Tag Archive | "Healthy"

Dogs And Cats Need Healthy Teeth And Gums Too


Your pet’s dental care is important; it is an integral part of your pet’s health. According to a noted veterinary hospital, just as you brush your teeth every day and have them professionally cleaned by your dentist, your animals need the same or similar treatment. A common indication of dental disease in your pet is of course, bad breath. With dogs and cats, naturally, some breath odor is unavoidable at times. However, when the breath odor is really bad, this may be due to the metabolism of some of the bacteria present in the mouth when excessive plaque is present.

Veterinary professionals state that plaque forms when there is a buildup of bacteria and other components of saliva along the teeth and/or gums. It mainly consists of bacteria and is soft at first. When plaque is soft, it can be removed easily at times by frequent brushing. After plaque hardens it is known as calculus—more commonly called tartar. Calculus can build up on your pet’s teeth. This calculus is usually below the gum line and can lead to periodontal disease. Periodontal disease is a major initiator of infections in the gums, which can also lead to infections throughout the body. Oftentimes the teeth become very painful and loose. Some animal may begin to lose their teeth.

Do not allow the tartar to build up on your pet’s teeth. Built up calculus can cause severe dental disease. One of the first signs of dental disease is gingivitis, which is inflammation of the gums. The gums will be sore and reddened, and the animal’s breath will have a bad odor. There may be some drooling due to the soreness. If you brush the teeth, the gums will probably bleed.

This is where preventative maintenance comes in: The best kind of preventative care for your pet’s teeth is simply regular brushing. Occasionally, dental prophylaxis at your veterinarian’s office may also be required. A dental prophylaxis (often called dental prophy) is an in-depth teeth cleaning and oral exam performed by veterinarians. In this instance, the animal will be placed under general anesthesia so that the dental prophy can be performed.

Brushing your pet’s teeth need not be difficult. Once your pet is used to it, it should not take long to do. Brush your cat or dog’s teeth using a soft bristled toothbrush along with pet toothpaste. The toothpaste that we use as humans should not be used with our pets as it may irritate their stomachs if swallowed—which is a possibility. Get your pet used to the brushing when your pet is young; this will make is less difficult in the long run. Vets state that most pets will tolerate brushing no matter what their age. Brush your pet’s teeth gently on a regular basis. This will go a long way to reducing plaque buildup.

Dogs, as we all know, love chew toys or other toys specifically designed to help clean teeth. This can be a great help for you and your dogs. For pets, dogs and cats, dry food is the best choice for keeping teeth clean, according to vet professionals.

All pet owners should check with their vets for further information on their pets’ general health; other important helpful points, in addition to those stated above, can be obtained from vet professionals who are used to seeing various kinds of pets and therefore, can provide assistance to pet owners.

Author lives in Illinois; loves animals?especially cats, dogs; and is a home entrepreneur. See information on author’s business at: http://mysite.verizon.net/limoore
Training a dog? https://paydotcom.com/r/9416/limoore/401261/
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Caring For Your Cat : Keeping Your Cat Healthy and Your Home Clean


There’s no question that our cats are really a family members! Their loyalty, their love, and their ability to comfort us are unparalleled. Sometimes, though, their hair or odors can leave an unwelcome foot prints in our homes. Just as we clean up the spills made by our kids it’s up to us to clean up after our cats. Luckily, there are any numbers of products that make pet care a breeze.

Cat Litter Boxes:
Cats are generally low maintenance pets, but their litter boxes do very little to contribute to our home decor, and can become a smelly nuisances well. Today’s litter boxes, though, can bring a touch of color to your interior design, while their functionality can put an end to messes and odors.

One line of litter boxes comes in an assortment of patterns and colors, from solid silver and solid black, to polka dot, and wood grain. The litter tray door pulls out, and the automatic litter pan the metal sifter rake pulls and lifts litter out of the tray for easy cleaning. Another ingenious design has a triangular shape so that you can easily place it otherwise used corner space.

If you want to make cat care even easier, self-cleaning litter boxes are the answer. One style has an internal grill that traps used litter. You simply roll the enclosed litter box on its side and remove the waste tray. Another type takes self-cleaning to the next level by having a slowly but rotating system that quietly but continuously scoops used cat litter into a receptacle. The ultimate litter box is one that automatically flushes cat waste down your toilet. Instead of cat litter, this box uses permanent granules that are washable. 

Kitty Litter:
When it comes to kitty litter, many cats have a preference for one brand over another. But if you start with the right litter or are persistent, you can find kitty litter that can help eliminate odors while keep your cat healthy. One particular brand of kitty litter on the market not only neutralizes litter box odors, but also changes color if your cat has a urinary tract infection. Given that urinary tract infections in cats can quickly become life threatening, early detection is very important to your cat’s health. It’s also helpful to have information about a potential infection to give to your veterinarian.

Shedding Tools
Many people who love cats are troubled by allergies, or by the cat hair that clings to furniture and clothes. Products that help with shedding take one of two approaches: either they work at the source of the problem your cat or they make it a snap to clean up hair off of furniture.

Cats typically shed their undercoat not just the top coat, so a product that helps you remove hair from your pet – means you’ll never see it on your couch. These products brush out the dead hair from the undercoat but won’t cut it, while bringing your cat’s natural oils to the surface. Because this type of product also helps stops over zealous self-cleaning, your cat may be less likely to be bothered by hairballs.

Cat care isn’t difficult, and the great litter boxes, kitty litter, and shedding tools make it even easier!

NOTE:  This article is for information only.   See your veterinarian for medical advice.

We plan to post articles that are informative and helpful to other cat lovers. Having been “owned” by cats for years, we know they can be demanding, but also be very entertaining and fun. Visit our website for products your cat may enjoy http://www.besthousecatcare.com and our blog http://besthousecatcare.blogspot.com

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Pet Grooming For a Healthy and Happy Pet!


Our pets are more than just animals who happen to live with us. They are also our friends and sometimes even our own family member. We should take care of them and even though some may raise an eyebrow, pet grooming is the “in” thing now.

Two of the most common pets that people have are dogs and cats. In this day and age these animals also have needs that we need to address. Since they are living with us we want them to be clean and we want them to smell good. That is why pet grooming is a must for any pet owner. Let’s take dogs for example they are very playful animals and most of the time we play with them in our gardens or in the park. In those areas they can accumulate millions of bacteria while running in the grass or mud. The very basic thing we can do is to give them a regular bath as part of pet grooming. This will not cost you much since you only need clean water and dog shampoo. Just make sure that you clean your dog well so that the germs can be removed. Also brushing the dog’s coat is recommended. This will remove tangles and dirt. It is also advised that you brush the dog’s teeth twice a week to remove stains and bad odor. You can purchase dog toothpaste and brushes in most pet stores. For added grooming you can visit pet salons which offer, nail maintenance, special fur treatment and other things that will make your dog more beautiful to look at.

Now let’s go to cats. They are much more difficult to handle than dogs when it comes to pet grooming. Since we all know that cats hate water they seldom take a bath and on the occasions that they do, you can be assured that it will be a very tough task for both you and your pet. But thankfully nowadays there are pet salons where you can avail of their services. Most of their services already include a bath, personal styling, trim of their fur and toenail trim. If you are willing to pay then this is a good and easy way to make sure your cat is well groomed. But if you prefer to give the cat a bath yourself then you should put him or her in a bathtub and put inside it something that he or she can cling to, like a wooden platform. The cat needs that so he or she will have something to scratch while you are giving the bath. After the bath use a towel to dry the cat. You can also comb the fur, especially for cats with long furs, they should be combed properly. As mentioned above, you can avail of grooming services in your local pet stores if you don’t have the time to do it yourself.

Pet grooming is essential so your pet will live a long and healthy life.

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Cat Care 101: Keeping Your Home Clean and Your Cat Healthy


Our cats are full-fledged family members – there’s no doubt about it. Their loyalty, their love, and their ability to comfort us are unparalleled. Sometimes, though, their hair or odors can leave an unwelcome footprint in our homes. Just as we clean up the spills made by our kids (or our spouses!), it’s up to us to clean up after our cats. Luckily, there are any number of products that make pet care a breeze.


Cat Litter Boxes


Cats are generally low maintenance pets, but their litter boxes often contribute little to you home decor, and can become a smelly nuisance. Today’s litter boxes, though, can bring a touch of whimsy to your interior design, while their functionality can put an end to messes and odors.


One line of litter boxes comes in an assortment of patterns and colors, from solid silver and solid black, to polka dot, leopard print and wood grain. The litter tray door pulls out, and a metal sifter rake pulls and lifts litter out of the tray for easy cleaning. Another ingenious design has a triangular shape so that you can easily place it otherwise used corner space.


If you want to make cat care even easier, self-cleaning litter boxes are the answer. One style has an internal grill that traps used litter. You simply roll the enclosed litter box on its side and remove the waste tray. Another type takes self-cleaning to the next level by having a slowly but rotating system that quietly but continuously scoops used cat litter into a receptacle. The ultimate litter box is one that automatically flushes cat waste down your toilet. Instead of cat litter, this box uses permanent granules that are washable. After your cat uses the box, the granules are automatically washed, disinfected, and dried. Liquid and any solid waste are flushed down the toilet with fresh water.


Kitty Litter


When it comes to kitty litter, many cats have a preference for one brand over another. But if you start with the right litter or are persistent, you can find kitty litter that can help eliminate odors while keep your cat healthy. One brand of kitty litter on the market not only neutralizes litter box odors, but also changes color if your cat has a urinary tract infection. Given that urinary tract infections can quickly become life threatening, early detection is key. It’s also helpful to have information about a potential infection to give to your veterinarian.


Shedding Tools


Many people who love cats are troubled by allergies, or by the cat hair that clings to furniture and clothes. Products that help with shedding take one of two approaches: either they work at the source of the problem (your furry feline) or they make it a snap to clean up hair off of furniture.


Cats typically shed their undercoat (rather than the hair you see), so a product that helps you remove hair from your pet – a “furminator” of sorts – means you’ll never see it on your couch. These products brush out the dead hair from the undercoat (but don’t cut it), while bringing your cat’s natural oils to the surface. Because this type of product also helps stops over zealous self-cleaning, your cat may be less likely to be bothered by hairballs.


Cat care isn’t difficult, and the great litter boxes, kitty litter, and shedding tools make it even easier!

Linda Cain at Rain Shadow LLC and Rain Shadow Gardens. All Rights Reserved. Copyright 2007


(NOTE: Article shown above may be linked and circulated freely on web sites, as long as ALL article content, links, author and copyright information remain UNCHANGED in any way whatsoever.)

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A Healthy Mouth Makes a Healthy Pet


February is pet dental health awareness month. Nearly 85% of our pets over the age of 7 already have dental disease and some suffer silently.


Periodontal disease is the most common dental disease affecting our pets and develops when the bacteria in the mouth mix with the mucin in the saliva and forms a white, sticky substance called plaque. If the plaque is not removed on a daily basis either by brushing or by mechanical means, such as dental chews, the bacteria adds minerals from the saliva and forms a hard substance called tartar.


The tartar is not easily removed once deposited on the tooth. The bacteria then continues to spread, creating by-products and toxins that began to irritate the gum and slowly works its way between the gum and the tooth. The by-products then begin to eat away at the bony structure holding the tooth in the socket, loosening the tooth and infecting the gum and tissue. The bacteria can now enter the blood stream, showering the body and causing infections in the heart valves, kidneys and other major organs.


Signs of dental disease can include excessive drooling, dropping food when eating, eating on one side of mouth, pain when eating or a foul odor coming from the mouth. Some dogs do not exhibit any outward signs until the disease is well advanced.


What can you do to help keep your pet’s mouth healthy?


1. Brush your pet’s teeth. It is best to begin getting your pet used to brushing when they are still young. Start by lifting the lips and giving a treat when they oblige. Put toothpaste designed for pets on your finger and rub it on their teeth. As you and your pet progress, you can start using a toothbrush. Do not use human toothpaste. It has fluoride in it that can be toxic when swallowed. I have yet to teach a pet to rinse and spit. In older pets, a dental exam should be done before you start to brush. If there is already some dental disease present, fractured teeth or exposed nerves, the brushing will be very painful for the pet.


2. Use dental chews that are designed to help remove the plaque. CET chew, Greenies and Enzadent chews are examples of chews made to remove the plaque and tartar. Do not use real bones, cow hooves or other really hard products. These can result in fracturing the teeth.


3. There are special diets available that are also designed to promote dental health. Ask your veterinarian which one they recommend.


