Feather Picking

Questionnaire for Behavioral Issues

Print, fill out and bring to appointment or email it to jhutchins@seavs.com

Owner Name

Pet Name and sex(if known)

Age

Species

Address

Work phone

Home phone

E-mail

Bird source and raising

1. Where did you get your bird? 1. Pet store 2. Breeder 3. Bird show 4. Other___________

2. How was your bird raised? 1. Hand raised 2. Parent raised 3. Wild caught

3. At what age did you get your bird?

4. Was your bird weaned when you got it?

5. Describe the weaning of your bird. 1. Wean on his/her own 2. Forced wean 3. Hand fed over 6 mths

6. How many previous owners has your bird had?

7. Did you visit your bird before bringing it home?

Grooming and veterinary history

1. When was the last time your bird has been seen by a veterinarian?

2. Please describe any medical problems. If possible, please include medical records.

3. Is your bird fully flighted or clipped?

4. If clipped, when was the first trim done? 1. Before weaning 2. After weaning 3.When mature

5. Describe the wing trim style.

6. Is the trim one side or both sides?

7. How often and what way do you bathe your bird?

8. How do you dry your bird after a bath?

Environment and caging

If possible, please include a picture or video tape of the cage and surrounding area.

1. Choose one of the following that best describes the activity level of your house.

1.Very busy 2. Periods of activity and then quiet 3. Quiet and calm all of the time

2. Describe cage. Give brand name, dimensions, etc...

3. Location of the cage in the house? Use the space to draw a map of the house giving cage location and areas where the bird and family members spend most of their time.

4. Describe all the contents of the cage. Perches, toys, etc...

5. List all toys that the bird has access to:

6. How many hours a day does your bird spend in the cage?

7. How and where does your bird spend the remaining hours of the day?

8. How many hours does your bird spend alone?

9. What stimuli (sights, sounds, etc) are available to your bird when alone?

10. What type of lighting is around the cage?

11. Light intensity is: 1. Bright 2. Moderate 3. Dim

12. Does the bird have access to natural sunlight?

13. When do the lights come on in the morning? When are they turned off?

14. How many hours of sleep do you think you bird gets every night?

15. Are there any smokers in the house?

16. Do they smoke around the bird?

17. What other odors or fumes is your bird exposed to?

Diet

1. Describe your bird’s diet in detail. List brand names of pellets and your birds likes and dislikes.

2. What is your bird’s feeding schedule?

3. Please list favorite treats.

Flock information

1. List all members of your house.(Human and animal). (Please include the ages of any children)

2. Who primarily takes care of the bird?

3. Who spends the most time with the bird?

4. Who is the bird’s favorite? Least favorite?

 Patient behavior testing

1. Your bird will step up 1. easily 2. hesitantly 3. never

2. Is your bird ever allowed on your shoulder?

3. How does your bird greet you when you come home? Other family members?

4. Does your bird play? Describe play behavior.

5. Is your bird afraid of the towel? How does your bird handle restraint?

6. Does your bird talk? Can it use words appropriately?

7. Approximate vocabulary: 1. < 10 words 2. 10-20 words 3. > 20 words

8. Does your bird like to be touched/petted?

9. If so, where does the bird like to be touched?

10. How often is the bird in physical contact with someone when out of the cage?

1. Always 2. Intermittently 3. Rarely 4. Never

Describe your bird’s response to the following stimuli:

1. Anxiety 2. Fear 3. Calm 4. Happy 5. Excited 6. Aggressive 7. No response

Favorite approaching cage Loud noises

Other approaching cage New object in cage

Stranger approaching cage New object out of cage

Favorite open cage Strange places

Other opens cage New food item

Stranger opens cage Other birds( if housed with another)

Favorite hand in cage

Other hand in cage

Stranger hand in cage

Favorite step up

Other Step up

Stranger step up

Favorite touching/petting

Other touching/petting

Stranger touching/petting

Favorite offers food

Other offers food

Stranger offers food

Other approaching favorite

Favorite approaching other

Other approaching stranger

Favorite to other transfer

Stranger to other transfer

Other to favorite transfer

Favorite to stranger transfer

Animal approaches

Favorite out of vision

11. List and describe behavior issues that you would like addressed.

12. How long has your bird been showing the behavior?

13. Describe when these behaviors occur.

14. How do you react to these unwanted behaviors?

15. If your bird is a feather picker, what parts of the body are affected?

16. Does the picking behavior interrupt normal activities?

17. Is the picking behavior associated with a certain activity?

18. Describe in detail when the picking occurs.

19. Are feathers damaged when they are: 1. Mature 2. When they first appear 3. When they start to open up

20. Can you stop the picking behavior? If so how?

21. How does your bird act when picking? 1. Like it hurts 2. Like itches 3. It does not bother him/her

This questionnaire was adapted from Evaluation, Diagnosis and Modification of Behavioral Disorders, 2003 MASAAV Conference Proceedings, Kenneth R. Welle, DVM, Diplomate ABVP (avian).

Please use the following space to give any pertinent information. Thank you for taking the time to fill out this questionnaire.