DEAR DR. FOX: I have an 8-year-old teacup Yorkshire terrier who was diagnosed with encephalitis over four years ago.

He began walking in circles whenever he was awake. I took him to our family vet, who referred me to a neurologist. The neurologist performed a spinal tap and a CAT scan, which confirmed that my Yorkie had encephalitis. The prognosis for my dog's survival was one week. In spite of this, the neurologist prescribed cyclosporine and prednisone to be given twice daily. I took my dog home with little hope he would survive. He has been on these medications ever since. He stopped walking in circles one day after beginning the drug combination. His health and quality of life have been mainly quite good. He does what "well" dogs do: barks at the cat, plays, interacts with my other dogs, follows commands and does tricks. He has a sweet disposition.

I want to share this with your readers: Just as with humans, it is possible to shop around for reasonably priced prescription medications for companion animals. It is important to keep your dog on medications without going bankrupt. For example, prednisone is frequently given to humans, and it is inexpensive. I get a prescription for it from my family physician, and then I cut the tablet down to the correct dosage for my dog.

If I'd had to buy cyclosporine locally, the cost would have been $500 a month. I would have had to put my dog down years ago because I could not afford that. Instead, I get it for $30 a month from a mail-order place out of state that specializes in veterinary drugs. -- L.R., Montgomery Village, Maryland

DEAR L.R.: I am glad that this drug combination helped your dog overcome his inflammatory brain disease that may well have been an adverse reaction to a vaccination, which in the future would probably best be avoided.

Yes, the cost of pharmaceuticals has really gotten out of hand, and veterinarians are being wrongly blamed for this drug industry profiteering and monopolistic, cartellike business practices.

Readers will appreciate your diligence in finding less costly sources for the human medications, generally prescribed in the category of "off-label" by veterinarians when they are not specifically approved by the government for animal use.

A veterinarian friend of mine, Dr. Ron Gaskin of Shakopee, Minnesota, who has been investigating this issue, sent me the following statement, which I ask all readers to pass on to their congressional representatives:

"Pet owners of America might have noticed that the prices of medications for their pets are increasing. Many of these drug price increases are astonishing! Over the last three years, our veterinary clinic has seen an increased frequency of manufacturers backordering drugs. When -- and if -- the drug returns to the market, a huge price increase usually follows. This has happened to doxycycline, a powerful antibiotic used to treat tick-borne diseases found in Minnesota. The human generic doxycycline tablet price has increased at least 600 percent. Generic doxycycline tablets from some human drug wholesalers have gone up as much as 1,800 percent.

"Another example of stratospheric drug price increases is phenobarbital, a human anti-seizure medication used to control epileptic seizures in cats and dogs. Phenobarbital has been a frontline drug for extra-label use in my patients for over three decades. Phenobarbital tablets were on a manufacturer backorder for eight months. When the tablets finally came back into the market, we had a 600 percent price increase. Yet another example is the cost of fluoxetine, an anti-anxiety drug used for feline behavior problems, which increased 2,300 percent in one day. This is a drug that can save a cat with such issues from being surrendered to a shelter, abandoned or worse.

"If these human generic drug price increases continue at this rate, veterinarians will not be able to economically treat our nation's pets within five years! Some pets will go without treatment or have to be euthanized because their guardians cannot afford the necessary medications.

"Human doctors are seeing the same problem. Senior citizens are often unable to afford their digoxin tablets, a formerly cheap but very effective drug used to treat congestive heart failure. When a senior citizen cannot afford the digoxin and is forced to go without it, he will likely end up in urgent care struggling for his life! Only in the American health care system does it seem that it is less expensive to treat a senior with decompensated life-threatening congestive heart failure than it is to manage the disease with a previously affordable 6-cent tablet.

"Why is this happening in America today? We are seeing human generic drug manufacturers increasing their prices just because they can. The drug powder or active pharmaceutical ingredient (API) price has not gone up, nor has an API shortage been a problem. It comes down to one cause: human greed. There used to be six manufacturers of phenobarbital; now there are only two, and they set the price. Small, independent, competing generic drug manufacturers are being acquired and shut down or incorporated into larger drug manufacturing corporations, who then control the price of the generic drug.

