DEAR DR. FOX: I have a 17-year-old Chihuahua that has CCD (Canine Cognitive Dysfunction), congestive heart failure, liver disease and kidney disease. His congestive heart failure is managed with with Vetmedin, Lasix and Benazepril. The primary concern is his CCD.

It is unclear, per our vet, if his heart problem is causing less oxygen to reach the brain or not. But he’s either pacing and circling or sleeping. He does not interact with others, and I suspect it’s for a variety of reasons: deafness, near-blindness and cognitive dysfunction. However, he does know when he’s alone in a room, as he will seek out signs of anyone being in the house. If he thinks he’s alone, he makes this “mooing” sound. He doesn’t understand what it means to go on a walk anymore, and will go in all directions. He is weak and wobbly; what he does most is walk a few feet, stop and stare as if his brain has been interrupted, look as if he is about to fall, then will continue walking. He does the staring and circling quite often throughout the day. He will also go to the side of my chair where I’m sitting and will begin to whimper. He gets lost in the house and trapped under barstools.

He doesn’t ask to get in bed with us like he used to (by reaching up with his paws), but he will come to the side where I’m at, then circle and leave. I retrieve him and put him in the bed, but he either settles down quickly or becomes very agitated and fights to get down. The other positive thing he does is he still eats and drinks water.

He doesn’t greet me at the door, and when I go to him and pet him, he doesn’t respond like he knows me. So basically his days now are spent either pacing or sleeping.

It’s becoming almost impossible to watch him 24/7, which he needs. I’ve had conversations about “quality of life,” and that it should determine whether to intervene or to let nature take its course. But I am so close to him that I just can’t say with full conviction that I think it’s time to intervene. How do I know what the best choice is for him? Everyone, including my husband, is telling me to let him go. I just keep thinking if I intervene, am I robbing him of days he needs to keep living? If I do nothing, will he be suffering?

I am reaching out to you because you seem to really understand animal behavior on a deep level, and not just what the books say. I made a commitment to take the best possible care of my pets, and I love them like my own children. At the age of 17 years and four months, he’s given me some of the best years of my life. He’s been the spark in my day. I don’t know if I’m holding on to the past or what. I really want what’s best for him, and don’t know if he’s trying to hang on to keep living or if he’s saying his body is spent.

I sincerely welcome your perspective. -- K.D. (address withheld)

DEAR K.D.: Your letter is important to other readers facing this kind of situation where an old animal can be kept alive with the best of care.

But what is the emotional and physical cost to the caregiver? That is an essential part of the equation in assessing animals’ quality of life, as detailed in the peer-reviewed article on my website, drfoxvet.net. Your competence and devotion are quite evident in your letter.

For the dog’s sake and yours, it is time to sever the tenuous thread that is keeping this old spirit in a decaying body. Discard any feeling of guilt or failure in accepting this. The inevitable is merely being postponed, and in the interim, the poor dog is being subjected to a situation where, cognitive dysfunction notwithstanding, there are probably episodes of feeling the terror of total disorientation and abandonment. One temporary solution would be to carry the little dog next to you in a sling or comfortable bag most of the time, until you can reconcile yourself to the reality of your dog’s deteriorated condition and incredible will to live.

As a culture, we have difficulty accepting death, especially of our loved ones, whether human or nonhuman. But euthanasia is a humane and ethical decision, and one which I would consider now for your dog. I would secure the services of a veterinarian to do in-home euthanasia for the comfort of all.

VETS SAY CHARITY DID NOT FOLLOW THROUGH ON PROMISES

At least 17 veterinarians, veterinary technicians and practice managers, along with four pet owners, say the Dr. Steve Abrams Memorial Foundation -- Petsavers Inc. -- has failed to live up to promises to pay for treatments and surgeries. The charity is run by Alan Abrams, who has been convicted of practicing veterinary medicine without a license and has been sued multiple times for actions he took as a veterinary practice consultant. -- Veterinary Information Network, Nov. 2

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 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: Some animal organizations have jumped on the bandwagon and are promoting free adoptions, just to empty out the kennels and to keep the killing (euthanasia) rate to a minimum. This will look good on paper: Increased adoptions equal decreased killings. What more could the humane public ask for?

However, the crucial part missing from this happy equation is a concern for the quality of life for the animal. This is the responsibility of the adoption agency as well as the adopting person/family, and calls for concern and empathy -- the ability to understand and share the feelings of another.

To those facilities that give away animals without any concern for the animals’ safety and well-being, I would like to pose this question: “Where is your humanity?” One would hope that over time, we would have made more progress on the empathy scale. In fact, I thought we had grown way beyond attitudes from the past that animals are disposable commodities.

Free adoptions are only part of the solution. The second part is to formulate a different approach to adoptions. In my opinion, such a plan would include the following steps:

1. Arrange for home visits, both pre- and post-adoption.

2. Educate the public about ”breed-specific legislation,” which prohibits some breeds in certain areas. These laws are often, basically, pit bull bans, and are determined by individual municipalities. But not all dogs are the same! In many communities, there are experts who can help with temperament testing and provide classes in dog handling/training at the shelter or another facility.

