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Jeffersonville 5012 1∕2 E Hwy 62
New Albany 3105 Grant Line Rd.
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Cushing's Clinical Score
Cushing's Clinical Score
Your Name (First & Last):
*
Pet's Name:
*
Your Email:
*
Is this an Access Vet Care patient?
*
Yes
No, my pet is seen elsewhere
Your Veterinarian's Email:
*
Instructions: Please choose the category that
best
describes how your dog is
today
Drinking
- Compared to before the onset of Cushing's:
Thirst
*
NORMAL: Drinks the same amount or less
MILD: Some increase in drinking
MODERATE: Notable increase in drinking
SEVERE: Constantly seen to be drinking
Urination
- Compared to before the onset of Cushing's:
Urination
*
NORMAL: Urinates the same amount or less
MILD: Some increase in urination
MODERATE: Notable increase in urination
SEVERE: Constantly needs to be let out to urinate
Appetite
- Compared to before the onset of Cushing's:
Appetite
*
NORMAL: Appetite is the same amount or less
MILD: Finishes food more eagerly
MODERATE: Finishes food more eagerly then begs for more
SEVERE: More obsessed with food than ever
Appearance
- Compared to before the onset of Cushing's:
Condition
*
NORMAL: Appearance is the same
MILD: Slightly poor hair and skin quality
MODERATE: Poor hair and skin quality with some hair loss and/or some muscle loss/pot belly
SEVERE: Substantial hair loss and/or noticeable muscle loss/pot belly
Attitude/Activity
- Compared to before the onset of Cushing's:
Behavior
*
NORMAL: Attitude/activity is the same
MILD: Not quite themselves
MODERATE: Quieter and less active and/or panting more than normal
SEVERE: Very quiet, dull and weak and/or noticeable increase in panting
Your Pet's Cushing's Clinical Score:
If you are human, leave this field blank.
Email to My Veterinarian
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