Behaviour Deep Dive
Thank you so much for taking the time to share your dog with me. If there are any questions that don't apply to you or you're not sure how to answer them, that is no problem at all - just answer them to the best of your ability or leave them blank.
General Information
What is your dog's name?
How old are they?
Are they male or female? Spayed, neutered, or intact?
If they are spayed or neutered, what age did they undergo this procedure?
What breed(s) are they?
When did they join your family?
Where did you get your dog from? What do you know about their background before you got them?
How many people and/or other animals live in your home? If there are children, please include their ages.
Separation Anxiety Section
IMPORTANT NOTE! If your dog doesn't struggle with being alone, skip ahead to the next section (General Behaviour)
What does your dog do when they are left alone? Please describe their behaviour in as much detail as you can.
How long have they been struggling with this behaviour? How did you first notice this was a concern for them?
What sort of things have you tried so far to help your dog cope being alone? Please share as much detail as you can.
General Behaviour
Hello non-separation-anxiety folks and welcome back separation-anxiety guardians! Please complete the rest of this form to the best of your abililty.
What behavioural concerns are you experiencing with your dog? For separation anxiety guardians, are there any other behavioural concerns you're experiencing with your dog?
When did this/these concern(s) start and how long have they been going on for?
How has this/have these behaviour(s) interfered with your dog's quality of life?
How has this/have these behaviour(s) with your quality of life?
What are your goals for you and your dog?
To your knowledge, has your dog ever experienced a traumatic event? (e.g., accident, vet emergency, dog attack?) If yes, please describe.
Has your dog ever engaged in aggressive behaviour? If so, describe the context.
Has your dog engaged in aggressive
Has your dog ever shown aggressive behaviour? Aggressive behaviour includes things like growling, snapping, biting, lunging, etc. If so, can you please describe in more detail?
Has your dog ever shown aggressive behaviour? Aggressive behaviour includes things like growling, snapping, biting, lunging, etc. If so, can you please describe in more detail?
If you answered "yes" to the above question, have they shown an increase in this behaviour recently? If so, when did it start getting worse?
What does your dog do when they are meeting new people?
What does your dog do when they are meeting/around other dogs?
Does your dog like meeting new people? What do they look like meeting new people?
Does your dog like meeting new dogs? What do they look like meeting new dogs?
Can your dog make new friends (human or dog) under the right circumstances?
Have you observed a decrease in their playfulness with other dogs and/or people?
Have you observed a change in their independent play?
Please describe in as much detail as possible, any areas your dog doesn't like to be touched on their body, or places they seem to be "weird" about handling.
If you answered "Yes" to the above question, has this always been the case or have you seen a change over time? If so, when did the change occur?
Can your dog stretch all 4 limbs, scratch both ears with ease and lick their hindquarters? If no, please describe their limitations.
Does your dog lick or scratch excessively? What part of their body?
Does your dog resist or refuse to jump into your vehicle? Do they have big feelings in the car?
Does your dog enjoy going to new places?
How much physical exercise does your dog get per week?
What types of physical exercise does your dog engage in?
How often does your dog get to engage in "dog" behaviours? (e.g., sniffing, digging, chewing)
What kind of "dog" behaviours do they get to engage in?
Have you ever thought there's something about how your dog moves or sits or lays down that just looks "weird" or "off"? If so, can you explain more about it below?
Have you observed a change in your dog's willingness to engage in physical exercise?
Have you observed a change in your dog's willingness to engage in "dog" behaviours?
Have you observed stiffness in your dog after exercise?
Have you observed stiffness or difficulty rising after resting?
Have you observed restlessness (e.g., panting and pacing?)
Have you observed your dog hesitating to jump on furniture or increased use of floor resting spots?
How much sleep does your dog get in a 24 hour period?
What sleeping spots does your dog have access to?
Have you observed a change in your dog's willingness to eat/drink or sniff the ground? Explain.
Have you observed a change in how your dog holds chews or plays with treat disepensing toys? If yes, explain
Have you observed a change in willingness to chew or pickiness in eating (or, has your dog always been a picky eater?) If yes, explain.
What does your dog eat? (Including meals, treats, chews, and "human food")
Have you observed an increase or decrease in their appetite?
How often does your dog scavenge outside or eat non-food items?
Have you ever noticed behaviour and/or energy change after eating a meal? If yes, please describe below
Please select the type below that best describes your dog's bowel movements:
Type 1: very hard and dry, individual pellets that leave no residue behind. Pooping requires a lot of effort.
Type 2: firm but not hard, segmented appearance that leaves little to no residue.
Type 3: moist and log-shaped, leaves residue but holds it's shape
Type 4: very moist, soggy, and log-shaped. Leaves residue and loses shape when picked up.
Type 5: very wet but still has distinct shape. Piles up like soft serve ice cream.
Type 6: has texture but no defined shape.
Type 7: watery texture, puddles.
When your dog poops, do they move around (the walking poops?) or stand in one spot?
Has your housetrained dog had more accidents (urine or fecal) than normal recently?
Have you observed your dog licking surfaces or the air?
Have you observed your dog snapping at "flies" that aren't there or staring at the ceiling?
Does your dog have a history of allergies or itchiness? If yes, please explain.
Does your dog have an on-going history of gastro/stomach concerns? If so, please explain.
Is your dog really burpy and/or farty? If yes, explain
Does your dog frequently express their anal glands on their own or need to get them expressed at the vet/groomer frequently?
Does your dog frequently have a really gurgly stomach (loud enough that you can hear it?)
Does your dog have really bad breath?
Do you or your vet have concerns about your dog's dental health? Do they have a lot of tarter build up on their teeth or seem extra sensitive to mouth handling/teeth brushing?
What type of home does your dog live in? (e.g., apartment, condo, house with yard, etc)
Does your dog have to navigate stairs on a daily basis? How easily do they navigate stairs?
What type of flooring does your dog spend most of their time on? (e.g., carpet, hardwood, rugs)
Have you observed your dog slipping on the floor?
What type of ground does your dog spend most of their time on outdoors? (e.g., grass, pavement, rocks)
Does your dog have noise sensitivities to things like thunder, fireworks, beeping, etc? This could either look like running away/shaking/drooling when they hear noises or barking a lot every time they hear a noise. If yes, please describe.
Have you noticed a difference in your dog's willingness to engage in training?
Please list all the training methods and tools you've tried:
What training classes have you participated in? (in-person or online/apps)
Have you noticed an increase in your dog's frustration? In other words, big feelings when your dog can't access something that they want?
Have you noticed your dog doing a lot of mouthing, jumping up, or humping?
Have you noticed a change in your dog's willingness to interact with you? (either becoming more clingy or more withdrawn?)
Do you anticipate pushback from other members of the household when implementing behaviour and wellness changes?
Are there any accomodations you need in order to get the most out of your behaviour and wellness consult?
Does your dog have any known underlying health concerns in addition to anything you may have stated above? If so, what are they?
Is your dog on any medication? If so, what is it?
Has your dog ever had any surgeries or undergone any medical procedures?
Did your dog have giardia as a puppy? If yes, did they receive metronidazole as a treatment?
Have you considered rehoming or euthanasia?
If there is any important information not covered in the form, please add it here.
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