3. Form a respectful partnership with volunteers, and work in tandem with them. Their help is priceless. It is also free of charge. Volunteers are not only loving caretakers, but they can help educate by developing a rapport with the public via community outreach.

These are just a few suggestions. Many more options are available if we only open ourselves to the possibilities. In my opinion, animals should never be offered “free.” There are worse fates than euthanasia -- for example, being used as a “bait dog” and suffering a protracted, slow and painful death. Another is winding up in a neglectful or abusive home.

The animals depend on us! -- H.S., St. Louis, Missouri

DEAR H.S.: Your excellent synopsis of one of the dark sides of the “no kill” animal shelter movement will be appreciated by many as a wake-up call to communities where this practice of animal shelter giveaways is going on. I would stress that those engaging in this periodic activity should be closely watched by local media and humane investigators. I also invite other readers to share their concerns about animal welfare and protection issues.

PRECAUTIONS FOR DOG WALKERS

Whether you’re walking a friend’s dog, are employed as a dog walker, or are starting your own dog walking business, there are disease and injury risks that should be addressed and measures that can be taken to prevent problems. To help dog walkers navigate these potential hazards, the American Veterinary Medical Association has compiled resources on dog walking preparation, injury prevention, disease risks and more. To view these tips, go to AVMA.org and search “dog walkers.”

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 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: I want to encourage you to write a column about snakes. All they want is to be left alone! Also, while I completely agree with your statement that ownership of non-domesticated animals should be banned, I want to tell you the story of our little special-needs rescue rat snake. I hope you’ll see that exceptions must sometimes be made.

Orion is our fella’s name, and his mother was killed with a shovel. She gave birth anyway, as snakes do, and all of his siblings who survived were releasable. However, Orion suffered some sort of brain damage in the attack. His sensory perception seems to be lessened and he loses his balance if he turns too fast. In the wild, he’d starve to death if some predator bird didn’t snatch him up first.

Someone with compassion brought his mom to the rescue center, and they saved Orion and as many siblings as they could. The rescue is very focused on returning injured animals to the wild, especially snakes, but Orion was obviously not a candidate.

Long story short, we met this sweet, docile little guy and took the leap, adding him to our family of six other dog/cat rescues. Orion is safe in his terrarium and the balance problems bother him very infrequently. He can’t hunt very well, but if we help him a little, he can track a frozen mouse and eats fine. We keep him in a stress-free environment and consider that our main priority, as that is the best way to keep him healthy.

Right or wrong, he needed someone’s help, and I’m grateful to have the chance to provide it. He’s a 20-year commitment, but his life is worth the same as any other animal out there. We’d never buy another, and would only take on another rescue in the same circumstances.

Anyway, snakes help this planet immensely and people need to be reminded of that, by a respected voice like yours. Snakes will leave people alone and have no interest in hurting any human, ever. They’re just scared because we’re big. There is no animal that has suffered as much blind, ignorant mistreatment as snakes.

Thanks for listening and thanks for sticking up for snakes. I’m interested in your thoughts on Orion (although I’m committed to caring for him for his whole life, so please don’t talk me out of it). -- A.B. (address withheld)

DEAR A.B.: Some people will ridicule your snake-saving life commitment, while others, like me, see your compassionate response as quite normal.

Obviously, this neurologically impaired little snake could not be released into his natural habitat except as food for some predator. Since there was no evident suffering and you were available to provide food and a safe environment, euthanasia was not an option.

State authorities could come and confiscate Orion if it is illegal in your state to keep wild animals that are regarded as state property, and if you do not have a wildlife keeper’s or rehabilitator’s permit. So we will not publish your city and state of residence.

The uninformed and ecologically illiterate who organize rattlesnake roundups and kill any and all snakes on sight are an abomination -- one more venomous and depraved than the most poisonous of snakes. The public health role of snakes is but one of their gifts to us, and the balance of nature helps regulate rodent populations that can carry plague, hantavirus and other diseases.

We should have a healthy fear of snakes, and translate that into respectful avoidance. I abhor other snake traditions, such as pitting a mongoose against a relatively helpless snake, and of course India’s snake “charmers,” who make a living while depriving another living spirit of its intrinsic right to be free. Snakes do more good for us than we for them.

DEAR DR. FOX: My little poodle, age 15 years, has warts and seems to get more and more as time goes on.

Is this a sign of an illness and what could cause them? She has a heart murmur and sneezes a lot. Is this a symptom of her heart condition? -- T.G., Phoenix

DEAR T.G.: Warts are not uncommon in dogs young and old. They are caused usually by a papilloma virus, similar to those causing warts in humans, but not contagious to us. Their presence can indicate a weakened immune system, but they do tend to disappear eventually without treatment. They do not turn cancerous and are best left alone, unless they start to cause the dog discomfort, as on an eyelid or when one or more becomes itchy and ulcerated from secondary infection.

Some veterinarians remove them for purely aesthetic reasons in older dogs, often under general anesthesia, but I do not concur with such treatment, considering the costs and risks.

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 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.)