Prescription diet might not be the best solution

January 3, 2013

Dear Dr. Fox:

I am writing for your advice on food for my 16-year-old male cat, Chester. He’s feeling the effects of his age with constipation and less-than-ideal kidney function (but not in the danger range yet).

The vet wants to put him on prescription low-protein dry food, either Iams or Science Diet. I’m not a fan of dry food or of those brands. Based on your column’s pet food suggestions, Chester has been happily eating Evo moist food with pumpkin and fish oil added for several years.

Do you have any suggestions for alternatives to prescription low-protein food? Anything homemade? What is your opinion of giving constipated cats a laxative?

M.S., McLean

DF:I would think twice about forcing an old cat onto a new, unpalatable diet he might loathe, which can make him suffer hunger pangs and a lowered quality of life.

While some of these prescription-only special diets can be beneficial, they are highly profitable and tend to be relied upon too much as the best remedy for various pet ailments.

I would never put a cat with kidney disease that likes moist, canned foods onto an all-dry diet. Low-protein diets are not advisable when the kidney disease causes more protein to be passed in the urine. Supplements such as fish oil (which your cat enjoys), potassium, vitamin D3 and a phosphate binder such as Renagel (under veterinary supervision) should help. The tasty product Laxatone and abdominal massage should help alleviate your cat’s constipation.

obsessive licking

Dear Dr. Fox:

I have a 5-year-old domestic shorthair spayed cat that started to compulsively lick her stomach and the backs of her legs. It got to the point where she had licked off most of her hair.

The vet said there was no way to figure out why she was doing this and wanted to put her on a behavioral medication. Before going this route, I tried changing her food from one with chicken as the main ingredient to one with no chicken at all. Within a week of the diet change, my cat had stopped the obsessive licking.

It has been about six months since the diet change. I have been observing her closely and have not seen any obsessive licking, but her fur is still very thin. It grew back a little, but not much.

Do you have any suggestions for anything I might add to her diet to help with fur growth, or is this how she is going to look from now on?

J.K., Mount Rainier

DF: I applaud your initiative and regret the limited scope of possible causes and treatments your veterinarian offered.

Hypersensitivity or allergic reaction to certain ingredients in the cat’s diet and hyperthyroidism are two considerations to be ruled out before making a behavioral, anxiety or obsessive-compulsive disorder treatment decision.

It is quite possible that there is some ingredient other than chicken underlying your cat’s malady. It could also be compounded by the beginnings of thyroid disease — hyperthyroidism is very prevalent in cats that groom themselves excessively.

Fish oil, wild salmon and mackerel, or sardines rich in omega-3 fatty acids can do wonders for cats’ dermal health, helping make for thick, lustrous coats. Always introduce any new supplement or food ingredient gradually, beginning with a minute amount mixed in with regular food. Also note that some cats are allergic to fish, so organic, free-range, grass-fed beef and butter can be good omega-3 sources.

GOING indoors

Dear Dr. Fox:

I bought a Maltese puppy for my great-granddaughter. The dog is about 3 years old.

He was very difficult to train, as I’ve heard this breed is. He has now started to urinate and defecate in the house.

We take him out, but he still urinates in the house. We keep him confined to the kitchen now because he has urinated on the TV stand, recliner, coffee table, etc. I can’t get rid of him because my great-granddaughter is so attached to him.

P.S., Chesapeake, Va.

DF: Maltese terriers and other small breeds do seem to have a higher incidence of cognitive impairment when it comes to toilet training, especially compared with other breeds.

This urination activity in your home calls for some analysis. If he is straining and having difficulty or pain while urinating, your dog might have a urinary tract or bladder infection or stones. A veterinary checkup is then urgently needed.

If he is raising his leg and marking, this could be hormone-related territorial behavior. There’s also the probability that it could be anxiety-driven if there is some cause for emotional stress in his environment. Ask yourself whether he is anxious for some reason, and address that problem. Is he taken out frequently enough? Does he need more attention and physical activities?

It could also be a habit triggered by the residual scent where he has urinated before. Use an enzyme cleaner on all soiled areas. Let him out of his kitchen confinement on a long leash and harness for control. Pull him up short as soon as he sniffs and readies to urinate. Carry him outside and put him on a pad already marked with his urine (or place it in the kitchen). Be sure to give lots of praise and a treat after he urinates.

Many small breeds are amenable to urination pad training (which is a blessing for apartment living). Check out thepetloo.com for an indoor toilet system for small dogs.

Medication problems

Dear Dr. Fox:

I lost my German shepherd/chow mix and my Great Dane/Lab mix to cancer within months of each other last year. I immediately adopted Buddy, a 4-month-old golden retriever/Lab mix, from a no-kill shelter because I love big black dogs, and I know they have a horrible time finding homes.

I took him to the vet because he had a sore on his back leg and one on his penis. I wanted to make sure that he did not have ringworm. (He didn’t.) The vet looked at some skin scrapings under a microscope and told me that he had a bacterial infection. She prescribed cephalexin. Buddy got diarrhea almost immediately after taking the medicine. His stool wavered between soft and loose. I stopped the cephalexin and called the vet. The vet put him on PVD FortiFlora Canine. The next day, his vet was off duty, but another vet put him on metronidazole. The stools were firmer after five days, so I stopped the pills.

After 24 hours, the soft/loose stools returned. I put him back on the metronidazole for several days. I called the vet to renew the prescription, and this vet informed me that the normal dosage should have been four times the amount I had been prescribed, so she changed that for him.

He was perfectly fine until the cephalexin. One of the vets suggested he be examined again, but I am not sure what good this would do. I seem to get different answers depending on which vet I speak to that day. I gave Buddy probiotics all of this time. Can you help?

K.W., Imperial, Mo.

DF: I am shocked that the veterinarian prescribed such a powerful oral drug as cephalexin rather than treating the skin infection with a topical ointment.

Clearly, the cephalexin wiped out some of the beneficial bacteria in your dog’s digestive tract, causing dysbiosis or bacterial population imbalance. The corrective treatments prescribed were appropriate.

I would give your dog a good-quality probiotic twice daily, along with a prebiotic such as inulin (not insulin) and digestive enzymes. Herbal preparation of marshmallow root, chamomile, aloe vera and cramp bark might help alleviate the diarrhea. Glutamine, N-acetyl glucosamine, lecithin and montmorillonite clay or calcium aluminosilicate are all potential remedies for this kind of diarrhea.

Avoid food with soy or grain. For more details, including my home-prepared dog food and treat recipes and a dog food quality scoring system, check my Web site, www.drfoxvet.com.

Michael W. Fox, author of a newsletter and books on animal care, welfare and rights, is a veterinarian with doctoral degrees in medicine and animal behavior. Write to him at United Feature Syndicate, 1130 Walnut St., Kansas City, Mo. 64106.

2012 United Feature Syndicate

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