Survey Templates Surveys Coprophagia - COPIED [FCYLTSRQBI]

Coprophagia - COPIED [FCYLTSRQBI]

Coprophagia

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Dear Pet owner,

You are invited to participate in our survey.
This questionnaire is designed to help us learn more about canine behavior. Coprophagia (feces eating) is a common, yet poorly researched behavioral problem. Most owners consider consumption of fecal material a highly undesirable behavior, but due to lack of information it is difficult to counsel clients on ways to resolve the problem. Answering this questionnaire will help us learn more about the problem and its causes in order to treat the condition more effectively.

This study is designed to examine behaviors of all dogs, both coprophagic and non-coprophagic. If you have more than one dog, we hope that you will take the time to fill out our questionnaire for each of your dogs. If you can only complete one questionnaire, we ask that you randomly select one of the dogs because we also need behavioral information regarding non-coprophagic dogs.

We appreciate your time in helping us learn more about canine behavior. Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn about your dog's behavior.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Christine Hoang at the e-mail address provided below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

Dr. Petra Mertens, D.V.M., FTAV & Christine Hoang (Class of 2007)

University of Minnesota, College of Veterinary Medicine

What is the name of your dog?

What is the breed of the dog?

Please provide approximate age of dog in months.

Gender:

Female, spayed

Female, intact

Male, neutered

Male, intact

Acquired from:

Breeder

Friends

Shelter/ Rescue

Other

Exercise:

	times per day	total minutes per day	times per week
Back yard	times per day	total minutes per day	times per week

Walk on leash	times per day	total minutes per day	times per week

Walk off leash	times per day	total minutes per day	times per week

Playing with dogs	times per day	total minutes per day	times per week

Playing with people	times per day	total minutes per day	times per week

Special exercise (hikes, hunting, etc.)	times per day	total minutes per day	times per week

Housing:

apartment/condominium

duplex

single family home

Other

Location:

City

Suburb

Rural/Country

Yard Fencing:

none

electric/ invisible

chain link/ wood

Other

How high is the fence?

1-3 ft

4-6 ft

greater than 6ft

Does your pet have free run of the house all day?

yes

Confinement (please provide hours per day next to each option):

	Hours per Day
Kenneled Outside	Hours per Day

Crated Indoors	Hours per Day

Confined in one or more rooms	Hours per Day

Other (please describe)	Hours per Day

Dog(s):

Cat(s):

Other (please list types and number of each):

Does your dog soil the house?

yes, urination

yes, defecation

How often does this behavior occur (urination or defecation)?

daily

2-3 times per week

monthly

2-3 times per month

when left alone

when sick

Other

At what age was the dog housetrained?

has never been completely housetrained (more than 1 accident per week)

< 2 months of age

2-4 months of age

4-6 months of age

6-12 months of age

At time of adoption (please provide approximate age if known)

Does your dog eat feces/ stool?

yes

When was this behavior first observed?

What type of feces/ stool does he or she eat and when does the behavior occur?

	Year round	Winter	Spring	Summer	Fall
His/her own	Year round	Winter	Spring	Summer	Fall

Other dog's (in the household)	Year round	Winter	Spring	Summer	Fall

Other dog's (in the park, outside, etc.)	Year round	Winter	Spring	Summer	Fall

Cat's	Year round	Winter	Spring	Summer	Fall

Cattle	Year round	Winter	Spring	Summer	Fall

Geese (or other birds)	Year round	Winter	Spring	Summer	Fall

Horse	Year round	Winter	Spring	Summer	Fall

Rabbit	Year round	Winter	Spring	Summer	Fall

Other	Year round	Winter	Spring	Summer	Fall

If your dog eats feces/ stool of another species that is not lisited above, please describe.

How often does this coprophagic (feces eating) behavior occur?

