Dear Dr. Fox • I have a problem with my Cavalier King Charles Spaniel. Charlie is 4 1/2 years old, and for the past three years, I've had a hard time with fungus on his skin.

I went to my regular vet, and he said to bathe him in Betadine, leave it on for five minutes and then shampoo him. I did that, and it seemed to help, but it came back. I used an antifungal cream, leaving it on for 24 hours. It seemed to help, but it smelled so bad that I had to give him a bath in between applications.

I took him to a dermatologist, and he gave him an antibiotic and Malaseb Pledgets to wipe him down. The dermatologist said he had a fungus, and this medication would get rid of the problem forever. It didn't. It keeps coming back.

I have stopped putting flea liquid on him, thinking that the medicine wasn't doing any good. The fleas still bite him and then die, but the bite sites get this fungus stuff on him, and we go around again.

He also had back surgery a year ago for two bulging discs that left him dragging his hind end. Some of the medicine for that left him with a damaged liver. My regular vet put him on some medicine to repair the liver. We also found that he had low blood sugar. He had another bad time (uncontrollable shivers), and we had to go to the emergency vet. They kept him 24 hours, had him on an IV and gave him shots. They said his sugar was low and to put him on two teaspoons of honey a day. — E.E., Suffolk, Va.

Dear E.E. • I am sorry you and your poor dog have had to go through so many problems. For such a young dog to have chronic skin and back problems is in part the legacy of his genetic background, coupled with (most probably) far too many vaccinations.

Your dog needs a total medical health makeover to address his ongoing problem from a holistic perspective, integrating conventional treatments with nutrient supplements in his food, especially fish oil and brewer's yeast (up to 1/2 teaspoon of each daily), and plain live yogurt or kefir for immune-system-boosting probiotics. A shampoo containing tea-tree oil should help get rid of any fungal infection, but remember, part of the dog's skin reaction to flea bites is an allergic response to flea saliva. So if he gets itchy, a short course of antihistamine treatment should help.

Low blood sugar and acute hypoglycemia are common in small breeds and can be fatal. It may be prevented to some degree by feeding three to four small meals daily. Eliminating cereal grains, corn and all starches (these metabolize into sugar) is advisable for your Charlie.

www.twobitdog.com/DrFox Dr. Fox, c/o "Animal Doctor," United Features Syndicate, 200 Madison Avenue, New York, N.Y. 10016