Framheim German Shepherds

P O Box 1244
OH 43062
joan@framheimshepherds.com

Our Health, Medical and Behavioral Survey

This is a survey we developed to track the development of the puppies and dogs we bred. We asked puppy families to fill this in and return to us preferably with medical records - generally between 14-20 months of age. X-raying joints became a requirement in our warranty. The first set of x-rays were performed between 12-16 months of age so we had timely results for planning future breedings. Families could follow up with official x-rays after 24 months of age. Most families were excellent with providing us with periodic updates. For this, we are very grateful!

HEALTH/MEDICAL/BEHAVIORAL SURVEY FRAMHEIM SHEPHERDS

DATE:_________________

FAMILY NAME:______________________________________________

ADDRESS:_________________________________________________

CITY:____________________

STATE:_______ZIP:____________

PHONE/S:__________________________________________

DOG NAME:__________________________________________

MICRO-CHIP or TATTOO:___________________

BIRTHDATE OF DOG:________________________

AKC #________________________________

SIRE & DAM:__________________________________________________________

I) HEALTH/MEDICAL HISTORY

** If you are sending a copy of medical records, you only need to answer questions not covered by the medical records. We really appreciate copies of medical records!

1) Measurements:

Weight:__________________ Age when weighed_________________

Height at withers:__________________

(The dog needs to be standing. You can use a yardstick placed along the outside of the front leg. Measure the distance from the ground and along the back of the front leg to the top of the dog. This measurement should be the wither height.)

2) Check any of the following health problems your dog has experienced:

_____diarrhea _____dentition (please explain)

_____poor appetite _____ears

_____parasites _____allergic reactions:

______food

_____skin problems ______flea

_____itching _______bee stings

_____poor coat

_____hot spots _____reactions to vaccinations

_____sores/licking _____reactions to medications

_____flea allergy _____injuries/accidents (please explain)

_____demodectic mange (_____localized ____ generalized)

_____limping/lameness

_____osteo-chondrosis dessicans

_____panosteitis

_____eye problems

Other:_______________________________________________________

Please use the backs of pages of this survey to explain the health problems you have checked in the section above. Explanations should describe the condition and length of time you noted this problem, what medical steps were taken and their effect, medications (dosage/length of treatment), what you think may have caused this problem, etc. We appreciate as much information as possible.

3) List medications/treatments prescribed by your vet that were not included in the conditions/explanations listed above: (examples: anti-biotics, wormers, skin treatments, flea control) Include brand names, formulas, dosage, whenever possible.

1)_______________________________________________________________

2)_______________________________________________________________

3)_______________________________________________________________

4)_______________________________________________________________

5)_______________________________________________________________

6)_______________________________________________________________

4) List medications/treatments that you gave your dog (without vet prescription) and describe the condition that prompted you to use these. (examples: flea treatments, ear cleansing, anti-biotics, anti-diarrhea, wormers)

1)_______________________________________________________________

2)_______________________________________________________________

3)_______________________________________________________________

4)_______________________________________________________________

5)_______________________________________________________________

6)_______________________________________________________________

5) List the brand names and type (live or killed) of vaccinations, and date or age of your dog that each vaccine was given: (This information is IMPORTANT and easiest to just send medical records.)

Brand name/formula/type Date or Age of dog

1)_______________________________________________________________

2)_______________________________________________________________

3)_______________________________________________________________

4)_______________________________________________________________

5)_______________________________________________________________

6) Is your dog on heartworm prevention?________

Product name___________________

How many months of the year is it given? _____________

7) X-Ray Record

What x-rays have been taken of your dog?

hips_____ elbows______ other______________________________

Age of dog when taken:______________________________________

Were the x-rays sent to : OFA_____ OVC_____ SV_____

PenHip______ GDC________ other___________________________

radiologist_______(Name____________________________________)

Rating on hips:_________________________ elbows:_________________

Certification number for hips_________________elbows_____________

8) Are there any other health or medical details that you would like to share with us?

_________________________________________________________________

II) DIET

1) List the foods you have fed your dog.

