Report a Case

Reporting Veterinarian*

Reporting veterinarian name is required.

Age of Dog*

City (where the dog lives)*

City is required.

State*

Please provide a valid state.

Does the dog have any exposure/co-mingling risks within the 4 weeks prior to symptom onset?

Is the dog up-to-date on the following vaccinations?

DA2PPV:

Yes No I don't know

Bordetella:

Yes No I don't know

Canine Influenza:

Yes No I don't know

Predominant clinical symptoms (check all that apply):

Cough

Fever (T >103F/39C)

Inappetance

Ocular Discharge

Nasal Discharge

Dyspnea (increased respiratory rate and/or effort)

Radiographic findings:

Were airway cultures performed?

Antimicrobial therapy used in case & clinician assessment of efficacy:

Did the case require hospitalization?

Outcome at time of reporting: