AAHA Cushing\’s Questionnaire – K. Vet Animal Care

Please fill out the form below for the doctor to review. Thank you.

AAHA Cushing's Questionnaire

Name*
First Last
Pet's Name*
Phone*
Email*
What dose of trilostane does your dog receive?*
How many times per day?*
When your dog was diagnosed with Cushing's syndrome, how much was he/she drinking compared to 1 year prior to diagnosis?*
- Less
- About the same
- A little more
- A LOT more
How much is your dog drinking now, compared to when he/she first started taking trilostane?*
- A lot less
- A little less
- Same
- More
How much is your dog urinating now, compared to when he/she first started taking trilostane?*
- A lot less
- A little less
- Same
- More
Has your dog had any urinary accidents/leakage within the past month?*
- No
- Yes, but less than before
- Yes, same as before
How active is your dog compared to when he/she first started taking triolstane?*
- Less active
- The same
- A little more active
- A lot more active/back to normal
Rate your dog's appetite change since the beginning of treatment.*
- A lot less
- A little less
- Same
- Increased
Rate your dog's panting since the beginning of treatment.*
- A lot less
- A little less
- Same
- Increased
How does your dog's haircoat look?*
- Less hair
- Slight Improvement
- No change
- Hair improved/normal
Overall, how do you think your dog is responding to treatment for Cushing's syndrome?*
- Now worse
- No difference
- Some improvement
- Nearly normal now
- Completely normal
Have you had to use the dexamethasone tablets provided at previous visit?*
- Yes
- No
Has your dog had any:*
- Vomiting
- Diarrhea
- Trembling
- Other signs of illness
If they had any symptoms above, please explain below.

Where to Find Us

1 Gibralter Way
Greensburg, PA, 15601

Call: (724) 216-5174
Email: info@kvetac.com

Mon-Thurs: 8:00 am-6:00 pm
Friday: 8:00 am-4:00 pm
Saturday: 9:00 am-12:00 pm
Sunday: Closed