DEAR READERS: After evaluating veterinary practices in the Minneapolis-St. Paul area, the nonprofit Twin Cities Consumers’ Checkbook published some of its findings in the Star Tribune (“Finding the best care for your pet,” Oct. 4). The results include patterns and discrepancies that should interest pet owners across the country.

For instance, Checkbook’s Kevin Brasler says that accreditation by the American Animal Hospital Association seems to have little relationship to reported quality of veterinary care: On average, accredited practices scored about the same as nonaccredited ones. Brasler also reports that Checkbook found “astoundingly big price differences” among practices for the same services. To spay a 7-month-old, 25-pound dog, mystery shoppers were quoted prices from $243 to $825. And to clean the teeth of a 6-year-old, 65-pound dog, quotes ranged from $218 to $790.

Many readers of my column have had similar experiences. Aside from these evident discrepancies in veterinary services, my big concern is for the people who cannot afford to take their animals in for regular veterinary health checkups. These visits include mandatory rabies vaccinations, and at least blood and fecal tests to check for parasites, some of which can infest people. Skipping these checkups therefore raises significant public health concerns, as well as animal health and welfare issues, which need to be addressed by the richer animal charity organizations and state veterinary associations.

Thousands of cats and dogs have been adopted during the COVID-19 pandemic, and there are questions about the unanticipated costs of providing good nutrition and veterinary care -- especially when incomes are uncertain for many families.

Brasler also pinpoints some of the pitfalls in pet health insurance schemes, noting that some policies do not cover preexisting conditions, and that premiums increase as the animal ages. My advice is to consider an accident-only policy if you have an animal who often gets out, risking being hit by a car or injured in a fight with another animal.

I was heartened to learn about veterinarian Dr. Marie Louderback’s discounted veterinary visits to assisted living facilities and low-income homes. Her organization, Minnesota Supporting Companion Animals for Seniors and the Disabled (MnSCASD.org), accepts donations to support and expand her practice. We need more charity organizations like this across the country in these challenging times. Read on for another great example.

NONPROFIT OFFERS MORE HELP FOR SENIORS WITH PETS

The nonprofit Pets for the Elderly helps older people around the country get pets by subsidizing adoption fees, and the group recently began helping with food, grooming and routine veterinary care costs. Pets have been shown to motivate seniors to exercise and take medications as prescribed, says Executive Director Susan Kurowski.

DEAR DR. FOX: My 18-year-old female cat recently had a stroke. After a month of nurturing, she has made a nice recovery. But now, she uses her litter box to urinate, but defecates on the rug in my sunroom. I change the litter regularly, and when she went in front of me in the sunroom once, I showed her that it upsets me. After that episode, she used the litter box for two days, but is now back to urinating in the litter box and pooping on the sunroom rug. Help! -- D.M., Tom’s River, New Jersey

DEAR D.M.: Your cat is old, and I would let her defecate on the rug in the sunroom -- at least it is confined to one spot in your home! Place a large pee-pad on the area and smear some feces on the surface to encourage her to use that spot.

She may be constipated and experiencing pain when in the litter box. Add a few drops of olive oil to her food. An abdominal massage, as per my book “The Healing Touch for Cats,” may also help.

HALLOWEEN CELEBRATIONS ALL AWRY

The pandemic certainly affected Halloween this year: With trick-or-treating and gatherings curtailed, many pet parents chose to show off their dogs’ costumes via video calls or social media. However, I am very concerned about the exploding use of energy and radiation from all this telecommunications technology. If it were up to me, I would switch it all off for Halloween so the dead spirits of the forests and grasslands, or any other natural ecosystems we now occupy, could be felt, along with all our ancestors and relations as we listened to the night.

Our electric lights have killed the dark and made the stars invisible to our children. Halloween should be a night of darkness, when we come to our senses and revere all life, remember the dead and find gratitude, joy and wonder.

(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 DrFoxOneHealth.com.)

DEAR READERS: Several mammalian species, including cats, are susceptible to infection by people with COVID-19. A feline lockdown is called for, keeping all cats indoors (except for safe enclosures, aka “catios”). Otherwise, cats coming from homes with infected people could spread the virus to other cats. Back at home, those other cats could then infect any pet ferrets, rabbits or hamsters present. Infected cats could also spread the disease to wildlife, notably foxes, squirrels and rabbits.

Free-roaming and “working” rat-control cats could create a coronavirus pool of infection in various communities, becoming a link between an infected human population and wildlife already at risk (doi.org/10.1111/mam.12225). If the virus infecting cats (including the big cats in zoos) ever mutates and becomes transmissible back to humans, there could be a public backlash of cat and/or wildlife extermination, as occurred centuries ago during the Black Death.

At least one company, Applied DNA Sciences, plans to initiate clinical trials of one of its vaccine candidates for veterinary use to prevent coronavirus infections in domestic cats. The trials will be conducted in collaboration with biotechnology firm EvviVax S.R.L. upon receiving approval from the U.S. Department of Agriculture.

Precautionary measures -- like wearing masks, washing hands and avoiding crowds -- are essential elements of preventive medicine. All cat owners should treat keeping their cats indoors as another necessary precaution, and all TNR (trap-neuter-release) programs by animal shelters should be curtailed.

