Health surveys - background info, types and getting ready

Cocker Spaniel sitting outside
Without a health survey, you are left with only anecdotal evidence regarding the health of your breed and no way of knowing how things are changing.

This toolkit has been written primarily for breed health coordinators, but is expected to be widely shared with, and used by, health and welfare sub-committees, as well as breed clubs and councils.

The content of the toolkit has been developed to help you get started. It is meant to be practical and realistic. It is not prescriptive and you will need to develop an appropriate approach to running health surveys that works in your breed and meets your breed’s needs.

These toolkit has been developed by breed health co-ordinators, for breed health co-ordinators. We hope you find it useful.

Why do a health survey?

The challenge facing all breed health co-ordinators and their clubs/councils is to bring about a continuous improvement in breed health. Knowing how to achieve this can be difficult. Health problems will vary from breed to breed and to make progress it is essential to define where your breed is now.

Can you answer the following questions?
  • What are the main health concerns in your breed?
  • Can you rank them in order of incidence or priority?
  • What proportion of the breed is affected by each problem?
  • Are these problems getting better or worse since The Kennel Club's 2004 and 2014 health surveys?
If you do not have the answers to these questions, or can only make anecdotal responses, then the best way to move forward in your breed’s health improvement is to undertake a breed health survey.
How can a breed health survey help?
A breed health survey will help:
  • to gauge the health of your breed
  • to resolve anecdotal evidence of specific conditions
  • to pinpoint problems and to monitor progress with improvement
  • to create a baseline of health in the breed so as to be able to repeat the same survey and compare at a later date
  • to give evidence-based guidance and recommendations for health tests to members so as to improve the health of the breed
Breed health surveys do not need to be complicated and this guide will explain the different types and ways of undertaking a survey and analysing the results. Breed health is not static, so a breed health survey needs to be repeated, or revised, as required.

Tip: It’s a good idea to start with a basic survey to get a quick idea of any health problems in your breed.

Deciding on the scope of your study

Once you have decided to do a survey, the potential value of its results will depend on its objectives and the areas in which you gather data. In the next health surveys toolkit - creating a survey, we describe the survey process from start to finish. Setting your objectives is the first step.
Your survey could cover any, or all, of these areas
  • Health - specific diseases that may occur in your breed
  • Mortality - age and cause of death
  • Breeding - dogs that have been bred from, any breeding issues, how many puppies were reared, or if a dog has been neutered
  • Feeding - the type of diet fed and how often it is fed
  • Exercise - how much and what type of exercise a dog gets
  • Housing - where a dog is kept - in the house, or in kennels, on its own or with other dogs
  • Inoculations - whether a dog is regularly inoculated by a vet
  • Alternative therapies - any use of alternative or “natural” treatments
  • Temperament - how easy a dog is to live with and if it has the right temperament to do what it was bred to do
  • Activities - if a dog is involved in showing, working, obedience, agility or any other canine activities
  • Health testing - any screening tests a dog has had and the results
A breed health survey could therefore gather answers to a wide range of questions. It's important to be clear about why you need to do a survey in the first place.

What type of surveys are there?

Surveys are a good way to collect facts and perception data from people (breeders, exhibitors, pet owners etc.), particularly if there are large numbers of people whose views it would be useful to know. Participants may be put off by long lists of questions and, often, a short survey with carefully
considered questions will get high response rates and provide good quality data.

There is no single “right way” to conduct a health survey and therefore it can be rather daunting to a breed health co-ordinator when deciding how to get started.

There are four fundamental choices you will have to make about the type of survey you wish to carry out:
  1. Will it be paper-based, or an online survey (or a combination of the two)?
  2. Will you have one survey form per dog, or one survey per owner (who fills in data for multiple dogs on the same form)?
  3. Will you collect data only on dogs with health problems, or on all dogs: with or without health problems?
  4. Will the survey responses be anonymous, or will you ask for names of owners and dogs?
Paper or online?
In order to carry out a survey, you will need to decide whether your questionnaire will be available to be completed online, or as a paper-based survey, or a combination of both.

Online surveys

Online survey tools have the advantage of being easier to analyse the data, as the information is entered by the respondent. You may have to check the quality of the data first though. Online surveys also potentially mean that people without internet access cannot take part. However, it is possible to conduct online surveys at zero cost to your breed club. 

Tip: Don’t have your survey for download as an Adobe pdf file unless you’re able to save it in an editable form; otherwise, most people won’t be able to complete it electronically.

Paper-based surveys

Paper-based surveys can be sent directly to a large number of people, but there are print and postage costs to be considered. The response data also then have to be keyed into some form of software to permit analysis to be carried out.

If you don’t want to set up an online survey, you can still make your survey available online as a Word document for people to download. Alternatively, you could e-mail the survey out to potential respondents. They can then make their own choice about whether to print it out and post the response back, or to send it back electronically.

