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  Home > VBS Faculty > James R. Mickelson > Canine And Equine Genetics Laboratory > Exercise-Induced Collapse (EIC) > Exercise Induced Collapse in Labrador Retrievers and Related Breeds > Survey
 

Survey

University Of Minnesota
EIC Follow-Up Questionnaire

 

Information submitted via this questionnaire is for the purposes of research.  The identity of dogs and owners participating in the research will not be revealed.  ALL INFORMATION IS CONFIDENTIAL.

Section 1: Dog Information

Breed: Male Female Intact Neutered/Spayed

Call Name: Birthdate:

Registered Name: Sire:

Reg #: Dam:

What line(s) is your dog from?:
Field Trial
Hunt Test
Conformation
Pet
Other:


What activities does your dog routinely participate in?:
Field Trial
Waterfowl Hunting
Hunt Test
Agility
Fun Retrieves( Alone With other dogs)
Guide/Service Work
Training Retrieves on land
Flyball
Training Retrieves in water
Obedience
Upland Game Hunting
Search and Rescue
Conformation Showing
Other:

 

1. Has your dog had episodes of collapse?
If yes, please also complete the collapse information portion of this questionnaire that begins at Section 3.
Check: Yes No


2. How would you judge your dog's body condition right now?
Obese, out of shape
a little heavy, but in good shape
in perfect condition
very thin


3. How would you judge your dog's temperament?
excitable
normal
laid back


4. Since finding out the EIC-status of your dog, have you changed their training program/routine? If so, how?


5. What is your dog's usual home environment? Are they in training full-time, a house pet, a kennel dog, etc.?


6. Is this your only dog, or do you have others? If so, how many dogs do you typically have at any given time?


7. What is your dog's routine? Is he/she exposed to many different situations, or is he/she always in the same house/yard and always with the same people and other dogs?


8. Does your dog have any significant medical problems? If yes, please specify.


9. Does your dog take any medications or supplements?


10. Compared to other dogs, does your dog seem to be more intolerant of high temperatures and/or humdity?


11. Are you aware of either parent or full or half-sibs of your dog that have EIC? If yes, how would you rate their severity based on the number of collapse episodes, and the collapse itself?


12. Have you ever taken your dog's temperature during/after intense exercise? If so, what was it?


13. Do you use an e-collar for training? If yes, compared to other dogs, how does your dog handle repeated correction?


14. Have you bred this dog? If yes, how many litters and total offspring?


15. Do you know the EIC-status of the dog(s) that they were bred to? If so, please specify.


16. Have any of your dog's offspring been found to be EIC genetically affected?


17. Have any of your dog's offspring experienced episodes of rear limb wobbliness/collapse?

 

 

Section 2: Owner Information and Consent

 

Name:

Phone: ()- -

Street Address:

Alt. Phone:

City,State,Zip:

Fax:

Country:

e-mail:

I submit this questionnaire for the purpose of DNA research. I understand that the identity of dogs and owners participating in the research will not be revealed; and I have supplied complete and accurate information, to the best of my knowledge.

Signature:   Date:

Section 3: Collapse Information, complete if your dog has collapsed

 

1. When was the first episode of collapse noted?


2. What was the weather (temperature, humidity) like during the episode(s)?


3. What was the dog doing at the time of the episode(s)?


4. What did you see first?


5. Were the front legs, hind legs, or both involved and in what order? Please describe any differences between the front and hind legs during the collapse. Please include whether the legs were stiff and/or floppy and/or uncoordinated.


6. Did your dog completely lose the ability to move? If not, please describe how your dog moved/walked.


7. What did you do and what happened next? Please describe anything you noted during recovery.


8. How long did the collapse last from the start until your dog seemed normal again?


9. Was your dog evaluated by a veterinarian during or after an episode of collapse? What testing was done?


10. Approximately how many episodes has your dog had? (Please answer with a number - even if estimated.)


11. Have all the collapse episodes been similar, or were there differences? Please describe any differences.


12. Has there been anything abnormal that you note before an episode?


13. Has there been anything that you think seems to make your dog more or less likely to have an episode on a given day?


14. Does it seem to you that it has gotten easier to induce an episode, or is it harder to induce or unchanged?


15. Is your dog always completely alert and aware during the collapse? If not, please describe any abnormalities in your dog's mental condition during the collapse (i.e. disoriented, unconscious, etc.) and whether these abnormalities occurred before, during, or after the collapse (i.e. during recovery).


16. Have you taken your dog's temperature during an episode of collapse? If so, what was it?


 Information submitted via this questionnaire is for the purposes of research.  The identity of dogs and owners participating in the research will not be revealed.  ALL INFORMATION IS CONFIDENTIAL.



 

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