Question:

My 3-year-old female pug has had three urinary tract infections (UTIs) in the past six months. We finally seem to have gotten rid of the last one after a six-week round of antibiotics. However, after the antibiotics, she still had struvite crystals in her urine. Also, the antibiotics make her sick, so she vomits after most of her meals.

Her vet would like her to be on a prescription diet, but that contains ingredients that she doesn't do well on (chicken). I would also like to avoid the dry kibble if at all possible. I feed her a homemade diet. She gets a variety of meats; she gets acid reflux with poultry, but eats beef, buffalo, lamb and salmon. I alternate her veggies among broccoli, carrots, sweet potatoes, peas, green beans and squash. She gets either rice or oatmeal. She takes a multivitamin daily. Since she was having UTIs, I added cranberry powder to her diet.

A friend told me that I shouldn't give her rice or oatmeal. Is that a problem? Do you have any other advice? I tried the diet on your website and she likes it as long as I leave out the kelp. Should I be doing anything else?

K.B., Alexandria, Va Sep 25, 2012

Answer:

Certain breeds seem to be more prone to develop struvite crystals and stones (uroliths) than others. But two main contributing factors are too much alkaline in the diet and the dog not drinking sufficient water. Those are easily fixable.

Give your dog a canned dog food and also a home-prepared diet minus any cereals or grains -- these tend to make the urine alkaline, which potentiates struvite crystal formulation. Cat and dog foods with high fiber contents -- often used to help reduce weight in obese pets -- may also promote struvite crystal formulation.

For more details about this common problem in dogs and cats, see my website, DrFoxVet.com. In the latest versions of my home-prepared foods, I have omitted the seaweed ingredient (kelp) because of concerns over heavy metal contamination and excess iodine affecting thyroid function.

Question:

My indoor male cat is about 9 years old. Lately, he's been limping or favoring his right hind leg or hip area.

Sometime last year, he may have fallen from a cat climbing tower or window and landed wrong. We're not sure exactly what happened, but he avoids climbing the tower now. His vet thinks he has some arthritis due to the probable injury and the fact that he is a large-framed cat who weighs 14 or 15 pounds.

My vet has given me a sample of tramadol to try for him as needed for pain relief. I have heard that the taste of the tablet is very bitter and that he could foam at the mouth after taking it. Aside from the bitter taste, are there any serious side effects of using this drug as needed for my cat?

As a side note, he is also asthmatic and has been on a daily regimen of inhaled Flovent and albuterol for about six years. He is very good about this routine.

L.W., Alexandria, Va Aug 28, 2012

Answer:

After middle age, many cats suffer from chronic arthritis, which is often only diagnosed when they take a tumble because of reduced mobility, like yours probably did.

The tramadol will give some pain relief, but I would not advise long-term use. Fish oil is something I recommend frequently because of its anti-inflammatory properties.

Massage therapy and acupuncture can be beneficial, ideally done in-home by a qualified therapist or trained veterinarian. There are schools for pet massage -- just search the Internet -- and my book, "The Healing Touch for Cats," is used by many for in-home therapy.

You are fortunate that your cat accepts the inhalation therapy. Many cats protest this and are stressed by the experience. With patience, many often come to accept the treatment -- no doubt because of the associated relief.

In all cases of diagnosed asthma, food allergy and heart disease must be ruled out. A change in diet -- trying various formulations -- might be all your cat needs if this has not been considered before.

Question:

We have a pair of male Abyssinian cats. We got the littermates when they were 4 years old; they are turning 7. They are very healthy except for a problem with loose stools accompanied by mucus tinged with blood.

They both had ringworm coming from the breeder. Their previous owner's vet had them on a regimen of antibiotics (C-Tylosin) their entire lives for the loose stool, but it never helped the problem. We ended that when they came to us.

We feed them the best kinds of foods from Weruva and Prairie Foods. We give them natural supplements like Phytomucil, Gentle Digest and probiotics to help them heal, but they never seem to.

What are your thoughts?

B. and R.M., Alexandria, Va Jul 17, 2012

Answer:

The long-term treatment with antibiotics is an absurd regimen and may be at the root of your cats' bowel disorder. Judicious, short-term use of drugs like Tylosin, metronidazole and prednisone can be extremely beneficial for some cats with irritable bowel syndrome and inflammatory bowel disease.

