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Owner Perception of the Effectiveness of Trilostane Therapy Questionnaire
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Name
*
First
Last
Email
*
Pet's Name
*
Please rate your dog's behavior/appearance for the past four weeks in the following categories.
Drinking - Do you think your dog has drank:
*
Less than normal
Normal
More than is normal (eg, 1 or 2 times normal)
Very much more than is normal
Urinating - Do you think that the volume or frequency of urination is:
*
Less than normal
Normal
More than is normal (e.g., 1 or 2 times normal)
Very much more than is normal
Appetite - Would you describe your dog's appetite as:
*
Very poor (not eating at all or hardly eating)
Poor (does eat some food but requires encouragement)
Normal
Increased (eats all food quickly and will look for more)
Greatly increased (seems ravenously hungry all the time)
Vomiting and diarrhea - How often has your dog had sickness and diarrhea?
*
Never had sickness or diarrhea
Has had sickness or diarrhea once
Has had sickness or diarrhea more than once but not every day
Has had sickness or diarrhea every day
Exercise - How active is your dog?
*
Lies in one place nearly all of the time
Goes for walks and will also play on occasions
Very active, happy to run off-leash but does get tired
I cannot tire my dog out!
Skin and coat - How would you describe your dog's coat and skin condition?
*
Very poor (e.g., thin coat, bald patches, very dull)
Poor (e.g. slightly thin coat, hairs dull)
Reasonable (e.g., no bald patches, slightly dull)
Very good (e.g., thick coat, shiny, no dandruff)
Other problems - Does your dog have any of the following?
*
Trembling/shaking/muscle twitches more than once a week
Persistent panting even at rest
Pain (anywhere)
Difficulty moving
Mental depression
None of the above
General - How do you feel your pet enjoys life?
*
Miserable most of the time
Has more bad days than good days
Happy most of the time, occasional bad days
Happy all of the time
Overall - How good do you feel your dog's current treatment for Cushing's is?
*
My dog has more clinical signs than before treatment
There is no difference now than before treatment
There is some improvement since starting treatment
My dog is nearly back to his/her normal self
If I did not know, I would think there was nothing wrong with my dog now
Submit