PIGS
Downer
(Potential reason: _________________________________________ )
Dog-sitting
Laming/Arthritis (one limb affected ; two limbs affected ; complete fusion of rear legs )
Skin ulcerations
(hip ; shoulder ; open ; closed )
Hernia
(small ; medium; large )
Lacerations
(minor , extensive ; bleeding )
Dehydrated
Other
__________________________________________________________
BEEF CATTLE
Muscle rupture
Heat-exhaustion
Pink eye
(level of blindness_______; one eye affected ; both eyes affected )
Broken horn
Broken penis
Other
__________________________________________________________
DAIRY COWS (check all that apply)
Downer
Mastitis
(# of infected teats ____; teats cut off ____; udder dropped Y/N)
Leaking milk
Laming
Emaciated
Broken hoof
Hoof Rot
Twisted Stomach
Other
_______________________________________________________
HORSES (check all that apply)
Overgrown hooves
Lameness
(number of limbs affected ____)
Lacerations
(minor ; open and bleeding ; large and too swollen for stitches )
Emaciation
Dehydration
Blind
(one eye ; both eyes )
Too young
(approximate age __weeks)
Strangles infection
(wound closed ; wound open and weeping ; wound appears natural ;
wound appears to have been caused by a sharp knife )
Founder
(sawhorse stance ; hooves hot )
Colic
(circling ; shaking head ; difficulty defecating ; pawing ground ;
biting/kicking at flanks ; sweating ; rolling )
Choke
(head outstretched ; coughing up bile and saliva )
POULTRY
Urine scald
Loss of feathers
Lameness
(able to stand somewhat ; unable to stand ; prone (laying on back) )
Missing toes
(how many? ___)
Debeaked
End of toes cut-off
Potential fracture(s)
(of what?___________________________)
Blood present
(from where/what injury?_____________________________________)
Dead
(approximate # dead _____)
P.O. Box 18024, 2225 West 41st Avenue, Vancouver, British Columbia, Canada V6M 4L3
email: care@cetfa.com website: www.cetfa.com