Hospital Veterinário Consulta

Universidade de Cuiabá
Divisão de Clínica de Pequenos Animais
Data: ____/____/____
SETOR ____________ Veterinário _______________________

Nome: RG: Idade: Peso: Sexo:

M /F / C

Queixa Principal:

Anamnese:
Assinalar quando verificado
_____________________________________________________________ Queixa atual:
_____________________________________________________________ 1. □Tempo de evolução
_____________________________________________________________ 2. □ Tipo de evolução
_____________________________________________________________ 3. □ Tratamento (s)
_____________________________________________________________ 4. □ Resposta a tratamento
Outros sistemas:
_____________________________________________________________ 5. □ Tegumentar
_____________________________________________________________ 6. □ Digestório
_____________________________________________________________ 7. □ Respiratório
_____________________________________________________________ 8. □ Cardiovascular
_____________________________________________________________ 9. □ Urinário
10. □ Genital
_____________________________________________________________ 11. □ Nervoso
_____________________________________________________________ 12. □ Músculo-esquelético
_____________________________________________________________ 13. □ Oftálmico
_____________________________________________________________ Manejo geral:
_____________________________________________________________ 14. □ Comportamento
15. □ Alimentação
_____________________________________________________________ 16. □ Vacinações
_____________________________________________________________ 17. □ Vermífugos
_____________________________________________________________ 18. □ Ambiente
_____________________________________________________________ 19. □ Acesso à rua
_____________________________________________________________ Saúde pregressa:
20. □ Doenças anteriores
_____________________________________________________________ 21. □ Medicação contínua
_____________________________________________________________ 22. □ Queixas adicionais
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 Hospital Veterinário
Universidade de Cuiabá
Divisão de Clínica de Pequenos Animais

Exame Físico
TR: ºC FC: bpm FR: mpm TPC: seg Peso: Hidratação:

1. Pulso arterial Regular Irregular Filiforme Fraco Forte Outro

2. Mucosas = Rosadas Pálidas Hiperêmicas Cianóticas Ictéricas Congesta
3. Consciência Alerta Deprimido Estupor Coma
4. Estado nutricional Caquético Magro Normal Obeso Muito Obeso
5. Comportamento Dócil Inquieto Medroso Agressivo Outro
6. Ectoparasitas Não _____________________________________________
Sim
7. Postura e Movimentação Normal Anormal _____________________________________________
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8. Olhos Normal Anormal
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9. Orelhas Normal Anormal _____________________________________________
10. Pele e anexos Normal Anormal _____________________________________________
11. Respiratório Normal Anormal
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12. Circulatório Normal Anormal _____________________________________________
13. Digestório Normal Anormal _____________________________________________
14. Abdome Normal Anormal _____________________________________________
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15. Urinário Normal Anormal
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16. Genital Normal Anormal _____________________________________________
17. Músculo-Esquelético Normal Anormal _____________________________________________
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18. Nervoso Normal Anormal
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19. Hemolinfático Normal Anormal _____________________________________________
20. Cavidade Oral Normal Anormal _____________________________________________
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21. Outros Normal Anormal
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