Dear Dr. Fox:

I have a 16-year-old Tonkinese cat with early signs of kidney dysfunction (only indicated in her blood work). My vet recommends weekly subcutaneous hydration and a low-protein diet. Since my cat eagerly devours "tuna water" (small amount of low-salt tuna with water) two to three times a day, I've decided to cut back on the hydration to twice a month. I'm assuming that ingesting the water is equally beneficial (and preferable) to hydration. Is this a good assumption?

Also, I'm a bit confused about the low-protein diet recommendation. Research seems mixed on the connection between high-protein diets and kidney dysfunction, and my cat's acupuncturist recommends only fresh (even raw) poultry and fish for her. So, I've compromised a bit and feed her a little of the low-protein food mixed with her dry food (Wysong Geriatric) as well as fresh tuna, turkey and the tuna water. If the high-protein diet is the cat's preference (and what they would eat in nature), does this mean that many cats in the wild would probably die of kidney disease? What's your opinion on low-protein diets in relation to kidney disease?

R.A.K., Washington

There is no simple answer to your basic question. Cats with kidney disease are put on low-protein diets in order to help prevent uremia, the presence of excessive amounts of urea in the blood. Healthy kidneys easily rid the body of urea, a byproduct of protein breakdown, but your cat does not have healthy kidneys. That also means that some protein is lost via her defective kidneys, so she should receive some high-quality protein in her diet, which you are providing.

I would add cooked eggs to the list of proteins. Try feeding her some raw foods as well, and offer her various blended vegetables, beans, lentils and especially chickpeas (which contain much-needed potassium). On a daily basis, offer her 1 tablespoonful of chopped greens, wheat or barley grass, and dandelion leaves and roots (an excellent salad herb that's good for urinary tract problems). Also provide a daily half-teaspoonful of organic flax or sesame seed oil to help her kidneys. Your veterinarian may also want to prescribe a potassium supplement since kidney disease can lower blood potassium, which may affect the heart and also lead to anemia.

Since there is still salt in the tuna water you're feeding your cat, make some fish juice without salt by boiling a piece of fresh tuna or salmon. Add a crushed, pediatric multivitamin/multi-mineral tablet to each serving.

Because certain feline vaccines are developed using cat kidney tissue, some veterinarians believe that an autoimmune disease is triggered by their use and damages vaccinated cats' kidneys -- a situation no wild cat would be challenged with.

Dear Dr. Fox:

I have a 5-year-old male golden retriever. About four months ago he developed a hematoma in one of his ears. The vet gave us the option of a surgery or having it lanced. They took him into the back room and I could hear the dog yelping when they did the lancing procedure.

The hematoma is back. It's worse than before and he has one on each ear. I felt it would be more humane for me to lance it myself, as I would freeze it with ELA-Max cream and ice first. I can't afford the more expensive surgery. Is this something that will go away on its own with regular ear cleaning and making my dog wear an Elizabethan collar? Please help, this poor dog is suffering.

I.C.B., New Boston, Mich.

Your veterinarian did what you requested since you were not prepared to have your dog's ear problem surgically corrected.

Lancing simply empties the hematoma (or blood blister), which soon fills up again. You can't keep lancing it. You have only two options: have the corrective surgery done or leave the ears alone. Without the surgery, the hematomas will become hard and your dog will end up with deformed, crumpled ears.

Dear Dr. Fox:

I read your response to a question regarding the appropriate age to neuter a kitten -- about five to six months. I adopted my male kitten, Caesar, from the city shelter at the age of two months. Their policy is to neuter and spay prior to releasing for adoption. I always thought that two months was too young for neutering a male kitten. Caesar prefers dry kibble to moist food. Does that mean that I have to make sure he eats more canned food in order to prevent any urinary tract problems in the future? I also have two 4- year-old female cats, which makes it more difficult to monitor Caesar.

C.F., Washington

The older male kittens are when they are neutered, the less chance of urethral narrowness and blockage later in life. Give your cat moist food and just a couple of tablespoonfuls of dry food a day, which is very addictive to cats and can lead to obesity, diabetes and other health problems. Cats need moist foods because, unlike dogs, they have a low craving to drink water (or a high thirst tolerance) and so do not necessarily drink when they should -- as after a meal of solely dry cat food.

Michael Fox, author of many books on animal care, welfare and rights, is a veterinarian with doctoral degrees in medicine and animal behavior. Write to him in care of United Feature Syndicate, 200 Madison Ave., New York, N.Y. 10016. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

(c) 2004, United Feature Syndicate Inc.