Equine Magnesium Deficiency Questionnaire "*" indicates required fields 1Section 1: General Information2Section 2: At Home3Section 3: Away from Home4Section 4: In the Crossties5Section 5: In Training Does your horse have a history of medical problems, laminitis, or colic/ulcers?* Yes No Has your horse been treated for ulcers?* Yes No Does your horse have a history of abuse or neglect?* Yes No Was your horse over-trained or over-ridden as a youngster?* Yes No Was your horse competed on extensively from ages 3 to 6?* Yes No My horse works 4 days or more per week and is getting worse with time, not better.* Yes No Has your horse been diagnosed as a headshaker, or does your horse shake their head excessively?* Yes No My horse bites, kicks, or acts aggressively:* Never Sometimes Frequently You never know, day to day My horse grinds his teeth:* Never Sometimes Frequently Always My horse is high strung or nervous:* Never Sometimes Frequently Always My horse spooks:* Never Sometimes For no reason And and cannot settle down afterwards My horse displays repetitive motion behavior: like stall walking, head bobbing, weaving, cribbing, or head shaking.* Never Sometimes Frequently Always My horse gets a supplement containing Hyaluronic acid such as Gut-X.* Never Sometimes Frequently Always My horse gets a slippery elm supplement.* Never Sometimes Frequently Always My horse gets sweet feed, more than 1 pound a day.* Never Sometimes Frequently Always My horse is grumpy or anti-social.* Never Sometimes Frequently Always My horse runs or paces the fence in the pasture.* Never Sometimes Frequently Always My horse is good at home and comes undone at shows.* Never Sometimes Frequently Always My horse refuses to go forward (balky) to go through gates.* Never Sometimes Frequently Always My horse dislikes being bathed.* Never Sometimes Frequently Always My horse dislikes being brushed with a stiff brush or a firm curry.* Never Sometimes Frequently Always My horse pins his or her ears during saddling and girthing.* Never Sometimes Frequently Always My horse trembles (commonly in knees and flanks).* Never Sometimes Frequently Always My horse dislikes chiro/body work or needs more than normal.* Never Sometimes Frequently Always My horse's skin flinches or twitches when touched.* Never Sometimes Frequently Always My horse has trouble holding his or her hind legs for the shoer.* Never Sometimes Frequently Always My horse is hard-muscled or tense, even at rest.* Never Sometimes Frequently Always My horse paws, frets, or becomes defensive when tied.* Never Sometimes Frequently Always My horse is consistently inconsistent, in attitude and in training.* Never Sometimes Frequently Always Has been described as lacking focus (ADD).* Never Sometimes Frequently Always He or she feels stiff or hollow moving.* Never Sometimes Frequently Always Over reacts to cues and aids.* Never Sometimes Frequently Always Requires a long, slow warm-up.* Never Sometimes Frequently Always My horse has difficulty with transitions, cantering, or collection.* Never Sometimes Frequently Always My horse chomps on the bit constantly.* Never Sometimes Frequently Always My horse has unexplained bucking or bolting episodes.* Never Sometimes Frequently Always My horse had an injury and was competed while in pain.* Never Somewhat Extensively Excessively Is any of this very NEW behavior for an otherwise well-trained horse?* Yes No (Optional) Your Name(Optional) Your Horse's Name Δ
