Caregiving Survey
Address *
- {name}
I agree to have Wild Hearts contact me regarding my caregiving experience. *
- Yes
- No
Gender *
- Female
- Male
Neutered? *
- Yes
- No
Did this pet have insurance? *
- Yes
- No
Your pet's suspected or confirmed diagnosis: *
- Arthritis
- Brain Tumor
- Cerebellar Hypoplasia
- Congenital Disorder
- Cryptococcosis
- Degenerative Myelopathy
- Discospondylosis
- Distemper
- Dysplasia
- Epilepsy
- FCE (stroke)
- GOLPP (polyneuropathy)
- Hemivertebrae
- Hydrocephalus
- IVDD (disc disease)
- Limb Loss
- Megaesophagus
- Meningitis
- Myasthenia Gravis
- Myelopathy
- Paralysis - unknown cause
- Rheumatoid Arthritis
- Spina Bifida
- Spinal Tumor
- Spondylosis
- Spinal Cord Injury
- Swimmers Puppy Syndrome
- Syringomyelia
- Trauma
- Vestibular
- Wobblers
- Other
I took my pet to consult with the following specialist(s): *
Please select all that apply.
- Internist
- Neurologist
- Orthopedist
- Primary Care Vet
- Rehabilitation Vet
- None
What diagnostics were performed? *
Please select all that apply.
- Bloodwork
- CT
- MRI
- Surgery
- Radiographs
- Urinalysis
- None
Was surgery an option? *
- Yes
- No
How would you describe your pet's mobility at the start of diagnosis or when you first started caring for your pet (i.e. if the pet was a foster)? *
- No mobility issues or concerns
- Ataxic (uncoordinated)
- Paretic (weak)
- Front Limb(s) Paralyzed (unable to move)
- Hind Limb(s) Paralyzed (unable to move)
- Front Limb Limb Loss
- Hind Limb Limb Loss
- Limb Deformity
How did your pet's mobility change? *
- My pet's mobility remained the same.
- My pet's mobility improved.
- My pet's mobility continued to deteriorate.
Did your pet receive any of the following treatments? *
Please select all that apply.
- Acupuncture
- Assisi Loop
- Chiropractic Care
- Homeopathic Treatment
- Laser Therapy
- Massage Therapy
- NMES (Neuromuscular Electrical Stimulation)
- PRP Injections (Platelet Rich Plasma)
- Shockwave Therapy
- Surgery
- TENS (Transcutaneous Electrical Nerve Stimulation)
- Therapeutic Exercises
- Therapeutic Ultrasound
- Underwater Treadmill/Swimming
- None
Did your pet utilize any of the following assistive devices or supplies? *
Please select all that apply.
- Belly Band/Diapers
- Booties
- Brace
- Cart/Wheelchair
- Harness with handles
- Orthotic/Prosthetic
- Potty Pads
- Sling
- Toe Grips
- None
Was your pet fecal incontinent? *
- Yes
- No
Was your pet urinary incontinent? *
- Yes
- No
Was your pet prescribed any of the following medications? *
In support of comfort, incontinence/bladder, mobility, neurologic function. Please select all that apply.
- Antibiotics (Amoxicillin, Baytril, Cephalexin, Clavamox, Clindamycin, Doxycycline, Enrofloxacin, Flagyl, Metronidazole, Sulfamethoxole, Tetracycline, Tylan/Tylosin)
- Anti-seizure (Diazepam, Felbamate, Keppra, Levetiracetam, Phenobarbital, Potassium Bromide, Valium, Zonisamide)
- Behavior Modifiers (Acepromazine, Diazepam, Fluoxetine, Midazolam, Trazadone, Xylazine)
- Bladder Focused (Bethanechol, Phenylpropanolamine, Prazosin, Prion)
- NSAID/Pain Reliever (Carprofen, Deracoxib, Gabapentin, Galliprant, Firocoxib, Meloxicam, Metacam, Rimadyl)
- Opioid Pain Reliever (Butorphanol, Codeine, Fentanyl, Meperidine, Oxycodone)
- Steroids (Dexamethasone, Prednisone, Prednisolone)
- None
Was your pet given any of the following supplements? *
In support of comfort, incontinence/bladder, mobility, neurologic function. Please select all that apply.
- Adequan
- Bladder Support
- CBD
- Chinese Herbs
- Fish Oil
- Homeopathics
- Joint Support
- Ligament/Tendon Support
- MYOS
- Neurologic Support
- Probiotics
- Vitamin B12
- None
Did your pet experience any of the following? *
- Behavior changes/issues
- Difficulty breathing
- Dragging/knuckling of feet causing wounds
- Licking or chewing on affected area(s)
- Loss of sensation in limb(s)
- Muscular twitching
- Phantom Pain
- Pneumonia
- Pressure sores
- Reactivity or sensitivity to touch
- None
How often did your pet experience pain or discomfort? *
- All the time
- Most of the time
- Some of the time
- A little of the time
- None of the time
Pain or discomfort interfered with your pet's behavior. *
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
Pain or discomfort interfered with your pet's ability to walk or move about. *
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
Pain or discomfort interfered with your pet's sleep. *
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
Pain or discomfort interfered with your pet's normal activities. *
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
There were people to confide in regarding my pet. *
- All the time
- Most of the time
- Some of the time
- A little of the time
- None of the time
Caring for my pet has interfered with my normal daily activities. *
- All the time
- Most of the time
- Some of the time
- A little of the time
- None of the time
I have enjoyed caring for my pet. *
- All the time
- Most of the time
- Some of the time
- A little of the time
- None of the time
I have been satisfied with my pet's ability to do what they enjoy doing. *
- All the time
- Most of the time
- Some of the time
- A little of the time
- None of the time
I have felt weighed down, worried, anxious, or nervous by my pet's health concerns. *
- All the time
- Most of the time
- Some of the time
- A little of the time
- None of the time
I have struggled financially because of my pet. *
- All the time
- Most of the time
- Some of the time
- A little of the time
- None of the time
I felt comfortable leaving my pet alone. *
- Yes
- No
Did you go on vacation with your pet? *
- No
- Yes
I felt comfortable leaving my pet: *
Please select all that apply.
- At home with a friend/family member
- At home with a service (pet sitter)
- At my veterinary clinic
- At a boarding facility
- My pet was always with me
What tools, if any, did you use to help care for your pet? *
Please select all that apply.
- Blog
- Books
- Friends/Family
- Online research
- Support groups
- Veterinary advice (specialists, rehabilitation)
When caring for my pet I wish I had access to: *
Please select all that apply.
- An online forum or support group where I could ask questions and share experiences regarding my pet
- Boarding/Daycare specializing in pets with mobility impairments
- Financial assistance to cover my pet's needs
- More information about my pet's diagnosis
- Specialty veterinary advice
- Workshops or classes on caregiving techniques such as bladder expression and health, massage, range of motion
- Other
Would you take on the responsibility of caring for a pet with mobilitiy impairments again? *
- Yes
- No
If you would like to share anything else about your experience or your pet please do so!
Please include any challenges, memorable moments, quality of life concerns, physical limitations, or stories.
- {name}
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