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Dachshund Back Disorder Database
Please fill in the form with as much information as you can.  All information is voluntary.
Note:   Be sure all numerical fields have a number or 0 entered

Dog's Name:
AKC #:
Owner's Name:
Email Address:
Website:
Variety / Size: ML - Miniature Long MS - Miniature Smooth MW - Miniature Wire SL - Standard Long SS - Standard Smooth SW - Standard Wire
Sex: Male Female
Current Age (if less than one year old or age is unknown, enter "0"): *required field
Does the Dachshund Have a Pedigree? Yes No Unknown
If Pedigree is Online, Enter Website:

Age When Back Problems Started (if less than one year or age is unknown, enter "0"): *required field
Type of Back Problem: Back Neck   ***Note: If your dog happens to have both Neck and Back problems, please select "Neck" and make a note in the "therapies" section below.  Thanks!***
Is the Dachshund Walking or Paralyzed? Walking Paralyzed
How Many Separate Back Problem Incidences Has the Dachshund Had? One More Than One
Did the Dachshund Regularly Climb Stairs Prior to Having Back Problems? Yes No
Did the Dachshund Get Regular Exercise Prior to Having Back Problems? Yes No
Type of Exercise:
Was the Dachshund Overweight at Time of Back Problems? Yes No
Diet Before Back Problems First Occurred: Raw Home-Cooked Kibble
Brand of Food:

List any of the following therapies your dachshund has had: Surgery, Acupuncture, Chiropractic, VOM, Medical/Drug Therapy (name the drugs: Adequan, Steroids, etc.), or anything else not mentioned:

Has the Dachshund Ever Been X-rayed for Calcifications? Yes No
Age at Time of X-ray (if no x-ray or age is unknown, enter "0"): *required field
Results of the X-ray:

Did the Dachshund Start Supplements Before or After First Having Back Problems? Before After Never
What Supplements is the Dachshund Taking?

Where was the Dachshund Purchased? Show Exhibitor Bred By Owner Rescue Other    Other:

Does the Dachshund Have Any Known Relatives Who Have Had Back Problems? Yes No Unknown
Details:

(Please only hit the Submit button once, it may take a couple of seconds to submit the information.)