1. How many years have you owned Norwegian Elkhounds?

1-5 yrs
6-10 yrs
11-20 yrs
> 20 yrs

2. How many Norwegian Elkhounds currently live with you?

0
1-5
6-10
11-2O
more than 20

3. What are your primary interests in the breed? (Check all that apply)

Breeder
Show
Field/Hunt
Agility
Tracking
Obedience
Search & Rescue
Companion/pet
Assistance/Therapy
Other Specify:

4. If you breed, how often do you breed?

Less than one litter every 5 years
One litter every 2 to 5 years
One litter per year
2 to 4 litters per year
more than 4 litters per year

1. Norwegian Elkhound’s Country of Birth:
Norwegian Elkhound lives in what country?

2. Sex:

Male
Female
Date of Birth
Date of death (if applicable):

3. Adult Norwegian Elkhounds at least two years old:

Height: inchesOR centimeters
Weight: lbs OR kilograms

4. Where did you obtain this Norwegian Elkhound?

Bred it myself
Established breeder
Shelter or Rescue
Pet store
Casual breeder
Given to me from a friend/family member
Newspaper ad

5. How old was the Norwegian Elkhound when you got it?

0 to 8 weeks
8 weeks to 6 months
>6 to 12 months
1 to 4 years
4 to 7 years
>7 yrs.

6. General Health:

Excellent
Good
Fair
Poor

If fair or poor at what age did health begin to decline?

Birth to 6 months
6 to 12 months
1 to 4 years
4 to 7 years
>7 years

7. Is this dog listed in the DNA Bank?

Yes
No

1. Type of food fed. Check all that apply.

Commercial Dry: Brand:
Commercial Canned: Brand
Home prepared Natural
Commercial Raw: Brand:
Home prepared Raw
Combination RAW and Commercial Dry or Canned:
Table Food (scraps)

2. Supplements
Do you give your dogs supplements regularly?

Yes
No

If so check all that apply.

Vitamins:
Yes
No

If yes, type/brand:

Herbals:
Yes
No

If yes, type/brand:

Treats:
Homemade
Commercial
Brand

1. Where does your Norwegian Elkhound primarily live? (More than 50% of a day)

loose in the house
loose outside
outside kennel
crated in the house
loose in a fenced yard
tied to a dog house or garage outside
loose in garage
with a show handler
with a field training handler
other :

2. Do you use an air filter in the area the dog is housed?

Yes
No

a. If so, brand
b. How long have you filtered the air?

Less than a year
One year to five years
Longer than five years

1. Norwegian Elkhound attended puppy kindergarten?

Yes
No

2. Norwegian Elkhound has attended obedience classes?

Yes
No

3. Norwegian Elkhound has formal training in performance areas (agility/therapy/field/other)

Yes
No

4. Norwegian Elkhound is trained for the show ring?

Yes
No

Please check any and all of the following treatments used on your Norwegian Elkhound during the last year. List all brand names and describe any adverse reactions if applicable.

1. Parasite Control

Flea Preventative: Brand
Reactions?

Yes
No

Describe any reactions:

Flea Treatment: Brand
Reactions?

Yes
No

Describe any reactions:

Tick Preventative: Brand
Reactions?

Yes
No

Describe any reactions:

Tick Treatment: Brand
Reactions?

Yes
No

Describe any reactions:

Heartworm Preventative: Brand
Reactions?

Yes
No

Describe any reactions:

Heartworm Treatment: Brand
Reactions?

Yes
No

Describe any reactions:

Giardia Treatment: Brand
Reactions?

Yes
No

Describe any reactions:

Other: Brand
Reactions?

Yes
No

Describe any reactions:

2. Vaccinations

a. If you know, was this dog vaccinated as a puppy?

Yes
No

b. Describe your vaccination schedule for this puppy; age and the type of vaccine used.


c. Have you changed your vaccination protocols/schedule for this Norwegian Elkhound since its birth?

