Behavior Conditions

Behavior Conditions
Tell us about your pet! Help us get to know your pet on a more personal level by answering a few questions and bringing the printed form with you to your next appointment.This questionnaire consists of 3 main sections (History, Aggression & Cognitive; beginning with your Basic Information), with roughly 30 questions each. It should only take 20 to 30 short minutes, so grab your beverage of choice and let's see how well you know your pet!

Basic Information

Pet's Sex :

History

Environment

1) Type of House

What type of house do you live in?
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2) Sleeping Arrangement

Where does your pet sleep?
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3) Pet Source

Where did you get your pet?
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4) Age Acquired

The age of your pet when you acquired it?
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5) Number of People

How many people are in your house other than yourself?
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6) Neutered

Has your pet been neutered?
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7) Food Form

Some behaviors are caused by the type and consistency of the food you feed your pet. What type of food form do you feed your pet?
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8) Food Brand

What brand of food do you feed your pet?
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9) Who Feeds

Who feeds your pet in your house?
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10) When Feed

You should feed your pet on a set schedule so that both you and your pet can have a regular routine. How often do you feed your pet?
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11) Treats

If you are consistent on when you give your pet treats, then it will help with the long-term training goals. When do you give your pet treats?
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12) Table Food

Feeding table food to your pet may develop undesirable behavior such as begging. Do you feed your pet table food?
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13) Table Food Reaction

How does your Pet React to Table Food?
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Exercise and Play

14) Hours Outside

What is the amount of time your pet spends outdoors?
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15) Restraint

This is the type of enclosure you use outside for your pet such as a fence, leash, chain, etc. What do you use?
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16) Walks

Walking your pet helps both you and your pet because the amount of time spent walking and the frequency of walks helps keep both the owner and the pet healthier. How often do you walk your pet?
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17) Leash Type

The type of leash you use on your pet has a great deal to do with how he/she responds to training. What type of leash do you use on your pet?
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18) Play Type

What items or things you and your pet play with contributes to the long-term behavior of your pet. Things or items such as balls, ropes, shoes, etc. are all types of play. What is your usual type of play with your pet?
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19) Play Frequency

Playing with your pet may contribute to their behavior. How often do you play with your pet?
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Problem History

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20) When did it Start -Lifestage

At what lifestage did the problem begin?
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Obedience

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21) Obedience Training

Obedience training is a way to help you get better control of your dog, however, it is not the best way to solve behavior problems. You will learn how to teach your dog sit, down, come when called, not to jump and so on, but not how to deal with separation anxiety or aggression. Did your pet attend obedience training?
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22) Head Halter Trained

This means that your pet is trained with a Gentle Leader, Halti or other head halter device. These are humane ways to train your pet and gain control without excessive force or the use of chain or prong collars. Head halters are similar to horse halters and give you control over your pet's head with the idea being that where the head goes; the body will follow. These halters will not only allow you to walk your dog with ease but they also hit pressure points around your pets neck and muzzle that help calm them down. Was your pet trained with a head halter device?
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23) Crate Trained

Your pet has been trained to respect his/her crate and this is their safe haven and sleeping area. Does your pet respect his/her crate?
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24) House Trained

This indicates that your pet has been house trained and understands the difference between eliminating inside versus outside. Is your pet house trained?
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Obedience Commands

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25) Stay

This is an obedience command that means stay here until I come back to you and release you. With basic training, your pet learns to stay in one spot while you walk away from them. In advanced training, your pet will learn to stay where you tell them while surrounded by distractions. This command is helpful when your pet gets away from you and crosses a busy street or when your hands are full of groceries. Does your pet stay?
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26) Heel

This is an obedience command that means to walk beside your leg. Heel is a very specific command that means your pet should have their muzzle level with your leg and be within 2 inches of you. For average walks where you are only interested in your pet not pulling you, then a command of "Walk" is more appropriate. Does your pet heel?
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27) Down

