DEAR READERS: According to the American Veterinary Medical Association, in 2011, 21.5 percent of cat owners and 29.3 percent of dog owners did not visit a veterinarian because they could not afford it. The percentage of cat and dog owners not taking their animal to a veterinarian has since increased, raising the serious issue that a growing segment of the companion animal population is not receiving any veterinary attention.

An estimated 23 million pets live in poverty alongside their human families, lacking access to veterinary care, proper nutrition and basic supplies. All animals should have access to veterinary care, which is now the rule of law in the United Kingdom. The good news is that this serious issue is recognized by many veterinary colleges and nonprofit organizations, which provide affordable, basic veterinary care in low-income communities and to financially challenged individuals, many burdened with their own unaffordable health care concerns.

Michael Blackwell, DVM, chief veterinary officer with the Humane Society of the United States says: "We have a large sector of the American population who, frankly, are poor and can't afford private care. The model the profession built (this robust private veterinary industry, in all of its glory) is not a panacea. It is not complete in its ability to address the needs of all animals." Dr. Blackwell's organization is part of a coalition that is advocating for shelters and nonprofit veterinary clinics to supplement and complement the veterinary industry by addressing unmet needs in the companion animal sector. For more information, visit jav.ma/accesstovetcare and jav.ma/moneytipsforpetowners.

DEAR DR. FOX: I adopted a pair of kittens six months ago, and I love them. I am at work all day, and I hate for them to be bored. I read an article about using puzzles with food treats inside for pets, similar to what zoos use for enrichment for their animals. I got a couple, and my cats love them. They spend time fishing out a pellet and chasing it around for hours. They've stopped chewing on my furniture -- a bonus!

I'm wondering if it's a problem that I use dry food pellets in the puzzles. They still eat a can of good wet food every day, and I bought dry food that is supposed to be grain-free, but do I need to worry about them eating the dry food from the puzzles? I would guess they eat only about a half-cup a day, and they are nearly adult-size at this point. -- B.M., St. Louis

DEAR B.M.: I am glad that you found your cats to be responsive and engage with the cat puzzles as a source of stimulation and food reward. Not all cats engage with these "environmental enrichment" toys, but when they do, it certainly does add something to their lives, especially when they live alone with no other animal in the home and no windows to look out of, ideally overlooking a bird feeder and bath.

We should all consider what quality of life we are providing our indoor cats, and for a start, having more than one cat, ideally a littermate or mother can make a big difference. Boredom, depression and obesity are all-too-common consequences of cats living boring lives.

I would purchase freeze-dried meat treats as well as good-quality dry cat food that is free of corn and soy, and ideally with organically certified ingredients.

DEAR DR. FOX: My 2-year-old Saint Bernard won't eat.

I'll find a food she will eat for a couple days and think I've found something she likes, but on day three, she sniffs the food and puts her nose in air and won't eat. She is healthy, but I'm wondering if she is playing with me because she knows I'll find a different food every time. What should I do? -- P.S., Forked River, New Jersey

DEAR P.S.: You may be turning your dog into a finicky eater, or rather, your dog is playing you in a game that needs to end. Cats are better at this kind of caregiver training and manipulation, and they often make themselves sick from eating mainly canned tuna or raw beefsteak.

So ignore your dog. Put the food down and sit quietly close by. Leaving her alone could make her anxious. See how she eats.

Other things to consider:

-- An elevated platform for the food bowl may make eating easier, since big dogs have to bend low and may have difficulty swallowing.

-- Dry food can be difficult to swallow, so moisten with hot water or give canned or raw food.

-- Schedule a vet checkup to rule out a broken tooth or other pain-related oral issue that could make eating unpleasant for your dog.

DOG FOOD RECALL

Blue Ridge Beef is voluntarily recalling two of its frozen products due to the potential to be contaminated with salmonella and/or listeria monocytogenes. Salmonella and listeria can affect animals eating the product. For details, visit truthaboutpetfood.com/blue-ridge-beef-recalls-product-because-of-possible-health-risk.

(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.net.)

DEAR READERS: The consequences of invoking the right to life for others coupled with the doctrine of ahimsa (not harming or killing), which prohibits compassionate mercy killing and death with dignity, results in much otherwise avoidable suffering in some countries and segments of society, as my wife Deanna Krantz and I document in our book, "India's Animals: Helping the Sacred and the Suffering."

Quality of life concerns can be confounded by personal, religious and politically contentious right-to-life beliefs. So the terminally ill and suffering are put on life support, unadoptable dogs are incarcerated for life in no-kill shelters, many with chronic health issues, and cats are neutered and released into unprotected environments. To not consider each individual's quality of life and to claim they have a right to life regardless of the consequences is tantamount to abdicating ultimate responsibility as their guardians and caregivers.

DEAR DR. FOX: I have a problem that is slightly different from the other articles I have read on the trap-neuter-release (TNR) program.

I live in Virginia, where feral cats are protected by code. However, I have a neighbor who "rescued" a cat. She brought it home and dumped it outside. She may feed it, but it is essentially is a feral cat with no human contact. It is never permitted in her home. It terrorizes the neighborhood. Neighbors complain that it stalks their bird feeders. I have a koi pond, and it spends hours on our property every day.