Yes, I vaccinate MORE often.
Yes, I vaccinate LESS often.
Yes, I vaccinate for fewer diseases.
No, I use the same schedule.
I no longer vaccinate this dog

d. Please indicate which of the listed vaccinations this Norwegian Elkhound received in its life, and how often. List the vaccine brand.

1. Rabies:

Yes
No

Brand if known:

Every Year
Two Year
Three Year

Based on State Law?

Yes
No

2. Bordetella:

Yes
No
Brand:
Every six months
Yearly
Every three years
>Three years

3. Distemper:

Yes
No
Brand:
Every six months
Yearly
Every three years
>Three years

4. Parvovirus:

a) Killed
Yes
No
Brand:
b )Live
Yes
No
Brand:

5. Leptospirosis:

Yes
No

Brand:

6. Hepatitis:

Yes
No

Brand:

7. Coronavirus:

Yes
No

Brand:

8. Lyme’s Disease:

Yes
No

Brand:

9. Others (specify) :

Describe any adverse reactions to these vaccinations:

e. Do you use Titers? (Antibody measurements via Blood Testing)

Yes
No

If yes, how often?

Every year
Every two years
Every 3-5 years
Once in a lifetime

Lab used:

f. Do you use Nosodes (Homeopathic Vaccinations) ?

Yes
No

g. Have you changed your vaccine protocol for this dog in the past year?

Yes
No

1. Are pesticides used in the living environment of this dog.

Regularly
Occasionally
Never

2. List names of brands and type

1. Has this Norwegian Elkhound ever been bred?

Yes No

2. Is it neutered/spayed now?

Yes No

a. If so, when? Date neutered/spayed:
b. Reason for Neutering/spaying: Check all that apply

potential health benefits
health problem - describe:
temperament
convenience
other:

3. Was this Norwegian Elkhound ever on birth control medications?

Yes
No

4. Whelping History

Litter No.	Month/Year	No. Born Live	No. Stillborn	No. Weaned	No. Euthanized for defects	Natural	C-section	Breeding
1
2
3
4
5
6

Breeding Code: 1=natural, 2=AI-fresh semen, 3=AI-chilled semen, 4=AI-frozen semen, 5=surgical insemination-fresh, 6=surgical insemination –frozen.

Comments:


5. Neonatal Disorders
Please list the number of each condition in individual litters.

Neonatal Disorder	Litter1	Litter2	Litter3	Litter4
Stillborn
Congenital Abnormalities
Failure to Thrive
Birth Trauma
Death/unknown cause
Fading
Cleft Palate
Cleft Lip
Cleft Abdomen
Backwards Legs
Hydrocephalus
Swimmer’s Syndrome
Anasarca (Congenital Lethal Endema)

1. Is this Norwegian Elkhound alive today?

Yes
No

If not,

a. Date of death
b. Age at death:
c. Cause of death if known:

Old Age
Accident / trauma - - Describe how the dog died.
Illness

1. Diagnosis if known

2. Veterinary confirmed?

Yes
No

2. Was an autopsy performed?

Yes
No

3. Was the Norwegian Elkhound euthanized ( life intentionally terminated)?

Yes
No

Reason:

	A problem now?	Vet	Self	Age/Date at Diagnosis
Aggressiveness (Bites, growls unprovoked)	Yes No
Fearful of people	Yes No
Fearful of environmental changes	Yes No
Merry/generally outgoing and friendly.	Yes No
Excitable	Yes No
Active, energetic	Yes No
Afraid of children	Yes No
Submissive urination (piddling)	Yes No
Housebreaking problems	Yes No
Noise/Thunderstorm Fears	Yes No
Separation Anxiety	Yes No

Comments:

1. Hips
a. Were Hips ever x-rayed for evaluation?

Yes
No

b. If not, please skip remainder of question. If yes proceed,

1. OFA Status: age at OFA:
Normal:

Excellent
Good
Fair

Indeterminate:

Borderline

Dysplasia, Degree:

Mild
Moderate
Severe

Findings:
2. OFA Prelim Status: Age at prelim:
Normal:

