DEAR DR. FOX: I am writing to you after reading a recent column, where a cat owner stated that her 10-year-old cat's appetite had diminished. Yes, as you stated, a trip to the vet needed to be considered, as well as possible kidney disease.

However, I was surprised that you did not mention possible dental issues. Cats are notorious for hiding health issues, and teeth problems can be a real health concern. Also, just a visual inspection of the teeth often does not reveal the whole picture. Based on my own dental experience of having an abscess that did not show up on visual inspection, I suggested to the vet to have X-rays taken. My cat also had an abscess that had not shown up on visual inspection. He was eating regularly within a day.

A further testimony to having X-rays done happened in a conversation with a friend who told me that her friend had a cat who was not eating. The cat had every test possible, and a visual inspection of the teeth didn't detect any problems. The vet suggested the owner should have the cat euthanized, despite not knowing why it was not eating. I told my friend my story and how it helped my cat. She called her friend and the cat was taken to a different vet, X-rays were requested and sure enough, there was an abscess. Dental X-rays saved that cat's life.

So many cat owners never pay attention to the health of a cat's mouth, and I would like to see that addressed in your column. -- K.L.W., Mercerville, Virginia

DEAR K.L.W.: Your concern over dental abscesses in cats is, indeed, a red flag for cat owners and for veterinarians who may rely on visual inspection of the oral cavity of cats who have difficulty eating or who have stopped eating altogether. But I would be concerned if dental X-rays became yet another routine, add-on diagnostic procedure for cats who are off their food.

Careful observation of a cat's eating behavior and attempts to eat help in making a diagnosis and justification for dental X-rays, especially if a cat solicits being fed but then avoids the food or cannot chew but is still hungry -- this points to a possible dental abscess, periodontal disease or a fractured and painful tooth.

DEAR DR. FOX: We have an 11-year-old 62-pound female shepherd mix who is a sweet family pet.

She is drinking more water and beginning to have urinary incontinence issues at night. She is still peppy on walks and actually seems to have less stiffness in her joints -- without any pain meds or anti-inflammatories.

After an exam and blood work, the vet said it's probably Cushing's disease, since all tests for diabetes, infectious causes and kidney problems were normal -- her alkaline phosphatase and liver enzymes were up. The vet proposed a crazy day of diagnostic testing, giving Dexamethasone and testing blood every few hours.

I think the testing and treatment both sound too painful and stress-inducing, not to mention expensive. I think we will do nothing and enjoy and spoil her while we can. Do you have any insight into why this happened? -- A.F., Rockville, Maryland

DEAR A.F.: Cushing's disease (hyperactive adrenal glands) is all too common in dogs and does take time and expense to determine the right dose of medication to subdue adrenal activity. I know of no simple and effective herbal or other alternative medication, although some believe that vitamin C and melatonin may be beneficial.

This condition often develops in both male and female ferrets after they have been neutered, which causes a hormonal imbalance. The same may be true for neutered dogs; neutering after 1 to 1 1/2 years of age is less disruptive to the dogs' endocrine systems than neutering at an earlier age. This early neutering is an accepted practice in animal shelter adoptions because of overpopulation.

DEAR DR. FOX: My 40-year-old son has moved in to help care for my wife, who has Alzheimer's disease, and he brought his cat to live here, too. In two years, we fell in love with this little 14-year-old cat.

She recently started feeling ill, and our vet thought she might have a virus and prescribed a medicine for her. After a few weeks, she seemed well. Then, suddenly, she died.

My wife is incontinent and has bowel problems. My son feels that the cleaner he used on her urine and feces might have left a coating on the floors and the cat might have picked up some of that.

We would like to get another cat, but my son insists that cleaning up after my wife could kill it. Would you please offer some comments to help settle this issue? -- R.D.Z., Lakewood, New Jersey

DEAR R.D.Z.: I sympathize with your family caregiving situation, which must be demanding on many levels.

Considering the cat's age and moving into a new environment, such stress could have weakened her immune system, which would have then been impacted by the disinfectant that was used on the floor and other surfaces that the cat may have had contact with.

In the future, I would use a combination of 1 cup distilled white vinegar and 1/4 cup baking soda. This is a potent anti-bacterial and anti-mold cleanser and is cat safe.