Tip: Using a combination of paper and online surveys will probably increase the chances of getting a good response to your first survey.
One form per dog or one per owner?
The Kennel Club’s 2004 health survey allowed each owner to provide information on up to 10 dogs which, for a paper-based survey, reduced the number of copies that had to be sent out. Surveys “per owner” can also be quicker and less repetitive for respondents to complete. Each dog has to be identified with a code number and health issues are then recorded against that code.

Surveys “per dog” are easier to design because you do not have to allow space in each question to identify different dogs. e.g. in The Kennel Club's 2004 survey, each question allocated space for up to six dogs.

Forms “per dog” can be easier on the eye for the respondent, because there aren’t so many boxes for them to fill in.

Tip: If you’ve not carried out a survey before, a “per dog” questionnaire will probably be the best way to start.

Tip: If you are using an online survey tools, you may find it easier to design a survey that is on a “per dog” basis.
Dogs with health problems or all dogs?
One decision you will need to make is whether you would like responses from owners of dogs that have suffered some form of ill health, or if you also would like owners to report on their healthy dogs.

Collecting responses on healthy dogs, as well as those that have suffered health problems, will enable you to draw some conclusions about the prevalence of each condition. e.g. it is more useful to know that 15 dogs had been affected by hip dysplasia and 85 had not been affected (15% prevalence), than simply having 15 reports of the condition.

Tip: If you can encourage owners to submit reports on all their dogs, whether or not they have any particular health condition, you will be able to get much more useful data.
Anonymous or named?
If you have not carried out a health survey before, there may be worries among breeders and owners about what will happen to the information they provide. Some people may be reluctant to provide the registered names of dogs that have health problems, or may not be happy to give their own name when returning a survey.

Once you can guarantee anonymity then it may be appropriate to ask for the respondent’s name, or e-mail address, particularly if you will be targeting people for any follow-up investigations.

If you wish to perform analysis of pedigrees, you will need the names and/or Kennel Club numbers of the registered dogs collected in your survey.

Once you have built up trust about how surveys are used in your breed community, you can move towards future surveys asking for more specific information to identify individual dogs.

Tip: For your first survey, make it optional whether people give their name and the names of their dogs.

Three levels of survey

For the purposes of this toolkit, three different levels of survey have been identified that you could carry out: basic, intermediate and advanced.
Diagram on surveys
Basic survey
A basic survey is likely to gather information in a way that is easy for the respondent to complete; e.g. by allowing for free-form answers and yes-no questions. Typically, it will be laid out with lots of “white space” on the page so that it does not look intimidating to the person completing it.

Tip: If you are running a breed seminar, consider handing out a basic survey to gather some quick, basic, or general information from your audience.

Analysis of your basic survey will enable you to progress to outcomes and actions which will need to be confirmed by a level 2 intermediate survey or possibly a level 3 advanced survey.

Ultimately, you will want to have a rolling survey, either repeated annually, or available online continuously. Intermediate and advanced level surveys should change from “owner” to “dog” orientated so you can build more specific information.
Intermediate survey
If you have already carried out a basic survey and have a database of information on some of your breed health issues, you may wish to start with an intermediate survey or even progress straight to an advanced survey.

An intermediate level survey will ask for more detailed information about individual health conditions, e.g. age of diagnosis, age of death, treatment given. It is likely to cover more of the subject areas previously discussed.

Tip: Where possible, data on healthy dogs should also be gathered in order to allow you to determine how common specific health conditions are.

With an intermediate level survey, you may need a more structured approach to categorise health conditions and diseases.

Tip: It will help your survey respondents if you write a glossary of health conditions that they can refer to for clarification on what the various conditions are, particularly where some have colloquial or alternative names (e.g. gastric torsion = bloat).
Intermediate survey - possible categories
  • Aural (ears) - deafness, otitis, ear mites
  • Cancers/tumours - bone, lung, mammary, ovarian, skin, stomach, testicular
  • Cardiac (heart) - dilated cardiomyopathy, heart murmur, mitral valve disease
  • Cerebral vascular - stroke
  • Dental (teeth) - dental disease, retained puppy teeth
  • Dermatological (skin) - alopecia, dermatitis, demodex, inter-digital cysts, pyoderma
  • Endocrine (hormone system) - Addison’s, Cushing’s, diabetes, hyperthyroidism
  • Gastrointestinal (digestive system) - colitis, gastric torsion (bloat), irritable bowel disease
  • Haematology (blood) - platelet abnormalities, Von Willebrand’s disease
  • Hepatic (liver) - chronic liver disease, hepatitis, pancreatitis
  • Immune system atopy, auto-immune disease
  • Musculoskeletal (bones, muscles, joints) - arthritis, elbow dysplasia, hip dysplasia, patella luxation
  • Neurological - epilepsy, intervertebral disc disease, Wobbler’s syndrome
  • Ocular (eyes) - blocked tear ducts, cataracts, distichiasis, glaucoma, PRA
  • Reproductive – female difficulty whelping, false pregnancy, failure to conceive
  • Reproductive – male cryptorchidism, infertility
  • Respiratory - bronchitis, kennel cough, pneumonia
  • Urological - cystitis, cystouroliths, incontinence, urinary tract disorder
Tip: It’s worth taking time to decide on the most appropriate way to categorise your health data, as it will affect the design of your survey and the structure of the questions.
Advanced survey
Advanced level surveys are typically used for major breed health research, e.g. when collecting information about the breed worldwide, or specific epidemiological studies where the data must be robust and statistically valid. The survey will need to be designed so that the results can be analysed using dedicated survey software and therefore the form will largely be made up of “tick-box” type questions for ease of data processing.