Name of food and formula Approx. length of time fed to dog

1)_______________________________________________________________

2)_______________________________________________________________

3)_______________________________________________________________

4)_______________________________________________________________

III) SUPPLEMENTS

1) List supplements. (Vitamins, oils, enzymes, etc.)

Brand names, formulation How much/ How often/ How long?

1)_______________________________________________________________

2)_______________________________________________________________

3)_______________________________________________________________

4)_______________________________________________________________

2) List additional foods that are regularly fed: (meats, dairy, vegetables, fruit, eggs, etc.)

Type of food (Specify kinds of meat)

1)_______________________________________________________________

2)_______________________________________________________________

3)_______________________________________________________________

4)_______________________________________________________________

Other dietary additions? __________________________________________________________

__________________________________________________________

If you fed a raw diet:

What approx. percentage of the dog’s total diet was raw? 10%____50%____75%____95%____

What approx. percentage was kibbled feed? 10%___50%____75%____100%____

3) If you noticed changes in your dog and its condition with various diets, explain what they were: (ie.: dry skin with a certain brand of food, more plaque on teeth, licking feet, etc.)

_________________________________________________________________

IV) BEHAVIOR

1) Check the characteristics that you think apply to your dog:

(Use the back for any explanations)

_____independent _____dependent

_____affectionate with family _____aloof with family

_____friendly with strangers _____indifferent to strangers

_____nervous away from home _____relaxed away from home

_____demands affection rarely _____demands affection a lot

_____watchdog barking _____boredom barking

_____slow, finicky eater

_____will eat anything _____gulps meals quickly

_____stubborn/hard to train _____easy to train/eager to please

_____aggressive

_____with other dogs _____submissive

_____near food/toys _____timid with strangers

_____with yard/home _____aggressive with strangers

_____initiates play with you _____not interested in playing

_____loves to retrieve balls

_____never retrieves anything _____retrieves balls sometimes

_____calm in house _____nervous/paces in house

_____chews appropriately on _____chews destructively

bones/toys

2) How would you rate your dog with the following characteristics?

(0 = none; 1 = low/little increasing to 5 = high/a lot)

Circle appropriate number:

0 1 2 3 4 5 general excitability

0 1 2 3 4 5 general activity level

0 1 2 3 4 5 growling/snapping at children (*please explain on back of page if this has happened!)

0 1 2 3 4 5 nuisance barking (barking for no apparent reason)

0 1 2 3 4 5 affection demand (pawing, nudging for affection)

0 1 2 3 4 5 watchdog barking (barking at noises, door, fence)

0 1 2 3 4 5 acceptance of strangers

0 1 2 3 4 5 aggression to other dogs

0 1 2 3 4 5 how well dog obeys family members

0 1 2 3 4 5 how well dog settles when family is ‘settled’ (relaxing, eating dinner, surfing net, etc)

0 1 2 3 4 5 destructiveness

0 1 2 3 4 5 house-training ease

0 1 2 3 4 5 learning abilities (ease of teaching obedience, tricks, learning house rules)

0 1 2 3 4 5 playfulness

0 1 2 3 4 5 destructive digging

0 1 2 3 4 5 destructive chewing

0 1 2 3 4 5 submissive urination

3) What other behaviors/mannerisms have you observed with your dog? (These can be positive or negative. Examples. herding interests; chasing cats, tail, cars; opening doors/gates, excessive licking, digging/burying; carrying objects)

1)_______________________________________________________________

2)_______________________________________________________________

3)_______________________________________________________________

4)_______________________________________________________________

4) Where does your dog spend most of the time? Please write an `H' for when you are at home and an `A' for when you are away from the home.

_____free in house _____confined in an area of the house

_____crate _____outside in the yard _____a kennel/run

other_____________________________________________________

5) What exercise do you and your dog enjoy together?

_________________________________________________________________

6) How many times a month (on average) did you and your dog go somewhere away from home? (Obedience class, pet store, park, shopping center, etc – do not include daily exercise like walking – see below)

0___ 1-2___ 3-4___5-6___7-8___9-10___11-12____13-14___15 or more____

7) What type of ‘daily’ exercise does your dog get generally? (Check all that apply on a regular basis.)

