Pet Health Assessment - Cats
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Be prepared! Complete the questionnaire below and share with your veterinarian at your next visit.

Pet Health Assessment - Cats

Cat's Name
Gender  Age: Years Months  Weight lb
1. Has your cat’s weight changed unexpectedly recently?
My cat has lost interest in food and is losing weight
My cat is being fed the same amount but is losing weight
My cat is eating the same amount but is gaining weight
My cat is eating more and gaining weight
My cat’s weight has not changed recently
2. Have you noticed any recent changes in your cat’s water consumption?
My cat seems to be thirstier and drinks more water
My cat appears to drink less water than before
My cat drinks about the same amount of water as always
3. Have you noticed any of the following characteristics in your cat’s stool?
Nothing unusual
Fresh blood and/or mucus
Black, tarry color
Rice-like white specks on stool that sometimes move
4. Have you noticed any changes in your cat’s urination habits?
Nothing unusual
My cat urinates more frequently than before
My cat seems to strain to urinate
My cat’s urine is dark
My cat urinates in inappropriate places
5. How would you describe the inside of your cat’s ears?
Normal (no discharge, skin smooth, mild pleasant odor)
Waxy (brown discharge from the ear)
Skin rough and dry in the ear
Skin moist and red with an unpleasant odor in the ear
6. Does your cat seem to be scratching excessively in any of the following areas?
Around the ears
All over the body
Around the anal area
My cat scratches only occasionally
7. How would you describe your cat’s skin?
Smooth, flesh-colored
Areas of red marks, bumps, or scales
8. Is excessive grooming and/or hair loss a problem in your cat?
Yes
No
9. Does your cat have any of the following breathing problems? (check all that apply)
A hacking "cough"
Wheezing
Cat snores loudly
Panting
None of the above
10. How often do you take your cat to the veterinary clinic (not including emergencies)?
Twice a year
Annually
Every few years
Rarely or never
11. Is your cat on heartworm prevention?
Yes
No
12. When was the last time you took a stool sample to your veterinary clinic for examination?
Within the past year
More than a year ago
13. Has your cat received a dewormer in the last year?
Yes
No
14. Is your cat on a flea control treatment?
Yes
No