18.      Any indications of bloat in the lines of the Dam or Sire? 

Please list the percentages of bloat occurring in the following litters (example: list as 3 out of 5.  10 puppies in the litter total). How did you handle each occurrence in litters you placed?   

Sire’s Littermates _________________             

Dam Littermates ______________

All sire’s siblings including ½ ________                   

All dam’s siblings including ½ ________

How many litters total? _______                                  How many litters total? _______

All sire’s siblings’ (inc. ½) litters _______                      All dam’s siblings’ (inc. ½) litters _______

How many litters total? _______                                  How many litters total? _______

Sire’s offspring ___________                                      Dam’s offspring ___________

How many litters total? _______                                  How many litters total? _______

19.      Any indications of epilepsy or fly biting in the lines of the Dam or Sire? 

Please list the percentages of epilepsy or fly biting found in the following litters (example: list as 3 out of 5. 10 puppies in the litter total). How did you handle each occurrence in litters you placed?   Please also list the age of diagnosis. 

Sire’s Littermates _________________             

Dam Littermates ______________

All sire’s siblings including ½ ________                   

All dam’s siblings including ½ ________

How many litters total? _______                                  How many litters total? _______

All sire’s siblings’ (inc. ½) litters _______                      All dam’s siblings’ (inc. ½) litters _______

How many litters total? _______                                  How many litters total? _______

Sire’s offspring ___________                                      Dam’s offspring ___________

How many litters total? _______                                  How many litters total? _______