This is an obedience command that means to lie down. It is very important that you are consistent with this command and when you want your pet to get off of the couch or counter, you say off and not down. If you use down in both contexts, then you will confuse your pet about what the command actually means. Does your pet obey when you tell him/her to lie down?
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28) Sit

This is an obedience command that means for your pet to get into a sit position or have their rump on the floor. Does your pet obey when told to sit?
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29) Come

This is an obedience command that means "stop what you are doing and come over and sit in front of me." In basic work, you will work on calling your dog from a distance of six feet and have them come and sit in front of you. In advanced work, you will increase the distance and then your pet will learn to work with distractions. This command is very helpful when you need to get your dog away from something. Does your pet come when you call him/her?
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Aggression

Aggression History

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1) Bitten Human or Animal

Has your pet ever bitten a human or another animal?
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2) How does your pet react to: Being Petted while Eating Delicious Food?

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3)How does your pet react to: You Touching their Bowl while Eating Delicious Food?

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4) How does your pet react to: Being Petted while Eating Food?

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5) How does your pet react to: You Touching their Bowl while Eating Food?

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6) How does your pet react to: Being Petted while Eating Rawhide?

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7) How does your pet react to: You Touching their Rawhide while Eating?

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8) How does your pet react to: Being Petted while Resting in a Preferred Spot?

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9) How does your pet react to: Being Petted while Resting?

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10) How does your pet react to: Being Petted while Sleeping?

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11) How does your pet react to: You Putting on their Collar?

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12) How does your pet react to: You Pulling on their Collar?

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13) How does your pet react to: You Putting on their Leash?

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14) How does your pet react to: You Pulling on their Leash?

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15) How does your pet react to: Handling their Feet?

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16) How does your pet react to: Being Hugged?

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17) How does your pet react to: Being Brushed or Combed?

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18) How does your pet react to: You Taking away their Favorite Toy?

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19) How does your pet react to: Being Reprimanded in a Loud Voice?

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20) How does your pet react to: Being at the Veterinarian's?

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21) How does your pet react to: Being Restrained at the Veterinarian's?

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22) How does your pet react to: A Strange Dog Approaching while Walking?

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23) How does your pet react to: A Strange Dog Entering your Yard?

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24) How does your pet react to: An Unfamiliar Child Approaching?

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25) How does your pet react to: An Unfamiliar Child Petting your Dog?

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26) How does your pet react to: A Stranger Approaching You?

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27) How does your pet react to: A Stranger Entering your Yard?

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28) How does your pet react to: A Stranger Walking past your Home?

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29) How does your pet react to: A Jogger Running past your Dog?

Cognitive

Confusion, Awareness, Spatial Orientation

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1) Gets Lost in Familiar Locations

This means your pet cannot remember his or her way around familiar places, such as the house or backyard.
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2) Gets Stuck or Cannot Navigate

This means once your pet is in a particular area, he/she cannot remember the way back or out. They may become confused or scared and will stay in one area for long periods of time.
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3) Goes to Wrong Side of Door (Hinge)

This means your pet has forgotten the usual way they move through the door.
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4) Less Responsive to Stimuli

This means your pet no longer responds as he/she previously did to petting, showing toys, treats, invitations to play or walks, or sounds and sight.

Activity -Decreased (apathy)

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5) Decreased Appetite or Disinterest

A decreased appetite can be an indication of many illnesses from behavioral problems to medical problems, and additional tests and evaluations will be necessary to determine the cause.
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6) Decreased Exploration or Activity; Apathy

This means your pet has trouble exploring new and old places and has a reduced activity level known as apathy.
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7) Decreased Self-Care

This means that your pet is no longer licking (grooming) himself/herself, but is urinating or defecating on himself/herself. These behaviors are signs that something is wrong, such as a sign of old age, separation anxiety, illness, stress or some other behavioral problem.