(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: You recently wrote about a dog with a skin issue. I urge you to inquire about a product that could cure this pitiful dog's problem. One product is Dinovite (dinovite.com).

My neighbor's Lhasa apso was on prednisone and a variety of allergy shots for five years without his terrible skin condition improving. After three weeks on Dinovite, the skin is clear. I've given the name and website to people I see whose pets are obviously in trouble. Months later, I bump into them, and their dogs are so happy. Dinovite cured the problem -- itching, oozing ears, terrible breath and fur falling out in hunks.

I take care of a big female golden retriever. I've done this for two years on weekdays while her owner works. He kept her in a room up to 14 hours a day. I was appalled at the neglect and persuaded him to let me take care of her weekdays, just not overnight. He finally agreed. Weeks later, he and his mother said that the retriever was a different dog: happy and relaxed. She wasn't the sad, depressed dog she'd been for well over a year.

I do not get a penny for taking care of her, nor have I asked for anything. I do this for the dog. Whatever she wants, I give it to her gratis. I have her on Dinovite. I sprinkle it, as prescribed, on her kibble. As a result, she sheds much less than before, her coat is soft now, her breath is sweet and she no longer smells "doggy." She also has stopped scratching herself. I do not get anything from the Dinovite people. I feel that telling people about it is helpful.

The Dinovite company makes a supplement for cats now, too. I wanted to ask you to investigate Dinovite. Some of the supplements you suggest are hard to get. Dinovite even pays for UPS shipping. -- A.G., Norfolk, Virginia

DEAR A.G.: I always appreciate hearing from readers who have discovered the benefits of various companion animal health care products, some of which are posted on my website, DrFoxVet.com.

I checked the ingredients of Dinovite, and, in my opinion, it is an excellent nutritional supplement for dogs and cats, improving coat and general physical conditions, and probably helping repel fleas.

You deserve a medal for caring for that neglected golden. It is disgusting how many people care so poorly for their animal companions, even when they claim to "love" them.

DEAR DR. FOX: We have a 2 1/2-year-old male presa Canario dog who weighs 130 pounds. He started having seizures when he was 1 1/2. He had three to four seizures the first hour, then farther apart -- one hour, three hours, five hours and one or two the next day. These were bad seizures: lying on one side, kicking and shaking. He now has seizures every three weeks.

Our vet prescribed phenobarbital and potassium bromide. He still has seizures every three weeks, almost to the day. We don't know if the medicine is helping, but it might be worse without it. We started giving him levetiracetam eight weeks ago, and there were no seizures for 4 1/2 weeks.

When the seizures come on a timed cycle, almost to a day, shouldn't there be a way to prevent them? -- R.C., Spring Church, Pennsylvania

DEAR B.B.: Seizures are very prevalent in dogs who, as a species, seem especially susceptible. The causes are many, which are difficult to determine and rectify. In some instances, it has a genetic or hereditary basis. In others, an adverse reaction (vaccinosis) to anti-rabies or distemper shots or severe liver disease seems to be the trigger.

Many dogs stop having seizures when their diet is wheat-free or when they are taken off manufactured dog foods that contain other potentially epilepsy-triggering ingredients such as monosodium glutamate.

Try this dietary approach, using my home-prepared dog food recipe posted on my website, DrFoxVet.com. Weigh your dog at the start to be sure you are not feeding too little or too much. Let me know if this dietary change helps. And, of course, gradually take your dog off the anti-seizure medication over a three-day period when you start this trial. Let your veterinarian and me know the outcome.

(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: Our 8-year-old neutered male cat, Tiger, was prescribed a seven-day course of Clavamox for a urinary tract infection, as he was urinating blood outside his litter box.

Less than two weeks later -- after completing this course of antibiotics -- I noticed that he was straining to urinate and constantly moving from place to place to try to go. It was obvious that he was in trouble. I took him to the vet immediately, and, after extensive blood work and X-ray, it was determined that he had crystals, but thankfully no bladder stones. He remained at the vet's overnight for catheterization and intravenous fluids. The vet also recommended a prescription from a combining pharmacy (sort of a Flomax for cats to help relax his urinary tract) along with a 14-day course of Clavamox. When completed, we did give him fish oil and pet probiotics in a syringe to offset the antibiotic effects.

The first week of treatment, he had to return to the vet's for additional intravenous fluids and an overnight stay. The vet prescribed Hill's Prescription Diet c/d for urinary tract health -- for the rest of his life.

My concern is that the fourth and fifth ingredients of the food are corn gluten meal and wheat gluten. As a very health-conscious individual who opts for natural solutions in my own personal health care, my concern is that these glutens are not a normal food that a cat would eat. Do animals need these grains in their diet? Also, the genetically modified organisms in corn and wheat are something else to be reckoned with, as they may affect humans and animals.

Weight gain also seems a side effect of this particular cat food.

We just spent hundreds of dollars for treatment of our pet (and we have four other cats), and do not wish for him to go through the pain, stress and anxiety of a repeat episode, nor do we have an inexhaustible budget for medical costs incurred with this problem. -- Y.J., Yadkinville, North Carolina

DEAR Y.J.: You have certainly been through the proverbial mill that was costly for you and stressful for your cat and all who love him.

I blame high-cereal-content cat foods, which make the urine abnormally alkaline; a sedentary life; and poor drinking habits or fluid intake, especially in cats given only dry cat food.

This problem is all too common in the cat population today. In some cases, it's possibly caused by corn, with secondary bacterial infection and crystals/calculi/stones forming that can block the lower urinary tract, especially in neutered males. A more biologically appropriate diet is the best preventive. For details, visit feline-nutrition.org.

I share your concern about the corn and wheat gluten ingredients in the costly prescription diet your veterinarian is selling you. Such ingredients have no place in a cat-carnivorous diet.

Keep up with the fish oil and probiotic supplements, and encourage Tiger to eat a meat-and-vegetable canned cat food, or try my home-prepared cat food recipe posted on my website, DrFoxVet.com. Several good varieties of cat foods are also posted on the website.

DEAR DR. FOX: Keltie, my 7-year-old female German shepherd, has exocrine pancreatic insufficiency, which was diagnosed at about 7 months, when my son was raising her.

The main symptoms were normal for this condition: large, loose, grayish cow pies for poop and drastic weight loss. Unfortunately, it took the vet some time to diagnose, though I don't know why since shepherds are susceptible and the signs were obvious.

She came to live with me when she was around 3, after being diagnosed and having pancreatic powder stirred into her food for some months. She was quite thin, but has progressed admirably through the years and is of normal weight with normal stools. Is the powder form better than tablets?

Keltie, though a very sweet, smart, loyal dog, is also afflicted with obsessive-compulsive disorder (pacing) and super sensitivity to almost any odd happening, from pulling curtains closed across a window to my flipping my head back to put drops in my eyes. Meal times or visits by friends create a pacing, whirling dervish punctuated by yips or barks, sort of like Tourette's syndrome. She still periodically paces back and forth (it used to be constant) for no apparent reason. This started when she was a puppy and my son played with a laser toy pointed and moving along the floor. He's convinced that she's still looking for the dot! If she can suck you in, she will continually bring you a ball, waiting for it to be kicked or thrown back and forth until hell freezes over.

She has been on Prozac for years, which I think helps. Since coming to me, she has improved dramatically, perhaps because she has a calmer household and another dog companion as well as competition. I use a Thundershirt on her when necessary and it helps, but generally I am amazed at her progress and am able to ignore her antics.

I would appreciate any suggestions you might have for such a super-sensitive startle-prone dog. I understand that shepherds are susceptible to OCD and believe it is probably mostly bad breeding. What a shame. -- G.B.G., Arlington, Virginia

DEAR G.B.G.: Poor Keltie has her genes to curse for her need for digestive enzymes. I am not aware of the powder being any better than tablets, but you might also try three to four cubes of canned pineapple, which also contain digestive enzymes. Before meals, give the dog some probiotics. A couple of tablespoons of plain kefir or "live" yogurt may also prove beneficial.

One theory is that shepherds and some other breeds raised on a high-cereal diet don't fare well because the diet leads to pancreatic enzyme deficiency and all the well-known symptoms you describe.

It seems you have done a good job dealing with Keltie's OCD, which may indeed have been triggered during her formative months by hyper-stimulation with a laser light. You may want to increase the daily dose of Prozac, but first try melatonin morning and night. This super-antioxidant can help calm down animals, and several readers have found it helpful for their dogs' "thunderphobia" and old dogs suffering from insomnia or dementia.

(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.)