DEAR DR. FOX: I recently read your column regarding the cat with a feline hyperesthesia syndrome.

When my cat was 9 months old, he developed the syndrome suddenly. He was completely normal one day, and then it happened in the middle of the night. After countless traditional and holistic vet visits and numerous hours of research, my husband and I realized the trigger, changed his diet and it's been over 18 months since he's had an episode.

I was feeding him a poultry-based diet with supplemental canned fish. After much research, I completely took him off all feathered foods and put him on a raw diet. I'm currently feeding him Primal Raw Beef and Salmon, with canned fish and beef on occasion. I buy freeze-dried treats, and I keep Origen Regional Red dry food on hand if I need it in a pinch.

My take on feline hyperesthesia syndrome is that it's not triggered by just one thing; rather, it's a combination of mind, body and environmental components. In my experience, there were triggers that set him off, specifically sensitivity on the body itself, especially his paws. He had no injuries, but I noticed they were sensitive. In addition, a fabric softener smell triggered him. Once he was at the point of a rolling back and twitching, I gave him a massage to calm him down, which helped, and gave him a treat as a sort of reset.

Sometimes he became fixated on overgrooming, and I would stimulate him by playing with him several times a day. After taking this into account, both my husband and I agreed that another cat could help, and we were willing to give it a shot. We sought a cat who was a little younger than he, and after looking for almost two months, we found a perfect match.

Our cat's last episode was in the summer of 2013. I'm delighted to say that here we are living a healthy and happy life all together. -- T.L., St. Louis

DEAR T.L.: Same with one of my cats! It was fish that set him off. Still, he has sudden episodes even after a change in diet, and I, too, find that gentle grooming, massage therapy, redirection with interactive games or time outdoors on our cat-secure open deck gets him out of his compulsive self-grooming. Underlying thyroid issues must be considered, and for many cats who live alone, boredom and lack of stimulation may be significant triggers, as is anxiety, which can trigger more serious self-mutilation.

This is a far more complex feline disorder than generally perceived. One complication can be cats ingesting harmful chemicals from contact with floors and countertops cleaned with quaternary ammonium compounds, as in Swiffer's WetJet antibacterial cleaner.

DEAR DR. FOX: We have a 1-year-old Cavalier King Charles spaniel, who we have had since she was 8 weeks old. She is adorable, playful and affectionate, but she has some issues that we aren't sure how to deal with. She has always seemed prone to nervousness and anxiety, but things have escalated recently.

She growls or whines when certain new things are brought in the house, she growls at reflections on the wall, and now she has become fearful of eating out of her food bowl. This started shortly after she returned from spending several days with a dog sitter who has other dogs in the house. I have tried other plates, bowls, etc., but she will only eat off a paper towel on the floor. Since she eats dry food, it is not an issue to feed her this way. Lately, she becomes anxious when I take her to some new places for walks. I took her to a new place the other day, and she whined and cried so much that I finally turned around. I try to give her as much exercise as I can -- she is walked at least three miles a day, has a fenced-in yard to play in and I play fetch with her daily. She has a lot of energy, and if she is not exercised, she is very restless. She has always been a good sleeper at night, thankfully.

The vet suggested we try giving her the herbal pill Anxitane, and she's been taking it for three months. I think it helps somewhat. We wanted to try this before we tried Prozac or another type of pharmaceutical for anxiety.

We would prefer not to spend a small fortune on hiring a behaviorist, so I wanted to see if you had any suggestions. We love her dearly, but we would like to have a more relaxed dog if possible. We are open to Prozac and are willing to go that route if it would help her.

We have had other dogs before (including a Cavalier) and have never had these kinds of issues before. -- L.R., Cabin John, Maryland

DEAR L.R.: You letter clearly indicates that you are an informed and caring canine caregiver and for whatever reason have the burden of a young dog with ever-increasing behavioral problems.

