Cat Urination Problems | Inappropriate Urination

Inappropriate elimination : Client Questionnaire

Thank you for filling out this questionnaire. Your answers give us the information we need to help you with house-soiling problems occurring in your household.

Please complete all fields marked with an * even if you don’t know the answer.

1Section 1

Your name*

Date*

Your email*

Spouse, partner or roommate*

Children and ages*

2Section 2

Cat's name, age, sex and breed*

3Section 3

How does your cat interact with family members?*

Friendly

Aggressive

Nervous

Avoids contact

Who is your cat's favorite person*

4Section 4

How does your cat interact with strangers?*

Friendly

Aggressive

Nervous

Avoids contact

5Section 5

Name and age of other cats. Please label the order they arrived into the house*

6Section 6

Other pets (species, breeds and ages)*

7Section 7

If you have other cats or pets in the household, have you recently seen your cat responding to them in any of the following ways?

Playing together

Sleeping together

Mutual grooming

Being aggressive (e.g. hissing, growling or swiping

Running away

Please describe

8Section 8

How do you think your pets get along?

9Section 9

Does your cat go outside?*

Yes

Occasionally sneaks out

Goes outside supervised

Goes outside unsupervised

Has pen or outside enclosure

10Section 10

Do you have a cat door or flap to the outdoors?*

Yes

Cat flap type

11Section 11

Can your cat see other animals from inside your home?*

Yes

If yes, describe (i.e. cats, birds at feeder, etc.)

12Section 12

What type of food do you feed your cat?*

Canned Food

Dry Food

Have you changed the food recently?*

13Section 13

How many litter boxes are in your home?*

What type of litter do you use?*

Open

Hooded or covered

Automatic

Liners Used

Deodorisers Used

Average size in cm or inches*

14Section 14

Who scoops the litter box*

How often?*

Twice daily

Daily

Weekly

If not, Twice daily, Daily or Weekly

15Section 15

Type of litter used*

Fine grain (clumping)

Non-clumping clay

Coarse granules

Wood or paper-based pellets

Scented

Silica granules or beads

Other Litter Types

16Section 16

How often do you wash the litter box and what cleaning products do you use?*

17Section 17

If your cat urinates when house-soiling, how would you describe the urine?*

Normal

Large volume

Small volume

Strong odor

Sticky consistency

Bloody

Passed more/less frequently than usual

18Section 18

If your cat defaecates when house-soiling, how would you describe the stools?*

Normal

Small and hard

Soft and watery

Blood / mucous

Formed in part, then softer

If none of the above how would you describe them

19Section 19

How long has the house-soiling been occurring?*

Years

Months

Weeks

20Section 20

Do you remember the first incident?*

Yes

If yes, please describe

21Section 21

What kind of surface is targeted?*

Carpet

Wood

Vinyl

Tile

Bedding / clothing

Bath / shower / sink / basin

A particular family member

Other target

22Section 22

Is the cat targeting vertical surfaces with urine?*

Yes

If yes, what volume is being passed?

23Section 23

How often is the house-soiling soiling occurring?*

Once daily

Multiple times daily

Weekly

Other

24Section 24

How has the frequency changed since the problem started?*

Increased

Decreased

Remained the same

Don't know

25Section 25

Have there been any changes recently (or around when the house-soiling started)?*

Moved to new home

New baby or pet

Absence of family member or pet

Other (including work / school schedule changes, please provide details)

26Section 26

Please detail what you have been doing to clean the soiled areas*

27Section 27

Have you used any physical punishment in response to the house-soiling (eg, rubbing nose in the urine or stool, spanking, water pistol, shouting, confinement)?*

Yes

If Yes, Please describe

28Section 28

Is your cat easy to medicate?*

Yes

29Section 29

What are your preferred formulations for any medications?*

Pills

Medication in food

Oral liquids

Transdermal gel (where available)

30Section 30

Upload a basic house floor plan*

This is very important but it does not have to be to perfect scale. Mark all items listed below on the house floor plan so we can get a feeling for the environment where your cat lives.

Litter box locations
House-soiling locations
Windows and doors
Scratching post locations
Food and water bowl locations
Cat doors or flaps

Please number the house-soiling locations in chronological order in terms of when you became aware of deposits in those locations (eg, b1, b2, etc).