Penn Vet | Miyadera Lab - PRA Genetics Study

This online form is for English Springer Spaniel owners and breeders:

To update vision and eye exam statuses of dogs whose DNA is already collected by the University of Pennsylvania PRA research group or banked at the University of Missouri.
To add any new dogs to participate in the survey.

Please submit one form per dog. We encourage you to submit all genetically “affected” dogs you have had over the years including the dogs that have already passed.

This study is being conducted by the Miyadera Lab at the University of Pennsylvania School of Veterinary Medicine.

Owner Information

Dog Information

If deceased, year or age at passing:

Vision & Eye Exams

1. Please mark your impression of this dog's vision • at present (if alive) • at the end of life (if deceased)

Normal - Completely normal. No hesitation under dim or bright light.
Mild decrease - Minor hesitation. Something is slightly off with vision.
Moderate decrease - Obvious difficulty navigating and occasionally collides with objects.
Blind - Completely blind night and day. Cannot follow motion and constantly collides with objects.

2. Please provide any details regarding vision (e.g., age first noticed, stable vs. progressive)

3. Please report CERF/OFA examination results and year of exam

Examples:
• OFA Normal Feb 2017, May 2018, Aug 2019
• CERF Generalized retinal atrophy, Sept 2009
• Diagnosed as PRA based on ERG, normal vision, July 2014

Known Relatives Afflicted with PRA

4a. If you answered "yes", please note who was afflicted, at what age, and DNA test status, if known.

Additional Questions About Your Dog

6. If you know the DNA test status of this dog, how did you find it out?

Please type in institution/company name that performed the test, or "by parentage" if applicable.

7. (Optional) Please feel free to add any other comments about your dog or the study.

Authorization

I understand that my dogs' DNA may be used for research efforts aiming at improving the health of English Springer Spaniels and other breeds. I hereby authorize the use of the samples in compliance with the agreement upon Sample submission to the University of Missouri DNA Bank.

I understand.

I authorize access to CERF/OFA data associated with my dogs for research purposes. I understand that the confidentiality will be strictly protected and that the data will only be used by the investigators for research purposes.