4. Bring your pet in for an annual dental exam by your veterinarian. If there is significant amount of tartar visible on the teeth, there is a good amount beneath the gum-line not visible. It may be time for a professional prophylaxis by your veterinarian. Once the teeth are cleaned, it is then up to you to keep them that way.


What is involved in a dental prophylaxis?


The pet prophylaxis and a human prophylaxis have many commonalities. The main difference is a thorough pet prophylaxis involves general anesthesia.

The anesthesia used in veterinary medicine today is a lot safer and can be done on older pets.


Pre-anesthetic blood work is recommended to screen for underlying diseases such as diabetes or kidney disease.


An intra-venous catheter is inserted for administration of fluids and medications.


The pet is then intubated with an endotracheal tube and maintained on gas anesthetic and oxygen. A cuff on the tube is inflated to keep fluids from the mouth from entering the lungs and to maintain the proper flow of anesthetic and oxygen.


A pulse oximeter is used to monitor the oxygen saturation, heart rate and breathing.


Radiographs are then taken to view the roots for any problems that cannot be seen on visual inspection. The mouth is also examined closely for any tumors or other defects.


The teeth are then cleaned with an ultrasound dental scaler. A broad tip is used to get the bulk of the tartar off the main part of the tooth. A very thin tip is used to go beneath the gum and clean what can not be seen.


A periodontal probe is then inserted around the tooth checking for any sub-gingival pockets that may need further treatment with antibiotic gel.


Teeth with significant disease are extracted. If desired, some teeth can be saved with extensive salvage techniques such as root planing, root canals and crowns. Veterinary dentists with specialized training can perform these procedures if the owner desires. Because of the cost and after care needed for these procedures, the tooth is sometimes extracted. Pets with significant amount of dental disease do much better without the diseased teeth than with them.


The main point is to start preventative maintenance earlier to avoid the extractions.


Once the teeth are scaled and the diseased teeth are treated, the tooth surface is then polished, just like human dentistries. The polishing also makes a smooth surface to slow down the plaque from sticking to the teeth.


The teeth are then treated with fluoride to help strengthen the enamel.


The veterinarian will then recommend to apply Oravet to the teeth. Oravet also coats the tooth and keeps plaque from sticking to the tooth. The Oravet must then be applied on a weekly basis by the owner for it to be effective.


Antibiotics are also given and sent home to help with the infection. Depending on the amount of dental work performed, pain medication may also be given and sent home.


Once home, it is up to the owner to take care of the teeth to keep them healthy.


Schedule an appointment with your veterinarian and develop a dental health plan for your pet. A healthy mouth makes for a healthy and happy pet.

Dr. Debra Garrison is a veterinarian and owns a small animal hospital in Spring, Texas. Her goal is to promote the bond between pets, their owners and their veterinarians,the other family doctor. Visit her clinic website at www.tvet.com.

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Staying Healthy: Magnet Maintenance



If you are one of the lucky Americans that doesn’t have a physical injury that gives you pain on a daily basis, congratulations! Now that you are completely healthy, you must strive to maintain your health and live disease-free. You can accomplish this high quality of life with proper diet, exercise and health supplements. One such supplemental program is magnet therapy.

A popular perception of magnet therapy is that you have to be sick or injured to use the magnets for benefit. Believe it or not, you can use many other magnetic products that will provide an extra preventative health measure against negative health consequences.

You spend about a third of your life in bed: sleeping, reading, watching T.V. and relaxing with family. A great way to take advantage of all this bed time is to use magnets in bed! You can begin your bed time health program with a magnetic mattress pad and magnetic pillows that can provide overall body recharging and healing. Using these products differs from the more specific products (the metal bracelet, braces) by giving total body magnetic therapy every single night.

Do you sometimes suffer from sinus or stress headaches? There’s even a magnetic solution to this problem! Using a magnetic eye mask (similar to the black eye masks you can use to sleep) will provide arterial and venous relaxation which will alleviate the pain of your headaches and sinus pressure.

While you spend a third of your life in bed, the other two-thirds is spent on your feet. Magnetic insoles can help minimize the pain the long days at work by keeping your tendons and ligaments stretched and relaxed throughout the day. Magnetic insoles also have a very centering effect on your mental focus and clarity, since the magnetic force of the Earth directly contacts your feet.

You can even share the love of magnets with your pets. Pet products that will help your older dogs and cats stay healthy into old age when arthritis becomes a problem. Magnets for your pets can also cut down on cancer and heart problems in older dogs.

