DEAR DR. FOX: My 15-year-old terrier mix, Betsy, started throwing up and had diarrhea. Blood tests showed kidney and liver issues and her heart is weak.

The veterinarian wants to do a liver biopsy and endoscopy to check for inflammatory bowel disease. This will cost more than $1,000, and I cannot afford that, being on a fixed income and having no pet health insurance.

What do you advise? My old dog is very weak and I don't want her to suffer. -- W.S.P., Alexandria, Va.

DEAR W.S.P.: I have received several letters like yours recently and have discussed this trend in companion animal veterinary care in my recent book, "Healing Animals & the Vision of One Health." "Life-saving" interventions in the terminally ill that prolong suffering should be viewed as "death-delaying" interferences.

In my opinion, this is the stigma of the health care provided by some medical and veterinary professionals whose focus is more on the organs and systems of the body than on the whole patient and his or her quality of life. The life-saving quest becomes an intellectual challenge that is driven less by compassion than by the enchantment of biomedical technologies and a mechanistic attitude toward life and the living. Future generations will surely look back on these times in disbelief that death was delayed in the terminally ill and suffering was unnecessarily protracted.

But now, thanks to the human and veterinary hospice movement, the cultural attitude toward death (especially as a challenge and failure for the life-saving professional) is changing. Ask your veterinarian for a referral to a hospice care veterinarian who will provide your old dog with palliative care in your home. I have details about this new service on my website, DrFoxVet.com.

DEAR DR. FOX: A recent column dealt with a writer's fear that your condemnation of commercial food keeps people from adopting a rescued animal. Here's another reason:

We are bombarded with pleas to save animals, but if one is a renter, this is a big roadblock. Just read the ads: "no pets" is often included. I did find a rental complex that requires a $300 deposit for a pet, returned according to how the premises look upon moving out, plus $50 a month rent for said pet. This is a low-income complex, so these requirements are preposterous.

I know of a good tenant who had to euthanize his beloved 13-year-old cat but can't afford to replace her because of the expensive requirements to do so. It is heartbreaking. This tenant is an asset to our complex, but he will move out when his lease is up. -- CONCERNED (name and address withheld upon request)

DEAR CONCERNED: This issue cuts both ways. What is a landlord/rental property owner to do with irresponsible pet owners who do not clean up around the property, allow their dogs to bark constantly and leave stained carpets, chewed doors and scratched walls and floors?

The irresponsible have jeopardized the rights and needs of responsible dog and cat owners living in or seeking to move into rental properties.

I have sympathy for the uncounted numbers of elderly people and children and their families being denied the benefits of an animal companion. I appeal to all renters with animals to be responsible and to landlords to not engage in emotional and financial exploitation. One solution might be a rental agreement of immediate eviction if animal-caused damage is not quickly addressed. The same applies to legitimate claims from other residents.

FLORIDA TOAD WARNING

Readers in Florida and those vacationing there, especially the many "snowbirds" from Northern states who take their dogs with them for the winter, take note: Florida veterinarians are warning dog owners to be on the lookout for Bufo toads, an invasive species that secretes potentially deadly, hallucinogenic toxins from glands on its head when attacked. If owners suspect their pet has licked, bitten or otherwise come into oral contact with a Bufo toad, they should rinse their pet's mouth with water, preventing the water from entering the throat, and seek immediate veterinary care. People should also wash any toxin off the animal's paws or coat and should remove any toxin residue from their hands.

(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 read your column faithfully every week and appreciate the sound advice you offer your readers. I'm especially drawn to the holistic nature of your advice and was wondering if you might be able to help me with my cat, Blue.

Blue is an incredibly adorable flame point siamese mix. He's 8 or 9 years old, an indoor cat, extremely healthy (although a little overweight) and has only one issue, really: a growth on his right hind leg.

I discovered this growth in March 2011 and took him to the vet for a biopsy that showed no malignancy. Since Blue is getting up in years and the growth doesn't seem to bother him, I decided not to have it removed. But I also proceeded to comb the Internet for information regarding the connection between feline vaccines and fibrosarcoma -- something that, quite honestly, scares the wits out of me. Even though the biopsy showed no malignancy, I'm concerned that the growth may still be there due to the rabies booster Blue had in August 2009. Consequently, when he was due for his next booster in July 2012, I took him to a vet to see if she could run a rabies titer before giving the vaccine. Unfortunately, the vet didn't draw enough blood, so the test was never run. I decided against giving him the vaccine at that time.

Since it's now been four years since Blue's last rabies booster, I'm wondering how to best proceed from here. Should I have him vaccinated or should I try to have another titer run first? I've already decided against any additional FVRCP vaccines, but am concerned about the rabies. -- L.W., Pine Plains, N.Y.

DEAR L.W: Because of the growth at the vaccination injection site, even though it did not test positive for cancer, it is evidence enough of vaccinosis, a vaccine-induced disease or adverse reaction. Your cat may well develop a similar reaction when a repeat vaccination is given, and there is no guarantee that the growth will not turn out to be malignant.

Since he is an indoor cat and because of his evident vaccinosis, I see no reason why the veterinarian should not provide you with a note indicating that, for health reasons, giving further vaccinations is not advised. Reasonable health authorities should accept this if the vaccination status of your cat is ever questioned.