Activity -Increased or Repetitive

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8) Increased Appetite

An increased appetite can be an indication of behavioral or medical conditions and additional tests and evaluations may be necessary to determine the cause.
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9) Licking Owners or Household Objects

This means your pet has developed a habit of licking you, the owner, or objects in the house.
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10) Pacing or Aimless Wandering

This means your pet has developed a habit of wandering around the house without purpose.
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11) Staring, Fixation, or Snapping at Objects

This means your pet has started staring at objects and fixating on them along with snapping at them more frequently.
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12) Vocalization

This means your pet exhibits behaviors of barking, whining, howling or singing.
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13) Increased Irritability

This means your pet is easily irritated more often.

Anxiety or Increased Irritability

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14) Restlessness or Agitation

This means your pet has become restless and agitates easily.
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15) Separaton Anxiety

This is a panic disorder that your pet has when left alone. The most common signs are destructive behavior, vocalization, inappropriate elimination, depression, excessive licking, vomiting, diarrhea, and excessive drooling. Destructive behavior, which is part of normal adolescent behavior, is widespread throughout the house, while destructive behavior due to separation anxiety focuses mainly on windows and doors. It is very important to gradually get your puppy used to being left alone by taking short trips away at first, like 5-15 minutes, and then increase them to 30 minutes, one hour, etc. It is not a good idea to confine a dog that suffers from separation anxiety while you are gone, even though it might decrease the destruction, it will only make matters worse for your pet. If you think that your pet suffers from this disorder, then please talk to a member of our healthcare team so that we can create a training program to help you solve this behavior issue and possibly prescribe some medication, such as Clomicalm, to help out during the process.

Sleep-Wake Cycle

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16) Increased Daytime Sleep

This means your pet has increased the amount of daytime sleep he/she requires.
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17) Restless Sleep or Waking at Night

This means your pet has developed a habit of sleep walking or walking at night, which may be that your pet has forgotten or switched its internal clock.

Relationships and Social Behavior

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18) Alterations or With Social Hierarchy

Your pet no longer understands his/her role in the family and this may be happening as your pet matures and attempts to establish a new role for himself/herself. This could also happen as your pet ages or as the result of trauma.
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19) Decreased Greeting Behavior

This means your pet no longer greets you with the same enthusiasm as he/she used to.
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20) Decreased Interest in Petting Contact

This means your pet's interest in being petted or having contact while petting has reduced.
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21) In Need of Constant Contact (Clingy)

This means your pet has difficulty leaving your side and he/she wants attention more often than before and appears clingier.

Learning and Memory -Work, Tasks, Commands

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22) Decreased Ability to Perform Tasks

This means your pet may understand your requests and desire to perform certain tasks, however, he/she seems physically unable to perform them.
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23) Decreased Cognition of People or Pets

Your pet has trouble recognizing familiar people or other pets. This could be due to aging or a brain injury.
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24) Decreased Responsiveness to Commands

This means your pet may understand your requests and desire to perform certain tasks, however, he/she seems physically unable to perform them.
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25) Impared Working Ability

This means an injury or illness is preventing your pet's ability to perform working tasks.
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26) Inability or Slow to Learn New Tasks

This means your pet has difficulty learning new tasks.

Learning and Memory -Housesoiling

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27) Decreased Signaling

This means your pet no longer makes you aware of his/her need to go outside.
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28) Elimination in Crate or Sleeping Area

This means your pet has problems with eliminating in the crate or sleeping area, which may mean your pet has forgotten or has lost the ability to hold urine and stool.
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29) Goes Outdoors, Eliminates Indoors

This means your pet has difficulty remembering that the elimination station is outside. Your pet may be confused and will need personal attention to help remember when and where to eliminate.
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30) Incontinence

This means your pet seems to be unable to control defecation or urination.
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31) Indoor Elimination at Random Sites

This means your pet has started eliminating in the house at odd places.
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