Livingston Vet - Senior Dog Wellness Checklist

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SENIOR DOG WELLNESS CHECKLIST

Senior dogs start aging more quickly with each year that passes, and they’re more likely to develop health problems. But when detected early, many of the aches, pains and diseases associated with “getting old” can be successfully managed to make your dog more content and comfortable. Your observations and input are very important to help determine what’s best for your dog. Please take a few moments to complete this questionnaire.
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* This field is required.
Dog’s name
Owner’s name
Email
Date
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Signs
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Difficulty climbing stairs or jumping up
Yes
No
5
Increased stiffness or limping
Yes
No
6
Changes in hearing or vision
Yes
No
7
Loss of house-training; house soiling
Yes
No
8
Increased thirst
Yes
No
9
Increased urination
Yes
No
10
Changes in activity level
Yes
No
11
Excessive panting or changes in breathing patterns
Yes
No
12
Circling/repetitive movements
Yes
No
13
Confusion or disorientation
yes
No
14
Excessive barking
Yes
No
15
Less interaction with family/hiding
Yes
No
16
Decreased responsiveness
Yes
No
17
Tremors or shaking
Yes
No
18
Skin and haircoat changes, lumps or bumps
Yes
No
19
Excessive scratching
Yes
No
20
Changes in sleeping patterns/location
Yes
No
21
Less enthusiastic greeting or behavior
Yes
No
22
Altered appetite
Yes
No
23
Weight change
Yes
No
24
Bad breath
Yes
No
25
Does your pet have an identification microchip
Yes
No
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Other concerns/comments
Should be Empty: