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Gezondheidsonderzoek

Maremma Health Survey

Gesundheitsuntersuchung

 

 

Van de Maremma wordt gezegd dat het een erg gezond ras is. Om meer te weten te komen over de gezondheid en eventuele problemen, wil ik u vriendelijk vragen dit formulier in te vullen. Alle informatie wordt zeer gewaardeerd.

 

The Maremma Sheepdog is supposed to be a very healthy breed. In order to find out more about the health or any possible health problems of the Maremma I would kindly ask you to fill out this form. Any information is highly appreciated. 

 

Der Maremmane soll eine sehr gesunde Rasse sein. Ich bitte Sie dieses Formular aus zu füllen, damit wir mehr über die Gesundheit und eventuelle Probleme der Maremmane wissen können. Jede Information wird in hohem Maße geschätzt.

 

Fields marked with *) are obligatory.
Need a translation? Try http://www.freetranslation.com/

 

 

Name of owner:

 

Address, city: 

 

Country: 

 

Email address*:

 

Pedigree name of the dog*:

 

Pedigree number:

 

Sex*:      desexed

 

Date of birth*:    --(dd-mm-yyyy)

 

Date of death:    --(dd-mm-yyyy)

 

Cause of death:

 

Name of the father of the dog:

 

Name of the mother of the dog:

Hip dysplasia*:

Teeth*:       What kind of teeth*:        

When incomplete which teeth are missing?                  

Did/does your dog suffer from any of the below mentioned problems?

Cataract: yes  no
Ectropion: yes  no
Entropion:  yes  no
Epileptic syndrome: yes no
Heart problems: yes no
Skinproblems: yes no
Food allergy: yes no
Ear problems: yes no
Bloat (stomach torsion): yes no
Cryptorchism (one or both testicles not present): yes no
Hypothyroidsm (insufficent working of the thyroid glands): yes no
Cruciate ligament rupture: yes no
Urinary problems: yes no
Cancer: yes

no
What kind of cancer?
If you have answered any of the above questions with 'yes', please specify the problem(s).

 

 

Can you describe the character and behaviour of your Maremma in a few lines.

 

If you have any problems with the character of your Maremma, could you please describe the problems.

 

Remarks or additional information:

 

Thank you very much for your time and co-operation.