Excellent
Good
Fair

Indeterminate:

Borderline

Dysplastic:

Mild
Moderate
Severe

Findings:

3. PennHIP DI: age at PennHIP:

Left: :
Right: :

4. Other Registry
(note details, registry name, veterinarian, or other identification:

Status (e.g. 0/2, 10/20):

Left:
Right:

2. Elbows
a. X-ray Screening?

Yes
No

If yes, age when screened:
(If no, please skip remainder of question.)

b. OFA Status: age at OFA:
Normal:

Left
Right

Dysplasia:
(grade and finding)

Left:
Right:

c. OFA Prelim Status:
Age when screened:
Normal:

Left
Right

Dysplasia: (grade and finding)

Left:
Right:

Other (note registry/vet/other):
Status (unaffected or dysplastic and degree of findings)

Left:
Right:

For the following selections, please check all that apply. Where applicable, please indicate how diagnosis was made, whether by lab test (lab), by vet (vet), or by yourself (self).

	Lab	Vet	Self	Age/Date at Diagnosis
Arthritis
Cleft Lip/Palate
Dwarfism
Hip Dysplasia
Luxation of the Elbow
Luxation of the Patella
Osteochondritis Dissecans
Overshot Jaw
Undershot Jaw (OCD)
Panosteitis
Missing Teeth

Other:



Include information on treatments and outcomes

Cataracts
Type:

One eye or
Both

1. Age at diagnosis:

Birth to 1 year
1 to 2 years
2 to 5 years
5 to 8 years
>8 years

2. First eye diagnosed- age at onset:

Birth to 1 year
1 to 2 years
2 to 5 years
5 to 8 years
>8 years

3. If both eyes involved, the age of onset in second eye:

Birth to 1 year
1 to 2 years
2 to 5 years
5 to 8 years
>8 years.

	Lab	Vet	Self	Age/Date at Diagnosis
Distichiasis
Ectopic Cilia
Ectropion
Entropion (eyelashes turned in on the eye)
Imperforate Lachrimal Punctum (Epiphora)
Trichiasis (facial hairs in tear film)
Glaucoma
Lens Luxation
Microphthalmia
Progressive Retinal Atrophy (PRA)
Retinal Folds
Multifocal Retinal Dysplasia
Retinal Dysplasia (Geographic Detachment)
persistent pupillary membrane
Early Retinal Degeneration
Plugged Tear Duct

Comments/Other:

	Lab	Vet	Self	Age/Date at Diagnosis
Hypothyroidism
Hyperthyroidism
Diabetes
Addison’s (hypoadrenal)
Cushings (hyperadrenal)

Comments/Other:

	Lab	Vet	Self	Age/Date at Diagnosis
Deafness Left side Right side Both
Vestibular Disease
Ear hematomas (blood blisters)

Comments/Other:

	Lab	Vet	Self	Age/Date at Diagnosis
Anasarca (Congenital Lethal Endema)
Factor X Deficiency
Hemophilia B (Christmas Disease)
Hereditary Platelet Storage Pool Defect
Phosphofructokinase Deficiency (PKF)
Prothrombin Deficiency
Von Willebrand’s Disease/Factor VIII

Comments/Other:

Dilated Cardiomyopathy (DCM)
a. Diagnosed by

x-ray
EKG
Ultrasound

b. Were Taurine levels checked?

Yes
No

c. If yes, was it treated?

