DEAR DR. FOX: I'm worried about our 17-year-old orange female tabby cat, Gabrielle. She's always been in good health, but over the last few years she's lost 4 or 5 pounds, down from 13. And most worrisome, she's started throwing up just about every night. Her episodes are preceded by cries of pain -- little whimpers and, once in a while, a loud cry. Then her whole body will convulse and she'll throw up brown water.

During the day she seems to be fine, eating normally and relaxing out in the sun or resting. But these bouts of vomiting are very distressing, especially since she's started sleeping in my bedroom, waking me up with her cries.

Any suggestions? -- R.C., Annapolis, Minn.

DEAR R.C.: I appreciate your writing to me, but, like other readers who write about their animals who are clearly suffering and in declining health, your animal companion should be examined and treated by a veterinarian without further delay.

Your old cat could be diabetic or have deteriorating kidney function and thyroid disease; she could have a fur ball in her stomach, or even cancer. Diagnosis and appropriate treatment or palliative care is called for, and you know that you owe old Gabrielle no less. A vet who does home visits might be best for a start if she is not a good traveler.

DEAR DR. FOX: I have a male cat who I picked up off the sidewalk with his sister three years ago when they were about 4 weeks old. I took them to the vet for exams and got rid of their fleas. They were healthy kittens.

When they were about 4 months old, I took them to a vet-recommended cat rescue organization that would spay/neuter them for less money. The organization seemed OK, so I left them there. Mistakenly thinking they were both females, I named them Sue and Ellen. When I picked them up that afternoon, they said they couldn't find Sue's ovaries, and to bring her back when she was in heat. I later took them to a vet at PetSmart for their shots. The vet said, "Why did you name him Sue?" Well, that explained the lack of ovaries. I had him neutered and renamed him Sueler.

Sueler is very fat, no matter what I feed him -- Natural Balance Fat Cats dry food or Fancy Feast that has fewer calories. I have tried other expensive food recommended by a vet, but the cats won't eat it. Sueler is not very active and keeps getting fatter. His idea of being outside is to be in the garage and watch whatever is happening outside. If a leaf blows his way, he is frightened. It is so different with Ellen -- she runs and plays and enjoys life.

What can I do for Sueler that doesn't involve an expensive vet visit? I took him to the vet services at PetSmart for an exam that cost more than $200, but I would have needed to spend a lot more for blood work to indicate why he is so overweight.

I feel the vet that searched for Sueler's "ovaries" might be the initial cause for his intestines not assimilating food correctly, but I am just assuming.

There is one more thing worth noting: Sueler keeps licking his fat belly to where it is raw and irritated. Anything I could use as a salve/ointment says, "Do not ingest," so I don't dare try them.

Can you help? -- A.W.J., Naples, Fla.

DEAR A.W.J.: A PetSmart-based veterinarian charging $200 just to examine your cat is exorbitant. You should file a complaint with your local Better Business Bureau.

As for a veterinarian taking the word of the cat owner that both young cats were female and not checking himself to be certain -- this is not an uncommon, one-time mistake. I doubt this has anything to do with Sueler's metabolic weight issue. Neutering a cat at an early age, along with a high-grain diet, could have derailed his metabolism. This might get back on track with a grain- and soy-free, high-protein diet with some fish oils or free-range beef to provide essential fatty acids.

Feeding him four to six very small meals a day may also help, as will getting him off a high-fiber, weight-loss diet food that can mean constant hunger and malnutrition.

(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.com.)

DEAR DR. FOX: I'm writing to you about my mother's 5-year-old shih tzu, Molly. She is very attached to the both of us. My mother bought her from a pet store as soon as she was able to be away from her mother. I have been with them both, on and off, over the past five years. Both of us spoil Molly.

However, since December, when I moved back to Florida from my hometown of New York City, she has become very aggressive. When I stayed at my mom's, Molly slept with me in the guest room on the bed. When my mother would come into the guest room to take her out for her first walk of the day, Molly would go berserk and start barking and growling at my mother. She would even go so far as to try to bite my mother. I would have to either get up and take her out myself or pick her up and put her down on the floor. Once on the floor, my mother could take her out for the walk.

However, if Molly slept with my mother in my mother's house and I happened to wake up first and went to get her for a walk, she would do the same barking and growling at me.

I think she is either protecting the person who's sleeping or is possibly bipolar. I know it sounds funny, but who knows nowadays? Maybe she needs mood stabilizers?

