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Info about the last 4 weeks
Pl= Possible illness- If answer 3 or more answers given then dog classified as unwell.

Name

Email Address

Pet Name

DRINKING. DO YOU THINK YOUR DOG HAS DRANK:

Less than normal: PI
Normal: 1
More than normal (for example 1-2 times normal): 3
Very much more than normal: 4

URINATING. DO YOU THINK THAT THE VOLUME OR FREQUENCY OF URINATION IS:

Less than normal: PI
Normal: 1
More than normal (for example 1-2 times normal): 3
Very much more than normal: 4

APPETITE. WOULD YOU DESCRIBE YOUR DOG'S APPETITE AS:

Very poor (not eating at all or hardly eating): PI
Poor (does eat some food but requires encouragement): PI
Normal: 1
Increased (eats all food quickly and will look for more): 3
Greatly increased (seems ravenously hungry all the time): 4

VOMITING AND DIARRHEA. HOW OFTEN HAS YOUR DOG BEEN EXPERIENCING VOMIT OR DIARRHEA?

Never had vomit or diarrhea: 0
Has had vomit or diarrhea once: 0
Has had vomit or diarrhea more than once but not every day: PI
Has had vomit or diarrhea every day: PI

EXERCISE. HOW ACTIVE IS YOUR DOG?

Lays in one place nearly all the time: 4/PI
Goes for walks and will also play on occasion: 3
Very active, happy to run off the lead but does get tired: 2
I cannot tire my dog out!: 1

SKIN AND COAT. HOW WOULD YOU DESCRIBE YOUR DOG'S COAT AND SKIN CONDITION?

Very poor (thin coat, bald patches, very dull): 4
Poor (slightly thin coat, hairs dull): 3
Reasonable (no bald patches, slightly dull): 2
Very good (thick coat, shiny, no dandruff): 1

OTHER PROBLEMS. DOES YOUR DOG HAVE ANY OF THE FOLLOWING?

GENERAL. HOW DO YOU FEEL YOUR DOG ENJOYS LIFE?

Miserable more of the time: PI
Has more bad days than good days: 0
Happy most of the time, occasional bad days: 0
Happy all of the time: 0

OVERALL HOW GOOD DO YOU FEEL YOUR DOG'S CURRENT TREATMENT FOR CUSHING'S IS?

My dog has more critical signs than before treatment: 5/PI
There is no difference now than before treatment: 4
There is some improvement since starting treatment: 3
My dog is nearly back to their normal self: 2
If I did not know, I would think there was nothing wrong with my dog now: 1