An advanced survey will enable you to gather large quantities of data to give detailed insight into the breed’s health and welfare. This inevitably means the data processing job is large and the analysis task can be very time consuming and may require a statistician.

In some breeds, especially at intermediate and advanced levels, you may find your returns improve dramatically if you have an independent analyst. This could prove to be particularly beneficial if you are looking to create a world health survey of your breed, where respondents will definitely react better to a respected independent analyst.

Tip: If you think your breed needs to carry out an advanced survey, discuss your plans with The Kennel Club’s health team at an early stage. They will be able to offer advice on the specialists who can help you.

Organising to carry out a survey

This section of the toolkit is intended to give you some simple ideas on ways to organise carrying out a survey. It will outline what jobs/roles are needed.

It will also look at:
  • what skills are needed
  • where you might find these skills
Jobs/roles
Carrying out a survey requires the undertaking of several different jobs, so it would be useful to have a small team involved. Most breeds will have sufficient members on their club/council committees to manage the administration and research needed to deliver a good survey to its members and pet owners. However, some jobs may need specific skills, such as IT, and this may necessitate identifying people from outside your committees, but who may be members of clubs, and can help with managing and reporting data.

Designing the survey form

  • Compile the questions
  • Create an easy-to-follow, sequential format

Create an introductory letter

  • Print sufficient letters to accompany a mail-out

Distribution

  • Decide where/how the forms will be accessed (mail-out/download)
  • Decide how many to be printed and arrange printing/mailing/distribution

Data capture

  • Dealing with returns, spreadsheets or online software ready to capture data input; set up in line with the survey form design

Analysis and reporting

  • Analysing the returns and creating clear, meaningful reports to publish
Skils
There are three main skill sets required:
  • Leadership/project management
  • Communication
  • IT skills and knowledge
As well as specific technical skills related to survey design and analysis, effective communication, co-ordination and leadership skills are needed throughout.
Leadership/project management
It is essential to have someone who has the energy, drive, and leadership skills to head up organising any survey(s) you decide to undertake. Excellent organisational skills, ability to provide a timetable of events and organise resources, both material and human, are essential to ensure a well managed team effort. Effective meeting skills are important and presentation skills are desirable, as you will see below, for effective communication.
Communication
Having an individual on the team whose “people” and communication skills are well honed will be a great asset for both face-to-face and written communication. Designing the questionnaire itself is an exercise in effective communication. Compiling the questions, for instance, will need effective questioning techniques, which are important in gaining the information you want and how much detail is needed. A mixture of open and closed questions is needed to be effective in this respect.

Tip: Closed questions are useful for when you require a yes/no or short, confirmation answer.

e.g. Do you own a stud dog? Do your dogs have annual vaccinations?

To gain short answers, use questions starting with the words 'do you?', 'have you?', 'did you?', 'will you?'

Tip: Open questions will generally gain a fuller response, but can be more difficult to analyse.

e.g. What illnesses have your dogs experienced? What treatments have you used with your dogs?

Communication skills to share and distribute results, whether written or by personal presentation, must also be considered. Those who take part in the survey will wish to see/hear the results and will expect them to be user friendly.
IT skills and knowledge
You will probably appreciate that compiling some surveys will require specific IT skills and knowledge, and you will have to find out if there is someone in your breed club committees or within your membership who may possess these skills.

If you are able to find someone with the correct skills, another consideration is whether they will have the time available to dedicate to setting up an electronic survey on your website. You may have to budget for an external expert in this field to help you set up the IT system and train a suitable person to input and maintain the database and provide survey reports.

Knowledge of the computer software available that can be used on your website to create the survey itself, record the returns and analyse the results is essential.

In summary

There is a lot to consider in organising a survey and it is hoped that the points above will assist you in finding the right people with the right skills to help make your survey a success.

Acknowledgements

We wish to thank the following people for their help in developing this toolkit.

Main author

Ian Seath

The project team

Judith Ashworth, Sheila Atter, Archie Bryden, Brian Hill, Dorothy McIntyre, Shula Shipton and Marion Wilks