DEAR DR. FOX: Should a booked vet offer referrals? Our son's 14-year-old chow suddenly had problems standing on her back legs. When I helped her up and released her, her back legs buckled.

I called our vet for an appointment on a Friday, but was told there were no appointments available until Tuesday. I asked for a recommendation. The person taking the call said that without seeing the dog, she had no idea what to recommend. I said that I meant a recommendation of another vet. I was told I'd have to "call around." We have had this vet since 2001 when we moved to this area. I Googled other vets in the area and found one who took her immediately.

Am I wrong to be so disappointed in my vet? Shouldn't I have, at least, been told about emergency animal hospitals in our area? There were two vets at our office, but the original one has recently retired. -- P.K.P., Scranton, Pennsylvania

DEAR P.K.P.: No veterinarian who has been seeing a client on a regular basis has any excuse for not advising, personally, over the phone or through an assistant, what to do when there is an emergency like yours, and where to take the animal if she is fully booked with appointments. You should let her know your concerns so that this will never happen again in that veterinary practice.

POISONOUS WATER WORRIES

In early August 2014, 400,000 people in Toledo, Ohio, could not drink, bathe or cook with municipal water because of a blue-green algae bloom in their water source, a shallow part of Lake Erie. Waters polluted by phosphate and nitrogen run-off from farms and sewage treatment plants trigger such blooms. Blue-green algae (also known as cyanobacteria) produce various toxins, called cyanotoxins, which rapidly destroy the liver, causing acute illness, coma, seizures and death. Recovered animals can become sunlight sensitive, losing skin on their ears and backs, especially after exposure to sunlight.

This human-exacerbated water quality problem is likely to get worse with climate change and agricultural expansion with ever more agrichemicals being put on the land, many of which end up in surface waters without adequate buffer zones to limit runoff.

While ruminant animals (cattle and sheep) and birds are more sensitive to these toxins than monogastric animals like pigs and dogs, dogs frequently pick up cyanotoxins when allowed to drink from standing water and suffer the consequences. For more details about pure water and hazards in our drinking water, check my website, DrFoxVet.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: I noticed in a recent column that the Florida couple with the frantically grooming cat had recently done a lot of home renovation. Their cat's sudden licking problem could be related to new materials introduced in their home renovation.

We had a wonderful, well-adjusted Burmese who suddenly started twitching and licking as though he had biting insects on his body. Our vet checked him for insects, did a skin biopsy, tried him on a rotation diet and gave him a short course of prednisone. He found no insects or skin condition, and neither the diet change nor the prednisone had any effect. We tried other vets without getting any relief for him. He struggled with the problem for several years before he passed away at 16.

A few years ago, I read an article about new carpets being a culprit in allergic reactions. This reminded me that after our new wall-to-wall carpet was installed throughout the second floor of our house, I could no longer walk on it barefoot or my feet would itch. I don't know why I didn't connect this with our cat's frantic licking, which started around the same time.

Our cat spent most of his days sleeping in the sun on this carpet, often upside down. He always seemed to improve when we traveled with him, but we couldn't figure out why. You may want to advise your readers that there are other common sources of allergens besides food, and new carpets are among them. Thanks again for your column and for all your wise counseling. -- C.P., Neptune, New Jersey

DEAR C.P.: Yes, new carpets emitting formaldehyde, flame-retardant bromide chemicals and other potential endocrine disruptors and allergens, not to mention inhaled small fibers, volatile chemicals and chemical residues in dust can be a household health hazard problem for cats and people alike. I have often mentioned this in my column, and more than one cat owner like you has had problems like yours. Use throw rugs and nonsynthetic rug materials (cotton, jute, hemp and wool) since synthetics build up a static charge, which can cause discomfort.

DEAR DR. FOX: Our shih tzu acts like he's getting goosed regularly. He suddenly jumps and runs away.

What should we check for? He eats Wellness Weight Control and Merrick's canned dog food as a topper on his dry food. -- J.P., Winston-Salem, North Carolina

DEAR J.P.: I am glad that you did not simply laugh off your dog's behavior. It could be a blocked, infected or even cancerous anal gland. Another possibility that's not uncommon in dogs with docked tails -- a routine mutilation of many breeds, which I abhor, but is rarely done on shih tzus -- is pain in the stump of the tail. This is often diagnosed as "phantom tail," or an amputation neuroma. I advise a veterinary checkup. His tail could also have been trapped accidentally in a door or trodden on, resulting in chronic pain from bone and ligament injury.

In rare instances, dogs develop a conditioned response when they start to drink or eat, quickly spinning around and biting at their tails. This bizarre behavior may have a physical cause, or it may be purely psychotic, as though another dog was slinking up to steal the food.

DEAR DR. FOX: I keep hearing that it's not safe for a person to give his dog ice cubes. My family has had animals for more than 40 years, and most of them at one time or another has had an ice cube. -- A.S., St. Louis

DEAR A.S.: Ice cubes are great for dogs, but all in moderation. Gulping one down could cause accidental choking. Eating too many could possibly harm the stomach lining or cause problems for a dog with a damaged stomach or esophagus from acid reflux or esophageal abnormality.

I would offer a little crushed ice on occasion, especially in hot weather, and a bag of ice cubes on the back and tummy can help cool down an overheated dog.

DEAR DR.FOX: I am desperate for information. My cat has just been diagnosed with inflammatory bowel disease.

In May 2013, she started vomiting after eating. I have 13 cats, and it took some time to figure out who was vomiting. She weighed 14 pounds in 2013. She now weighs 9.5 pounds. My vet performed an endoscopy and colonoscopy last week and also took biopsies. The biopsy histopathology report indicated IBD. They now want to put her on prednisolone for 14 days. Approximately one month ago, I transitioned her onto PetGuard organic food from Wellness (per my local holistic vet). She is still vomiting, but not as much.

I am desperate for any information you can give me. I prefer to treat her with holistic or natural methods; however, she is wasting away, and my vet says she needs the prednisolone to stop the inflammation and calm down her immune system in order to stop the weight loss. I would appreciate any help you can give me. -- B.D., Springfield, Massachusetts

DEAR B.D.: This is an all-too-common condition in cats today, and I would bet that in her old food, there was corn, soy and carrageenan (a thickening agent widely used in canned cat and dog foods), which most likely contributed to this disorder. For details, check my website for information about this additive.

Inflammatory bowel disease is costly to owners (though highly profitable for veterinarians) and stressful on cats to accurately diagnose and differentiate from other similar conditions. There may be an autoimmune element. With inflammatory bowel disease, irritable bowel and leaky gut syndrome (an allergic or hypersensitivity to certain dietary ingredients) may develop. This is why a short course of prednisone therapy is advisable.

Supplements such as anti-inflammatory fish oils, probiotics and prebiotics may be helpful. Transition your cat onto a GMO-free organically certified grain- and soy-free diet, and consider fecal implants from healthy cats. For more details, check my website, DrFoxVet.com.

LIKE IT OR NOT, YOU SUPPORT THE PET FOOD INDUSTRY

Susan Thixton (truthaboutpetfood.com) reports: The Pet Food Institute (PFI), the trade association that represents the largest manufacturers of pet food in the U.S., received $1,361,288 in 2014 from a United States Department of Agriculture foreign agricultural service program. Your tax dollars are supporting PFI.

(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 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.)