Whenever the dog has access or the opportunity to engage in the behavior

daily

weekly

monthly

Only when a puppy (please provide age) or only when sick (please indicate disease)

Punishment

cured

improved

unchanged

worsened

Other

Scolding

cured

improved

unchanged

worsened

Other

Electric shock collar

cured

improved

unchanged

worsened

Other

Citronella collar

cured

improved

unchanged

worsened

Other

Leash control

cured

improved

unchanged

worsened

Other

Immediate scooping

cured

improved

unchanged

worsened

Other

Distraction

cured

improved

unchanged

worsened

Other

Treats

cured

improved

unchanged

worsened

Other

Added bad tasting substance (such as hot sauce, bitter apple, etc.)

cured

improved

unchanged

worsened

Other

Put 'Forbid' ® on food

cured

improved

unchanged

worsened

Other

Put meat tenderizer on food

cured

improved

unchanged

worsened

Other

Please estimate frequency of scooping the yard.

twice daily

daily

2-3 times per week

weekly

2-3 times per month

monthly

every other month

Other

Dog's access to the yard:

on demand, supervised

on demand, unsupervised

dog door

Other (please describe)

Does your dog suffer from any medical problem(s) currently?

Yes, (please list)

Has your dog suffered from any medical problem(s) in the past?

Yes, (please list)

Does your dog receive any type of medication currently? (Please include any over the counter medications and topical treatments).

Yes, (please list)

Does your dog have allergies?

Yes, (please describe)

Do you regularly submit stool samples to your veterinarian to test for worms?

Yes, (please provide last test date)

Does your dog receive heartworm prevention treatment?

yes, seasonally

yes, year round

Which medication is used?

Frontline

Frontline Plus

Interceptor

Other

NUTRITION: Please list what, how much, and how frequently you feed your pet. Please include brand name and product names of all foods, snacks, and treats. This description should provide enough detail so that we could go to the store and purchase the food. This description should provide enough detail that we could go to the store and purchase the food. Include human foods given as treats or at the table. Two examples are given below each category.

What is your pet eating now?

BRAND/ PRODUCT/ FOOD Examples: Purina Dog Chow Boneless Chicken (white meat)	FORM Examples: dry raw	AMOUNT FED PER MEAL Examples: 1 1/2 cups 2 ounces	# OF MEALS Examples: twice per day 3 times per week	FED SINCE Examples: May 2000 June 1998
BRAND/ PRODUCT/ FOOD Examples: Purina Dog Chow Boneless Chicken (white meat)	FORM Examples: dry raw	AMOUNT FED PER MEAL Examples: 1 1/2 cups 2 ounces	# OF MEALS Examples: twice per day 3 times per week	FED SINCE Examples: May 2000 June 1998

BRAND/ PRODUCT/ FOOD Examples: Purina Dog Chow Boneless Chicken (white meat)	FORM Examples: dry raw	AMOUNT FED PER MEAL Examples: 1 1/2 cups 2 ounces	# OF MEALS Examples: twice per day 3 times per week	FED SINCE Examples: May 2000 June 1998

BRAND/ PRODUCT/ FOOD Examples: Purina Dog Chow Boneless Chicken (white meat)	FORM Examples: dry raw	AMOUNT FED PER MEAL Examples: 1 1/2 cups 2 ounces	# OF MEALS Examples: twice per day 3 times per week	FED SINCE Examples: May 2000 June 1998

BRAND/ PRODUCT/ FOOD Examples: Purina Dog Chow Boneless Chicken (white meat)	FORM Examples: dry raw	AMOUNT FED PER MEAL Examples: 1 1/2 cups 2 ounces	# OF MEALS Examples: twice per day 3 times per week	FED SINCE Examples: May 2000 June 1998

BRAND/ TREATS/ SNACKS (Include human foods given as treats or at the table)	AMOUNT FED	FED SINCE
BRAND/ TREATS/ SNACKS (Include human foods given as treats or at the table)	AMOUNT FED	FED SINCE

BRAND/ TREATS/ SNACKS (Include human foods given as treats or at the table)	AMOUNT FED	FED SINCE

BRAND/ TREATS/ SNACKS (Include human foods given as treats or at the table)	AMOUNT FED	FED SINCE

BRAND/ TREATS/ SNACKS (Include human foods given as treats or at the table)	AMOUNT FED	FED SINCE

BRAND/ TREATS/ SNACKS (Include human foods given as treats or at the table)	AMOUNT FED	FED SINCE

CHEW TOYS (rawhide, pig's ear, etc)	HOW OFTEN?	GIVEN SINCE
CHEW TOYS (rawhide, pig's ear, etc)	HOW OFTEN?	GIVEN SINCE

CHEW TOYS (rawhide, pig's ear, etc)	HOW OFTEN?	GIVEN SINCE

CHEW TOYS (rawhide, pig's ear, etc)	HOW OFTEN?	GIVEN SINCE

CHEW TOYS (rawhide, pig's ear, etc)	HOW OFTEN?	GIVEN SINCE

CHEW TOYS (rawhide, pig's ear, etc)	HOW OFTEN?	GIVEN SINCE

Does your pet have access to other unmonitored food sources (i.e. food from a neighbor, cat food, etc.)?

