Senior Wellness Checklist – Feline Pet* Date* MM slash DD slash YYYY Name* First Last Email* Behavior/Neurologic My cat is just not acting like himself/herself. My cat is not seeking as much attention and interacts less with the family. My cat seems confused or disoriented. My cat has been vocalizing for no apparent reason. My cat's sleeping patterns have changed. My cat has had tremors or episodes of shaking. My cat has displayed circling, head tilts, or repetitive movements. Comments on BehaviorBody Functions My cat has bad breath and red or swollen gums. My cat has difficulty chewing. My cat's eating habits have changed. My cat has gained weight. My cat has lost weight. My cat is drinking more water than usual. My cat is urinating more frequently than usual. My cat's bowel habits have changed. My cat's bowel habits have increased in frequency. My cat has diarrhea. My cat is constipated. My cat is straining. My cat vomits more than occasionally. My cat seems to have trouble seeing or hearing. Comments on Body FunctionsHeart/Lungs My cat has been coughing, or seems winded after playing. My cat tires more rapidly or seems short of breath. Comments on Heart/LungsActivity/Orthopedics I have noticed a change in my cat's behavior or activity level. My cat has difficulty climbing stairs and jumping. My cat limps, especially after exercise. My cat shows signs of pain. Comments on ActivitySkin and Coat My cat scratches, licks, and chews excessively. My cat has changes in hair coat, skin, or new lumps or bumps. My cat's skin has an odor. Comments on Skin and CoatWhat foods and treats are you currently feeding your cat? How often? What medications and/or supplements are you currently giving your cat? How often? Medication/Supplements Labels Photo UploadPlease upload a photo of the labels or the bottle of medication and any supplements that you are currently giving your cat. Please group products together in one or two photos. Maximum file upload is 10MB. Drop files here or Select files Accepted file types: jpg, jpeg, png, Max. file size: 10 MB, Max. files: 5. Do you have any specific questions or concerns about your cat? Δ
