DEAR DR. FOX: We have a 7-year-old pit bull (male), who has been diagnosed as having pancreatic insufficiency. The vet has recommended pancreatic enzyme Concentrate, plus fat-soluble vitamins consisting of lipase, protease, amylase and vitamins A, D3 and E. He gets three tablets before each meal, so nine tablets daily. His meals consist of chicken breasts, rice and yogurt.

He is still having diarrhea. Can you offer any other alternatives? It would be greatly appreciated. -- F.M.A., Ocean View, Delaware

DEAR F.M.A: The yogurt in your dog's diet is a good idea, provided it is not pasteurized, because of the beneficial bacteria in "live" yogurt and kefir. Alternatively, a daily dose of probiotics may help your dog's overall condition.

Pancreatic enzyme insufficiency is all too common in dogs, and I attribute this primarily to their diets being too high in starches (corn and other cereals).

Try my home-prepared diet on my website, DrFoxVet.com, and cut the rice and grain content by 75 percent. Give your dog three or four pieces of canned pineapple daily. This fruit contains digestive enzymes that will help compensate for your dog's deficiency. Use lean meat and poultry and low-fat yogurt, because a high fat intake could possibly trigger an episode of pancreatic inflammation or pancreatitis, which can be extremely painful.

DEAR DR. FOX: In response to the letter from J.M., I had a similar problem with a cat who had kidney failure.

She was 13 years old at the time it was diagnosed, and I was told to use fluids under the skin twice a day. My vet said he'd heard from someone who had used Azodyl successfully. We decided to try this with Pepcid AC twice each day, along with the fluids.

She is now 17 years old, and her latest blood work shows everything within normal ranges. She eats like a healthy, happy cat!

Azodyl is a dietary supplement made by Vetoquinol and is made in the United States. It's worth considering. -- J.J.L., Silver Spring, Maryland

DEAR J.J.L.: I appreciate your letter attesting to the benefit of Azodyl for helping alleviate your cat's chronic kidney disease. This proprietary supplement, which includes probiotics, does indeed seem to be of significant value in helping cats with this condition and is being more widely prescribed by veterinarians.

Of course, there is no panacea for this all-too-common feline malady. Judicious application of various interventions is called for, including a special diet; vitamin D, potassium and thiamine supplements; blood pressure monitoring and medication as needed; and a phosphate binder if blood tests indicate this is needed. Fish oil may help improve kidney function. A high-quality dietary protein is advisable, since protein deficiency and dramatic loss of weight and muscle mass occurs with some forms of kidney disease. An injection of various hydrating and nutritious solutions under the skin is a key in helping cats enjoy some quality of life when their kidneys begin to fail.

DEAR DR. FOX: I read recently about the 14-year-old Chihuahua-rat terrier's skin problem and felt it might be useful to let you know how we brought our terrier's similar skin problem to a comfortable and manageable level.

When our now-14-year-old female was about 8 years old, she had extremely itchy, "alligatored" and crusted skin -- mainly on the belly, teats, legs and ears. She was an emotional wreck, and I think the vet mentioned Cushing's disease. There was no mange found after many tests, and I don't think her thyroid was a problem. We worked through her extreme terror, and with carefully measured exercise and diet, she took about 22 pounds off her now-65-pound frame.

Apparently, she doesn't have Cushing's -- at least not now. I think the vet could have figured that out. We tried many medications for the skin problem that remained, overhauled her diet (she is now on a no-grain Merrick chicken and yam diet) and started giving her supplements.

We really saw a tidal change for the skin when she went to the vet, who administered the following: an allergy shot of dexamethasone and depo-medrol; antibiotics Cefpodoxime and Ampicillin; a small but long-lasting dose of prednisone; and GentaSpray for the very occasional flare-ups.

Even though she may never be totally cured of the propensity toward this trouble, she is, and has been for quite a while now, a very comfortable and happy girl. I thought this might help someone else for what seems to be a rather common problem. -- C.R., Freehold, N.J.

DEAR C.R.: Chronic skin problems can often be difficult to diagnose, and in many cases, it is of significant cost-savings to first try the double whammy of antibiotics and judiciously prescribed corticosteroids.

While I have frequently addressed the harmful side effects of this latter class of hormonal medications, with careful prescribing, small miracles can be accomplished. Such hormonal treatment helps the body re-establish varying degrees of normality, the skin of the dog being a reflection of a number of underlying health issues.

Corticosteroids are an important part of veterinary and human medicine, especially because of their potent anti-inflammatory properties.

(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 3-year-old Maltipoo who refuses to eat dog food. We have tried many brands and types, to no avail.

At present, we are feeding her chicken and beef, mixed with rice, green beans, carrots and lima beans. We add several pieces of dry dog food to this mix, and she eats that well.

Her long-term health is a real concern, and we wonder if you have any suggestions. -- A.O., Edenton, N.C.

DEAR A.O.: Your dog may be exercising what I call "nutritional wisdom." She wants fresh, whole, natural food.

Some brainwashed veterinarians and other "dog experts" still insist that only scientifically formulated, highly processed manufactured dog foods are what dogs should eat. The effect on many dogs can be like what would happen to you if you got all your meals from fast-food restaurants for three to six months.

Visit my website, DrFoxVet.com, and pull up my home-prepared dog food recipe for a start; consider some of the dog food brands I endorse, along with the new generation of frozen and freeze-dried dog foods available in some of the better pet supply stores.

