English Shepherd Club Health Questionnaire

By completing and submitting this online form, you are agreeing to allow the inclusion of the data in the database and to hold the ESCR harmless from any disclosure of information.

If you prefer download the PDF and return completed surveys to: registrar@esc-registry.org or mail to: Rebecca Wingler, Registrar 1904 Transit Trail / Apex, NC 27502

Alive *

Sire and Dam Information

Information that a dog has not been diagnosed with a problem is as significant as information about a diagnosed health condition so please fully complete the questionnaire below. If you have other information about your dog’s health, please add that information to the Section “Other Information” along with the age of the dog at diagnosis or other specifics. This would include a condition that was not diagnosed through testing, etc. but which responded to treatment (for example, ear infections or skin condition which improved or resolved with a change in diet) or when a veterinarian believes a condition existed but which can only be proven with specialized testing or a necropsy. Finally, if the dog has been tested for genetic disorders, screened for orthopedic issues or has a DNA profile on record, please provide a copy of the results with your response.

Neurological

Epilepsy
Ideopathic (unknown Cause) Seizures

Eyes

CEA *
PRA *
Cataracts *
Glaucoma *

Allergies

Environmental (pollen, grasses, etc.) *
Food *
Drug *
MDRI Status *

Respiratory

Cardiovascular

Heart murmur
Dilated Cardiomyopathy *

Endocrine

Diabetes *
Hypothyroid *
Cushings’ Disease *

Gastrointestinal

Genitourinary

Intact *
Mammary Tumors *
Prostate Cancer *
Hernia *
Kidney Disease *

Musculoskeletal

Hips: Dysplastic *
Elbows: Normal *
Osteosarcoma *

Cancers

Please provide copies of all genetic testing and health screening (hips, etc.) The information collected through this survey will be available through the ESC Registry Database and will provide both breeders and owners of English Shepherds valuable information to help conserve this breed. Collection of this information is not intended to denigrate any breeder or dogs and should not be used by anyone for such purposes. It is important to acknowledge that health issues exist in English Shepherds and being aware of what issues may exist in this breed will assist both breeders in making educated decisions with breeding practices as well as helping owners recognize potential health problems in their beloved dogs. Your cooperation in participating in this survey is greatly appreciated.

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