Liverpool Osteoarthritis in Dogs (LOAD)

Owner questionnaire for dogs with mobility problems

Dear Pet Owner

Thank you for agreeing to complete this questionnaire. Your assistance in this endeavor will enable us to gather valuable information about your pet and is a vital component in our ongoing quest to combat painful and debilitating diseases such as arthritis. It is important that all questions are answered to the best of your ability and if you have a question regarding the questionnaire, please contact us.

Thank you again for your help.

Today’s date: *

Please choose which hospital you'd like to send it to: *

Noes Ark
Bark Avenue

Owner’s name: *

First

Last

Client number:

Email *

Owner’s phone number: *

Pet’s name: *

Breed of pet: *

Pets age: *

Sex: *

Male
Female

Background

1. How long has your pet been suffering with his/her mobility problem? *

2. Has your dog been diagnosed as suffering from any other problems in addition to his/ her orthopedic disease? *

No
Yes

3. If you can, please list any medications that your pet is currently receiving, stating when he/she received the last dose of each: *

Lifestyle

1. In the last week, on average, how far has your dog exercised each day? *

5. On what sort of terrain does your dog most often exercise? *

On level grass
In woodland
On street
Over rough ground

6. At exercise, how is your dog handled? *

Walk on leash
Walk off leash
Trot

7. Who limits the extent to which your dog exercises? *

You
Your dog

Mobility

5. To what degree does your dog show stiffness in the affected leg after a ‘lie down’?

12.To what degree does your dog show stiffness in the affected leg after a ‘lie down’ following exercise? *

Get In Touch

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Contact Us

Call: 480-210-5610 ext. 1
Text: 480-571-5008
Fax: 480-807-5542
Email: hospital@barkavepet.com

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Location

3109 E McKellips Rd
Mesa, AZ 85213

Click here for directions.

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Hours

Mon – Fri: 7:30 AM – 7:00 PM
Sat – Sun: 8:00 AM – 2:00 PM

Click here to make an appointment.

Have a question?

Complete the form below and our team will be in touch with you shortly. If you’re in need of immediate assistance, please contact us directly at 480-210-5610 ext. 1.