There may be permanent damage to your cats' digestive systems. The condition dysbiosis could be significantly alleviated by the three supplements you are giving to your cats. Ask your veterinarian to consider preparing capsules of fecal bacteria from healthy cats with which to inoculate and help restore your cats' digestive tracts if probiotics do not help. Give them a teaspoon of dried catnip to eat every two to four days and one or two drops of peppermint extract hidden in their food every day for seven to 10 days.

Bacterial probiotics are very important. Anti-inflammatory fish oil may also be of benefit, beginning with one or two drops in their food and increasing gradually to 1/2 to 1 teaspoon daily.

If there is no significant improvement, discuss with your veterinarian setting up an elimination diet to test for another complication such as a food allergy or intolerance to beef, eggs, corn, dairy products, corn or soy.

Question:

In May 2009 we adopted an abandoned cat that our friends found in a box giving birth. A home was found for the kittens, and we took mama cat. We immediately took her to the vet, who spayed her, gave her shots and performed a complete physical exam. The vet estimated the cat was about 10 months old. She weighed 6.5 pounds, and her tests indicated she was very healthy.

We named her Jackie Paper and took her back to the vet for a checkup in June 2010. She presented as a healthy cat, except that her neutrophil level had dropped from 7,000 to 1,350 (the normal range is 2,500 to 8,000). The vet suggested we have her retested. We did so one month later, and her level dropped even more, to 957. At that point, the vet tested the cat for feline leukemia and the corona virus -- the results were negative for both. A few weeks later, new tests indicated her neutrophil levels had increased to 1,408. The vet thought she might have had some temporary condition that she was getting over.

Jackie's neutrophil levels go up and down for no reason we can explain. And, with one exception (February 2011), her levels remain below normal. The vet consulted with other vets, set up a blog and researched the possible causes, but neither she nor any other vet has come up with a plausible cause for Jackie's condition. We had a bit of hope early in the summer of 2011 when one consulting vet suggested a probable bacterial infection and prescribed Orbax. The cat loved the medicine, but, unfortunately, her neutrophil level dropped from 1,940 to 1,540 during the four months she was taking the medication.

We're at a loss as to what to do. The vet and her consulting vets suggest a bone marrow biopsy, but we hate to put the cat through that if, in the end, there's nothing we can do to help her. Can you suggest any probable causes for her condition or any medications or food that would boost her neutrophil level?

B.K.K., Alexandria, Va May 28, 2012

Answer:

As you have no doubt learned, neutrophils are white blood cells produced by the bone marrow and play a vital role as part of the immune system defense mechanism to fight infection and inflammation.

Feline viral infections can result in neutropenia (low white blood cell counts). It is my opinion that your Jackie Paper may have a viral or bacterial infection that is not showing up in blood tests. Alternatively, she could have a congenital bone marrow defect or have been treated for ringworm prior to you adopting her with a drug such as griseofulvin that damaged her bone marrow neutrophil production.

Since the antibiotic treatment did not help improve her neutrophil count, we can probably rule out a chronic bacterial infection. I would give her supplements to help boost her immune system functions such as coenzyme Q10, Resveratrol, fish oil and a good multivitamin and multimineral supplement such as Platinum Performance Plus. Short-term treatment with recombinant human granulocyte colony-stimulating factor (G-CSF) may be beneficial. I would question doing a bone marrow biopsy. Ask what treatments might be subsequently prescribed, depending on what is diagnosed.

Cats do not respond well to invasive procedures. If your cat were mine, I would wait and see, especially since she is showing no other signs of illness. A prior infection from which she recovered could have brought on her neutrophil anomaly, and, provided her health is maintained with good nutrition and a stress-free environment, she may live happily for many years.

Some normal cats may have low neutrophil counts (between 1,800 and 2,500). As a precaution, I would avoid giving your cat any further vaccinations or anti-flea drugs.

Question:

I want to thank you so much for your repeated suggestions to put dogs on a wholesome diet to get rid of itchy skin and digestive problems. After visits to more than one veterinarian who did not get my dog well after expensive tests and different medications -- including steroids, which made him anxious and overweight -- I took your advice and tried your home-prepared diet.

After a few days his bloating and occasional bouts of diarrhea stopped, and now he is a happy, active dog with a shiny coat and a much better disposition.

