Dr. Kevin Byrne, DVM, MS Diplomate American College of Veterinary Dermatology Patient History Form
List any drug allergies: ____________________
This information will help us help your pet.
1. What are your pet’s problems currently: (check all that apply)
Scratching, chewing, licking, rubbing, skin ( )
Red bumps, pimples, scabs ( )Ear infections ( )
Nail infections or nail loss ( )Other (describe) ( ) ___________________________________________
2. How long has/have the current problem(s) been present? _____________
3. What did your pet’s problems look like initially? ______________________
4. What areas of your pet are affected? (check all that apply)
Ears ( ); Face ( ); Neck ( ); Armpits ( ); Rump/tail area ( ); Underside ( );
Groin/inner thighs ( ); Legs/paws ( ); Anal/genital area ( ); Other___________
5. What treatment has your pet received for his/her skin problem? Check all that
apply and list or circle names if possible:
Antibiotics (list if you know) __________________________________
Oral cortisone e.g.: prednisone, Vetalog, dexamethasone
Antihistamines e.g.: Benadryl, Atarax, chlorpheniramine
Fatty acids/oils, fish oil capsules, vegetable oils
Ear ointments or drops (list if you know) _______________________
Herbal or homeopathic remedies (list if you know) ______________
Allergy vaccines: based on skin test: __ or blood test: __
6. Did medication/therapy help your pet’s problem(s)? Yes( ) No( ) If no, go to 7If yes, which medication was the most effective?_____________________________
Did the lesions resolve with this medication/therapy? Yes( ) No( ) Did the
lesions return after medication/therapy was stopped? Yes( ) No( ) How long
did it take for the lesions to return?___________ (weeks/months)(circle)
7. On a scale of 1-10 with 1 = occasional chewing or scratching and 10 = severe,
constant scratching that keeps you up at night, how would you rate your pet’s
level of itchiness now? (circle number from 0-10): 0 1 2 3 4 5 6
How would you rate chewing or scratching while your pet was on antibioticsand nothing else?____/10. Or, my pet was never on antibiotics alone: __
8. Is there currently a relationship between your pet’s problem(s) and the season
of the year? Yes ( ) No ( ) If yes, please check the season(s) when the problem is
worse: Spring ( ); Summer ( ); Fall ( ); Winter ( )
In the past was there a relationship between your your pet’s problem(s) and the
season of the year? Yes ( ) No ( ) If yes, what seasons? ____________________
9. Do you have any other pets? Yes ( ); No ( ); Please list any other pets ______
10. Do your other pets have any skin problems? Yes ( ); No ( ); Does not apply
( ) If yes, what are the other pet’s problems? __________________________
11. Describe the indoor environment of your pet – such as bedding, where
he/she sleeps, etc. _______________________________________________________
12. Describe the outdoor environment (grasses, weeds, trees, wooded areas,
etc…) __________________________________________________________________How many hours of the day is your pet outdoors?__________________________
13. Have you noticed fleas on your pet recently? Yes ( ); No ( )
14. What flea products do you currently use? _____________________________
15. Has any person in your household had skin problems since your pet started
having skin problems? Yes ( ); No ( ) If yes, please describe _________________
16. What oral or injectable medication is your pet presently receiving and whenwas it last given? _____________________________________________________
17. What shampoos, sprays, creams, ointments, lotions are your pet presently
receiving? __________________________________________________________
What ear medications and cleansers is your pet presently receiving?_____________________________________________________________________
18. Which food is your pet currently receiving? ______________How long? _____
19. Does your pet receive anything else to eat? E.g. table food, treats, biscuits,
vitamin supplements, or rawhide chews given? Please list ____________________
_______________________________________________________________________
20. Does your pet have any other medical or surgical problems unrelated to the
skin disorder? Yes ( ); No ( ) Please describe:
______________________________________________________________________
Is your pet receiving any medication for this disorder? Please list medications: ______________________________________________________________________
21. Are there any changes in food or water intake, changes in urination ordefecation, changes in activity level?Yes ( ) No ( ) Please list: ________________________________________________
22. Has your pet ever been on a special food elimination diet? Yes ( ); No ( ); If
yes, what brand of food or home-cooked diet ingredients were used and for howlong? _______________________________________________________
Were treats, table food, biscuits, rawhides, or chewable medications given
23. For dogs: Is your pet currently on heartworm prevention? Yes ( ); No ( ) If
24. For cats: Was your pet tested for feline leukemia virus (FeLV)? Yes( ) No( )
25. Has your pet always lived in this part of the country? Yes ( ) No ( )
Exploiting Redundancy in Natural LanguageChristoph Karlberger, G¨unther Bayler, Christopher Kruegel, and Engin Kirda{christoph,gmb,chris,ek}@seclab.tuwien.ac.atProbabilistic systems: Systems such as Bayesian filtersare used to learn word frequencies that are associ-Today’s attacks against Bayesian spam filters attempt toated with both spam and non-spam messages [11]. keep the content of
BIOGRAPHICAL SKETCH Provide the following information for the key personnel and other significant contributors. Follow this format for each person. DO NOT EXCEED FOUR PAGES. EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such University of Western Ontario, London ON A. Positions and Honors. Positions and Employment 1989-1991 Head, Cli