"The American Veterinary Medical Association (AVMA) top brass, in a private conversation, stated that the human generic drug price increases are 'free enterprise-driven,' and they claim there is nothing that the AVMA can do about it. When the price of a human generic drug gets high enough, this could entice our veterinary generic drug manufacturers to apply for and get approval to manufacture economical generic veterinary drugs. Our veterinary generic drug manufacturers appear to be holding the line on their generic drug price increases; however, the writing is on the wall. For example, a bottle of veterinary generic levothyroxine, priced at $49 just three years ago, is now double the cost at $101. One of the gold-standard brands of levothyroxine is currently on a manufacturer's back order. I hope this is not a trend. It begs the question -- why can't human generic drug manufacturers hold down the cost of their generic drugs and charge fair prices?

"What is the federal government doing about this? Stringent Food and Drug Administration regulations and an aging drug manufacturing infrastructure have resulted in many small generic drug manufacturers being shut down or becoming more easily acquired by larger, predatory generic drug manufacturers. The Federal Trade Commission is allowing this monopolistic process to happen. Why is this happening? Money. There is a huge amount of money involved. A recent Senate oversight committee investigation has become silent about the exorbitant generic drug price increases. Pet owners should be aware it is not usually your veterinarian making the 'big money.' Our veterinary practice has started to write a lot more pet prescriptions to be filled at local pharmacies because the drugs are too expensive for us to inventory, or we just want to help the pet's owner find the most affordable option they can. Sadly, almost always our pet owners find out what the real, and unanticipated, costs of human generic drugs are -- for them and their pets."

I urge readers to send this statement to their Congressional representatives to address this serous issue affecting both human and animal patients in need of prescription medications.

(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.)

DEAR DR. FOX: We have a sweet, slightly elderly cat who has starting crying incessantly lately. Our boy is about 15 years old -- but could even be a bit older -- and is in relatively good health for his age. He does have thyroid issues and receives methimazole every day.

Over the past week or so, he's started crying quite a lot, especially at night. He's always been very affectionate, and the crying seems like he wants attention, but sometimes he continues to cry even when he's in the same room with the family. The crying has become an issue because it's keeping us awake at night, and we're worried that there is something wrong with him other than simply feeling needy. Nothing in his food or routine has changed. Any thoughts? -- J.B., Washington, D.C.

DEAR J.B.: This is a common problem with older cats, and I have addressed it many times over the years in this column. Generally, the following measures help, keeping in mind the possibility of dementia/brain degeneration, like Alzheimer's disease, and chronic pain from arthritis.

With the latter, a few drops of fish oil in the food daily may help; you can also try a good chondroitin and glucosamine supplement, which you should discuss with your veterinarian first. My book on massage therapy, "The Healing Touch for Cats," should help overall.

A warm place to sleep would be beneficial. Have the vet check for dental problems, another source of chronic pain and inflammation in cats.

To help with anxiety and chronic pain, there are other medications that may help your cat. Your vet can tell you about selegiline for possible dementia. If your cat likes catnip, I would advise a pinch or two later in the evening and giving some melatonin before you go to bed. I take it myself; it is a super antioxidant as well as a natural sleep aid.

DEAR Dr. FOX: I just reread your book "Understanding Your Cat." In it, you talked about domestic cats not swimming. Yes, most domestic cats do not like water, but I was truly blessed to experience a swimmer.

Several years ago, my neighbors had an above-ground pool with a nice deck around it. Their cat, Samantha, would sleep on the deck -- if no one was splashing her. I swam alone often, so I saw her there a lot.

One day, she got up, walked over to the pool ladder, put her feet in the water, jumped into the pool, swam a lap, got out of the pool, shook herself and laid back down. I was so stunned! I got out of the pool, banged on my neighbors' door and said, "I just saw Samantha swim across the pool!"

They told me that she does that every once in a while. Wow! -- D.B., St Louis

DEAR D.B.: Thanks for your swimming cat story. This is indeed rare, but some cats do take to the water. However, I do not advise people throwing their cats into the pool this summer!

Cats sometimes amaze us. My journalist friend in St. Louis was shocked when she told her cat to straighten up the pages of her manuscript that the cat had pushed off her desk and onto the floor -- and the cat did just that, pawing around the pages to try to put them together!

