AHIDA: Anstee Hub for Inherited Diseases in Animals

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For the anonymous submission your information will contribute to surveillance.  You will not directly be able to participate in research about the condition,  will not be able to receive clinical or genetic advice, will not be contacted for follow up, and we will not contact your veterinarian (please choose ‘No’ for these options at the end of this survey).

Saving incomplete submissions: it's best to leave this browser tab open until you've submitted your survey. However, if you close this browser tab, we will attempt to save any data you have entered so far, so you can resume later. When you open this page again, you will be asked whether you want to restore the saved data. You will need to open the page again on the same device and browser.

Incomplete surveys only stored locally in your browser and never submitted to our servers until you give your explicit consent and choose to submit.

Submit a report anonymously

Information

Fields marked with * are required

Submitter details
Is the person submitting the report the owner of the animal?
Name of animal's owner. Please ensure the owner agrees to their information being provided.
Click to select, or type to enter a new value
Click to select from the standard options, or type to enter your role if not present. You can select multiple options.
Click to select the state
State where the animal lives
Animal details
What you call the animal
Animal's registration number/ID, if known.
Microchip number/identifier, if known.
Click to select from common species. Or, search for other species by typing
Click to select from common species, e.g. cattle, dog, horse. If the animal is a different species, you can type to search
Click to select the sex. You can select Unknown if you don't know
Sex of the affected animal.
Enter the name of a breed and press Enter
Search to find the animal's breed. If the suggested options don't match, you can enter a custom option.
Click to select, or type to enter a new value
Is the animal alive at the time of reporting?
Birth information
Date of birth (if known). You can leave day or month blank if unsure.
Dissection of a fetus to facilitate removal from the uterus
Click to select, or type to enter a new value
If known.
Click to select, or type to enter a new value
How many animals in the litter were affected (if known)
Did the condition affect the animal's siblings similarly or differently? Were the affected siblings the same sex? Please comment on the birth of the siblings, if relevant.
Death information
Date of death (if known). You can leave day or month blank if unsure.
Parentage
Dam/Mother Information
Name of affected animal's dam/mother. Please use their registered name, if known.
Enter the name of a breed and press Enter
Breed of the animal's dam/mother. Search to find the breed. If the suggested options don't match, you can enter a custom option.
Dam/mother's registration number, if known
Sire/Father Information
Name of affected animal's sire/father. Please use their registered name, if known.
Enter the name of a breed and press Enter
Breed of the animal's sire/father. Search to find the breed. If the suggested options don't match, you can enter a custom option.
Sire/father's registration number, if known
Disease Information
You can leave the month or day unspecified if unsure, but please be as detailed as possible. Please check this against the date of birth to ensure it makes sense.
Enter an individual clinical sign and press Enter
What clinical signs (symptoms) has the animal shown? Search to find the closest matching clinical signs. You can enter multiple signs. If you don't feel there is a good match, create a new entry by typing a description of the clinical sign observed.
The clinical signs:
Diagnosis
Enter the name of a disease/disorder and press Enter
Search for diagnoses or diseases by typing. You can enter multiple responses. If you cannot find a good match, you can enter a custom option
Click to select
Have you seen animals present with similar clinical signs:
Additional information
Please select all that apply:
Click to select
Why do you suspect that this is an inherited disease?
Submission details
Additional information available
Would you be willing to submit any of the following additional information? The AHIDA team or researcher teams may request information about the condition or samples from your animal, if you consent:

What is your reason for submitting? Select all that apply
Consent
By submitting this information I consent to contributing to surveillance of diseases in animals and reporting of surveillance information on the AHIDA website and elsewhere. Personal information of animal owners or information that allows identification of their animals will not be included in reporting. I also consent to:

Name of your veterinarian/the veterinarian that treated the animal

Help

Please contact the AHIDA team if you experienced any problems with submitting your report ([email protected]).