Yes, (please describe)

Is food ...

left out for your pet during the day

taken way after the meal

Other

Is your pet receiving any vitamin, mineral or fatty acid supplements or herbal products?

Please list the name of each additional supplement your pet receives, indicate how much and how often your pet receives it. Examples are given.

BRAND/ PRODUCT/ FOOD Examples: Vitamin E Corn oil	FORM Examples: 1 pill oil	AMOUNT FED PER MEAL Examples: 1000 mg 1 tsp	HOW OFTEN? Examples: Once per week Once per day	FED SINCE Examples: May 2000 April 2001
BRAND/ PRODUCT/ FOOD Examples: Vitamin E Corn oil	FORM Examples: 1 pill oil	AMOUNT FED PER MEAL Examples: 1000 mg 1 tsp	HOW OFTEN? Examples: Once per week Once per day	FED SINCE Examples: May 2000 April 2001

BRAND/ PRODUCT/ FOOD Examples: Vitamin E Corn oil	FORM Examples: 1 pill oil	AMOUNT FED PER MEAL Examples: 1000 mg 1 tsp	HOW OFTEN? Examples: Once per week Once per day	FED SINCE Examples: May 2000 April 2001

BRAND/ PRODUCT/ FOOD Examples: Vitamin E Corn oil	FORM Examples: 1 pill oil	AMOUNT FED PER MEAL Examples: 1000 mg 1 tsp	HOW OFTEN? Examples: Once per week Once per day	FED SINCE Examples: May 2000 April 2001

What has your pet eaten in the past?

Please list other diets your pet has eaten in the past, indicating the approximate time period when they were fed. Examples are given.

BRAND/ PRODUCT/ FOOD Example: Purina Dog Chow Boneless Chicken (white meat)	FORM Example: canned raw	FROM Example: June 1999 March 2000	TO Example: March 2000 June 2001	REASON STOPPED Example: to try raw food diet too expensive
BRAND/ PRODUCT/ FOOD Example: Purina Dog Chow Boneless Chicken (white meat)	FORM Example: canned raw	FROM Example: June 1999 March 2000	TO Example: March 2000 June 2001	REASON STOPPED Example: to try raw food diet too expensive

BRAND/ PRODUCT/ FOOD Example: Purina Dog Chow Boneless Chicken (white meat)	FORM Example: canned raw	FROM Example: June 1999 March 2000	TO Example: March 2000 June 2001	REASON STOPPED Example: to try raw food diet too expensive

BRAND/ PRODUCT/ FOOD Example: Purina Dog Chow Boneless Chicken (white meat)	FORM Example: canned raw	FROM Example: June 1999 March 2000	TO Example: March 2000 June 2001	REASON STOPPED Example: to try raw food diet too expensive

BRAND/ PRODUCT/ FOOD Example: Purina Dog Chow Boneless Chicken (white meat)	FORM Example: canned raw	FROM Example: June 1999 March 2000	TO Example: March 2000 June 2001	REASON STOPPED Example: to try raw food diet too expensive

BRAND/ PRODUCT/ FOOD Example: Purina Dog Chow Boneless Chicken (white meat)	FORM Example: canned raw	FROM Example: June 1999 March 2000	TO Example: March 2000 June 2001	REASON STOPPED Example: to try raw food diet too expensive

How often do you observe your pet...

Recent involuntary or unintended:

weight gain

weight loss

neither

Vomiting?

yes, (please indicate times per day or week)

Diarrhea?

yes, (please indicate times per day or week)

Have you observed changes in any of the following:

	What was the specific change?	Since when?
Appetite	What was the specific change?	Since when?

Drinking	What was the specific change?	Since when?

Urination	What was the specific change?	Since when?

Defecation	What was the specific change?	Since when?

If you would like to be informed of the results and conclusions obtained from this study, please provide us with your contact information in the space provided below.

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Coprophagia - COPIED [FCYLTSRQBI]

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