Anamnesis sheet for the classical homeopathic treatment of animals.

To treat your animal homeopathical, I need a detailed description of you about all coplaints and about the natural functions of your animal.
I ask you to answer those question as detailed as possible. If you are not sure at any question please make a note.

Patient:

What kind of animal:			breed:
color:				sex:
date of birth:				castrated:
weight:				name:

name, address and phone number of petowner:

Main complaints:

Please describe the current main complaints of your animal.

When is the complaint came about? How long does this complaint exist?
Did the complaints arisedin a sudden or came slowly?
Where do they came from or couse of? (even speculations)
Where are the signs of  illness are located and how do they show of?
At what time are they the worst and at what time the best?
(Time, occupation, movement, rest, heat, cold, eating, bowel movement....)
If the symptoms are external how do they look in detail?
(Place, size, color, consistenz, smell)
Is the animal still eating or has it a loss of appetite?
Is it still taking liquidif yes how much and how often?
Are there other animals who got ill?
Specialities about the bowel movement or urinating?
What kind of deseases had your animal before and when were they?
What kind of medizine has it taken in the last time or is it still taking?

Additional symptoms:

To get an exact view of the patient I need you to give me details about the animals body functions.
In the homeopathic treatment an individual drug is given which is in accordance in its interety of the patients symptoms.
Please answer in details.

1.Mind/Soul: (how does it behave?) restless, jelous (when and how), disobedient, lazy/aggressive, irritable, when is it aggressive??, good- natured, frightened (what of), insulted, foibles/ticks
2.Eyes: (f.e. Itching, secretion, inflammation)
3.Ears: (f.e. Itching, secretion, smell, inflammation, swelling)
4.Nose: (f.e. Secretion, blocked nose, sneezing)
5.Mouth/gums: (f.e. Color, inflammation,), (spittel, dryness, ranula, bleeding, pus, paradentosis)
6.Teeth: (plaque), (f.e. Color, dad teeth, tartar)
7.Face: (f.e. Exanthem, abscess, swelling, inflammation, itching, expression, glandular)
8.Inner throat: (f.e. Problems with swallowing, inflammation, abscesses, cramp, paralysis, mucous membrane)
9.Outer throat: (f.e. Abscess, touching better or even worse, skin, struma, tumour, swelling)
10.Stomach/ appetite: ( f.e. Thirst, vomitting, desire, nausea, purping, desire after special kind of food> not what the animal would get in general more like on its desire: sweet, bitter, salty, smoked, ice cream, milk, fat, bread, is there a desire for especially cold or warm driks and or food?)
11.How is the What is it able to eat? (of what could the animal suffer from vomitting or diarrhoea)
12.Nutrition: (what are you feeding, how much and at what time of the day?)
13.Is it thirsty and how is the behavior of drinking? (f.e. How much, little or huge quantites at once, rarely or often?)
14.Abdomen: (f.e. Sounds – how and when, flatulences- how and when, pain- how and when, colic – liver, spleen, bowel, navel, pancreas)
15.Rectum: (f.e. Diarrhoea, impulse of bowel movements, reddening, bulge, pain while bowel movements, worms, itching, bleeding, prolaps)
16.Anus: ( f.e. Bleeding, crack, abscess, swelling, pain, tumours, pussing, deseas of the anal borsa, itching, paralysis)
17.Stool: ( frequency, color and consistency, maybe a special smell, maybe addings like blood or mucus, is there a tendency to diarrhoea or constipation (why), how are the bowel movements- by squeezing, in vain desire, or easy)
18.Urin: (f.e. Specialities: color, smell, how often, quantity, under pressing, incontinence)
19.Prostata: (f.e. Secretion, inflammation, enlargement, induration)
20.Urethra: (f.e. Secretion; inflammation, pain, bleeding)
21.Female genitalia: Discharge (color, smell, itching, consistence, when), swelling, reddening, on heat: when came it first (intensity, complaint,) in which intervals are the on heat phases and when does it showed of the last time? Has there been a phantom pregnancy? How and when, physical and psychical?`How is the sexual life?, pregnancy and birth (when how often), mamae, ovarias
22.male genetalia: Discharge ( smell, color, consistence, how does the glans/foreskin look like, inflammation, errection, exanthems of the skin, itching)
23.Pain of the genitalia, pain in genitalia of male and female animals
24.Trachea: (inflammation, swelling, sounds)
25.Breathing: (breathing from belly, superficially/deep, fast or slow, sounds, interrupted, gasping for breath, fast, long, shortness of breath)
26.Cough/ ejection: Time: during the day, in the evening, at night- attackes- time of the year (when, how does the cough sound like, where does it came from, does it got better or even worse from something, what is cought up, deseases of the heart, vaccination, coldness, laying down, air, wheather)
27.Heart: ( pounding of the heart, irregular, known deseases of the heart)
28.Brest: (mastitis, mammae, inflammation, exanthems of the skin, immorable)
29.Back: (problems, weakness, shaking, exanthems, loss of weight, itching, paralysis, cramp, spinal column)
30.Back ache: Throat- brest- lumbal vertreba- area, sacroiliacal joint ( pain while getting up, movement, pressure, wet weather, walking, bowel movements, laying, standing, injury)
31.How are The movements: (weakness, shaking, exanthems of the skin, itching, cold, pain in the limbs, respiration, swelling, deafness, restless)
32.Sleep: (waking up, position, sleepless, rhythm of the sleep)
33.Frost: (single parts of the body, outside, cough, breath, one-sided, deseased parts of the body, touching)
34.Skin and hair: (itching, exanthems> in detail, dry, scales (size, color), loss of hair, body odour, sore, warts, proliferation, scares, inspissation, induration, wetness, swelling, knots, heat, growth, pustule, coldness, bleeding, dirty)
35.Rash: (secretion, changing, expanding, pustules, vesicle, exanthem, furuncle, winter, scratching, swelling, crust, unpleasent smell, pimple, flat, urticaria)

      Prehistory

Are there any known deseases with the parents or siblings?
Which deseases had the patient before, any bad injuries?
When and how many operations had it? How many times it got an anaesthesia?
What kind of medizine got the patient in the last time? (name, ingredients, duration of use, well- tolerated?)
Where there any blood test, what results?
Where there x-raying? What result?

Vaccination
If your animal has been vaccinated please add a copy of all vaccinations or write them down.

Picture: To get a very clear view of your animal i need you to send me a picture of the full animal and one of the head.

Now you got through it...:)
I know you went to the trouble of this questionnaire but it's hard for me to treat an animal I haven't seen in personal.
That's why I have to ask so many questions.

Thank you very much.