Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. before? dog? to Thanks for participating in our Brachycephalic questionnaire! This questionnaire is only to be used in relation to your pets assessment for BOAS surgery and not in place of seeking veterinary attention for sudden breathing difficulties. Please answer the questions as best you can! If your pet is currently in distress or experiencing serious breathing difficulty, seek immediate veterinary care. Dr. Jenna aims to respond to website form enquiries within 3-5 business days. This form helps Dr. Jenna to work out if your pet is likely to benefit from BOAS surgery, and to provide you with an estimate of the likely costs involved before you spend any money. If Dr. Jenna believes BOAS surgery may help your pet, then once you have received your initial assessment result and estimate you will be invited to attend a consultation at the practice*. During this consultation Dr. Jenna will conduct a thorough examination of your pet to ensure that BOAS surgery is a good fit for them. Dr Jenna will also explain the details of the procedure and recovery process, as well as answer any additional questions you may have about the surgery. * Please note: the in-practice consultation carries a standard consultation fee, however, this fee will be deducted from your final invoice if you choose to go ahead with the BOAS procedure following your consultation. Your contact information: *FirstLastYour pets information: * *FirstLastIs your pet currently a patient with Gordon Vet Hospital? *YesNoBelow are some common signs people report seeing in their pet when BOAS surgery may be needed. The more information you are able to give, the better we can understand your pets needs. You can select as many of the below points that are relevent to your pet Please select all that apply to your pet: *➤ My dog often snores or breathes loudly while they are asleep➤ At times my dog suddenly wakes up from sleeping and gasps for a breath➤ My dog finds it more comfortable to sleep when their head is elevated or extended➤ I sometimes hear a coughing or choking sound while my pet is asleep➤ My dog often struggles in hot weather & isn't able to exercise in the heat➤ My dog is often very out of breath or struggling after small amounts of exercise➤ My dog often breathes through their mouth instead of their nose➤ My dog will make choking or gagging sounds while eating➤ My dog sometimes vomits or regurgitates after eating➤ I sometimes see my dog gagging or retching at random times, even if they aren't eating or drinkingFrom the options below, which is the most correct for a usual walk with your dog? *Choose most correct answerLess than 15 minutesLess than 30 minutesLess than 1 hourOver 1 hourHas your pet ever had airway surgery before? *YesNoHas your dog ever fainted or collapsed after exercise? *YesNoIs there any other information relating to your pets breathing you would like to share?Please note: Dr Jenna will aim to get back to your enquiry within 3-5 business days. This questionnaire is an initial introduction into surgical evaluation only. If you have any immediate concerns regarding your pets breathing, please DO NOT wait to hear back from us regarding this form and seek Veterinary attention for your pets health concerns urgently. Submit
19 Ryde Road, Pymble, NSW 2073
(02) 9498 3000
info@gordonvet.com.au
19 Ryde Road, Pymble, NSW 2073(02) 9498 3000info@gordonvet.com.au