Major Health Issues:

Has your dog been diagnosed with any of the following health issues?

Cancer or Tumors
     Gasatric
     Hemangiosarcoma
     Leukemia
     Lymphosarcoma
     Mammary Cancer
     Mast Cell Tumor
     Osteosarcoma
     Pancreatic
     Pituitary Tumors
     Sebaceous Gland Cancer
     Squamous Cell Cancer
     Testicular Cancer
     Other Cancer

Gastrointestinal Disorders
     Colitis
     Diarrhea, Chronic
     Diarrhea, Intermittent
     Infammatory Bowel Disease
     Megaesophagus, Primary
     Protein Losing Enteropathy (PLE)
     Other

Cardiovascular Disorders
     Cardiomyopathy
     Congestive Heart Failure
     Degenerative Valve Disease
     Mitral Valve Defect
     Patent Ductus Arteriosis (PDA)
     Persistent Right Aortic Arch (PRAA)
     Pulmonic Stenosis
     Subaortic Stenosis
     Tricuspid Valve Defect
     Other

Respiratory Disorders
     Brachycephalic Syndrome
     Collapsed Trachea
     Elongated Soft Palate
     Everted Saccules
     Laryngeal Collapse
     Laryngeal Paralysis
     Lung Lobe Torsion
     Stenosis Nares
     Other

Eye Disorders
     Cataracts, Juvenile
     Cataracts, Senile
     Cataracts, y Suture
     Cherry Eye
     Corneal Dystrophy
     Corneal Ulcer
     Distichaiasis
     Dry Eye
     Ectropion
     Entropion
     Glaucoma
     Iris Hypoplasia
     Multifocal Retinopathy
     Persistent Pupillary Membrane (PPM)
     Pigmentary Keratopathy
     Progressive Retinal Atrophy (PRA)
     Retinal Dysplasia
     Retinal Folds (Puppy Folds)
     Other

Ear Disorders
     Chronic Ear Infection
     Deafness, Unilateral (One Ear)
     Deafness, Bilateral (Both Ears)
     Malformation of the Ear Canal
     Other

Neurological and/or Muscular Disorders
     Ataxia
     Cervical Vertebral Instability (Wobblers)
     Constrictive Myelopathy of Pugs
     Degenerative Myelopathy
     Epilepsy/Seizures
     Intervertebral Disc Disease
     Lumbosacral Stenosis
     Narcolepsy
     Necrotizing Meningoencephalitis (NME) aka Pug Dog Encephalitis (PDE)
     Spinal Demyelination
     Spinal Stenosis
     Other

Skin Disorders
     Alopecia
     Autoimmune Skin Disease
     Brittle Nails
     Demodectic Mange
     Dry, Cracked Pads
     Seborrhea
     Staph Infections
     Yeast Infections
     Other

Liver Disorders
     Hepatitis
     Liver Failure
     Microvascular Dysplasia
     Portosystemic Shunts
     Other

Orthopedic Disorders
     Arthritis
     Cruciate Ligament Rupture
     Elbow Displasia
     Hip Dysplasia
     Hypertrophic Osteodystrophy (HOD)
     Legg-Calve Perthes
     Osteochondrosis Dessicans (OCD)
     Panosteitis
     Patellar Luxation
     Spondylosis
     Vertebral Anomalies
     Other

Blood/Lymph Disorders
     Anemia
     Autoimmune Hemolytic Anemia
     Hemophiliaa
     Idiopathic Thrombocytopeniaa
     Platelet Abnormality
     Pyruvate Kinase Deficiency
     vonWillebrand's Disease
     Other

Endocrine/Metabolic Disorders
     Addison's Disease
     Cushing's Disease
     Diabetes Mellitus
     Hyperthyroid
     Hypothyroid
     Pancreatitis
     Pituitary Disease
     Other

Kidney Disorders
     Age-Related Renal Insufficiency
     Bladder and/or Kidney Stones
     Chronic Urinary Tract Infection
     Familial Kidney Disease Diagnosed by Pathology
     Immature, Missing or Atrophied Kidney
     Renal Dysplasia
     Other

Reproductive Disorders
     Abnormal Sperm
     Cryptorchid/Monorchid
     Dystochia (Difficult Delivery)
     Eclampsia
     Failure to Conceive
     False Pregnancy
     Genital Infection
     Hermaphrodite
     Inverted Vulva
     Irregular Heat Cycle
     Litter Resorption
     Low or Lacking Libido
     Mastitis
     Prolapsed Uterus
     Pyometra
     Sterility
     Testicular Atrophy
     Vaginal Prolapse
     Vaginal Stricture
     Other

Dental Disorders
     Base Narrow Jaw
     Dental Enamel Hypoplasia
     Dropped Incisors
     Extranumerary Teeth
     Misaligned Teeth
     Missing Teeth, Incisors
     Missing Teeth, Molars
     Missing Teeth, Premolars
     Overbite
     Peridontal Disease
     Retained Puppy Teeth
     Underbite
     Wry Bite
     Other

Immune System Disorders
     Autoimmune Hemolytic Anemia
     Discoid Lupus
     Immune-Mediated Hypothyroidism
     Immune-Mediated Thrombocytopenia
     Juvenile Onset Polyarthritis
     Myasthenia Gravis
     Phemphigus (Bulbous, Foliaceus)
     Sebaceous Adenitis
     Systemic Lupus Erythematosis
     Other Immune System Disorder

Allergy Disorders
     Atopy (Inhalant), Seasonal
     Atopy (Inhalant), Non-Seasonal
     Drug Allergies
     Flea Allergies
     Food Allergies
     Topical/Contact Allergies
     Other Allergies

Temperament Issues/Disorders
     Aggressive to Dogs Within Household
     Aggressive with All Dogs
     Aggressive to Unfamiliar Dogs of Same Sex
     Aggressive to Unfamiliar Dogs of the Opposite Sex
     Aggressive to Familiar People
     Aggressive to Unfamiliar People
     Fear of Noise
      Obsessive-Compulsive Behavior (Flank Sucking, Spinning, Fixating on Light Spot, etc.)
     Rage Syndrome
     Separation Anxiety
     Shyness
     Reserved
     Other

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