Finally, before getting started with your magnetic health maintenance program, you should do your homework. Be certain that the company that provides you with your magnet products certifies the quality of its magnets and purity of the metals used in your magnets. Some online magnet therapy providers will give you very cheap impure magnets. These do not have any health benefits whatsoever! Pure metal magnets are the only way to get assured health benefits.

Health with magnets is a practical and reasonably priced way to maintain your physical well being. Why not start today?

Health With Magnets has the expertise in magnet therapy and was instrumental in the writing of this article. For more information about magnet therapy and products available for magnetic therapy health maintenance, please visit their website.

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Does Your Cat Have A Healthy Diet?


They say we are what we eat. This applies to your pet as much as it applies to yourself. A good diet means less health problems, less trips to the vet and lower veterinary bills. But how much thought have you given to what your cat should be eating to maintain optimum health? Ask yourself the following questions.


1) How many times a day do you feed your cat?


Since cats cannot be exercised like dogs can, the only way you can influence your cats weight is by controlling the amount and type of food he or she eats. If the cat is being fed individual meals several times daily, there is often a tendency by the owner to offer the daily supply of food on several occasions rather than divide up the daily feed into several meals. This can also occur with cats fed dry food ad lib. Cats usually regulate their food intake, but continual exposure to large quantities of food may lead to over-eating and subsequent obesity if too many calories are consumed. In short, both several individual meals a day and ad lib feeding are fine, it is the total amount offered per 24 hour period which is the important figure.


Kittens should be fed small meals at regular intervals due to their tiny stomachs. Four or five meals are recommended at eight weeks of age, decreasing to two at six months of age.


2) Is your cats diet manufactured specifically for cats or do you give human food?


Some cat owners like to spoil their cat by feeding them human food as the bulk of their diet. Others have tried feeding their cat regular catfood, but find their fussy cat will not touch it, and prefers to wait for the inevitable human food offering, which soon becomes the staple diet.


Is it really unhealthy to feed cats human food though? Of course it depends what food. Remember that cats are carnivores, and require a high proportion of meat in their diet. They simply cannot adapt to a low protein diet, and will lose bodyweight if deprived of it. In fact, as a species they are relatively unique… a deficiency of the amino acid, arginine, in a single meal can lead to symptoms of lethargy, hypersalivation and vocalisation. Arginine is required by the cat to produce urea, a waste product resulting from the breakdown of protein.


Another essential nutrient for the cat is the amino acid, taurine, which the cat cannot manufacture sufficiently by itself to meet its needs. The cat’s diet must therefore contain taurine in sufficient quantities. If a deficiency develops there is a high risk of serious and irreversible damage to major organs such as the heart and the eye. Taurine is found almost entirely in meat, confirming the fact that the cat is a compulsory carnivore.


Another disease of nutritional origin is that caused by cats eating raw liver regularly, who can suffer from a condition called hypervitaminosis A. Cats suffering from this can present with signs of lethargy, unthriftiness, a stiff neck and other skeletal problems. To play it safe, do not feed your cat liver more than once a week.


Reputable cat foods are formulated after extensive trials by pet food companies to provide the mixture of protein, carbohydrate and fat that suits feline physiology best. It is easier, cheaper and possibly more healthy for your cat to be fed a reputable cat food diet, with occasional treats if desired (tuna, liver etc).


3) Which is better out of dry cat food or wet cat food?


Most vets recommend complete dry biscuit based cat food. This is because studies have shown that cats on dry food diets are less likely to suffer from dental disease than those on wet food from a tin or pouch. The physical motion of biting these biscuits helps prevent tartar from adhering to the surface of the tooth. However, even cats with no teeth can eat biscuit based food without a problem, as they just scoop up the biscuits with their tongue and swallow them whole. Another advantage of dry food is that it does not spoil as quickly which is useful for cats that are fed ad lib.


There are occasionally reasons why a wet food is preferable, as a method to increase the water consumption in a cat with a urinary problem such as cystitis.


4) Which is the best cat food to choose?


There are so many different brands of cat food on the market, the best one is basically a matter of opinion. Certainly palatability is a factor, there is no point in purchasing a particular food if your cat cannot stand it, although this is occasionally a necessity in cats requiring prescription diets. Rather than recommending you a specific brand, we suggest that you choose one which adheres to the criteria below.