Yes
No

	Lab	Vet	Self	Age/Date at Diagnosis
Endocardiosis
Mitral Valve Defect (MVD, Mitral Stenosis)
Persistent Right Aortic Arch
Pulmonic Stenosis (PS)
Sick Sinus Syndrome (slow heart rate)
Subaortic Stenosis
Heart Murmur - - Grade:
Degenerative Valve Disease
Heart disease of unknown cause

Comments/Other:

	Lab	Vet	Self	Age/Date at Diagnosis
Chronic Active Hepatitis Diagnosed with biopsy? Yes No
Portosystemic Shunt (Extrahepatic)
Portosystemic Shunt (Intrahepatic)
Pancreatitis
Pancreatic insufficiency

Comments/other:

	Lab	Vet	Self	Age/Date at Diagnosis
Renal Dysplasia
Juvenile Renal Dysplasia
Fanconi Disease
Chronic Renal Failure
Renal Cortical Hypoplasia
Renal Glycosuria
Other Kidney Disease(explain below)

Comments/other:

	Lab	Vet	Self	Age/Date at Diagnosis
Anaphalytic Allergic Reaction Reaction to what? (vaccine, bee sting, etc.):
Immune Mediated Hemolytic Anemia Severity of reaction:
Demodicosis (mange mites) Generalized Localized
Idiopathic Thrombocytopenic Purpura
Autoimmune Disease –Cause Unknown

Comments/Other:

	Lab	Vet	Self	Age/date at Diagnosis
Allergic Dermatitis
Seborrhea
Dermoid Sinus (Dermoid Cyst)
Inguinal Hernia
Sebaceous Adenitis (SA)
Umbilical Hernia
Vitamin A Responsive Dermatosis
Sebaceous cysts

Comments/Other:

	Lab	Vet	Self	Age/date at Diagnosis
Neurological Disease- Unknown Origin
Cerebellar Degeneration
Ceroid-Lipofuscinosis (ATP Subunit C Storage)
Seizures Disorders Idiopathic Epilepsy Other Causes Controlled by medication? Yes No
Glycogenosis (Glycogen Storage Disease
Hydrocephalus (Water on the brain)
Idiopathic Facial Paralysis Left side Right side Both Permanent Resolved
Multi-system Neuronal Degeneration
Narcolepsy
Paralysis

Comments/other:

General

	Lab	Vet	Self	Age/date at Diagnosis
Hermaphrodite
Pseudohermaphrodite

Females

	Lab	Vet	Self	Age/date at Diagnosis
Irregular Heats
Failure to conceive
Fetal Death (before birth--abortion)
Vaginal infection
Pyometra
Herpes
Mastitis (mammary gland infection)
Metritis (uterine infection)
Difficult whelping/Distocia
Insufficient Milk

Males

	Lab	Vet	Self	Age/date at Diagnosis
Undescended testicles one both Abdominal Inguinal(flank)
Persistent Penile Frenulum
Impotence (no interest in females in heat)
Sterility
Prostatitis
Testicular Atrophy

Comments/other:

	Lab	Vet	Self	Age/date at Diagnosis
Reoccurring diarrhea
Irritable Bowel Syndrome
Bloat
Bowel disease
Hernia: umbilical inguinal perineal
Perianal Adenoma
Megaesphogasus

Comments/other:

	Lab	Vet	Self	Age/date at Diagnosis
Cancer of Unknown Type
Mast Cell Tumors
Lymphosarcoma
Mammary Gland Neoplasia
Hemangiosarcoma
Fibrosarcoma
Osteosarcoma
Hepatic (Liver) Neoplasia
Dermal/Soft Tissue Neoplasia (type unknown)
Gastro-intestinal Neoplasia (Intestines/Stomach)
Perianal Gland Adenoma
Hemangioma (Right Atrial)
Thymoma
Brain Neoplasia
Melanoma
Leukemia
Fibromatous Epulus
Layngeal Neoplasia
Dermal Sarcoma
Thoracic Neoplasia
Nasal Neoplasia

Comments/other:

Missing Teeth (non-injury related)
Incisors
      Number missing
Canines
      Number missing
Pre-Molars
      Number missing
Molars
      Number missing

Tooth injury
Abscess
Cracked
Broken
Extraction
Other: 

Malocclusions
Overbite
Even bite
Under bite

Excessive tartar buildup? Describe: 



Additional Comments
If there is anything else you’d like to mention that was not in the NEAA survey, please do so here:

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Norwegian Elkhound—Breed Health Survey