAR S.S.: In my opinion, you need to find a veterinarian who will take a more holistic approach to your young dog's potentially debilitating condition. This would include, after ruling out internal parasites and bacterial infection, providing digestive enzymes, probiotics, prebiotics and an elimination diet to rule out a food allergy. For details on this diet, and my home-prepared dog food recipe, which might be the best solution, check my website, DrFoxVet.com. Do be sure there is no carrageenan in the canned dog food and soft treats, because this thickening agent can cause serious bowel problems in dogs and cats.

I am disturbed that antibiotics and prednisone were used on your pup without any evident diagnosis, which I am sure you would have shared with me. Such treatment is likely to make the condition worse.

Some holistic veterinarians, like more and more human doctors, are discovering the benefit of fecal transplants (via a rectal enema) in patients with chronic diarrhea caused by a variety of conditions. To find a holistic veterinarian in your area, a searchable list can be found at holisticvetlist.com.

(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: What can be done to educate dog owners to not let their pets urinate on trees and in gardens near sidewalks in urban areas? I live in a densely populated area in downtown Washington, D.C. Residents try to keep their trees and gardens lush and healthy for the enjoyment of all. Repeatedly dog owners will allow their pets to walk in gardens or by trees to urinate. Damage is evident by wilting, trampled plants and distressed-looking trees.

The District built a very nice dog park nearby that could be used for such purposes.

Also, is it possible for pet owners to have their dogs use the curbs? Thank you. -- S.D., Washington, D.C.

DEAR S.D.: You raise a very significant environmental and public health issue. I lament the fate of many urban trees with little soil, stifled by concrete and brick sidewalks, poorly nourished, rarely watered, with poor root formation making them prone to disease and being toppled by wind storms. All should have large soil and gravel beds around them, which would do much to help dilute and biodegrade dogs' urine.

All dog walkers should be fined for not picking up dog feces, which is a public nuisance for footwear and can be a public health hazard, being a source of potentially harmful bacteria and viruses. 

Dogs, especially males, need to mark their routes or territories with urine, and fire hydrants and lamp posts, again with a large circle of gravel and soil around the base, should be preferred targets directed by the dog walkers.

The cavalier attitude and indifference of some dog walkers when it comes to preventing their dogs from evacuating on neighbors' lawns and plants give a bad name for dog owners who are more mindful and respectful. Neighborhood parks, primarily for children, should have designated, ideally off-leash, dog zones, and strict rules when it comes to cleaning up after dogs and not allowing aggressive or unmanageable dogs off-leash.

DEAR DR. FOX: Our Weimaraner has developed allergies to almost all foods. Her reaction is severe ear infections.

Blood tests show the only things she isn't allergic to re beet pulp, potatoes and eggs. Her next lower sensitivity is to chicken and turkey. Is there any help out there? She's even allergic to the super-hypoallergenic dog food from Science Diet.

My husband wants to have her destroyed because we are to the point we can't afford to keep up her steroid medicines while I'm in school. I need help to find something to feed this dog to keep her from getting so many ear infections.

Any help would be appreciated. -- D.K.H., Wood River, Illinois

DEAR D.K.H.: Weimaraners are extremely sensitive to vaccinations and can develop a variety of adverse reactions, which can impair their immune systems. So I would first advise no more vaccinations and no oral or topical anti-flea and tick drugs. Check my website, DrFoxVet.com, for more details.

Science Diet special prescription foods can be of help for some dogs, but they are not free of additives, preservatives and manufacturing plant contaminants. These can cause problems for some dogs.

An ear product called Zymox, available online, would be worth trying. Pure, organic olive oil can work wonders after washing the external ear canals with a solution of equal parts warm organic apple cider vinegar and warm water. Dry the ears well and apply the oil after an hour or so on a daily basis until the inflammation subsides.

A good hypoallergenic diet for many dogs is a mixture of white fish and potato, with one human multivitamin and multi-mineral supplement per serving; a few drops of flax seed or fish oil; 1 teaspoon of coconut oil; and try adding a little well-cooked sweet potato, blueberries and lightly cooked broccoli. Discuss this home-prepared dietary regimen with your veterinarian. Many veterinarians now provide special recipes for their clients' animals' various diet-related health issues.

(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.)