The SUGAR Group - The Sugar Glider Advanced Research Group

Seizure Study



Please complete the form each time your glider has a seizure.  All personal information will be kept confidential, per the SUGAR Group's confidentiality policy.


Please complete all fields as completely as possible
Your Name
Screen Name
Glider's Name
Glider's color (choose one)
Glider's Sex
Male - Intact
Male - Neutered
Female
Glider's Age
Date of Seizure
Time of day of Seizure
Describe circumstances just prior to the seizure (what was the glider doing before the seizure?)
Length of seizure (in minutes)
Indicate which of the following the glider exhibited during the seizure (choose all that apply)
Glider became limp
Fall
Clonic/Tonic (twitching) movements
Glider became stiff
Foam at the mouth
Other
If "other" behavior was noted, please describe
Length of postictal stage (time that glider was "off" after seizure) - in minutes
Indicate which of the following the glider exhibited during the postictal stage (choose all that apply)
Appears confused
Clumsy/unsteady
Slow moving
Weakness
Very thirsty
Climbs into pouch to rest
circle top of cage
crabby
Dehydration
Other
If "other" is noticed during postictal stage, please describe
What did you give the glider to eat/drink after the seizure?
What had the glider had to eat before the seizure?
How long before the seizure had the glider eaten?
Was the glider dehydrated prior to the seizure?
Yes
No
Unsure
Where did the seizure occur? (in cage, play room, bonding pouch, etc)
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