DEAR DR. FOX: I am a licensed massage therapist who has been doing massage therapy on humans for over 25 years. I am semi-retired now, but would love to use my massage skills on animals on a volunteer basis. I am not sure where and how to begin! I would be willing to study on my own so I can be prepared. -- M.S., Jupiter, Florida

DEAR M.S.: I think it would be wonderful for you to offer your skills to cats and dogs in animal shelters in particular, as well as in boarding facilities and for those living with elderly owners confined indoors. You might also take the dogs for a good walk!

You can adapt your skills to give beneficial massage therapy to cats and dogs following the instructions in my two books, "The Healing Touch for Cats" and "The Healing Touch for Dogs." Also, check out the two DVDs on my website (drfoxonehealth.com) that give a brief introduction to massage therapy for dogs and cats. I received training and certification in human massage therapy before I developed and applied veterinary massage therapy for companion animals.

DEAR DR. FOX: What are your thoughts on end-of-life decisions for dogs with advanced dementia? Our 16-year-old Shih Tzu is either sleepwalking or wandering with confusion through the house. She doesn't seem to be in any pain, but is taking Lasix for an enlarged heart. -- M.L., Bartlesville, Oklahoma

DEAR M.L.: Quality of life assessments can best be determined by those who live with the animal in concert with a caring veterinary consultant. But beware of the few who may seek to extend an animal's life just for the money. If in doubt, seek a second opinion.

Dementia in humans and other animals is a progressive, degenerative disease which cannot yet be reversed. But it may be prevented, and mental deterioration slowed to some degree, by regular exercise, games, exploring outdoors and good nutrition. Food should be high in free-radical-scavenging antioxidants. Melatonin is one excellent antioxidant, and I would give your dog 3 mg at bedtime and 1.5 mg around noon. Couple this with a twice-daily full body massage, as per my book "The Healing Touch for Dogs." Massage therapy has been shown to help prevent hospitalized patients from developing hospital psychosis/dementia, a dissociative and disoriented mental state.

If you see no signs of improvement within five to seven days, I would say it is time to say goodbye to this dear little soul.

DEAR DR. FOX: I want to thank you for an earlier column where you advised retired seniors to consider adopting an older dog. I did just that, taking in 8-year-old Max, an Australian heeler mix whose owner could not take him into assisted living.

Max rescued me from depression and thoughts of suicide since my wife had died, and we never had any children. Max is my devoted savior. I have someone to get up for every morning to care for -- and he cares for me, too, starting my days with a wild wagging tail and a happy face! He gives me a sense of purpose in living. -- G.L., West Palm Beach, Florida

DEAR G.L.: Thank you for sharing your story. Max gives you a reason to get up in the morning, and no doubt gets you outdoors for walks in addition to keeping you company in-home! For a fine collection of stories about how rescued animals have helped people, see Richard D. Rowland's book "A Glimpse Behind the Veil: Stories About the Human-Animal Connection" and the touching book "Mutual Rescue: How Adopting a Homeless Animal Can Save You, Too" by Carol Novello and Ginny Graves.

SMALL DOG BREEDS PRONE TO DENTAL PROBLEMS

Extra-small dog breeds -- those less than 14 pounds -- are up to five times more likely to develop periodontal disease than giant breeds weighing more than 55 pounds. Age, weight and history of preventive care are also risk factors, according to a study in The Veterinary Journal. The researchers say smaller dogs' proportionally larger teeth cause overcrowding, which allows more plaque and tartar to accumulate. And little dogs' alveolar bones are small in proportion to their teeth. (Full story: VetSurgeon, Oct. 6)

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 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 DrFoxOneHealth.com.)

DEAR DR. FOX: I've been in the veterinary care business, including emergency, for going on 20 years now, and I want to caution your readers about one problem with Banfield as a veterinary care provider.

Banfield, as a company, mandates what vets can and cannot do when it comes to testing and procedures for pets with a given set of symptoms. This greatly limits a veterinarian and, in my opinion, turns them into glorified vending machines. You put in the coins, you get the test the company says you can have -- not what a veterinarian's own skills and experience tell them a pet needs.

If at all possible, I recommend small, private vet clinics. There are plenty of online reviews for all but the smallest these days. A smaller practice will develop an ongoing relationship with owners and pets that may not be present at a corporate chain where veterinarian turnover is high. This relationship becomes crucial for pets as they age.

Also, a note on Blue Pearl: They're buying up local emergency practices as fast as they can, and they also enter the market with low pricing in order to "starve out" local competition. We're fortunate that here in Virginia Beach, there's a long-established practice that had the funds to withstand this until Blue Pearl racked up more negative reviews. Unfortunately, Blue Pearl still has the bankroll to afford diagnostic equipment that the other practice cannot provide. They also offer monetary incentives for specialists such as cardiologists and oncologists to use their space.

This leaves pet owners with only one choice in emergency veterinary care for all but the most common procedures. Again, working with a small, local practice will give pet owners the benefit of having someone who knows the ins and outs of all possible choices, and can give them an expert opinion of how the emergency hospitals have handled prior, similar cases. -- J.L., Virginia Beach, Virginia

DEAR J.L.: I agree wholeheartedly with what you are advocating. A major problem is that smaller, independent veterinary practices, both here and in the U.K., are burdened with rising costs. Some practices are staying independent but have large veterinary and support staffs, while smaller practices provide basic services and are tightly linked with second-opinion referrals for special services such as surgical, cardiac, ophthalmic and dermatological.

As consumer incomes fluctuate and demographics change, local veterinary services may wax and wane, but animals' needs do not. This is a challenge for all who care. Every community should have at least one basic veterinary hospital with emergency services provided at cost (and subsidized by charities for those who need additional assistance). This is all enlightened self-interest, since our animal companions contribute so much to the greater good -- especially the mental health of those who are socially isolated. A healthy animal population means a healthier human community.