Only yesterday, one of our cats, Pinto Bean, used the litter box in the bathroom, and I saw that his urine had not been covered with litter. I called out to my wife, "Pinto has not covered his pee." No sooner had I said that than Pinto Bean came running in and fastidiously covered his deposit!

HORSES DO BETTER HOUSED TOGETHER

Horses may do better with access to others of their kind, according to a study published in the journal Physiology and Behavior that found higher levels of corticosterone, a stress hormone, in horses housed in individual stalls than those housed in communal situations.

The greater the isolation, the higher the stress, the study found, which the team noted could lead to illness. "Group housing provides horses with an environment where they are able to display natural behavior and allows contact, improving overall welfare," said Kelly Yarnell, a Nottingham Trent University (U.K.) equine welfare expert.

(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.)

DEAR DR. FOX: Last winter, I noticed a longhaired stray cat roaming outside. I began to feed her, and eventually she consented to being a house cat during the night. While she was still an outside cat, she was in a catfight, so I had to take her to the vet. The vet thinks she is between 6 and 10 years old, and was probably abandoned. She does not have a chip.

Cat (her name) gets along fabulously with my 80-pound retriever mix. She lets me groom her and will even cuddle for a very short time. I have had dogs my entire life, but never a cat.

For the life of me, I cannot figure out why she would want to be outside during the day. Even when the temperatures were near-record cold, she yowled and put up a fuss until I let her outside. She likes to spend time in a storm sewer, which worries me to no end. At dusk, I call her and she comes inside and is very content to eat and spend the night in the house. I have given her two litter boxes, and she uses both of them when inside. But I am beginning to think that dogs really are smarter than cats. My dog would never choose the cold outside over the warm couch inside. Can you give me some suggestions to help me get her to stay inside during the day? -- K.W., Imperial, Missouri

DEAR K.W.: Cats are odd in many ways, and sometimes can be quite irrational -- like one of mine hissing at me when I am outside the house and looking in through the window. A dog would grin and wag his tail on seeing me.

I am glad that you took in and socialized this obviously lost/abandoned -- rather than feral -- cat.

It is just not safe outdoors for cats: She could be food for a coyote or get trapped, shot, hit by a vehicle or injured or infected by another cat. Get her microchipped, and try taking her out for short walks in a secure cat harness on one leash and a neck-collar and ID tag on a second leash. Cats can get out of harnesses, with potentially catastrophic consequences.

Do not let her out by herself. Spend time with her engaging in interactive games, especially around the time when she likes to go outdoors, and give her padded stools or ledges so she can see out the windows, ideally at bird feeders outdoors. A pinch of catnip may help her calm down.

GUARD DOGS FOR CONSERVATION

Should taxpayers' dollars be spent on compensating farmers and ranchers for livestock losses from wolves, mountain lions, bears and other predators when they refuse to use guard dogs to protect their animals?

The most effective guard dog breeds include the akbash, Kangal, great Pyrenees and komondor. Less commonly known are the Turkish kars, Turkish tazi, Czechoslvakian chuvatch, Polish tatra, the Hungarian kuvasz, Tibetan mastiff and Italian maremma. Donkeys and llamas have proven effective in many instances as protectors of sheep, goats and calves.

The methods employed by state and federal agents to kill these predators, which include poison bait and 1080 cyanide guns, are often indiscriminate, killing non-target animals -- including endangered species such as the lynx and golden eagle.

This sanctioned adversarial attitude toward wildlife in general and predators in particular, indifference about their suffering and disregard for their ecological value all add up to unethical and non-sustainable ranching and farming practices. Therefore, no compensation should be provided if guard animals are not being effectively deployed. This would also save our tax dollars.

Annual "harvest" hunting quotas for mule deer, elk and white-tailed deer should be drastically reduced so that predators have sufficient natural prey for themselves, rather than having to prey on livestock. For obvious reasons of ecological restoration and protection, all commercial trapping should be prohibited. Non-game and trophy hunting quotas need to be revised from an optimal ecological biodiversity perspective, rather than from a self-serving "sustainability" paradigm of maximal harvesting -- including fishing, both recreational and commercial.

The use of guard dogs to prevent predation as an alternative to lethal methods of predator control is surely an ethical imperative for a nation of meat eaters to have government more effectively institute. It is as sane and sensible as using goats instead of Roundup and other herbicides to control weeds.

(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.)