Our wonderful golden retriever, who loves the world and everything in it, now barks at this cat when it comes onto our property ever since the day we discovered the partially eaten remains of one of our fish. The cat even stalks us when we walk, which becomes a major distraction to this normally pleasant event.

I'd like to know why owners of cats are not held to the same level of responsibility for behavior and damage as other pet owners. By law, I can do nothing to protect my home and property from this menace. I fear for my dog's safety, as I am sure this cat's claws can do major damage, should it ever become cornered. My physical safety is also at risk, as the cat has caught both my dog and I off guard several times as we came out of the house. I came close to falling recently when it jumped out of a bush less than 2 feet from where we were walking. I have also experienced financial loss, as there is monetary value associated with my koi.

I am a cat lover. I kept my three cats inside, where they lived happily into their teens. This cat has become much more than a nuisance.

I do not understand how this can be OK. -- M.D., Virginia

DEAR M.D.: I understand your predicament, and the absurdity that "feral cats are protected by code" in your state.

There should be municipal codes concerning free-roaming animals who should not be allowed off owners' property. Get signatures and push for an appropriate code. In some municipalities, a collar and rabies tag must be worn, otherwise any animal can be caught by animal control.

Local authorities need to be educated about the very real public health and wildlife risks of free-roaming cats in the community. The animal protection organization People for the Ethical Treatment of Animals (PETA) has been very involved in this issue, and I regret that TNR has become a virtual cult of misguided affection and pro-life sentiment, which is doing more harm than good for cats and communities across the nation.

(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.net.)

DEAR READERS: The rights and welfare of animals and the protection of endangered species and their threatened habitats were never mentioned in all the various political debates I heard this year in America. Solutions to various environmental and related public health issues are deferred if jobs, local tax-yielding "development" and the GNP are threatened, and animal suffering is justified for the benefit of society.

I see no hope of significant progress until animal and environmental issues are put on the political agenda with the same level of public concern as human rights and interests. The biological deserts created by agri-industry destroying rain forests and grasslands are a testament to human ignorance and irreverence for life. Keeping animals confined and crowded in factory farms is an abomination, causing billions of animals to suffer every day. These animals become the source of epidemic diseases that threaten us year after year. Pesticides and other chemicals contaminate our bodies, air, food and water.

We should include animals in our politics and put them on the public agenda because of their many values and services to society -- ecologically, economically, emotionally and morally. Animal-protection laws and their effective enforcement are the litmus test of societal compassion and responsibility. Animals' moral value lies in our recognition and prohibition of animal cruelty and wanton annihilation of living beings and their communities because such actions are considered immoral. Immorality in any form is unacceptable in civil society. The late Cesar Chavez, president of United Farm Workers of America, wrote: "Kindness and compassion toward all living things is a mark of a civilized society. Conversely, cruelty, whether it is directed against human beings or against animals, is not the exclusive province of any one culture or community of people. Racism, economic deprival, dog fighting and cock fighting, bull fighting and rodeo are cut from the same fabric: Violence. Only when we have become nonviolent towards all life will we have learned to live well ourselves".

Crimes against humanity and nature and acts of terrorism against innocent peoples and other animals are of the same psychopathic currency, variously rationalized on the grounds of necessity by the executioners. A recent report by the World Wildlife Fund and Zoological Society of London shows that the world's wildlife population has dropped by a staggering 58 percent since 1970, with the greatest decline (81 percent) in lakes and rivers. This debacle, along with the billions of our 7 billion population suffering war, poverty and starvation and many indigenous cultures becoming extinct, means we must either evolve and flourish, or devolve and our humanity -- the virtue of being humane -- perish.

The antidote is living by the Golden Rule, which translates into the equality of justice for all beings, social justice and environmental eco-justice being complementary. We must establish mutually enhancing relationships with each other and other species, both wild and domesticated, as we strive to cause the least harm in meeting our basic needs and executing our planetary responsibilities. This is enlightened self-interest for us, the dominant species, to prevent accelerating deterioration of all indices of quality of life on planet Earth. We are interconnected and interdependent: one health, one environment and one wealth.

DEAR DR. FOX: My cat has started eating all kinds of fabrics in the house. She has eaten large chunks of a knitted wool sweater, nitrile gardening gloves, leather and foam gardening gloves, and cotton woven placemats. At times, I have found her gnawing on a glove before eating her canned food. Other times, she drags the object around the house and gnaws at will.

She is checked yearly by a vet and is well. She is 4 years old and indoor-only. There are five other cats and three dogs in the house, with whom she gets along well. Why is she doing this? -- S.T., Batesville, Virginia

DEAR S.T.: This behavior, called pica, is most often seen in Siamese cats. It is generally regarded as a vice or obsessive-compulsive behavior, but it should not be dismissed as purely psychological. Pica, especially in dogs, can be triggered by discomfort due to inflammation in the oral cavity and guts.

Some cats with pica improve after various dietary changes, including providing probiotics, digestive enzymes and more fiber, such as a half-teaspoon daily of soaked psyllium husks mixed in with the canned food. Transitioning onto a raw-food diet with fibrous muscle and organ tissues may help in some instances, or you can try giving your cat a daily scalded chicken wing or thin strip of gristly beef.

You need to do some detective work and get a closer veterinary checkup of her mouth and gums. Keep me posted!

(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.net.)