Cat foods labeled as complete and balanced must meet standards established by the Association of American Feed Control Officials (AAFCO), either by meeting a nutrient profile or by passing a feeding trial. There are now two separate nutrient profiles for cats – one for growth (kittens) and one for maintenance (adults). Maximum levels of intake of some nutrients have been established for the first time because of the concern that overnutrition, rather than undernutrition, is a bigger problem with many pet foods today. The standards include recommendations on protein, fat, fat soluble vitamins, water soluble vitamins, and mineral content of foods. If you are prepared to get technical, you should choose a food that comes closest to AAFCO recommendations.


In summary, consider the following points:


Choose a food that suits your cats age. Most big pet food companies will have different foods for kittens vs adults. Cats with medical conditions may be recommended special prescription diets.


Choose a food that come closest to AAFCO recommendations.


The ingredients contains the truth about a particular food. Everything else is there only for marketing purposes.


There are no legal and scientific definitions for the terms “premium,” “super premium,” “quality,” or “natural.”


Use dry matter numbers to evaluate and compare foods.


The source of ingredients (e.g. animal vs vegetable) does not matter, except in the case of food allergies.


Avoid supplementation. All commercial cat foods have more than enough protein, fat, vitamins, and minerals. Feeding your cat a good food incorrectly can lead to significant problems.


5) My cat is overweight, but no matter how hard I try I cannot get him to lose weight. What can I do?


Your cat is almost certainly being fed too much. Below some common mistakes are listed. Have a good look at these and make sure none of them could apply to your cat.


Not following the guidelines on the packet when measuring a portion. Most cat foods will have a table on the packaging suggesting daily portions for cats of different weights. The weight of food suggested is per 24 hrs, not per portion! Use your kitchen weighing scales to measure out the portion until you are sure of the correct amount.


Using a complete dry diet as a replacement for regular biscuits, and mixing it with wet cat food. If it says complete, you should not mix it with anything or you will overfeed.


Offering inappropriate food that is high in fat, or cream/full fat milk to drink.


Several members of the household feeding the cat at different times, whenever the cat is meows for food.


Giving the cat regular treats in addition to its main meal.


The cat is getting fed by neighbors, who think they are being kind by feeding it and enjoy the attention it gives them.


The cat is scavenging food from outside sources, such as other peoples bins.


The cat is part of a multi-cat household and is stealing food from the other cat(s), or even the dog.

Keep an open mind. If there is a possibility that any of the above scenarios might be the case with your cat, investigate it. If you are still at a loss, consider starting a prescription diet (see below).


6) I have heard you can get special light diets, or prescription diets for fat cats. Do they really work?


Yes they do, if used properly. These types of cat food are available in complete wet (tinned or pouches) form or dry (biscuit) form, and are growing in popularity amongst conscientious pet owners. They are low in calories and high in fibre, and often contain high levels of L-carnitine. L-carnitine has been used to help with fat metabolism in other species and recent scientific work indicates that it helps reduce weight in overweight dogs and cats. The real benefit of these low calorie diets though is that because of its low calories, cats can still eat reasonable sized portions and therefore feel full. This means they are more content and less likely to beg and look for extra food.

These diets are perfectly healthy for normal sized cats to eat too, so if you have a multi cat household and it is unfeasible to separate the cats during feeding time, you can safely feed all of the cats the prescription diet together.


7) Where can I buy this low calorie food from?


Many of the big pet food companies are waking up to the problem of pet obesity, and adding light versions to their range. However, they are unlikely to be as effective as the traditional prescription diets that are on the market.


They are known as prescription diets, because they are a specialist food normally prescribed by a veterinarian. However, you do not need a prescription to buy the food as it is a general sales list product. These foods are rarely available in supermarkets as many supermarkets are keen to sell their own brand, or have deals with the big pet food manufacturers. Many owners but their prescription diet from their veterinary clinic for convenience, whilst others prefer to shop around to get the best price. Many online pharmacies and pet stores are now offering these prescription foods, but whilst they may appear cheaper online, watch out for delivery charges added on top.

Dr Matthew Homfray is one of the veterinary pet experts at www.WhyDoesMyPet.com. Our dedicated community of caring pet experts are waiting to offer you advice, second opinions and support.

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