Dear Dr. Fox:

My 15-year-old terrier mix, Betsy, started throwing up and had diarrhea. Blood tests showed kidney and liver problems, and her heart is weak.

The veterinarian wants to do a liver biopsy and endoscopy to check for inflammatory bowel disease. This will cost more than $1,000, and I cannot afford that.

What do you advise? My old dog is very weak, and I don’t want her to suffer.

W.S.P., Alexandria

DF: “Lifesaving” interventions in the terminally ill that prolong suffering should be viewed as “death-delaying” interferences.

In my opinion, this is the stigma of the health care provided by some medical and veterinary professionals whose focus is more on the organs and systems of the body than on the whole patient and quality of life.

The lifesaving quest becomes an intellectual challenge that is driven less by compassion than by the enchantment of biomedical technologies and a mechanistic attitude toward life and the living. Future generations will surely look back on these times in disbelief that death was delayed in the terminally ill and suffering was unnecessarily protracted.

But now, thanks to the human and veterinary hospice movement, the cultural attitude toward death (especially as a challenge and failure for the lifesaving professional) is changing. Ask your veterinarian for a referral to a hospice care veterinarian who will provide your old dog with palliative care in your home. I have details about this new service on my Web site,


Dear Dr. Fox:

I recently got a 4-year-old bullmastiff mix from the Humane Society. It has taken him a long time to understand simple commands. That’s what I thought until I discovered that he understands Spanish and follows Spanish commands!

Should I continue with Spanish commands or stick with English (which he finally learned after 10 weeks)? I believe that he is grieving his Latino family and that he was surprised when he heard me speak Spanish, which my husband does not know at all.

J.S., Olney

DF: Dogs learn simple one- or two-word commands, ideally reinforced by hand or arm signals and body gestures. The latter are part of universal nonverbal communication, along with tone of voice.

By association, your dog will soon learn English words when coupled first with the Spanish word and signals that you can subsequently drop if you wish. There is one famous dog that has been trained to recognize more than 2,000 different words for different toys, demonstrating the remarkable word comprehension abilities of some good dogs.


Dear Dr. Fox:

I read about the cat with a persistent cough. A vet diagnosed asthma after examining out cat and prescribed treatment.

I then learned from a cat rescue group about a wonderful product, Dr. Elsey’s Precious Cat Litter. I switched our cat to it, and she was cured. That was 10 years ago.

This litter made a wonderful difference in our cat’s health.

S.M., Arlington County

DF: I always appreciate hearing from pet owners about the benefits of some products, but I am also wary that this can be a setup by some companies.

I do not think that this is the case with Elsey’s cat litter products, because one of the causes of cat asthma, cystitis and litter box avoidance can be the kind of litter in the box.

So keeping in mind that feline asthma can be caused by other allergens and from intolerance of certain food ingredients, addressing the kind of litter as a possible cause is an essential part of holistic feline medicine. Many cats enjoy good health once the offending litter, or box cover, is removed.

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.

2013 United Feature Syndicate