OCEANSIDE VETERINARY HOSPITAL
DATE OF APPT :
2960 SAN LUIS REY ROAD, OCEANSIDE , CA 92058
P: 760-757-1571 F: 760-757-1572
TIME OF APPT:
DVM:
Annual Wellness History - Canine
Date: ______________________________________
Pet’s Name: _______________________________________
Owner’s name: ______________________________
Male / Neutered, Female / Spayed: _____________________
Phone Number: ______________________________
Color/Breed: ______________________________________
Person(s) that will be bringing in pet: _____________
Date of birth or Age: ________________________________
___________________________________________
Weight (if known): __________________________________
Any concerns that you would like the veterinarian to address while you are here:
___________________
Any vomiting, diarrhea, coughing or sneezing?: ______________________________________________
________________________________
Urinating and defecating ok? Normal consistency and amount?: _________________________________
________________________________
Eating and drinking ok? Have you noticed any changes in their eating/drinking habits?: _____________
________________________________
Is their activity level normal?: ____________________________________________________________
What is their lifestyle like? (indoor, outdoor, parks, beaches, hiking, grooming, boarding or traveling)? If traveling, where
to?: ___________________________________________________________________________
Any weight change (loss/gain) that you have noticed?: ________________________________________
List any prescription medications, flea/heartworm/tick prevention or supplements your pet is currently taking (please
include frequency and dose given [ie: 1 tablet twice a day])
When were the medications last given [ie: last night at 6pm, this morning at 8am]? _____________________________
What does your pet eat? (food, treats, dental care, human food, etc.):
________________________________
Any previous injuries, illnesses or surgeries: _____________________________________________________________
On the next page --- ANNUAL RECOMMENDATIONS
OCEANSIDE VETERINARY HOSPITAL
2960 SAN LUIS REY ROAD, OCEANSIDE , CA 92058
P: 760-757-1571 F: 760-757-1572
DATE OF APPT :
TIME OF APPT:
DVM:
Annual Recommendations (please check all items you’d like to discuss
during your visit with us):
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DHPP Vaccination. After the initial vaccine series is completed, it is recommended to repeat the “Distemper
Combo” vaccine every 3 years to protect against several viral agents important for the health of your pet (Canine
Distemper, Adenovirus/Hepatitis, Leptospirosis, Parainfluenza, Parvovirus. This vaccination is extremely important for
pets and can help to prevent the diseases just by vaccinating.
□
Rabies Vaccination. Rabies is always fatal (animals and humans) when contracted! Since there is no cure,
prevention by vaccination is the only solution. Vaccination is extremely important AND required by law, as humans can
transmit Rabies easily. After the initial vaccination is completed, it is recommended to repeat the Rabies vaccine every 3
years.
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Bordetella Vaccination. This yearly vaccine protects against the upper respiratory disease that is best described
as an infectious bronchitis. While it usually is not fatal it can cause great discomfort for dogs and can be extremely
annoying to the owner. It is recommended to complete the Bordetella vaccination every 6 months if going to public
places often (boarding, grooming, dog parks/beaches, etc).
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Leptospirosis Vaccination (lifestyle vaccine). After the initial vaccine series is completed, it is recommended to
repeat the vaccine yearly to protect against the Leptospirosis disease. Dogs can be infected by leptospirosis when
abraded skin comes into contact with infected urine or with water contaminated with infected urine. It can also be
spread by bite wounds, reproductive secretions, and even consumption of infected tissues can transmit this infection. If
infected, the disease can be transmitted from dogs to humans.
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Lyme Vaccination (lifestyle vaccine). Dogs that are involved in outdoor sports, camping, hunting or hiking in
wooded areas should be vaccinated for Lyme disease. Lyme disease is a serious, debilitating disease that is spread by the
bites of the common dear tick. After the initial vaccine series is completed, it is recommended to repeat the Lyme
Vaccination yearly.
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Rattlesnake Vaccination (lifestyle vaccine). A "snake-bite vaccine" may be useful if you live in an area, or visit
areas, that have sightings of venomous snakes. Anecdotal evidence suggests that the Rattlesnake vaccine may lessen the
severity of signs from a snake-bite but does not act as a “cure.” Pets that have been bitten by a venomous snake should
still be taken into your Veterinary hospital or a Veterinary Emergency Clinic immediately for further care and
observation even if the pet has been vaccinated with the Rattlesnake vaccine. After the initial vaccine series is
completed, it is recommended to repeat the Rattlesnake Vaccination yearly.
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Heartworm Test. Heartworm is a fatal disease spread only by the bite of mosquitoes. It is not super prevalent
here but is a 100% preventable and many of the monthly heartworm preventatives will also deworm the pet once a
month as an added benefit. The test is highly recommended whether or not your pet is an inside or outside pet, as well
as whether or not your pet is on heartworm preventatives year round. Since it only takes one mosquito bite to cause
disease, all pets are vulnerable. The test requires a small blood sample and can be preformed while you wait.
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Intestinal Parasite Screen. Since some internal parasites can infect people, yearly stool tests protect both your
pet and your family. There are 12 common intestinal parasites that you pet may be exposed to on a regular basis. Dogs
put all sort of things in their mouths. Therefore, it is important to check annually for parasites. The test is performed by
examining a small quantity of stool through a microscopic flotation exam to identify characteristic parasite eggs.