G.F., Alexandria, Va Mar 20, 2012

Answer:

As Hippocrates, the founding father of modern Western medicine, advised, "Let your food be your medicine and your medicine be your food." This is as true for our animal companions as it is for us.

I observe with horror what many people eat and feed to their children and pets. Apparently, they see no connection to the food and obesity, allergies, behavioral problems and various other health issues from arthritis to high blood pressure and heart disease.

I would very much like to hear from other readers whose cats and dogs have shown improvements and even full recovery from illnesses (please specify) following a change in diet (also please specify). Mail or email me at the addresses provided in this column.

Question:

Our 17-year-old Maltese is failing. He has limited vision and hearing, and his hind legs and hips are weak.

We feed him your home recipe, but lately he can't seem to keep it down. We find bits of brown rice in his vomit, and his stools are loose. We took him to the vet, and he suggested a bitter-tasting medicine to stop the nausea. We're hesitant to give him any more drugs. The last drug for incontinence made him very sick.

We know he is probably in or near his last days. We want him to be comfortable. He has very few teeth left, so food choices are limited.

J.P., Alexandria, Va Jan 17, 2012

Answer:

Phenylpropanolamine, the commonly prescribed medicine for incontinence, can make some dogs restless and cause palpitations and panting. If your dog is on this, I would stop the medication and get him used to wearing a disposable baby diaper or doggy pad and put down a larger one where he lies down. My 17-year-old dog has had episodes of gastric upset and nausea. She responds well to a day of boiled white rice water (essentially "mini-fasting"), then two to three days of boiled white rice with a bit of cottage cheese or scrambled egg and Gerber baby food (turkey, chicken or beef). She is then given her regular food and regains her normal appetite and vitality.

Digestive enzymes and probiotics may be beneficial for older dogs who periodically go off their food. The number one reason for this is kidney failure, for which there are beneficial medications and supplements your veterinarian can prescribe. Visit my website archives for more details.

I always advise a veterinary checkup at such times in an animal's life. A routine veterinary examination every six months is an integral part of geriatric care. This includes fine-tuning your pet's diet; evaluating fluid intake and hydration; and checking urea, phosphate and potassium levels, as well as levels of cardinal indices of metabolism. This helps in maximizing comfort and deciding when it is time to let the animal go and administer euthanasia. Many older animals, like humans, show muscle wasting that is not entirely due to reduced activity, but to protein loss with impaired kidney function. This calls for the inclusion of high-quality protein in the diet rather than following the old protocol of providing less protein when there is poor kidney function.

Question:

Our 2-year-old seal point Siamese cat, a neutered male, has been losing weight. We got him and his sister from a rescue organization a year ago. Neither cat goes outside.

In the first few months at our home, he went from 9.2 to 10.6 pounds. He was a big, happy and beautiful boy.

But within a few months, he started losing weight. A year later, he is now 8.2 pounds. I have taken him to three veterinarians, including an internist/specialist. He has had every test suggested, including an endoscopy and multiple X-rays and blood tests. His blood work is always normal. His appetite is good, he is loving and affectionate and he plays with his sister. His stools are normal, and there is no vomiting. His sister is healthy and happy, yet he seems to be wasting away.

He was on a limited-ingredient diet for months with no progress. He has been on a mild steroid for a week or so, and he dropped another 4 ounces. He is now on a stronger steroid that doesn't seem to be working. He does not seem to be in any pain, but he looks like an older cat. The last blood test, as of a week ago, showed all organ functions normal.

I have had several cats who, as they've gotten older, developed thyroid problems and lost weight, but I've been told a thyroid problem in such a young cat is rare. I have also been told that my next step is for him to have invasive surgery to get multiple biopsies, and that it will be painful and may not identify the real problem.

Our hearts are breaking. Is there anything we are not thinking about?

E.B., Alexandria, Va Jan 10, 2012

Answer:

A cat as young as yours with an as-yet-unidentified wasting disease is indeed a veterinary challenge. I would certainly put off the proposed invasive surgery and go back to square one.

This means a thorough fecal examination for internal parasites. A careful examination of the mouth and teeth to rule out debilitating stomatitis is also in order. Then consider the possibility of an enzyme deficiency disease associated with chronic pancreatitis. Discuss with your veterinarian a course of treatment with digestive enzymes, probiotics and such supplements as taurine, fish oil and Platinum Performance Feline Wellness supplement (available only to veterinarians).

