DEAR READERS: Extremist idealism in any shape or form, exemplified by the high priest of Mammon, Donald Trump, can attract a certain coterie of tribal acolytes and sycophants, surprising in their numbers and vitriolic rhetoric. In a May 25 letter to the editor in The Washington Post, Alley Cat Allies president and founder Becky Robinson, who is ostensibly concerned about the well-being of cats and in protecting them from suffering, decried my suggestion of communities developing humane sanctuaries for unadopted cats as an alternative to euthanasia. Robinson would rather have them released back outdoors, where they never belonged in the first place.

Robinson asserts, on the basis of one instance, "Cats stacked in cramped spaces suffer from disease and mental anguish. Sanctuaries are expensive and cruel." Actually, sanctuaries can mean safe, humane, group housing in enriched environments and the frequent recovery and rehabilitation of cats so they can be adopted to loving homes.

Robinson refuses to acknowledge the article "Releasing Cats to Live Outdoors" on my website, DrFoxVet.net, which concludes that well-run sanctuaries and well-run trap-neuter-release (TNR) programs can both help reduce cat suffering and overpopulation. But for some, there is no middle ground, and it is regrettable that ideology should trump the greater good -- in this instance, the ultimate well-being of cats.

DEAR DR. FOX: We recently lost our 5-year-old dog. He was in good health before his veterinarian changed his medicine for heartworms, ticks, etc. to Trifexis.

Our dog became sick and couldn't eat. The vet said he was acting like an old dog. We had to have him put down.

Do you know if Trifexis has caused any problems or deaths to any other dogs? -- M.E.S., Lexington, North Carolina

DEAR M.E.S: I am saddened to hear about the death of your young dog associated with being given anti-parasite medication. The attending veterinarian should report your dog's death to the FDA Center for Veterinary Medicine.

I constantly voice concerns over the use of both oral and spot-on anti-parasite drugs, which are all too often given without due caution.

A quick internet search reveals many reports of adverse reactions in dogs with Trifexis. The Drugs.com website states, "The following adverse reactions are based on post-approval adverse drug event reporting. The adverse reactions are listed in decreasing order of frequency: pruritus, anorexia, diarrhea, trembling/shaking, ataxia, seizures, hyper-salivation and skin reddening."

All dogs should be tested for the presence of heartworms before being given this product, and it should not be given if they test positive.

For safe measures to take to prevent fleas and ticks, see my article on this subject, posted on my website, DrFoxVet.net

DEAR DR. FOX: I have had many cats in my 70 years, but never one like this.

Her person died, and she was put in a shelter, where she was not doing well. She's very shy, so a vet had her moved to a sanctuary, where she stayed for seven months until I brought her home.

She's been here for six months and seems comfortable -- unless someone else comes into the house, and then she hides. She's still shy, but she has settled in and is getting along with the older male cat -- they are both indoor only.

The problem is that she has mats on her back that are really dense, and I cannot trim her. I'm sure they are tight and uncomfortable. I managed to get her to the vet once in the beginning to make sure she was healthy, but I cannot afford to repeat the visit.

One day after that, I finally caught her, but I couldn't get her into the carrier because she was so hysterical. I got sedatives from my vet, but I can't get a whole one down her -- she's taken half twice, but they seem to have no effect.

Something has to be done about the mats, but I've never had a cat who was so uncontrollable. She likes to be petted, but she won't let me pick her up or even get too close. I've left out a carrier and she'll go in to eat, but only when I'm not around. It feels like I'm letting her suffer, but I don't know how to fix it. -- S.B., Talent, Oregon

DEAR S.B.: I am sure that you are not the only person with a cat who is impossible to get into a crate or carrier to get to the veterinary clinic for much-needed professional care.

My advice is to call your local animal shelter or humane society and ask them to send one or two experienced cat handlers to net and cage your cat. After all, this is a serious animal welfare issue. Alternatively, call the veterinary clinics in your area and see what they can do.

(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.net.)

DEAR DR. FOX: The American Kennel Club always wants it all ways. It says that it registers dogs, not breeders or kennels, but since registration of dogs doesn't provide sufficient income -- something on the order of half or fewer are actually registered -- it also registers litters and requires breeders of those litters to register and microchip them -- a good way to track their origin. The idea was that people would then go on and register their puppies. However, they weren't bothering to do that because most of them weren't breeding or showing the dogs, so there was no need for the papers.

There seems to be a thin line between registering breeders and requiring registration of a litter. In both cases, however, they fail to deal with the middleman: the broker, who is a major part of the horror show. Brokers don't breed dogs, but they deprive puppies of everything they need to be "normal" dogs. That's where epigenetic effects would seem to begin to show themselves. -- M.D., Miami, Flordia

DEAR M.D.: I hope that the exchanges in this column about the AKC, commercial puppy mills and the genetic and environmental (epigenetic) factors that can result in much suffering and costly veterinary care will help prospective purchasers of purebred and "designer" puppies think twice. Adopt from the shelters first!

Breeders need to change breed standards -- especially extreme traits like abnormal body sizes, conformation, deformed skulls and pushed-in faces, which can mean a lifetime of distress. This issue is gaining momentum in the United Kingdom with involvement of the British Veterinary Association, Kennel Club and major animal charities. For details, see the article "Recovering Canine Health" on my website. The AKC could take the initiative here in the U.S., which we all owe to every dog.

FINDING A HOLISTIC VETERINARIAN

The best medicine is prevention, and a holistic, integrative approach to companion animal health in this 21st century calls for a revision of vaccination protocols, of feeding highly processed commercial pet foods, and of over-medicating, especially with so-called preventive medications -- like those sold to keep fleas and ticks at bay -- when there are effective and much cheaper alternatives available that pose far less risk to animals' health, and to the environment.

For further information, contact a holistic veterinarian in your area. Find a searchable list at ahvma.org. Veterinarians and veterinary students wishing to learn more can access this website, and I encourage them to become members of the American Holistic Veterinary Medical Association.

BOOK REVIEW: "Just Life" by Neil Abramson

The double meaning in this book's title reflects the wit and wisdom of the author, a New York attorney and animal protection advocate. His deep empathy for animals and understanding of human nature drive this page-turning thriller where city dogs, strays and owned alike, face possible extermination while their rescuers and protectors deal with the corrupt elements of government and the genetic engineering, biotech and vaccine industries covering up the reason why children are dying and putting the blame on the dogs for this health crisis. If you want a good book for summertime reading and you care for animals and justice, this is the book for you.

(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.net.)

DEAR DR. FOX: Your recent article, "A Closer Examination of No-Kill Shelter Policies Is Needed," is a horrible example of the callous attitude that you have toward abandoned and feral cats.

You believe that all abandoned cats should be trapped and murdered, just for the crime of being unowned. I believe that my newspaper should stop carrying your column. A person who hates cats as much as you do cannot be trusted to give advice on any veterinary matter.

Your ignorance of the true policies of the trap-neuter-return movement leads you to make false claims that no-kill shelters "dump" cats on the street after they are spayed or neutered. This could not be farther from the truth. Cats are only returned to the place where they were living and being fed by a caretaker; now they are no longer reproducing, and they have been vaccinated against rabies. I have been running a no-kill nonprofit doing trap-neuter-return for 15 years, and have I have never dumped a cat anywhere.

In the ultimate irony, your daughter defends wolves while you advocate the murder of innocent cats. Dr. Fox, you blame cats for killing wildlife the same way wolf haters blame wolves for killing game animals. Humans are responsible for the decline of wildlife, not wolves or cats.

If you want to protect wildlife, you should take on the hunters protected by the United States Fish and Wildlife Service and state game management agencies. If we are really concerned about saving our wildlife, we will ban all hunting and trapping and protect our predators from arbitrary slaughter. -- S.W.B., Waldorf, Maryland

DEAR S.W.B.: I appreciate your concerns and efforts to help cats, but not your accusatory tone, which affirms the truism that a little knowledge often does more harm than good.

You are evidently not aware of or chose not to accept the fact that unadoptable cats are being "dumped" by some animal shelters using trap-neuter-release (TNR) as a cover. After conducting a lot of research, I have made it very clear that under strict conditions, TNR can be effective and ethical. For details, see "Releasing Cats to Live Outdoors" on my website, DrFoxVet.net.

My wife and I have trapped, had neutered, blood tested and fully vaccinated, wormed, rehabilitated and loved several feral cats, whom we either kept or found good homes for. Otherwise, they would have been put back in our neighborhood after neutering and vaccinating with no further care by the local Animal Humane Society of Golden Valley Minnesota. I've posted on my website a short photo-collage of one of these cat's progress under the title "Feral Cats Can Be Rehabilitated."

As for my daughter, Camilla, who founded and directs Project Coyote, she operates totally independent from me and has her own views and agenda. But there is no irony in her being a defender of wolves, since I was one of a handful of wolf scientists and no-hunting-or-trapping advocates who succeeded in the 1970s in securing protection for the wolf under the Endangered Species Act.

DEAR DR. FOX: I have been rescuing Dalmatians for more than 25 years, and I love the breed. I usually take the dogs no one else wants, and they always turn out to be wonderful, loving pets who only want someone to love them.

A few months ago in a column, you mentioned never giving dogs treats made in China because of some of the ingredients. When I buy dog treats, the country in which they are made isn't always listed. If I buy only the treats that specifically state they were made in the United States, it will significantly reduce the kinds of treats I get for my dog, including some of his favorites.

Do you have any suggestions? -- J.R., St. Peters, Missouri

DEAR J.R.: Good for you for rescuing these beautiful dogs who have been abandoned by people who lack understanding and empathy. Far too many people get dogs without first assessing if their lifestyles are compatible and without informing themselves as to the animals' needs and proper care.

Your question is very pertinent when it comes to the big gap between truth in labeling and obfuscation, which is especially true with many pet foods and treats. Ingredients may come from abroad -- from China in particular -- then go into a product manufactured in the U.S. The product labeled "distributed" by Company X is probably manufactured in China, Thailand or some other country where food quality and safety are not under the (still imperfect) U.S. standards of surveillance and regulation.

Some of the new freeze-dried treats with no preservatives or additives, such as Stella and Chewys, are made in the U.S. and in my preferred choice category. But the best solution is to start making your own treats, as per my recipe "Dr. Fox's Good-Dog Cookies," posted on my website.

(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.net.)