PET OWNER Section
BASIC HISTORY
Age of the pet when the problems started:
Season the problems started:
SYMPTOMS
Does the pet do any of the following?
Which of the following came first?
If yes, where?
ENVIRONMENT
Describe the area where the pet resides:
What other pets are in the household?
Percent of time spent indoors:
Do any other pets in the household have skin problems?
BATHING
How often is the pet bathed?
Shampoo type (check all that apply):
DIET
Food type (check all that apply):
Table Food
Treats
Veterinarian Section
Fleas controlled?
Are all the pets in the household on preventives?
Has a food trial been performed?
Was diet strictly adhered to?
During what season(s) are symptoms present?
Is Malassezia a problem for the pet?
Was Sarcoptes considered?
Were skin scrapings performed?
If yes, were skin scrapings positive?
Was pet treated for Sarcoptes?
How many times has the pet been treated for pyoderma?
What was the response to steroids?