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ASA Stabyhoun Inventory Form
This form is used for historical reference on the measurements and notable health information about the Stabyhoun breed in conjunction with NEDERLANDSE VERENIGING VOOR STABIJ EN WETTERHOUNEN.
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* Indicates required question
Name of Inventory Taker:
*
Your answer
Today's Date
*
MM
/
DD
/
YYYY
Registered Name of Dog
*
Your answer
Registration Type and Number
*
Example: NHSB 2720204 or FCPR P11.1250
Your answer
Microchip #
Your answer
Sex
*
Male
Female
Color of Coat
*
Black and White
Brown and White
Owner Info
Owner's Name
*
Your answer
Street Address
*
Your answer
City, State or Province, Zip Code
*
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Measurements and Weight
Weight of Dog in Kilograms
*
1 kg = 2.2 pounds
Your answer
Length of Muzzle in Centimeters
*
In photo, point A to B
Your answer
Length of Head from Occiput to Nosetip in Centimeters
*
in photo above, point A to C
Your answer
Muzzle circumference just below stop in Centimeters
*
around muzzle at Point B
Your answer
Muzzle circumference at nosetip in Centimeters
*
around muzzle at Point A
Your answer
Skull Circumference at widest point in Centimeters
*
around skull without including ears near Point C
Your answer
Breast Circumference at Widest Point in Centimeters
*
breast going around body around Points 2 and 3
Your answer
Length of Foreleg in Centimeters
*
from floor to "hole" in elbow joint -- Point 1 to 2
Your answer
Height at Withers in Centimeters
*
from floor to top of shoulder blade -- Point 1 to 3
Your answer
Overall Body Length in Centimeters
*
from breastbone to sitbone in straight line -- Point 4 to 5
Your answer
Exterior Assessment
Head
*
does the head have loose skin under chin or loose lips?
Dry, tight skin and no loose lips
Pendulous lips or dewlaps
Required
Muzzle
*
does the nose appear straight, or does it bend?
Straight
Convex (arched)
Concave (hollow)
Required
Nose tip color
*
Black
Brown
Other:
Required
Size of teeth
*
Normal
Small
Required
Teeth position
*
Overbite (top gaps over bottom)
Scissor (top just clears the bottom)
Underbite (bottom comes outside the top)
Level (top and bottom touch like pliers)
Cross bite ( some of each- Messy)
Required
Missing teeth?
please note which teeth are missing, if any
Your answer
Eye position in head
*
Level
Slanted
Required
Eye Lash Placement
*
Entropion
Good
Ectropion
Eye Set
*
Deepset
Normal
Protuding
Eye Color
*
Dark Brown
Brown
Lt. Brown
Yellow (Bird of Prey)
Ear Set
*
High
Normal
Low
Ear Fur
*
Typical, feathered and good length
Not Typical, extra long fur, or no feathers
Ear Form
*
Trowel
Other form, more round at tip
Ear Length
*
Short
Good
Long
Back support
*
Drooping
Good
Arched
Belly line
*
Pot belly
Good
Too tucked up
Fitness
*
Fat
Good
Skinny
Forehand angulation
*
Moderate
Good
Steep
Fore Feet
*
Cat feet
Round
Hare feet
Hindquarters angulation
*
Moderate
Good
Steep
Hind Feet
*
Cat feet
Round
Hare feet
Tail Set
*
High, at back level
Low, below back level
Tail Fur
*
Bushy
Feathered
Curly
Tail Carriage
*
Ring (up and over back)
"Happy", curled but not on top of back
Normal, carried low or slightly turned up
Coat Appearance
*
Sleek
Wavy
Curly
Wooly, like Wetterhoun
Stance of front legs
*
Narrow
Wide at elbows
Wide at floor
Narrow at floor
o-boned
x-boned
French Feet, toes pointing out
Toed in
Normal
Stance of rear legs
*
Narrow
Wide
Narrow at floor
o-boned
Cow-hocked
Normal
Movement at a walk
*
Steep
Diagonal Gait
Narrow
Wide
Normal
Movement at a trot
*
Steep
Diagonal Gait
Narrow
Wide
Normal
Ear Inflammation
Left
Right
Clear selection
Ear Inflamation
Please mention type of inflammation and frequency of occurrence
Your answer
Eye excretion
Left
Right
Clear selection
Eye excretion
Please mention type of excretion and frequency of occurrence
Your answer
Skin and Fur Abnormalities:
Dry skin
Flaky skin
Short fur
Color changes in Fur
Diffuse hair loss
Localized hair loss
Clear selection
Anal Glands
Inflammation?
Expression of glands?
Clear selection
Anal Glands
Please detail frequency of occurrence
Your answer
Respiratory System Abnormalities
Please detail type and frequency of occurrence
Your answer
Circulatory System and Heart Abnormalities
Please detail type and frequency of occurrence
Your answer
Digestion System Abnormalities
Please detail type and frequency of occurrence
Your answer
Urinary Tract Abnormalities
Please detail type and frequency of occurrence
Your answer
Reproductive System
Please detail frequency and intensity of occurrence
Your answer
Reproductive System -- treated for heat cycle
Yes
No
Clear selection
Reproductive System
Spayed or Neutered
Intact
Clear selection
Reproductive System -- Males only
Normal?
Cryptorchid?
Monorchid?
Clear selection
Mammory Glands -- Females only
Normal?
Tumors?
False pregnancy swelling?
Other:
Clear selection
Hip Joints
Radiographic dysplasia?
Clinical dysplasia?
Other:
Clear selection
Elbow Joints
Radiographic dysplasia?
Clinical dysplasia?
Other:
Clear selection
Other Joint Issues?
Stifle (knee)
Spine
Shoulder
Patellas
Other:
Clear selection
Epilepsy occurrences
Describe situation and frequency of occurrence
Your answer
Home Environment
*
Describe flooring in home and sleeping quarters, etc.
Your answer
Owner's Description of Dog's Behavior and Character
*
Description by owner
Your answer
Inspector's Description of Dog's Behavior and Character
*
Description by Inspector
Your answer
Additional Comments
Your answer
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