Playing in yard alone____ playing in yard with family dogs____ playing in yard with family____ retrieving toys in yard____ running in kennel____ running on treadmill____

Walks in neighborhood____ playing with other dogs in park____ retrieving toys in public park____

Other:_________________________________________________________________________

How long is the average daily exercise? (In time and/or distance and you can give separate totals for winter and warmer months.)

_____________________________________________________________

V) TRAINING/COMPETITION

1) Check the activities you have participated in:

_____Obedience:

_____AKC; to what level__________________________

_____UKC; to what level___________________________

_____household obedience classes

_____Agility

_____Herding; to what level_______________________________

_____Search/Rescue; Is dog certified? _____ Level________________

_____Therapy Service; TDI_____ Delta_____ other_________________

_____Schutzhund; to what level_______________________________

_____Ring Sport; to what level_______________________________

_____Police Service; certified?_____

_____Conformation/Breed ring:

_____AKC _____UKC _____SKC _____USA/SV Other______________

List wins/rankings__________________________________________

____________________________________________________________

2) How would you rate your dog's training abilities?

_____excellent _____good _____poor _____hopeless

3) How would you rate your dog's intelligence/problem solving?

_____excellent _____good _____poor _____hopeless

4) What `tricks' have you taught your dog?

_________________________________________________________________

5) What `special talents' does your dog possess?

_________________________________________________________________

VI) ABOUT YOU!

List books, videos, classes, and seminars you have studied on the subject of

dogs (training, showing, behavior etc.) that you have found interesting.

_________________________________________________________________

VII) GENERAL INFORMATION

Please answer the following NOT as the breed standard or the `ideal' calls for, but from what you actually see in the German Shepherd Dog today. Reality not idealism! If you don’t have an opinion, that’s fine, too!

1) How would you rate the German shepherd breed on overall characteristics needed to be a great pet/companion?

_____excellent _____good _____poor _____hopeless

2) How would you rate the German shepherd breed on overall characteristics needed to be a versatile working/service dog?

_____excellent _____good _____poor _____hopeless

3) How would you rate the German shepherd breed on overall soundness of temperament?

_____excellent _____good _____poor _____hopeless

4) How would you rate the German shepherd breed on overall soundness of health/vigor?

_____excellent _____good _____poor _____hopeless

5) How would you rate the German shepherd breed on overall soundness of genetic characteristics?

_____excellent _____good _____poor _____hopeless

6) What problems do you think German shepherd breeders need to address as most important to correct?

_________________________________________________________________

7) What characteristics do you think German Shepherd breeders should value or emphasize as most important? (Indicate with numbers the order of importance. 1=important and so forth)

_____ stable temperament/character _____ show-winning structure

_____ intelligence _____ movement/gait

_____ working/training abilities _____appearance/beauty

_____ correct structure _____health/vigor

Other_____________________________________________________

____________________________________________________________

8) What characteristics do you think we, at FRAMHEIM, need to concentrate on or correct in our breeding program?

_________________________________________________________________

9) Would you adopt another German Shepherd?_________________

Why or why not?_____________________________________________

10) Would you adopt another FRAMHEIM Shepherd? (Be honest!!)____________

Why or why not?_____________________________________________

_________________________________________________________________

11) What other issues, subjects or questions do we need to include in future surveys?

_________________________________________________________________

This survey is strictly for the improvement of the breed and our breeding program. We are sincerely grateful to you for taking the time to carefully complete this survey.

Signature of person completing this form:

_________________________________________________________________

If this survey is NOT about a Framheim Shepherd, list the parents and grandparents of this dog. You may send a pedigree as well.

Sire:____________________________________________________________

Grandsire: __________________________________________________

Grand dam: ___________________________________________________

Dam:_____________________________________________________________

Grandsire:__________________________________________________

Grand dam:___________________________________________________

Note: If any other members of your family would like to give their opinions and answers to any portion of this survey, feel free to copy this form and include their answers.

If you know any one else (breeder, trainer or any lover of dogs) who would like to participate in this project, please let us know or have them contact us. If you wish to share this survey with other people, also feel free to.

Thank you!!!

Joan Andreasen-Webb

joan@framheimshepherds.com

revised 9-2013

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P O Box 1244
OH 43062
joan@framheimshepherds.com