Let me know how he progresses. I would urge that he be weaned off the steroid medication and not be given any further vaccinations or anti-flea medications.

Question:

I adopted two kittens from our town shelter. They were about 10 weeks old and from the same litter. Now they are 1 year old and I want to thank you for writing in your column that it's best to have two cats, ideally from the same litter. Jim and Jane get on so well as playmates -- they always sleep together, groom each other and look out for each other.

One question, though: Is there more than the fact that one is male and one female (both neutered) to account for their very different personalities? Jim is more the introvert, while Jane is the tease and into everything.

J.M., Alexandria, Va Sep 19, 2011

Answer:

I appreciate your confirmation that raising two cats together is better than having just one cat deprived of ever realizing and enjoying all that it means to be a cat.

Cats "mirror" each other's behavior and provide reciprocal social enrichment and emotional stimulation. As for their very different personalities, one can rule out environmental influences because they were raised together. So it is primarily their genetic differences that determine how they react and initiate responses, as well as their likes, dislikes and motivations.

The more one gets to know different cats and becomes attuned to their subtle behaviors and to their likes, dislikes and quirks, the more one realizes what complex personalities they possess, often paralleling the kinds of differences we see in our own species!

Send all mail 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.

Question:

I have a Great Pyrenees named Avalon (185 pounds). Two years ago, Avalon had an episode of heat stroke/heat exhaustion. It was a spring day in May, around 75 to 80 degrees. She was vomiting repeatedly and drooling excessively. We took her to the vet, and her temperature was 108.

They immediately started cooling her down, shaved some of her hair and laid her on the tile floor with IVs and ice packs. They advised me to get her hair cut to help keep her cool. I had previously read about not cutting a Great Pyrenees hair all the way down, because they could get burned. Last year, in an attempt to avoid what happened the year before, I took her in early April to get a haircut. As spring progressed into summer, Avalon had several incidences of heat exhaustion -- vomiting, panting excessively and a 105-degree temperature. Should I be worried about the disguised mild mitral valve regurgitation, as stated in the vet's report? What symptoms should I look for to let me know there is a serious problem? Could there be another reason for her total inability to tolerate heat other than being overweight? Is there something to put on her skin to try to get her hair to grow back again?

S.D.Q, Alexandria, Va Jun 20, 2011

Answer:

Shaving a dog's thick coat can help prevent overheating, but can damage the hair follicles; and sunburn can be a problem, so keep Avalon in the shade and don't allow her to be active in the park because she is metabolically compromised.

She must lose weight since this is stressful on her heart. Supplements such as Coenzyme Q10, L-carnitine, magnesium, selenium, fish oil, selenium, vitamin E and Brewer's yeast are worth exploring with the attending veterinarian because of the possible benefits to the dog heart, skin and general condition.

Cold water poured on her back will have an evaporative, cooling effect and would be a good preventive when she goes out. Also try using a wet towel over her in your air-conditioned vehicle. Over-excitement (e.g., seeing other dogs) and being physically active are to be avoided until she sheds those excess pounds.

Question:

Pumpkin is our 10-year-old, neutered orange tabby that loves to be outside during the warm months and is very good about staying in our yard. But he seems to be a favorite victim of mosquitoes, especially his ears. He scratches incessantly, making them bleed. We have tried VIP and PetGuard Insecticide Gel, which aren't very effective. We try to keep him on our screened-in porch, but the mosquitoes find him no matter what. Any suggestions?

K.H., Alexandria, Va Sep 19, 2010

Answer:

Cats in the summer (and dogs, especially with erect ears) can get badly bitten by mosquitoes and other biting/flesh-eating flies outdoors. Cats can develop a hypersensitivity to bug bites. First, please don't use a UV electric bug zapper in your yard, which are an abomination and kill many beneficial and beautiful moths and other insects. Light up some citronella candles and put a dab of lemon bug repellant on your cat's ears and behind his head. Make the repellant by simmering one whole lemon sliced (including the peel) in 1 cup of water until mushy (about 10 minutes). Pulverize and store in a jar in the fridge. A dab of essential oil of lavender or vanilla may be effective alternatives. Giving your cat some Brewer's yeast, up to 1/2 a teaspoon mixed in with her food every day, beginning with just a pinch so she gets used to it, may also help repel insects.