Anamnesis del paciente (ENGLISH VERSION) Δ
WILL THE OPHTHALMOLOGICAL CONSULTATION TAKE PLACE TODAY OR ANOTHER DAY?
Has the patient undergone any tests? Please indicate any positive test results.
No tests have been conducted. Leukemia. Immunodeficiency. Toxoplasmosis Bartonellosis. Hemobartonellosis. FIP (Feline Infectious Peritonitis). Others
Please indicate which test has been done that does not appear in the previous list.
Summary of the reason for the consultation.
Is the patient spayed? (Referring to female animals)
Was the heat normal in quantity and duration?
Please select all the ophthalmological symptoms you have observed in the patient:
None of the mentioned. Eye closed or half-closed. Attempts to scratch the eye. Is sensitive to light. Has lost vision. Excessive tearing. Mucus-like eye discharge. Yellow-green eye discharge. Eyelid problem.
Has the patient consulted with their veterinarian regarding the eye problem?
Please indicate the diagnosis and treatment prescribed by the veterinarian.
Has the patient had any previous eye problems?
Please specify the previous eye problem, when it occurred, and whether the patient is still experiencing the problem. Also, if you remember the treatment, please provide that information as well.
Is it possible that the patient may have suffered a trauma or injury to the eye?
Describe the impact or injury.
Please indicate if the patient has or has had any of the following problems:
None of the mentioned. Allergies. Atopy. Otitis. Dental problems. Gastrointestinal problems. Heart problem. Respiratory problem. Liver problem. Kidney problem. Urinary problem. Reproductive system problem Presence of tumor Infection of any nature
What does the animal have allergies to?
Indicate if the animal has presented any of the following symptoms
None of the mentioned. Cough, tiredness Mucus, dry nose Vomiting or diarrhea Drinks more than usual Urinates more than usual Has gained or lost weight without reason Scratches or licks between the toes Has had seizures or loss of consciousness Is sad, doesn't want to walk, play or hides Barks without apparent reason
Has the patient ever had to undergo surgery?
When and what was the surgery for?
Does the animal have a hunting habit?
Does it eat what it hunts?
Does it tend to eat things from the ground?
Has the animal experienced recent stressful situations?
What is the patient's origin?
Was the patient born in the Canary Islands?
INDICATE WHEN YOUR PET CAME TO THE CANARY ISLANDS AND WHERE IT WAS BORN
Has the patient traveled outside of the Canary Islands?
Where and when did the patient travel?
Did the patient have any health issues when it started living with you?
Indicate what health problem the patient had
Do you know the health status of the patient's parents and/or grandparents?
Did the patient's parents and/or grandparents have any health problems? Which one?
Where does the patient live? Check all that apply
INSIDE THE HOUSE PATIO / ROOF GARDEN ORCHARD / LAND STROLL DOWN THE STREET (SIDEWALK/ASPHALT) STROLL THROUGH GARDENS/PARKS STROLL ALONG THE BEACH STROLL THROUGH THE MOUNTAIN OR FORESTS OTHER
Does the patient live with other animals?
What animals does the patient live with?
Dog Cat Bird Rabbit Other
Is the state of health of these animals good?
What is the health problem of those animals with which you live?
What does the patient's diet consist of? Check all that apply
Feed Soft Food (can) Homemade food Special Diet
What is the patient's special diet?
Has the patient been vaccinated in the last year?
Indicate which vaccines have been given to the patient, if known
Does the patient receive heartworm preventive medication?
Indicate which, if it is pills or pipettes, are they put monthly?
Has the patient had fleas or ticks at any point in its life?
Has the patient undergone any blood tests in the last year?
Briefly indicate the result of the analysis if you know them
SUBMIT FORM
