Name First Name Last Name Your pet's name * Which leg is affected? * Front left Front right Back left Back right Multiple legs Unsure When did you first notice your dog limping? * Just started today 1-2 days ago 3-7 days ago Over a week ago How often is your dog limping? * Constantly Only after exercise Intermittently throughout the day Only in the mornings or after resting Has the limping improved, worsened, or stayed the same since it started? * Improved Worsened Stayed the same How severe is the limping? * Mild (limping but can still walk) Moderate (struggles to bear weight but can walk) Severe (unable to walk on the affected leg) Does your dog show any of the following symptoms along with limping? Check as many as applied Swelling in the affected leg Bruising or discoloration Licking or chewing at the paw or leg Yelping or crying when the leg is touched Stiffness, especially after resting Reduced activity or reluctance to walk Loss of appetite Fever (if known) as your dog been involved in any of the following activities recently? * Running or playing in the yard Jumping off furniture or stairs Strenuous exercise (e.g., hiking, agility training) None of the above Has your dog had any previous issues with limping or joint problems (e.g., arthritis, hip dysplasia)? Yes No Is your dog currently on any medications for joint or bone health? Yes No Is there anything else you’d like to mention regarding your dog’s limping or recent changes in behavior? Thank you!
