Cat Behaviour Questionnaire

Step 1 of 11

Background Information

Your Details

Name*

Title First Last

Address*

Street Address Address Line 2 City ZIP / Postal Code

Phone*

Who is your current veterinarian?

Current veterinarian's email

Pet Details

Pet's Name*

Pet's Age*

Pet's Date of Birth*

DD slash MM slash YYYY

Pet's Species*

Breed

Colouring

Microchip ID*

Sex*

Male

Female

Neutered*

Yes

Age when neutered*

How old was your cat when you obtained him/her?*

How long have you had your cat for?*

If your cat had a previous owner, please describe the reason(s) for rehoming

Briefly explain the reason for obtaining him/her:*

Briefly describe your ideal cat:*

Please describe in a few words, the nature of the problem causing concern. (We will ask for more details later.) If there is more than one problem, please number them in order of importance (no. 1 = most important)*

Current Medical History

Is your pet currently on any medications or supplements etc. (such as dietary supplements or herbal products)? If yes, please list name and dosage. Please indicate which medications are used for behaviour.*

Is your pet on any medication for his/her behaviour now? If yes, please list name and dosage.*

Does your pet have any of these medical conditions?

Food allergy or aversion

Allergy to medications

Skin problems

Heart problems

Hormonal problames

Nervous system problem (i.e. seizures)

Mobility issues (arthritis, patella problems, etc.)

Breathing problems

Other

Household Information

Type of home (i.e., flat, garden, etc.)*

Does your cat have access to outdoor space?*

How does your cat go outside?*

Does your cat have a scratching post?*

If so please describe the type, material, length, where it is located and whether your cat uses it.

Does your cat scratch any area / objects other than the scratching post?*

Does your cat have a cat tree or similar? If so please describe details of its location and whether your cat uses it.*

Please list the people, including yourself, currently living in the house. Please add Name, gender, age, relationship (self, husband, wife, mother-in-law, etc.), and relationship with the pet*

Please list all the animals in the house. Please include (when was the pet obtained, name, species/breed, gender, neutered or not and current age.*

Describe a typical 24 hours in the life of the pet*

Diet

Type of food*

Dry

Wet

Other

Name of the food brand*

When and how do you feed your cat?*

Where is your cat fed from?*

Food bowl

Food dispenser

Food toy / puzzle

Scatter feeding

Other

How would you describe your cat's appetite?*

Please list and rank five edible things your cat is most fond*

How does your cat drink water?*

One water bowl

Several water bowls around the house

Water fountain

Outside

Toilet

Glasses

Other

Litter Box Arrangements

How many litter boxes do you have?*

None

One

Two

Other

Please measure the width and length of the litter boxes and indicate the shape (rectangle, triangle etc.)*

Is the litter tray covered or uncovered?*

Covered

Uncovered

Both

Other

Where are the litter boxes in the home?*

What type of litter / liner do you use?*

Have you always used the same make?*

Yes

Please specify which is the current make of litter you use and list other types used in the last 2 months*

How often is the litter box cleared of excrement and topped up with fresh litter as necessary?*

How often completely cleaned out (i.e washed and all litter replaced)?*

Background and Training

Did you see the mother and littermates? If known please provide any details of early life, including litter size, early illness, rehoming and so on.*

How was your cat housetrained? Please include details of the age at which you started training, and how long it took

How did you treat mishaps at this time?*

How do you correct your cat when she / he misbehaves?*

How do you reward your cat when she / he has done well?*

Please list any trick your cat does*

What do you think your cat's intelligence is?

Good

Average

Below Average

Please draw a map (similar to Lilchin's drawing example) or your house and indicate where are you cat's food areas, water areas, sleeping areas, litter trays, and problem occurs.

Accepted file types: pdf, jpg, jpeg, png, heic, webp, Max. file size: 128 MB.

Please upload a picture or similar.

Your cat's personality and behaviour

How would you describe your cat's personality?*

Does your cat have any known fears of things she/he dislikes?*

List any interactive games / activities you enjoy with your cat.*

Please list and rank below five toys / games / items your cat is most fond of (rank first favourite)*

Please list and rank five toys, items, activities your cat is most fond of.*

How does your cat respond to the following situations? Handling (picking up, checking ears etc)*

Tolerated

Enjoys

Resist

Not possible

I don't know

How does your cat respond to the following situations? Nail Clip*

Tolerated

Enjoys

Resist

Not possible

I don't know

How does your cat respond to the following situations? Grooming*

Tolerated

Enjoys

Resist

Not possible

I don't know

If you cat resists or does not allow any of the above, please describe some details below:

Do you consider that your cat grooms himself/herself a lot? If so, please indicate where and if this at ay particular time*

Aggression

Does your cat show any aggression toward people (growling, hissing, snarling, or biting) in the following situations?

When handling / grooming*

Yes - to adult female

Yes - to adult male

Yes - to children

Yes - to everyone

N/A

If disturbed when resting*

Yes - to adult female

Yes - to adult male

Yes - to children

Yes - to everyone

N/A

If discipline*

Yes - to adult female

Yes - to adult male

Yes - to children

Yes - to everyone

N/A

When petting or hugging*

Yes - to adult female

Yes - to adult male

Yes - to children

Yes - to everyone

N/A

Other (giving pills etc)*

Yes - to adult female

Yes - to adult male

Yes - to children

Yes - to everyone

N/A

Does your cat treat all members of the household in the same way? PLease give details of any differences*

Has your cat ever shown aggressive behaviour (growling, snarling, snapping, or biting) to any member of the household? If so, please give details*

Reactivity

Please choose from the following descriptive words, which one best describes best your cat's reaction to each of the following situations: (for example, familiar cat at home: friendly).

Familiar cat at home*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

Familiar cat outside the home*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

New cat at home*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

New cat outside the home*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

Dogs*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

Strangers outside the home*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

Strangers arriving at the door*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

Thunderstorm / Fireworks*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

Other noises*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

New places*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

Children*

Calm

Excited / Hyperactive

Timid / Fearful

Unsure

Friendly

Hissing / Scratching

N/A

If your cat is fearful or reactive to any of the above situations, please give as much detail about the body language (ears back, cowering, tail tucked, trembling, retreating, hiding, hissing, etc.) as you can remember:*

Do you have more than one cat?*

Multi-Cat Household

Please describe how/where cats are fed (i.e., separate bowls, in different rooms, one communcal bowl,etc.)*

How many water bowls do you have and where are they located?*

How many beds or sleeping areas are there in your house? Please describe them and tehir locations*

Please give details of which cats, if any, will share sleeping area with each other:*

How would you describe the relationship between the individual cats in your home? Please give details of which cats, if any, will groom each other, or which cats avoid each other*

Do your cats play together? Who initiates play, or who chases who when playing?*

Do you any of your cats hiss at each other?*

The current problem

What is, to you, the most important problem to overcome?*

When did the problem begin?*

How long has the problem been present?*

How old was the pet when the problem began?*

Where does the problem occur and with whom?*

How frequently does the problem occur? (Times per day, per week, per month or per year)*

List any techniques to reduce the problem that have had some success.*

List any techniques that have not worked or made the problem worse.*

Please describe THREE INCIDENTS: the first incidence of the behaviour that you can recall, the most recent and one other which you remember (i.e. 3 incidents in total).*

Is the problem getting better?*

Better

Worse

No change

Do you suspect any triggering cause?*

Other details of the main complaint:*

Does your cat have any other behavioural problems?*

What are the feelings of each family member about your pet’s present behaviour?*

In an ideal world what would you hope to achieve with London Vet Clinic helping your cat and your family?*

What are the essential changes you need to improve your cat’s and your family’s relationship?*

Are there any circumstances where you would you consider euthanasia (putting your pet to sleep)?*

Please provide any other information you think may be relevant to the situation:

Elimination Problems

Does your cat urinate or defecates in the house?*

Yes

Does your cat urinate outdoors? If so, how often?*

Does your cat defecate outdoors? If so, how often?*

Does your cat use the litter box?*

Only for urination

Only for defecation

For both

Other

Where does your cat orefer to eliminate (i.e., tray, carpet, outdoors,etc.)?*

How often would you say your cat passes urine and stools?*

If you have more than one cat, do they tend to use different litter boxes?*

Have you tried litter with deodorant? Please describe your cat's reaction*

Have you tried different depths of litter? Please describe your cat's raeaction*

Have you tried other types of litter boxes? Please describe the box and your cat's reaction*

Please specify the following information for the soiling incidents: Location of soil, surface type (carpet, floow, btile), urine/stool/both, when and how often does it happen*

Have there been any changes at home (new cat in the neighbourhood, new furniture, new pet, etc.)?*

What colour and consistency are your cat's stools?*

How often does your cat urinate and what colour is it?*

Does your cat strain to eliminate?*

For cases involving aggressive behaviour

We need as much details as possible to understand what is causing teh aggressive behaviour and be able to manage it effectively.

Are you concerned about your cat displaying aggressive behaviour (Growling, hissing, lunging, nipping, biting)?*

Yes

Describe the most recent incident and the setting in which it occurred.*

Describe the most recent incident and the setting in which it occurred. (Try to be as precise as possible, imagine you are drawing a picture: Where was your cat? Where was everyone in relation to your cat? What was everyone doing before the incident? What did your cat do exactly and what did (s)he look like just before and after the event?)

Are you aware of a trigger for the behaviour or for similar behaviour in the past?*

Were you aware of any warning signs before the incident?*

What was your immediate reaction?*

What was the reaction of the victim?*

How did your cat respond to this reaction?*

If there was a bite wound, where was it located on the body and what kind of a wound was it (puncture wound, tear, blue spot, etc)?*

Thank you for taking the time to complete this form.*

Yes

Your form will be passed to the behavioural team and we will be in contact to book an appointment with you shortly. The information provided can be used for research and education purposes keeping strict anonymity. Your form will be treated as confidential.

An Update on Our Behaviour Service

Welcome to Our Cat Behaviour Booking Page

Cat Behaviour Service

Background Information

Your Details

Pet Details

Current Medical History

Household Information

Diet

Litter Box Arrangements

Background and Training

Your cat's personality and behaviour

Aggression

Reactivity

Multi-Cat Household

The current problem

Elimination Problems

For cases involving aggressive behaviour

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