I share the concern of many virologists and epidemiologists that SARS-CoV-2 can mutate and become more infectious to one species, and then another. This has been reported in the Netherlands, where fur farm workers infected some mink, which then infected a previously healthy worker (medicalxpress.com/news/2020-05-dutch-farm-worker-covid-mink.html).

I am also concerned about the global pork industry, since pigs are susceptible to SARS-CoV—2 and thus potentially at risk from infected workers. A certain coronavirus in pigs (swine acute diarrhea syndrome coronavirus, discovered in 2016 in pigs in China) has the potential not only to devastate the pork industry, but also to spill over to human populations, according to a study published in Proceedings of the National Academy of Sciences (doi.org/10.1073/pnas.2001046117).

It is high time we all turned to more plant-based diets, since produce is so much safer to eat, is more sustainably produced, and does not suffer.

CAT WITH RESPIRATORY DISEASE HAD SARS-COV-2

A 16-year-old cat with severe respiratory illness was humanely euthanized and diagnosed with a SARS-CoV-2 infection, according to Pennsylvania State Veterinarian Kevin Brightbill. The cat lived in a home with several people who had positive COVID-19 tests. While there is no evidence that pets can transmit the virus to people, anyone with a confirmed SARS-CoV-2 infection should take precautions to prevent transmitting it to pets, says veterinarian Suresh Kuchipudi, a clinical professor of veterinary science at Pennsylvania State University.

DEAR DR. FOX: My dog is female, and has a very sweet, pleasant perfume smell just on the top of her head. It’s not coming from her breath or ears. What causes this? -- Z.C., Trenton, New Jersey

DEAR Z.C.: This issue comes up periodically, and I encourage people to sniff their dogs more. They have remarkable scent glands in the skin around their cheeks and on top of their heads. Some dogs give off little odor, if any, but others emit floral scents that remind me of frankincense, myrrh and sandalwood.

The purpose of these scent glands has yet to be determined, but they may have a calming or appeasing effect on other dogs -- similar to the calming pheromones coming from the skin around a mother dog’s nipples. (Years ago, a reader told me that when she was upset as a young child, her mother would tell her to go sniff their dog’s tummy to calm down!)

As a veterinarian, I was taught to use all my senses when evaluating an animal’s condition. Healthy animals, like healthy people, smell good! I advise all dog and cat owners to become accustomed to their animals’ scent. Any change could indicate a health issue -- perhaps dental, nutritional or one involving the kidneys or liver -- that would require veterinary attention.

(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 DrFoxOneHealth.com.)

DEAR DR. FOX: We spend the winter in southern Texas and need something for fleas. Our dog had been taking Simparica, but the last time, he had an adverse reaction: He got kind of catatonic and it took several days for him to be back to normal.

What could I use instead? We are in an RV park, and although we don’t go to the dog park, he likes to go on walks. So coming in contact with fleas is unavoidable. -- J.R., Mercedes, Texas

DEAR J.R.: I am sorry to hear about this frightening adverse event, and am glad your dog survived. Year after year, I hear accounts like yours, and wish the veterinary profession -- as well as dog and cat owners -- would wake up and use safer alternatives for flea control. I wonder about the long-term consequences on animals who recover from adverse reactions, or who do not develop immediate adverse reactions but could eventually become epileptic or more aggressive, or develop cancer or chronic spasmodic bowel conditions.

Safer flea-control suggestions are posted on my website (drfoxonehealth.com) under the titles “Companion Animal Risks of Flea and Tick Insecticides” and “Preventing Fleas, Ticks and Mosquitoes.”

DEAR DR. FOX: Regarding cat TNR (trap, neuter, release): After being trapped and neutered, these cats are returned to the only places they have ever known, where local caregivers supply them with food, water and care. Of course, if they can be adopted, they are. If they have kittens when trapped, the kittens are provided a better life.

These volunteers are helping the cats and their environment. What other alternatives are there? -- M.C., Vero Beach, Florida

DEAR M.C.: Volunteers could better help the environment and the cats by permanently removing them.

The alternative to TNR, for reasons spelled out in the article “Releasing Cats To Live Outdoors” on my website, is for our communities to provide cat sanctuaries: indoor-outdoor enclosures for lost, stray and feral cats and kittens. This is far preferable to releasing them to risk being killed or injured by traffic, or to catch and spread various diseases -- some transmissible to humans and wildlife. After all, these cats are domesticated animals, even though some can thrive independently as predators.

We are starting a movement in Minnesota of advocating for cat sanctuaries. When properly designed, these facilities can be places for people to commune with and adopt cats, many of whom do eventually recover from the mind- and spirit-changing experience of having to survive outdoors. Before being introduced to group housing, any new cats should be neutered, tested for feline viral leukemia and immunodeficiency virus, treated for any external and internal parasites, then quarantined for 10 to 14 days.

A GOOD DOG FOOD SUPPLEMENT

I advise adding shredded, unsweetened coconut to dogs’ food (1 teaspoon daily per 30-40 pounds of body weight). Coconut contains inulin fiber, a highly fermentable soluble fiber that helps sustain beneficial bacteria in the digestive system. Inulin fiber is one of the most well-studied functional fibers. Readers who already have my dog food recipe should add this ingredient!

(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 DrFoxOneHealth.com.)