Allergic Dermatitis Questionnaire A survey designed to track the progress of a pet with dermatitis. Please click the NEXT button to start the survey. If you have issues accessing this survey email [email protected] or [email protected] Thanks Select One of the following Categories based on how you feel your dog is today? Normal Dog Itching is not really a problem today Very mild itching occasional episodes of itching. The dog is slightly more itchy than before the problem began Mild itching. More frequent episodes of itching. May notice occasional episodes of itching at night. No itching when sleeping, eating, playing, exercising or when being distracted. Moderate itching. Regular episodes of itching when the dog is awake. Itching might occur at night and wake the dog. No itching when eating, playing, exercising or when being distracted Severe itching. Prolonged episodes of itching when the dog is awake. Itching occurs at night and also when eating, playing, exercising, or when otherwise distracted. Extremely severe itching. Dog is scratching, chewing, licking almost continuously. Itching practically never stops, regardless of what else is happening around the dog.How long has it been since your dog was given anti allergy medication (just select the closet answer) This only refers to medication that was given specifically to stop or treat your dogs itching. 2-3 days 1 week 2 weeks 4 weeks 6 months 1 yearHas your pet experience any off the following in the past week (Select all that apply or None) Diarrhoea Vomiting ( frequency and time frame in the comment field) Lethargy Anorexia - this means they are not eating Polydipsia - Increased water consumption (please estimate in the comment field)CommentsWhat diet or dry food do you feed your Pet Royal Canin Anallergenic Royal Canin Hypoallergenic Royal Canin Sensitivity Control Hills Prescripton Z/D Hills Prescription D/D Hills Canine Sensitive Stomach Ivory Coat - Grain Free Adult Food (multiple types) Other(Enter details in the comment field)Please select all other medications or supplements you are also using currently. Flea/ Tick Preventative Joint Supplements - Glucosamine / Chondroitin etc Antibiotics Omega 3 Fatty Acid Supplement (eg Megaderm) Corticosteroids (Prednisilone / Macrolone) Non Steroidal pain relief ( Metacam / Carprofen / Gabapentin / Tramadol Allergy Desensitizing Vaccines Apoquel Cytopoint (if given in the last 8 weeks)CommentsPlease fill in the comment box below. Thanks for completing the survey. Patient Name Owner Name Email Mobile Time is Up!