PetShrink

117 Lyman Rd,

Berlin, MA 01503

Phone (978) 838-0143/(508) 494 5405:Fax (978) 838-0216

dvm@petshrink.com

 

Behavioral Data Sheet - Feline

 

Instructions:Please fill out the forms giving as much relevant information as possible. While not all of this will appear to relate to your cat, completing the forms may disclose underlying problems that might otherwise be missed.

 

DATE:††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††

NAME & ADDRESS OF OWNER:

 

 

TELEPHONE:†††††††††††††††††††††††† FAX:††††††††††††††††††††††††††††††††††††††† E-MAIL:

 

NAME OF CAT:†††††††††††††††††††††††††††††††††††††††††††††††††††††††† BREED:

 

AGE OF CAT NOW:††††††††††††††††††††††††† AGE WHEN CAT WAS OBTAINED:

 

WEIGHT:††††††††††††††††††† COLOR:†††††††††††††††††††††††††††††††††

 

SEX:††††††††††††††† SPAYED/NEUTERED:

 

AGE OF SPAYING/NEUTERING:

 

REASON(S) FOR SPAYING/NEUTERING:

 

 

ANY BEHAVIORAL CHANGES AFTER SPAYING/NEUTERING:

 

 

MEDICAL PROBLEMS:

 

 

ANY CURRENT MEDICATIONS: PLEASE GIVE DOSES IF KNOWN:

 

 

 

 

 

 

 

 

BEHAVIORAL PROBLEMS:If the cat has more than one problem please include information on each problem separately.Please answer as fully as possible.

 

Problem:

 

 

 

 

 

 

 

Age of Onset:

 

Duration of each incident:

 

Frequency of occurrence:

 

Have there been any changes in the pattern, frequency, intensity and/or length of incidents from the time of onset to the present?

 

 

Can the cat be interrupted when engaged in the behavior?

 

 

What is the time interval between the behavior stopping and resuming?

 

 

Describe any methods used to treat the behavior and the catís response to those methods:

 

 

 

 

 

 

 

If there is more than one problem, please include information on further problems using the same format as above:

 

 

 

 

 

 

 

 

 

CATíS HISTORY AND HOME LIFE:

Where did you get the cat?

 

 

Do you know if the catís parents or siblings engaged in similar or other abnormal behaviors?

 

 

List people living in the house with the cat; please include the ages of any children in the household:

 

 

 

List other animals in the household, their species, breed, age, sex (neutered?).Please indicate which of these animals were in the household prior to acquisition of this cat.For those obtained afterwards, please note any relationship to this catís behavior problem(s):

 

 

 

 

Describe interactions between the cat and family members:

 

 

 

Describe interactions between the cat and other animals in the household:

 

 

 

Is the cat allowed outside?

If yes: 1. Does he/she stay on your property or roam further?

2. Describe the catís interactions with cats and other animals outside the home:

 

 

 

If the cat is allowed inside the house please give a general description of house lay out, (number of floors, including basements, include location of litter boxes if any):

 

 

 

 

When inside the house does the cat have access to the whole house?

If not describe areas where cat can go:(If easier describe areas that the cat cannot go:)

 

 

Is access limited at night?

 

Can the cat see activities outside the house?

 

Describe the activity level outside the house, in terms of wild and domestic animals and birds, people and traffic:

 

 

 

 

 

 

Describe the catís behavior in the veterinary office and during examination:

 

 

 

DAILY ROUTINE:

Please describe a typical 24-hour period in the catís life.Begin with where and when the cat is in the morning when the family wakes up:

 

 

 

 

 

 

 

 

 

DIET:

Type of food:

 

Frequency of feeding and amount fed

 

Other food, supplements, table scraps:

 

EXERCISE:

Time spent playing actively with owner.Describe activities that take place:

 

 

 

Time spent actively playing with other animals:

 

 

Does the cat initiate play?

 

Does the cat hunt?

Describe:

 

LITTER BOX USE:

Number of litter boxes:

Type of litter boxes (open, closed, large, small):

 

Type of litter used:

 

 

Does the cat always urinate in the box?

 

Does the cat always defecate in the box?

 

Does the cat cover the feces?

 

If the cat urinates outside the box, does he/she sometimes use the box?

 

If the cat urinates elsewhere is it one particular spot or several?Describe:

 

 

If the cat urinates outside the litter box, does he/she leave puddles of urine or spray against walls or other vertical surfaces, or both?

 

Do you ever see the cat straining to urinate or enter the box but not do anything?

 

If the cat defecates outside the box, does he/she sometimes use the box?

 

If the cat defecates outside the box is it always in the same location or in various parts of the house?Describe:

 

How often do you clean the litter box?

1.      1.      Scoop

2.      2.      Wash and completely change litter

 

INTERACTIVE BEHAVIOR:

 

Does your cat demand to be petted?

 

 

Does your cat ever seem irritated by or to resent petting?

 

 

Does your cat ever get aggressive during play?

 

 

Does your cat ever seem to lie in wait for and ambush you?

 

 

Does your cat vocalize excessively?

 

 

Does your cat cower or run away if people talk loudly or act boisterously?

 

 

 

Does your cat greet them, remain neutral or run away when strangers come to the house?

 

 

Describe any other odd things your cat does: