DEAR DR. FOX: We have a wonderful 3-year-old miniature poodle who is a delight in almost every way. Despite getting lots of exercise and having many chew toys to gnaw on, he still likes to chew our bed linens and decorative pillows. He's put holes in sheets and pillowcases.

What can we do? -- N.M., Gainesville, Virginia

DEAR N.M.: There are many reasons why your little dog engages in such destructive chewing. I would advise a veterinary wellness examination to rule out any chronic inflammatory condition, oral or abdominal, that could make your dog want to chew things all the time. If this behavior most often occurs when you are away from the home, your dog may be suffering from separation anxiety coupled with obsessive-compulsive behavior -- resulting in a neurotic need to chew.

Being bored and in the home alone all day can lead to destructive behaviors. Small dog breeds have varying degrees of paedomorphosis -- the perpetuation of puppylike physical traits into adulthood, including disproportionately large heads; protruding, "appealing" eyes; malformed jaws and dentition; and misshapen and misaligned limbs. All these paedomorphic traits can lead to a variety of health problems later in life.

Many dogs -- and not just smaller breeds -- also inherit, through human selection, what I term paedopsychic traits. The behavioral repertoire associated with extreme paedopsychosis, or behavioral neoteny, consists of predominantly infantile or puppyish behaviors normally seen just in brief episodes of spirited playfulness and moments of anxiety in most adult dogs. These behaviors include almost continuous attention-seeking behavior, excessive vocal and oral activity (chewing and licking) and searching behaviors, all of which can become obsessive-compulsive disorders.

Along with the physical ailments associated with paedomorphosis, these poor dogs do not have the best quality of life without constant attention and often considerable veterinary expense. They are especially prone to separation anxiety. Many suffer alone all day in holding crates in apartments in affluent urban communities worldwide, where they are currently popularized status symbols, fashion accessories and a source of emotional gratification. Abnormal behaviors related to boredom often develop in dogs confined in such unstimulating environments.

The attention-seeking behaviors that are rewarded by the devoted attention of owners highly conditioned by their dogs may in some instances evolve into Munchausen by proxy, especially when coupled with physical abnormalities. These overdependent, hypersocial dogs may carry the gene responsible in humans for the Williams syndrome, where affected children are exceptionally gregarious and friendly toward strangers.

Since extreme forms of paedomorphism and paedopsychism can lower the quality of life of such animals, their deliberate and continued propagation should be seriously reconsidered. Those caring for such dogs, many of which are adorable but are challenged physically and emotionally, should not overindulge, since that only reinforces dependency. Apart from not breeding dogs with such extreme traits, joining a regular play group with other dogs may be the best medicine to help let the real dog emerge by reinforcing more mature dog-dog interactions.

DEAR DR. FOX: We adopted a 1-year-old Pomeranian from a rescue group five years ago.

He has had trouble with a luxating patella for over a year. Now the vet says it is a Grade 3, and he needs surgery. He would have to be crated most of the time for a couple months, with no running. He is currently taking carprofen and tramadol (when needed).

This dog was crated the whole first year of his life. We only crated him until he was house-trained.

We asked the vet about exercises, and she said they probably would not help. At the present time, his quality of life is good. At what point do we say yes to surgery? -- J.S., Wentzville, Missouri

DEAR J.S.: Your dog's condition is quite common in smaller breeds. A luxating patella, or trick knee, calls for surgical correction if, toward maturity, the ligaments helping keep it in place do not tighten up.

This developmental defect has a hereditary basis. There are accounts of pups with this condition, after being given time to mature and regular exercise, having their kneecaps eventually stabilize, and surgery was not needed. Your poor dog's confinement in a crate during her early development most probably interfered with this self-healing process. Left untreated, your dog will be unable to enjoy full range of normal physical activities and is likely to develop inflammatory, arthritic lesions that will later interfere further with mobility.

I would opt for surgery without further delay, and shame on whomever kept him in a crate for a year. They should be prosecuted.

A LEGAL WIN FOR DOGS IN OHIO

An Ohio appeals court raised the value of dogs above that of other items of property by ruling that a lower court must revisit a 2015 civil suit that awarded a dog's market value ($400) to the plaintiff, even though the cost of the dog's treatment exceeded $10,000. "Pets do not have the same characteristics as other forms of personal property, such as a table or sofa, which is disposable and replaceable at our convenience," wrote three judges from the appeals court.

(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: You recently ran a letter about National Feral Cat Day, which is an insult to the domestic cat, our most popular beloved pet.

Forcing unadoptable cats to live and die outdoors through the misguided practice of trap-neuter-release (or abandon) rather than receive a quick, humane death is cruel and irrational. As the director of a cat shelter, I have witnessed too many who suffer miserably with prolonged deaths from parasite infestations or systemic infections from injuries or diseases transmitted by fleas and other animals. After one trip to the clinic for sterilization, these cats will never receive any palliative care for the many afflictions they may eventually acquire.

Cats do not belong on farms, where they can contaminate farm animals and vegetable crops with toxoplasmosis gondii oocysts -- spread via feces -- which they catch while hunting native wildlife, not just pest species.

Animal shelters were created to prevent cruelty to animals, not for people to do what makes them feel good. The true heroes are open-admission shelter staffs who make difficult but compassionate decisions for the sake of the animals while cleaning up the problems that irresponsible people leave behind. Love your cats by keeping them safe on your own property and away from wildlife.

I spent three months this past summer fighting the crazy "no-kill" people at town board meetings because they didn't approve of euthanizing feral cats instead of applying TNR to them. They basically spread lies about me stalking cats in backyards and taking peoples' cats! It was quite frightening. I came through with the help of my supporters and from three veterinarians. -- Gail Mihocko, Project Cat director, Accord, New York

DEAR G.M., I agree with you; communities endorsing TNR without question are undoubtedly betraying what I consider a sacred duty to care for cats and all creatures great and small. In most communities, releasing cats to live permanently outdoors is an abdication of responsibility for wildlife protection, public health and cats' welfare.

DEAR DR. FOX: I can relate to the reader who wrote about his two deceased dogs coming back to visit him. I, too, had that experience with my beloved black Labrador, King. He was 10 years old when he died last November.

About a week after he died, I was in my bedroom, crying. I looked out my window and saw a set of dog prints in the snow. I went outside. The gate was closed and had a lock on it. I opened it and saw dog prints; I followed them for about eight feet, right into the middle of my yard, where they just disappeared! I knew it was King, since no dog could possibly jump the fence, let alone leave paw prints that led to nowhere. I came in and had the most peaceful feeling ever, knowing my King was still here with me. -- P.C., St. Charles, Missouri

DEAR P.C.: Many skeptical readers, the latter-day doubting Thomases of instrumental rationalism, will have something to think about when they read your account of your beloved dog's communication with you after life. I have added your letter to the many that I have received to my website DrFoxVet.net, under "Animal Spirits." This subject is important because it adds a dimension to understanding the nature of reality, where perception is reality and seeing is believing! Letters on this very personal subject from other readers are always welcome.

(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: We lost our beloved 12 1/2-year-old springer spaniel last February. I should have never allowed the vet to give him a rabies vaccine. It made the last six months of his life miserable. Just two or three days after the shot, he woke up panting wildly; he lost his vision and acted rabid, which continued every night for six months. Nothing really calmed him enough to get a full night's sleep -- for any of us.

I reported the bad reaction to the Food and Drug Administration and the pharmaceutical company. Our vet never followed up as requested.

Interestingly enough, I stopped giving my dog distemper and parvo vaccine at age 6 and had titers done instead. He never needed another DAPP vaccine again!

We now have a new springer pup born Aug. 6. The breeder gave the DAPP vaccine on Sept. 17 and Oct. 1. My vet wants to give it three more times, but my breeder says the pup needs only two more. Our vet says the manufacturer recommends 10-week, 13-week and 16-week boosters. Is that too much? What do you think about the Lepto vaccine? The vet wants to give it twice. Is that overkill? -- S.B., Branson, Missouri

DEAR S.B.: The Lepto vaccine is very questionable if there is no risk of exposure. It's best to give the DAPP "core" vaccines at 12 and 16 weeks since at 10 weeks, antibodies from the mother could interfere with the pup's immune response to the vaccine. If the vaccination status and history of the mother is unknown, earlier vaccination between 8 and 10 weeks may be advisable. Don't give the rabies vaccine until he's much older!

I would go to another veterinarian. To find a holistic veterinarian who is not gung-ho with vaccinations, search ahvma.org.

Readers, please take note of these issues. For more details on dog vaccinations and the risks of vaccines, see the reports posted at DrFoxVet.net.

"SHOULD YOU LET YOUR DOG LICK YOUR FACE?"

This is the title of an article by Christopher Mele in The New York Times. Citing some medical and veterinary authorities, the article asserts that there are risks of bacterial and parasitic diseases being passed on from dogs' mouths to humans -- especially when their saliva contacts various mucous membrane areas of our bodies.

From my perspective, provided you do not have an impaired immune system and your dog is healthy and does not eat other dogs' poop, the risks are far less than when we do not wash our hands thoroughly before every meal, after gardening, after handling poultry and other meats and vegetables possibly contaminated with bacteria from improperly processed farm animal fecal "fertilizer," and when pet food is contaminated with these various bacteria.

We may be more at risk from shaking hands and kissing each other than from letting our canine companions give us a few affectionate and solicitous licks. Canine saliva has healing properties, as several people with various skin ailments have attested. Some of the bacteria will colonize family members and can reduce the incidence of allergies and frequency of antibiotic use for ear and other infections. Our germophobic society and excessive use of hand and other sanitizers, disinfectants and antibiotics have far more serious adverse public health consequences than the tender tongue kisses of happy and healthy 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.net.)

DEAR DR. FOX: We own a 13-year-old female beagle-mix dog who we rescued when she was almost a year old. She has never been an extremely playful dog, and in the last few years, even less so.

For the last year, she will not sleep through the night, and she barks to wake us up two to four times a night to either go to the bathroom or alert us that she has already gone to the bathroom (urine and/or stool) in the kitchen, where she stays during the evening. Our vet prescribed a sedative (lorazepam) that we have given her.

We expected that with the sedative, she might become relaxed and possibly that might result in the release of her bowels unexpectedly, so we have diapered her during the night and when we are away for a few hours. So that she doesn't tear the diaper away, we also place a cone collar on her. At night, the sedative has had no effect on her, even when giving her two tablets. She's used the diaper only twice -- once to pee and once to poop, but only when we were not home to take her out. I am usually home during the day, so taking her out when she needs to go is not a problem, although the frequency has increased over the last year.

My husband and I are at our wits' end regarding this interruption in our sleep. We love our dog and do not want her to be in distress during the night, but we are struggling to find a way to deal with her needs. Getting additional costly extensive tests done is not an option for us. -- J.E., Baltimore

DEAR J.E.: lorazepam would not be my drug of choice for your dog, nor would I consider lowering your dog's quality of life unnecessarily by putting a cone collar on her to stop her from removing the diaper.

Provided that chronic cystitis and renal failure are ruled out, I would address this as part of the old dog (and person) syndrome where incontinence and sleeplessness or restlessness are common problems. Give her last meal at 5 p.m., and restrict her water intake after 7 p.m. Feed her three small, low-fiber meals daily, along with a few drops of fish oil and digestive enzymes. Before bedtime, give her 3 to 6 milligrams of melatonin, which has helped many dogs with insomnia.