EXERCISE-INDUCED COLLAPSE QUESTIONNAIRE

 

This page is for owners of Labradors that have been tested by University of Minnesota to have two copies of the dynamin-1 gene mutation, aka "AFFECTED". 

No one other than the owner or breeder of the dog should use this form to report an affected dog.  You do not have to give your name and email, but it is appreciated to ensure there is not duplication of entries by co-owners, etc.

 

At this time, I am most interested in tested "affected" dogs who do not collapse, although it is important for me to also know if there are related dogs who do collapse.

All information will be kept confidential.  I am not requesting a copy of the report and trust that only accurate information will be given.  At this point, I am just trying to get a handle on the numbers of affected dogs who collapse versus those who do not.  Eventually, I would like to be able to provide some statistical information to the researchers and the Labrador fancy.  I appreciate your willingness to share this information.  As you might have guessed, I have a dog who has tested as 'affected' but does not collapse and I am looking for trends within extended families of 'affected' dogs.

 

Please feel free to email or call me if you'd like:  Carrie Eberhardt or call 214-543-4638

Name    Email address

 

Dog's Call name     Sex:  Dog  Bitch      Date of birth  

Please choose one:  100% bench bred       100% field bred          bench/field cross            BYB         unknown

Has your dog ever collapsed?

     Yes, under these conditions:

 

     No, and my dog has been exposed to the following:

Do you know of any immediate relatives (parents, siblings, half-siblings or get) that collapse?  If so, please elaborate. 

Please do not give registered names unless you are the owner or breeder or have permission to share the information.

 

If you wish to include it, the "Affected" Dog's Registered Name

Sire's Registered Name

Dam's Registered Name

Link to a website page with full pedigree:

 

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