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Navigation Menu
Home
ASA 2025 Specialty
About the breed
Summary
Breed Standard
Temperament
Training
Health
Breeding Regulations
Diversity
Genetics and DNA Testing for Diversity
Stabyhoun Diversity Project – Sept 2019 Webinar
Gallery
Gallery
Videos
Puppies
Looking For A Staby?
FAQ’s
Puppy Waitlist
Membership and More
About Us
Our Studs
Membership
Member Hub
Contact Page
Shop
Stabyhoun Health Questionnaire
Stabyhoun Health Questionnaire
Today's Date
(Required)
MM slash DD slash YYYY
Background Information
Owner's Name
(Required)
First
Last
Owner's Email
(Required)
Stabyhoun's Registered Name
(Required)
Stabyhoun's Registration Number
(Required)
AKC-FSS, FCPR, or Foreign Registration Number
Stabyhoun's Date of Birth
(Required)
MM slash DD slash YYYY
Stabyhoun's Country of Birth
(Required)
How did you obtain your Stabyhoun?
(Required)
Bred Yourself
Directly from a breeder
Rescue
Other
Sex of Dog
(Required)
Male Intact
Male Neutered
Female Intact
Female Spayed
What activities does your dog participate in? (check all that apply)
agility
hunting/field work
obedience
rally
therapy work
tracking
other
Other Activities
General Health of Your Stabyhoun
How would you rate the overall health of your Stabyhoun?
(Required)
Excellent
Good
Fair
Poor
Bad
Has your Stabyhoun had any significant health issues?
(Required)
No
Yes (Please describe)
If you answered 'yes', please describe:
Is your Stabyhoun on tick protection?
(Required)
No
Yes
Flea protection?
(Required)
No
Yes
Heartworm prevention medicine?
(Required)
No
Yes
Brand of tick Protection
Brand of flea Protection
Brand of heartworm prevention
Is your Stabyhoun vaccinated regularly?
(Required)
No
Yes
Please check all that apply
Distemper/Parvo Virus
Rabies
Kennel Cough
Leptospirosis
Lyme Disease
Canine Influenza
Other
Please list other vaccines
Do you use titers to determine immunity?
(Required)
No
Yes
Has your Stabyhoun ever had any adverse reaction to any vaccine?
(Required)
No
Yes
Please check all that apply
Distemper/Parvo Virus
Rabies
Kennel Cough
Leptospirosis
Lyme Disease
Canine Influenza
Other
What type of food does your Stabyhoun eat?
(Required)
Dry
Canned
Home Cooked
Raw Diet
What Brand(s) do you feed?
What dietary supplements do you give to your Stabyhoun?
joint
skin/coat
teeth
digestive (probiotics)
other (specify below)
Please list other supplements
What health issues do you think are most important or serious in the Stabyhoun breed and why?
Genetic Health of your Stabyhoun
Which of the following have you performed on your Stabyhoun?
Hip Testing
OFA
Penn Hip
Other (please specify)
Elbow Testing
OFA
Other (please specify)
Other Hip Testing
Other Elbow Testing
Eye Testing
CERF
Other (please specify)
Heart Testing
stethoscope
doppler
echocardiogram
Other (please specify)
Other Eye Testing
Other heart Testing
Specific Health Issues of Your Stabyhoun
Please check if your Stabyhoun is having issues or has been diagnosed with any of the following health problems. If yes, please explain in detail. Please check all that apply.
health issues
Cancer or tumors
GI (stomach, intestine) disorders
Cardiovascular disorders (e.g. heart or vascular problems including murmurs, PDA, heartworm disease, heart failure, others)
Respiratory (breathing issues)
Eye problems (e.g. cataracts, glaucoma, cherry eye, chronic infections)
Ear problems (e.g. otitis and ear infections)
Neurologic disorders (including epilepsy, nystagmus, others)
Muscular problems
Skin issues
Liver problems
Bone/Joint problems (including osteoarthritis, elbow dysplasia, hip dysplasia, others)
Blood/Lymph diseases (including anemia, Von Willibrand’s, others)
Thyroid issues (e.g. hypothyroidism), endocrine diseases (e.g. diabetes, Cushing’s, Addison’s, other)
Kidney disease (e.g. renal failure)
Reproductive disorders (e.g. metritis, retained testicle, benign prostatic, hypertrophy, mastitis, others)
Dental problems (gingivitis/periodontal disease; underbite, overbite, other)
Allergies (e.g. food hypersensitivity, environmental allergies, flea allergy, other)
Immune system problems (lupus, vasculitis, etc.)
Drug Reactions (confirmed or suspected) Please specify below.
Other (specify below)
Please list the drugs your Stabyhoun has reacted to
If you checked anything above, including other, please provide a detailed explanation of your Stabyhoun's health issues:
Temperament of your Stabyhoun
Please check all that apply
Aggression to other dogs (including provoked by staring, territorial aggression, etc)
Aggression toward people
Prey aggression (intense chasing of smaller animals with “intent to kill”)
Dominance toward other dogs (assertive but will not physically harm another dog unless challenged)
Separation anxiety
Shy with new people
Fearful of objects
Other (please specify below)
Please list other temperament issues
Breeding Status
Has your Stabyhoun given birth to or sired puppies?
(Required)
No
Yes
Has your Stabyhoun produced any stillborn puppies?
No
Yes
Has your Stabyhoun produced pups with birth defects or congenital problems? Please check all that apply
Cleft palate
Hip dysplasia
Elbow dysplasia
PDA
Other (please specify below)
Other birth defects
Thank you!
Thank you very much for sharing your Stabhoun’s health history with the ASA. It will help us tremendously to understand the health issues that face our beloved breed and to help make future Stabyhouns healthier and happier dogs.
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