Knowing something about genetic and developmental abnormalities in purebred dogs, the Cavalier King Charles spaniel in particular, most veterinarians would consider your dog's abnormal behavior as the first possible signs of a brain disease prevalent in this breed called caudal occipital malformation syndrome. This is a congenital abnormality at the base of the skull that, as the dog matures, results in compression on the rear part of the brain. This abnormality is usually combined with syringohydromyelia, which is the result of blockage of circulating cerebrospinal fluid.

This condition may be just beginning to show up in your dog as pain around the neck region, which could trigger anxiety and conditioned fear reactions to certain stimuli. More serious neurological symptoms may soon develop, including an unsteady gait and seizures.

This condition is treatable and should be ruled out as a possible reason for your dog's evident distress and abnormal behaviors before trying a short course of treatment with an anxiety-relieving drug.

(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: After a lot of trial and error with bones and chews, I settled on frozen beef marrow bones as a way to keep my dogs' teeth clean and satisfy their urge to chew. Most of the other things I've tried upset their stomachs, had a splinter risk or had something else about them that wasn't good.

I have been buying frozen bones labeled bovine growth hormone- and antibiotic-free from a family-owned pet store, but they just stopped carrying them, and butcher shops are now the only places locally to buy frozen beef marrow bones. Those bones may come from cattle given bovine growth hormone (BGH) and antibiotics. I do not know whether those things would make it to the bones and present a hazard to my dogs.

I found a pet store 60 miles away that carries the BGH- and antibiotic-free frozen bones and ordered enough to last a few months. If butcher shop bones would be safe, that would be cheaper and easier. On the other hand, if there is a possibility of BGH and antibiotics harming my dogs, I will keep making the drive. What do you think about giving dogs bones from BGH- and antibiotic-fed cattle? -- S.H., Minneapolis

DEAR S.H.: In my opinion, there is little or no risk for dogs regarding BGH and antibiotic residues in bones and bone marrow. I appreciate your vigilance, though. The recombinant bovine growth hormone is more an issue in cows' milk -- ditto antibiotics. Anabolic steroids and growth stimulants are the big issue in beef, but the bones are spared -- they accumulate lead and fluoride the longer the animal lives!

I advise allowing dogs to chew only raw (first scalded to kill surface bacteria) beef soup shank bones at least 4 inches long. Short "rings," commonly sold for soup making, can get caught behind dogs' canine teeth. Allow only short periods of chewing or gnawing to avoid cracked teeth, and store the bones in a plastic bag in your refrigerator.

CAT GAMES AND ENVIRONMENTAL ENRICHMENT

You don't have to spend a small fortune on cat toys and furniture to make your cat's life more stimulating.

Cats do like to sleep a lot, but fun for them is watching, hiding, ambushing, chasing and catching -- all elements of hunting behavior -- and engaging in short bursts of physical activity, ideally with another cat or with an understanding caregiver.

Here are a few activities your cat would love:

-- Hiding inside a big cardboard box with a small hole cut in the side, or under a towel.

-- Chasing a fluffy toy or large feather on the end of a string tied to a cane, which you can also poke under a towel or throw rug on the floor.

-- Chasing and catching a spiral of pipe cleaner, which some cats will even retrieve.

Beware of loose, long threads and balls of wool that cats may lick and swallow. The best source of environmental enrichment for a cat is another cat. For more details on cat games and even IQ tests for cats, see my book "Supercat: How to Raise the Perfect Feline Companion."

(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: My aunt suggested I reach out to you and tell you a little bit about my dog, Jasmine. She's a 6-year-old Cavalier King Charles spaniel mix whom I rescued as a puppy.

In the last few years, she has become obsessed with swimming. She's gone swimming in pools, lakes, ponds and the bay -- she's even jumped in the ponds in Central Park once or twice.

She developed a cough last June. I didn't take her to the vet right away, but when we finally went in July, she was put on an antibiotic. The vet listened to her heart and said all was good. The cough did not go away; in fact, it started to sound worse and almost like when a human has bronchitis, so I took her to a second vet.

The new vet took chest X-rays and told me her heart was "pristine," though he did see a little bronchitis in her lungs. He put her on a different antibiotic, a bronchial dilator and a cough suppressant. We went back a few times and had another set of X-rays done that were sent to a specialist. The specialist suggested a trans-tracheal wash and a bronchoscopy.

I took her for a third opinion. This vet put her on yet another antibiotic and agreed with the trans-tracheal wash. He also wanted to do a sonogram of the heart to rule out a heart issue common in Cavaliers.

I saw the third vet less than a week ago, and her cough has worsened. She is not eating her food, but I believe it has more to do with the antibiotic bothering her stomach. I have decided to stop the antibiotic so that she can get it out of her system, and so that we can get in to have the trans-tracheal wash and sonogram done sooner.

Have you ever heard of a dog having a cough for so long? Do you have any feedback about Jasmine's situation? -- K.G., New York City

DEAR K.G.: Considering her record of loving to get into any kind of water for a swim, your dog is a prime candidate for having a water-associated fungal infection called blastomycosis, which thrives in rich, moist soils around ponds, along waterways and in swamps.

Antibiotics will not eradicate this proliferating fungus from your dog's lungs and possibly other internal organs.

This disease is quite common in many parts of the United States, possibly aggravated by warmer weather and climate change. The fungus can enter the body via a cut on the skin, or more often via inhalation. So have the veterinarian check for this and let me know the outcome.

BETTER HANDLING MEANS BETTER CARE FOR CATS

Many people don't know how to properly and safely restrain terrified cats, which can be a problem with staff in animal shelters and even veterinary hospitals.

I applaud the initiative being taken by the American Association of Feline Practitioners (AAFP) to correct this serious issue and to facilitate more cats having regular wellness examinations. Far too many cats never see a veterinarian until they are seriously, often terminally, ill. To learn more, cat handlers, owners and veterinarians alike should visit AAFP's Feline Friendly Handling Guidelines, available at catvets.com/guidelines/practice-guidelines/handling-guidelines, and the Cat Friendly Practice Program, available at catvets.com/cfp.

(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 16-year-old domestic cat whom we have had since he was 6 weeks old. He has been in good health his entire life, although he's a bit overweight at 17 pounds. He sees our vet once a year to be checked over.

We recently noticed that he may not be seeing that well. I noticed when I gave him a treat, he did not seem to be able to see it, but he could smell it. After a couple of weeks, we took him to the vet to check his eyes, and we were told he had a detached retina in one eye, but he was responsive to light.

We had his bloodwork done, and his blood pressure was high (over 200). He was placed on medication (amlodipine). We also checked him for thyroid issues, and he was determined to be borderline. Our vet suggested monitoring it, but no medication was prescribed. After two weeks on amlodipine, we took him back to check his blood pressure, and it was back in the normal range. He is now taking the amlodipine daily.

Unfortunately, his vision does not seem much better. Our vet said his detached retina looked better, and he is still responsive to light. Our vet felt his vision should improve some over time, but said it's difficult to determine how much better (or worse) he sees.

He seems fine and gets around the house without issue, but it does appear that he walks right up to objects before he sees them.

Is there anything else we can do to help with his vision loss? -- G.P., Arlington, Virginia

DEAR G.P.: Your cat's eye problem is all too common in older cats who develop high blood pressure, which, among other things, can lead to detachment of the retinas.

Being overweight or obese results in the production of inflammatory substances in the fat cells, which can cause harm to the kidneys (which play a major role in regulating blood pressure), to the heart and blood vessels, and to the pancreas, leading to secondary cardiac and circulatory issues and diabetes. Further complications can arise with inflammation of the joints, fatty degeneration of the liver and cognitive impairment associated with changes in the brain, which can resemble Alzheimer's disease.

Giving kittens (and their pregnant mothers) biologically appropriate diets rather than high-cereal diets and poor-quality animal protein might prevent these problems. Some fish oil supplement or a couple of canned sardines every other day would help your cat, and I would not change the blood pressure medication other than having the pressure monitored every three to four months.