Heartworm Prevention Survey

 

Question 1


Commercial kennel owner
Trainer
Dog owner
Other
 

Question 2


Tell us about your experience


 
 
 

Question 3


Tell us about your kennel/dogs


 
 
 


 
 
 

Days Months Years
 
 
 
 

Days Months Years

 
 
 

to

Question 4


Topical mosquito repellents applied to the dog(s)
Chemicals applied to the environment
Screening the kennel
Taking dogs indoors during the time when mosquitoes are active
Other

Question 5


Stream
Pond
Low lying area with occasional standing water
Collections of old tires, woodpiles or other debris
None of the above

Question 6


During the months when mosquitoes are present


 
 
 
 
 

Yes No
 
 

Yes No
 
 

Yes No
 
 

Question 7


Yes No
 
 
 

 

 

The following questions apply to heartworm preventive medications. If you do not give heartworm preventive to dogs in your care, please skip to Question 19

 

 

Question 8


Advantage Multi
Heartgard
Heartgard Plus
Interceptor Flavor Tabs
Iverhart
Iverhart Max
Iverhart Plus
Revolution
Sentinel Flavor Tabs
Tri-Heart Plus
Other


 
 


 


 
 

Months Years
 
 

Question 9


Advice from veterinarian
Talking with other dog breeders/trainers/owners
Advertisements in magazines
Other

Question 10


I give heartworm prevention medication all year.
I start giving heartworm preventive medication each year based on advice from my veterinarian
I begin giving medication when I see the first signs of mosquito activity
I start giving heartworm preventive medication routinely the same day each year
 


 
 
 
 

Question 11


I give heartworm prevention medication all year.
I stop giving heartworm preventive medication each year based on advice from my veterinarian
I stop medication when I don't see any more signs of mosquito activity
I stop giving heartworm preventive medication routinely on the same day each year
 


 
 
 
 

Question 12


Read the package label and weigh each dog separately
Read the package label and do not weigh, but estimate the weight of each dog
Read the package label and give all dogs the same dose
Veterinarian's advice and weigh each dog separately
Veterinarian's advice and all dogs given the same dose
Other

Question 13


Yes
No
 
 

Question 14


I give medication on the same day each month
I write the date on the calendar or other record
I remember when to give the medication each month
Other

Question 15


With food
Place pills directly in mouth
Other

Question 16


Yes, for each dog
Yes, date when all dogs are treated
No, but I give the medication on the same day each month
No, none of the above

Question 17


Yes
No
 
 
 
 
 


 
 
 

Question 18


My veterinarian
I do
Employee
Family member
The same person gives medicine each time
Two or more people are responsible for administering heartworm preventive

 

 

The following questions relate to the heartworm testing procedure used for your kennel.

 

 

Question 19


Yes
No
 
 
 

Question 20


Yes
No
 
 
 

Weeks Months
 
 
 
 
 

Question 21


Once a year
Twice each year
Every other year
I do not test dogs under my care for heartworm
Other

Question 22


Yes No
 


 

Question 23


My veterinarian
Test is done by trained personnel employed by kennel
Blood sample is sent to a commercial laboratory
Other

Question 24


Antigen test and Screen look for microfilaria with filter or Knott's test
Look for microfilaria with filter or Knott's test (only)
Antigen test (only)
Not sure what test(s) were used
Did not test for heartworm in the past 12 months

Question 25


Yes
No
I did not switch products in the past 12 months.
 
 

Yes
No

Weeks Months
 
 

Question 26


Yes
No
 
 
 
 

Yes
No
 
 
 
 

Question 27


Question 28


Please tell us who you are


 

name@address.com

Question 29


Yes No
 
 
 

Phone E-mail