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Country of Residence:
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Email Address:
(can use xxxxxxxx if desired) |
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Do you pre-treat your puppy before giving vaccines.
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No
Yes, Benadryl
Yes, Steroids
Yes, other drugs
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Color of puppy.
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red
stag red
black and red
fawn
blue
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Sex of puppy.
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male
female
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What was the age of the puppy when vaccinated and had a reaction.
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Six weeks
Seven weeks
Eight weeks
Eight to ten weeks
Ten to twelve weeks
Twelve to fourteen weeks
Over fourteen weeks
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What type of vaccine/s were given to the puppy.
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Rabies
Distemper in a six way shot
Distemper in a five way shot
Distemper only
Parvo only
Other
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How many days after the vaccine was given was a reaction noted.
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Immediately
Within 12 hours
Two days
Five days
Seven Days
Nine Days
Ten days
Twelve days
Other (longer)
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Were there other treatments, medications given to this puppy close to time of vaccination.
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No
Other Vaccinations
Surgery that required anesthesia
Worming
Flea preparation
Other
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Was the puppy stressed within ten days of receiving vaccination.
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Travel
Change to new environment
Chilled
Overheated
Other
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What were the first symptoms noticed from this reaction.
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Facial Swelling
Rash
Injection site discomfort
Lethargy (sleepy/sluggish/depressed)
Vomiting or drooling
Food refusal
Shivering
Ataxia (falling over, uncoordinated, walking in a stager)
Twitching of body, head, limbs
Seizures
Other
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Give progression of symptoms if several were seen.
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How soon after symptoms were noticed was the puppy seen by a vet.
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Same day
One day
Two days
Over two days
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List treatments, medication prescribed by your vet.
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Blood test for Toxins
Blood tests other
Antibiotics
Anti-nausea medication
Anti-seizure medication
Anti-inflammatory (Prednisone, Hydrocortisone)
Benadryl
X-rays
None
Other
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How soon did the puppy improve after treatment started.
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Immediately
Within 12 hours
Within 24 hours
Within two days
Other
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How long did it take for the puppy to recover completely from the reaction.
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Did your vet diagnose this without suggestion of a vaccine reaction from you.
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Yes
No
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Response of your vet to the suggestion that this was a vaccine reaction.
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Diagnosed without additional information
Listened and treated appropriately
Was hesitant to diagnose this, but treated appropriately
Refused to consider this a vaccine reaction and would not treat as such
Second opinion required
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Are you aware of other related dogs in the family that had vaccine reactions.
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None
Mother
Father
Siblings
Grandparent
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Additional comments;
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