GUIDANCE ON INDOOR/OUTDOOR CAT LIFESTYLES

The American Animal Hospital Association and the American Association of Feline Practitioners recently put forth a joint publication entitled "AAHA/AAFP Feline Life Stage Guidelines." Below is some helpful information from the publication's Lifestyle Choices section:

"An indoor-only lifestyle may decrease the risks of injury, predators, poisoning and exposure to infectious and parasitic agents. At the same time, it may increase risks of compromised welfare, illness, obesity and behavior problems due to environmental limitations. Appropriate environmental enrichment is thus essential for maintaining the mental and physical well-being of cats.

"An indoor/outdoor lifestyle may allow a cat to express normal feline behaviors and provide a stimulating environment, but it also may increase the risks of infectious and parasitic agents, injury, poisoning, and exposure to wildlife and predators. Supervised or controlled outdoor access (e.g., during leashed walks or via cat-proof enclosures) may reduce some of the risks otherwise associated with access to the outdoors."

For more information, refer to the AAFP Position Statement "Impact of lifestyle choice on the companion cat: indoor vs outdoor," available at catvets.com under "Practice Guidelines." Additionally, I helped develop a website on TNE -- trap, neuter, enclose -- that has some good information for cat owners/guardians, which you can visit at trapneuterenclose.com.

CANNED DOG FOOD RECALL

Fromm issued a recall for about 5,500 cases of canned dog food that might contain an excessive amount of vitamin D. This can cause vomiting, loss of appetite, thirst, increased urination, excessive drooling, weight loss and renal dysfunction if consumed in very high amounts. Cans of Four-Star shredded beef, pork, chicken and turkey with a best-by date of August 2024 were recalled. (Full story: WEHT-TV, Henderson, Kentucky, Oct. 2)

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 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 DrFoxOneHealth.com.)

DEAR READERS: Here is an update on the topic of declawing from our friends at All About Cats (AllAboutCats.com).

"While many countries have outlawed the declawing of cats, the United States is still a bit behind the times. Recently, however, the Pittsburgh City Council advanced proposals to make it illegal to declaw a cat. The procedure has rightfully been dubbed 'cruel and inhumane.'

"City Councilman Bobby Wilson declared, 'The City of Pittsburgh should set an example as a humane city ... how we treat animals speaks to our deepest values. Declawing a cat does not just mean removing its nails. If this happened to a human, it would be like cutting off each finger and toe at the last knuckle.'

"Over the past few years, lawmakers in other cities have made similar proclamations. The entire state of New York announced a ban in 2019, and Austin, Texas, banned declawing earlier this year."

Dr. Fox here: Learn more about what declawing actually entails and why so many veterinarians and animal activists are against it by watching Dr. Robin Downing's webinar, "The Case Against P3 Amputation," at youtube.com/watch?v=y-1IVagV628.

For my take on this unethical mutilation of cats, visit drfoxonehealth.com/post/declawing-cats.

DEAR DR. FOX: My miniature poodle/cocker mix is having a problem with a red discharge below her eyes and around her mouth. This started around 18 months ago: She was having stomach problems, eating grass in the morning and then throwing up.

After an ultrasound, they found no problems in her stomach, but she did have a urinary infection. Our vet put her on an antibiotic and a special diet (Royal Canin Selected Protein PV). Her stomach problems went away, but a month after starting the new diet, I noticed the red discharge.

The vet said it may be allergies, so I have her on half a Benadryl and some ketotifen fumarate eyedrops, each twice a day. No change in the discharge.

Could the problem be the diet? -- D.N., Naples, Florida

DEAR D.N.: This is a very common problem in white-faced dogs because the iron (porphyrin) staining is more evident on the light-colored fur. The staining is due in part to bacteria, and may be aggravated by food-coloring agents -- including potentially cancerous azo dyes -- that may be secreted in dogs' saliva and tears.

The mineral supplements in your dog's manufactured food may be an issue. The ingredients list for the dry kibble includes these trace minerals: zinc proteinate, zinc oxide, ferrous sulfate, manganese proteinate, manganous oxide, copper sulfate, sodium selenite, calcium iodate and copper proteinate. The ferrous (iron) sulfate could be a contributing factor to your dog's staining secretions. I am concerned, as are some other veterinarians, about copper additives in pet foods, which can lead to liver problems and are not well regulated.

All dogs who tear a lot should have their eyes examined by a veterinarian for chronic infection, which could lead to corneal ulceration. This is especially common in toy breeds and in all dogs with bulging eyes -- the brachycephalic dogs like pugs and French bulldogs.

Clean around your dog's mouth and carefully under the eyes with a mixture of equal parts hydrogen peroxide and warm water. It will also help if you keep your dog's facial fur well-trimmed; moisture under the chin after drinking creates an ideal environment for bacterial and fungal proliferation and secondary skin disease.

I would try the home-prepared dog food recipe posted on my website, and also transition your dog onto an organic, additive-free commercial food like The Honest Kitchen's chicken or turkey with grains.

PET FERRET HAS COVID-19

A ferret in Florida is the first in the U.S. with a confirmed SARS-CoV-2 infection, according to the USDA. Officials say the ferret exhibited clinical signs of illness, including sneezing and coughing, and likely caught the virus from a person. (Full story: The Associated Press, Sept. 25)

This is a warning to all who have pet ferrets since, like mink, they are susceptible to this virus and can be infected by people with COVID-19. This could result in ferrets becoming a secondary reservoir for this extraordinary virus, leading to the infection of people with a new mutated form.

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 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 DrFoxOneHealth.com.)