Basic health and caregiving Step 1 of 8 12% Basic health and caregiving Your details This is just so we can match your form to your client folderName(Required) First Last Email(Required) Dog's Name(Required) Basic info Gender(Required) Male Female Weight in Kg (Approx.)Do you think your dog is ... Underweight About right Overweight Neutering Each dog and situation is different. There are a lot of reasons for both neutering and not neutering dogs and both options can have an impact on behaviour. Answering these questions can help us understand the reasoning behind your decision and effects, if any. Please Note: chemical neutering is a small implant placed under the skin called Suprelorin and is only used in boys. Has your dog been ...(Required) Surgically neutered (spayed or castrated) Chemically neutered (boys only) Neither - still entire Don't know What date were they surgically neutered?If you’re not sure of the exact date because it was done by a rescue or previous home, please put an estimate if you can, or if not just say ‘don’t know – was done in rescue/other home’What date were they chemically neutered?DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920What type of implant was it? 6 Months 12 Months Why was the decision made to neuter?Have you noticed any changes in behaviour since they've been neutered?If you're not sure because it happened before they came to you, just put 'N/A - Happened before they came to us'What is the reason they haven't been neutered?When was her last season?What is the reason you're not sure?(Required)e.g. they are a rescue, they’re a girl and you can’t see etc. Health We do of course get your record from the vet, but as you live with your dog, you will notice a lot of things your vet won’t be able to see at your appointments and you may also find there are things that haven’t come up yet during a vet appointment, so we would really love to get your opinion on your dog’s health as well as the more specific medical information from your vet.Has your dog had any health screening tests for common GENETIC issues?e.g. hip scores, copper toxicosis, eye testsDo you use any preventative treatments/tests for worms, fleas or other parasites?(Required) Yes No What is the reason for not using treatments/not testing for fleas/worms?(Required)Tell us about the tests/treatments you use(Required)To add another row, just click the '+' button at the end of the row, to the right.Name of product/testWhere do you get it from? e.g. vets, over the counter etc.How often do you use it?Date it was last used Add RemoveHas your dog been diagnosed with any conditions by your vet?To add another row, just click the '+' button at the end of the row, to the right.Condition (e.g. IBD, diabetes, epilepsy, ear infections)Current or previous?Treatment? Add RemoveDoes your dog experience any of the following?(whether or not they have seen a vet regarding these issues - please note we ask in a separate section about teeth and toileting)RegularlySometimesOccasionallyNeverEar Problems e.g. Scratching, need regular cleaning, infection etc.Eye Problems e.g. watery, discharge, red, itchy, dry etc.Skin Problems e.g. itching, redness, hair loss, dry hair, lumps and bumps etc.Limping/Stiffness or other concerns about painNoisy breathingStaring into space/vacant episodes/seizuresDoes your dog have any areas of discoloured fur (usually brown)? Yes No Please tell us where?e.g. Left front paw, all paws, groin, bottom etc.Has your dog been formally diagnosed by the vet with any allergies/intolerances?(Required) Yes No Please tell us about these diagnosed allergies/intolerances...To add another row, just click the '+' button at the end of the row, to the right.What is it?When was it diagnosed?How was it diagnosed? Add RemoveDo you suspect your dog has any allergies/intolerances that haven’t been diagnosed by the vet?(Required) Yes No Please tell us about the allergies/intolerances you suspect and why?e.g. poo is softer after eating chicken, more itchy after using a certain washing powder etc. To add another row, just click the '+' button at the end of the row, to the right.What is it?Why? Add RemoveHas your dog had any other injuries, accidents or illnesses that DIDN'T need you to go to the vets? Please tell us about these heree.g. fell of a wall at 6 weeks old, but seemed okay afterHave you noticed if any of these symptoms or issues discussed above have had any impact on your dogs behaviours? Please tell us about these heree.g. noticed sometimes limps on right front leg, but only for a day then stops or has a patch of dry, pink skin but doesn't seem to itchIs your dog currently taking any medications?(Required) Yes No Please list ALL the medication they are currently taking.To add another row, just click the '+' button at the end of the row, to the right.Name of medicationThe doseHow often do they take it? Add RemoveIs your dog currently taking any supplements, including any which are from the vet?(Required) Yes No Please list ALL supplements they are currently taking.To add another row, just click the '+' button at the end of the row, to the right.BrandName of supplementThe doseHow often do they take it?Why did you decide to start giving this supplement? Add RemovePlease tell us about any other current vet care your dog is receiving (including investigations etc)Please tell us any concerns about your dog’s health that you haven’t yet discussed with your vet.e.g. eyesight changes or worries about skin/ears/stiffness etc. Dental Health Please only look at your dog’s teeth if it is safe to do so, if not, please skip these questions.How are your dog’s teeth?1 - Lots of plaque and tartar2345 - Completely cleanWhat colour are your dog's teeth White Yellow Brown Grey Black How is your dogs breath?1 - Super stinky2345 - Fresh as a daisyDo they have any broken or worn teeth?Have you noticed any of the following; Rubbing mouth Eating/chewing on the side of their mouth Changes in what/how much your dog likes to chew Increased dribbling/salivation Brown stains around the mouth Preference for soft rather than dry/crunchy food When was your dog's last thorough dental health check at the vets? Grooming at home How often (approximately) do you do the following at home?Daily2-3 per week1 per weekoccasionallyNeverBrushTrim/ClipWipe pawsEar/eye dropsClean teethClip/file nailsBath/showerFor each of the following please give a score between 1 and 5 for how easy or difficult it is for your dog where Score Means Example Behaviour 0 We don't Do This N/A 1 Extremely hard Tries really hard to get away (or move the body part away), will bark, growl, snap or bite. 2 Hard Tries to move away or pull the body part away and needs restraint, could be very still, perhaps with tail tucked, ears back, whites of eyes. 3 Tolerates Allows you to do but signs of stress (turns head away, minor attempts to move, panting, stiff face and body). 4 Mostly relaxed No restraint or avoidance, willing participant, occasional signs of stress (looks at you/the equipment, breathing increases, licks lips). 5 Enjoys Comes to you when knows what you are doing, soft waggy tail and body, relaxed face, ears and eyes, offers the body part and when you stop signals for more. Please score each of these(Required)We don't do this1 (Extremely hard)2345 (Enjoys)Brush legsBrush tailTrim (scissors)Trim (clippers)File nailsClip nailsBrush teethWipe eyesWipe earsClean ears (e.g. drops)Pluck earsBath/showerTowel dryHair dryerWipe paws after walk Going to a groomer Does your dog go to a groomer? Yes No How often?Which groomer?Is it ... a salon/shop where you take your dog a mobile groomer (in a van) a groomer who comes into your house Does the groomer have more than one dog at a time or just your dog(s)?Describe how your dog behaves when the van arrives and going into the van.(Remember – do not put fine, okay etc. describe what your dog does)Describe how your dog behaves when the groom arrives at the house?Which room in your house is the groom done in?Does the groomer bring their own equipment with them? Yes No Please list the equipment they bring that they use with your dog ...Remember - press the + button to add another row. Add RemoveDescribe how your dog behaves when you arrive at the salon?(Remember – do not put fine, okay etc. describe what your dog does)Do you stay with your dog leave your dog with the groomer Describe how your dog behaves when you go back to collect them?What feedback has your groomer given you about how your dog copes with grooming?Does your groomer use restraints? e.g. a lead/strap to keep your dog attached to the table or workspace?Does your groomer use a muzzle? Yes No What sort of muzzle? (fabric or basket)Who introduced the muzzle? We did The groomer did Why was the muzzle introduced?Has your groomer found areas that are sensitive or said your dog finds difficult? Please describeWhat sort of things has your groomer asked you to practice at home with your dog?Have their been any changes in how your dog behaves in their grooming sessions over time? If so, please describe the changes in their behaviour here. Going to the vet Please describe what your dog does in each of the following situations In the waiting roomGoing into the consultation roomDuring a non-painful, non-invasive examination (e.g. stethoscope)During examination or procedures which may be uncomfortable (vaccinations, looking in ears, taking temperature, emptying anal glands)Are there any situations where your vet uses a muzzle with your dog (at your request or theirs)? Please describe.Have their been any changes in how your dog behaves at the vet over time? If so, please describe any changes here.And that's it! Time to submit.....
