Liverpool Osteoarthritis in Dogs (LOAD)- Owner questionnaire Liverpool Osteoarthritis in Dogs (LOAD)- Owner questionnaire Your Name* First Last Pet's Name*Your Phone Number*Client number*Breed of pet*Pet’s age*Sex* M F BackgroundHow long has your pet been suffering with his/her mobility problem?* Up to 6 months 6–12 months 12–24 months 24–36 months more than 36 months Has your dog been diagnosed as suffering from any other problems in addition to his/ her orthopedic disease?* Yes No Please list these if you can:*If you can, please list any medications that your pet is currently receiving, stating when he/she received the last dose of each:*LifestyleIn the last week, on average, how far has your dog exercised each day?* 0–0.6 miles 0.6–1.2 miles 1.2–1.9 miles 1.9–2.5 miles more than 2.5 miles In the last week, on average, how many walks has your dog had each day?* 0 1 2 3 4 What type of exercise is this?* Always on leash Mostly on leash Mostly off leash Always off leash Working Are there particular days of the week upon which your dog has significantly more exercise? (Check more than one box if necessary.)* Monday Tuesday Wednesday Thursday Friday Saturday Sunday On what sort of terrain does your dog most often exercise?* On level grass In woodland On street Over rough ground At exercise, how is your dog handled?* Walk on leash Walk off leash Trot Run freely Who limits the extent to which your dog exercises?* You Your dog MobilityHow is your dog’s mobility in general?* Very good Good Fair Poor Very poor How disabled is your dog by his/her lameness?* Not at all disabled Slightly disabled Moderately disabled Severely disabled Extremely disabled How active is your dog?* Extremely active Very active Moderately active Slightly active Not at all active What is the effect of cold, damp weather on your dog’s lameness?* No effect Mild effect Moderate effect Severe effect Extreme effect To what degree does your dog show stiffness in the affected leg after a ‘lie down’?* No stiffness Mild stiffness Moderate stiffness Severe stiffness Extreme stiffness At exercise, how active is your dog?* Extremely active Very active Fairly active Not very active Not at all active How interested is your dog in exercising?* Extremely interested Very interested Fairly interested Not very interested Not at all interested How would you rate your dog’s ability to exercise?* Very good Good Fair Poor Very poor What overall effect does exercise have on your dog’s lameness?* No effect Mild effect Moderate effect Severe effect Extreme effect How often does your dog rest (stop/sit down) during exercise?* Never Hardly ever Occasionally Frequently Very frequently What is the effect of cold, damp weather on your pet’s ability to exercise?* No effect Mild effect Moderate effect Severe effect Extreme effect To what degree does your dog show stiffness in the affected leg after a ‘lie down’ following exercise?* No stiffness Mild stiffness Moderate stiffness Severe stiffness Extreme stiffness What is the effect of your dog’s lameness on his/her ability to exercise?* No effect Mild effect Moderate effect Severe effect Extreme effect CAPTCHACommentsThis field is for validation purposes and should be left unchanged. Δ