DEAR DR. FOX: I am writing to you about my cat Sara. We've had her for two years, ever since we found her in our neighbor's yard when she was a few weeks old.

I am considering moving her to my mother's house (my parents are divorced) for a few reasons:

My first reason is that my father didn't want Sara in the first place. He now has a sort of fondness for her, but he isn't attached to her the way I am. My second reason is that we live in a tiny, three-bedroom house with seven people and another cat. We all have various wake-up times in the morning and after-school activities, too. Half of us aren't home during the week. Add another cat (who tolerates mine), and you get a lot of crazy.

Sara has no front claws and is also fixed. The little kids used to run up to her and get in her face and say her name in annoying voices. She is sometimes very twitchy; her tail flicks and she runs from room to room like there's something chasing her.

I would appreciate your honest opinion: to move or not to move this cat. -- M.R., Fenton, Md.

DEAR M.R.: I think you are a remarkable young person who knows what love really means -- responsible care.

Clearly, your beloved cat Sara is not living in the best environment -- and I wonder about you, too. I would advise you to work things out with your mother to adopt your cat and be sure that you can have visiting rights. Alternatively, call for a meeting with all who live under your roof and share your concerns about Sara, without making judgments; ask the younger ones to treat Sara gently, be quiet around her and respect her space. Teach them how to pet, hold, feed and groom her. Help them grow up as well as you have.

(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: My shorthair calico cat will be 11 years old this spring. I adopted her from a man in a van in the Petco parking lot who had trapped her and several other barn kittens. Immediately after adopting her, I took her to my vet. We believe that she was less than 6 weeks old.

She is a petite cat, although she is a vigorous eater. She is a lap cat, always wanting to be near or on me. I love this cat dearly, but she has an annoying habit: She jumps on dressers and tables and knocks things to the floor. This usually occurs while my husband and I are trying to sleep, but she also does this at night while I am watching TV.

She naps and eats all day and then gets crazy at night. She tries to attack me, and she also bites, occasionally breaking the skin. She is an indoor/outdoor cat, but she does not stray far from the house. When I put her out when she is acting crazy, she stays by the front door or jumps on the back deck to let me know she wants in again.

My husband is threatening to take her to the animal shelter. Because of her antics, I have been sleeping in a downstairs bedroom, and she has been sleeping on the bed with me. But just the other night, she woke up and went upstairs and knocked over something on my dresser. I thought she was doing this to get my attention, but I was asleep downstairs.

I am at my wits' end. I spoke to my vet, who gave me some treats that are supposed to calm her, but she doesn't like soft treats. The vet says there was nothing else she could prescribe, and that this is the nature of calico cats. Is this true? Do you have any suggestions? -- S.L., Alexandria, Va.

DEAR S.L.: I sympathize with your situation. You are not alone when it comes to the kind of stress a cat can bring into the home and into relationships.

That your cat is an indoor/outdoor cat is, I believe, part of the problem. This can affect her biorhythms, making her more active in the early morning and evening. Indoor-only cats generally synchronize their normally crepuscular (dusk to dawn) natural activity cycle to those of their human companions. They expect to be fed after you get up and before bedtime (with two to three snacks during the day) and enjoy interactive games early in the evening, especially with another cat. This is one of the reasons why I advise people to have two cats rather than one, and also to never let them become indoor/outdoor animals, as you have inadvertently done with yours.

Your cat is possibly too old to accept a new cat in her environment, but I urge you to engage with her during her evening crazies with various interactive games such as chasing a laser light or a lure on the end of a string tied to a cane. Her playful attacks on you are not a signal for you to put her outdoors, but to learn how to playfully interact with her. To live with cats, you must "become" a cat.

DEAR DR. FOX: I have a 7-year-old black-and-tan miniature pinscher who, within the past six weeks, has turned mainly brown. The fur has also gone from short and smooth to more of a fuzzy texture. He has also lost about 4 pounds since November, even though he is eating the same amount of food.

Our vet ran a blood test, and everything came back normal, even his thyroid levels. Do you have any idea what could have caused this? -- E.H., Chaptico, Md.

DEAR E.H.: Some animals have genes that change the amount of pigment in their fur, which is linked to changes in ambient temperature or amount of daily sunlight. Some dogs develop a seasonal alopecia (hair loss) that may be due to lack of sunlight while living indoors during winter months. This may be what is going on with your dog.

Almost all living beings are light-sensitive. One of the regulatory hormones, also found in plants, is melatonin. Since your veterinarian has ruled out possible thyroid disease (and hopefully Cushing's disease of the adrenal glands), my intuition leads me to suggest giving your dog 2 milligrams of melatonin late in the evening. Also, get him outdoors as often and as long as you can during daylight hours. Let me know if his coat color returns to its former shades.

DEAR DR. FOX: What is your opinion of NexGard, the new oral medication for killing fleas and ticks? Do you consider it safer for the dog than Frontline Plus? -- S.B., Washington, D.C.

DEAR S.B.: This new oral product, approved by the Food and Drug Administration and produced by the manufacturers of Frontline Plus, supposedly kills fleas and ticks for up to 30 days after the drug -- afoxolaner -- has been given. The company states, "NexGard is for use in dogs only. The most frequently reported adverse reactions include vomiting, dry/flaky skin, diarrhea, lethargy, and lack of appetite. The safe use of NexGard in pregnant, breeding or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures."

I would not use this on my dogs. Check my website, DrFoxVet.com, for safe methods of flea and tick control.

(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.)