DEAR DR. FOX: It is not unusual for me to see joggers running with pets on a leash and never stopping. Isn't this unnatural and harmful to a pet? I know of a woman who runs around the high school quarter-mile track with her dogs. I have watched and noticed the dogs stop and sit sometimes, then run and catch up with her. Isn't that more natural and healthful for a dog, rather than making them run all the time? -- B.B., Manchester, Mo.

DEAR DR. FOX: Please write something in your column about dog owners who like to take their dogs along when they go running. Some dogs appear very fit and able to keep up, but all too often I see dogs, even puppies, who seem to be in distress because they can't keep up with their owners or have been asked to run too far in hot weather. I hate to see these animals being dragged by the collar on a leash as they struggle to keep up with their athletic owners. How does a responsible pet owner judge how far and how fast he can ask a dog to go? -- L.S., St. Louis

DEAR B.B. and L.S.: I appreciate your concern. All dogs accompanying their jogging/running human companions should be first given time to sniff, mark and evacuate. They should be mature (not puppies), in good physical condition and show no signs of difficulty in keeping pace. Older dogs, those with pushed-in pug faces and all dogs in hot and humid weather may quickly become compromised and experience heat stress and even heat stroke, which is an emergency. A harness -- rather than a collar -- is essential when dogs tend to pull on a leash. Letting trained dogs stop by themselves and then catch up is fine if in a safe off-leash area.

All dogs need to be carefully monitored and provided with drinking water or even a cooling evaporative wet-shirt on long runs. Hot pavement can be an additional problem.

(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: We have a question regarding the diet for a cat with high triglycerides. Any advice you can give would be most appreciated by us and our lovely cat, Bess.

Bess is about 6 years old and weighs about 15 pounds. She is an indoor house cat and our only pet. We rescued her from the animal shelter.

She is on a special diet that is supposed to control her high triglyceride level (originally 2400, but now maintained for two years around 618). Our vet tells us if we change her diet, her triglycerides will skyrocket, with possible seizures and other dire results. We worry that the restricted diet does not give Bess the variety of nutrients she needs to stay well and happy.

She eats 1 to 1 1/2 cup Hills Prescription Diet r/d dry food over a 24-hour period (although the vet recommended only 1/2 cup due to Bess' weight) and 1 teaspoon Hills Prescription Diet r/d wet food twice a day. As a treat, we give her a small serving of dried bonito fish flakes from Cat-Man-Doo.

The problem is Bess is doing a lot of scratching and is trying to tongue-wash spots on her fur, usually near her flanks or on her tummy, particularly in the evening. She will suddenly jump up and seem irritated, like she was bitten; we had her checked and she doesn't have fleas. Thinking it might be dry skin, we have tried putting a few drops of fish oil in her wet food, but she will not touch it. She is very nervous and jumpy and sometimes stares crazily like she is hallucinating -- she crouches down and puts her ears back, flips over and starts racing around.

We are trying to determine whether Bess' symptoms are diet-related and how we can adjust her diet to give her the balanced nutrition she needs without her triglycerides skyrocketing. -- R.M., Fairfax, Va.

DEAR L.B.: It is good that your veterinarian has diagnosed your cat's condition.

Bess must certainly be kept on a zero-fat diet. But many cats and dogs have problems with manufactured prescription diets because of various additives and contaminants. Have your veterinarian contact Balance IT, veterinary formulated diets and therapeutic recipes at secure.balanceit.com. The company can offer a suitable recipe you could prepare yourself for Bess.

I would take her off the dried fish -- many cats are allergic to fish protein. See if her excessive licking abates.

Some cats develop elevated triglycerides after prolonged treatment with steroids. They can develop fatty growths on the abdomen, fat deposits in the eyes, show abdominal pain, be hypersensitive to touch and even have seizures. A grain-free diet may be the best preventive diet for many cats.

DEAR DR. FOX: I have an 8-year-old Yorkie who has had dry eyes for over a year now. He weighs 9 pounds. He has been taking the following medicines for his right eye for at least eight months:

-- Neomycin & polymyxin B sulfates and Dexamethasone Opthalmic ointment twice daily.

-- Tacrolimus eye ointment three times daily.

-- Optixcare Eye Lube as often as possible.

-- Pilocarpine hydrochloride ophthalmic solution mixed in his food twice daily.

When he was tested in April 2013, his right eye tear level was three; his left eye tear level was 12. He eats Wellness food. I understand I will have to continue with this treatment for the rest of his life.

Do you have any other suggestions or any other treatment that you would recommend for him? It is difficult to keep up with the treatment each day. -- E.W., Silver Spring, Md.

DEAR E.W.: I am glad that your little dog's dry eye condition was recognized and treated before serious damage to the cornea and loss of eyesight occurred.

While I have no additional treatment to suggest other than drops of ophthalmic Eye Bright, a potentially beneficial herb, your letter will serve as a warning to owners of Yorkies and other breeds, as well as all old dogs, about this condition. Undiagnosed and untreated, there will be increasing discomfort and eventual pain and suffering.

Usually this condition develops gradually and may be identified during the course of an annual physical or wellness appointment that I recommend for all dogs. More rarely, it is triggered suddenly by certain medications such as antihistamines.

(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.)