2018 NTUAS Owner Survey Welcome to the Norwich Terrier Upper Airway Syndrome (NTUAS) Owner Survey. All identification data such as dog names and owners will be kept strictly confidential. Only anonymized data will be summarized and distributed. The results of this survey will enable the Norwich Terrier Club of America and the NTUAS Study Group to determine the prevalence and severity of NTUAS around the world.Please answer the questions for each purebred Norwich Terrier CURRENTLY residing with you. We do not want the same dog to be entered twice into the survey! This survey takes less than 10 minutes to complete. Thank you for participating. Question Title 1. Patient information Dog call name Owner last name Sex(M=Male, MN=Male neutered, F=Female, FS=Female spayed) Year of birth Country of residence Question Title 2. Please indicate your dog's level of upper respiratory signs (e.g., raspy, gurgly, loud, snortly, choking) at this current point in time. No current upper respiratory signs Intermittent audible sound when breathing but does not affect behavior Always audible sound when breathing but does not affect behavior Always audible sound when breathing, has to rest with exertion/heat/stress Always audible sound when breathing, has had 1 or more episodes of going blue/collapse Always audible sound when breathing, is constantly affected Question Title 3. If your dog has respiratory signs, at what age did they start? < 1yr old 1-2 yrs old 3-4 yrs old 5-7 yrs old 8 yrs old or greater I am not sure Not applicable as my dog has no respiratory signs Question Title 4. Is your dog's breathing worse in hot weather? Yes, it gets worse No, it is unchanged I am not sure Not applicable as my dog has no respiratory signs Question Title 5. Is your dog's breathing worse after exertion? Yes, it gets worse No, it is unchanged I am not sure Not applicable as my dog has no respiratory signs Question Title 6. Has your dog's respiratory signs been attributed to allergies? Yes No I am not sure Not applicable as my dog has no respiratory signs Question Title 7. Do your dog's respiratory signs improve with medication? Yes No I am not sure Not applicable as my dog has no respiratory signs If yes, what medication? Question Title 8. Does your dog snore when asleep? Yes, all the time Yes, intermittently Very rarely Never Question Title 9. Does your dog have unusual bark? No I am not sure Yes If Yes, please describe in 100 characters or less: Question Title 10. Has your dog had its laryngeal saccules removed? Yes No I am not sure Question Title 11. At what age did your dog have its saccules removed? <1 yr old 1-2 yrs old 3-4 yrs old 5-7 yrs old 8 yrs old or greater Not applicable as my dog has not had its saccules removed Question Title 12. Did sacculectomy improve your dog's respiratory signs? No, signs were worse after sacculectomy No, there was no change after sacculectomy Mild or transient improvement after sacculectomy Moderate improvement after sacculectomy Marked improvement after sacculectomy I am not sure Not applicable as my dog has not had its saccules removed Question Title 13. Has your dog undergone any other surgery to his airway? Yes No I am not sure Question Title 14. What airway surgery other than sacculectomy did your dog have? Repeat sacculectomy Soft palate surgery Tonsillectomy Arytenoid lateralization ("Tie Back") Ventral laryngotomy (incision under the neck) Resection of redundant mucosa in larynx Permanent tracheostomy Another procedure not listed here Another surgery was done but I am not sure what procedure was performed Not applicable as my dog had no other or repeat surgery Question Title 15. List any other health condition your dog has, unrelated to upper respiratory issues. Condition 1: Condition 2: Condition 3: Condition 4: Condition 5: 100% of survey complete. YOU ARE DONE! THANK YOU.