Lately she has not been eating her moist food that my mother has been giving her every morning for years. My mother has resorted to spoon-feeding her -- sometimes it works, and sometimes it doesn't.

Any help with these two matters would be greatly appreciated. -- K.H., Naples, Fla.

DEAR K.H.: A bipolar dog who is being spoon-fed -- I've heard everything! You and your mother have a problem child. But the monster is not entirely of your own overindulgent and permissive making, because Molly is a responding and triggering player in this crazy triad of confused signals and conditioned reactions and expectations.

First, I would have her taken to the vet for a full physical exam. Dogs with a malfunctioning thyroid gland or a physical problem causing pain can become unpredictably aggressive or emotionally stable.

Molly's more predictable, situation-associated, possibly territorial aggression may be cognitive in origin, and calls for behavior modification and remotivation. This means changing how you and your mother react. I would advise you to practice consistent "tough love," consulting with a canine behavior specialist who can help you and your mother turn Molly into a gentle lamb, or at least a happier and better adjusted canine companion.

Prozac may be the last resort.

DEAR DR. FOX: We have three schnauzers who have about half an acre of land on which to run and play. One is a rescued female giant schnauzer who barks so loud when she is outside that I can let her out only to relieve herself, then bring her right back in. We also have a male giant schnauzer and a miniature schnauzer.

I was an obedience instructor, and I've had two other professionals work with the problem dog. I have purchased and used every type of anti-bark collar I can find. They may work for a couple of days, but then she barks through them all. The citronella collar worked for almost two weeks, but is no longer effective.

This dog and her brother were abandoned in an outside run with no food or water until they were rescued. I believe this plays a big part in her barking behavior, but how can I reprogram her? I do not believe in debarking a dog, but I just don't know what to do to stop her from barking so much. -- J.H., Swansea, Ill.

DEAR J.H.: As an experienced canine obedience instructor, you have known other dogs like this and found remedies, but this giant schnauzer is your nemesis! I agree, she may have a post-traumatic stress disorder issue playing a role in her obsessive barking, considering her trauma history.

Is she barking out of fear, anxiety or excitement? Can she be remotivated or distracted with a loud squeaky toy to catch? Is she afraid to be outside without you being there with her? Figure out her motivation, and work with it.

(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.com.)

DEAR DR. FOX: OK, we need help here... We have a 13 1/2-year-old female black lab. Eight weeks ago, she went to the vet for blood work -- she's in perfect health. Six weeks ago, she walked away from her Eukanuba food for the first time ever. Since then, she's been eating less and less. Her last meal was Wednesday, some ground pork. She's thrown up every day, especially after she drinks water, though she is still drinking. She's lost 10 lbs. Yesterday, she sat in the yard all day, drooling; she ate a lot of grass.

We almost put her down last night, but couldn't. She still follows me from room to room. It is hard to let her go as she is still alert and can move fine, but she's no longer playful.

She is now on mirtazapine and prednisone. Her spine sticks out in the back due to weight loss. It clearly hurts her. I just want her to eat, but it seems spinal pain causes a gag reflex. I use an oral injector on the side of her mouth to administer medications. What now? Better pain medications?

Vets here want $1,500 for an endoscopy -- mine was $1,200! How can they charge such high prices? Give me some ideas, please. -- P.G.

DEAR P.G.: I'm so sorry to hear about your old dog. You could spend a small fortune on diagnostics. My response following all of those tests: "Then what?"

I would first suspect and check her blood for renal failure and have an X-ray done to check out her vertebrae. Spondylosis and other degenerative diseases of the spinal cord can cause dogs pain, fear and lack of appetite. Analgesics and anti-inflammatory drugs can provide temporary relief, but can cause nausea and disinterest in food, and affect kidney and liver functions.

Massage therapy -- as found in my book, "The Healing Touch for Dogs" -- acupuncture and laser therapy may give some relief. Give her a heated pad to sleep on. Injections of vitamin B-complex are old-school remedies for poor appetite. She may eat Gerber's baby food or something similar made at home in a blender.

You need to consider a third-party evaluation of your dog's quality of life if you are undecided about the final hard decision of euthanasia, which, considering your dog's age and breed, may be the kindest step to take. In-home hospice care is catching on, with veterinarians and trained veterinary nurses coming into the home.

The bottom line here, considering your dog's age and symptoms, is palliative or comfort care. You and your dog are victims of the kind of veterinary practice which mirrors the human health care industry's costly diagnostics and treatments of terminally ill patients, focusing on organ functions rather than on the whole patient. It may be good business, but is it ethical and humane?

(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.com.)