Fillable AnimalHealthReport2016 - Animal Health Report

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AnimalHealthReport2016 - Animal Health Report

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MarquetteUniversityAnimalHealthReport PIandVetNotified
CreatedBy:________________________
Page____of____
Date:__________Time:__________  Protocol#:AR‐__________
PI:_____________________
AnimalLocation&Identification
Species:__________ Room:________Rack#_______ID#:________________
DOB:_________Sex:_________
NAD–NotabletoDiscern
1. Coat&Skin
HairLoss
Trauma
Ulcers
Barbering/FightWounds
Tumor
Other NAD
HealthAssessment:InitialAssessment/AdditionalComments
Animalappearstobeinpainand/ordistress: YES/ NO
ProposedTreatment:
Notreatmentrequiredatthistime.Monitorperprotocol
instruction.ContactVeterinarianifconditiondeclines.
Proposedtreatment(s):
Recheckfrequency: __________________________
2. Ears,Eyes,&Nose
Discharge
Redness
Ulcers
Other NAD
3. Mouth/Teeth
Malocclusion
BrokenTeeth
Other NAD
4. Legs,Feet,&Paws
Trauma
Lameness
RingtailSyndrome
Other NAD
5. Heart&Lungs
RapidBreathing
laboredBreathing
Paleears/nose/paws
weakness
Other NAD
6. Gastrointestinal
Noteating
AbnormalFeces
Other NAD
7. Neurological
lossofbalance
HeadTilt
limpness/partialparalysis
Other NAD
Re‐check:
Date/Time:_____________________Initial:___________
FinalDisposition:
Improved/Resolved Euthanized
8. Activity,Behavior,BodyWeight
Normal
AbnormalBehavior
Moribund
WeightLoss
Other NAD
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AnimalHealthReport2016 - Animal Health Report

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Completed 10 February 2020

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