Feline House Soiling Questionnaire Feline House Soiling Questionnaire HOUSE-SOILING: Cat Owner 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 check every box that applies and enter additional information where needed. Your Information Name * Name First First Last Last Date * Phone * Email * Spouse, partner, or roommate: Spouse, partner, or roommate: First First Last Last Children & Ages (if applicable): Your Cat's Information Cat's Name * Breed Age Cat's Sex * Male Female How does your cat interact with family members (check all that apply) Friendly Aggressive Nervous Avoid Contact Who is your cat's favorite person? How does your cat interact with strangers (check all that apply)? Friendly Aggressive Nervous Avoid Contact Name and age of other cats. Please label the order they arrived into the house: Other pets (species, breeds and ages) 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 (eg: hissing, growling swiping) Running away Please describe Does your cat go outside? * Yes No If yes, check all that apply * Goes outside supervised Occasionally sneaks out Goes outside unsupervised Has pen or outside enclosure Do you have a cat door or flap to the outdoors? * Yes No Type Can your cat see other animals from inside your home? * Yes No If yes, describe (cats, birds at feeder, etc) What type of food do you feed your cat? * Canned food Dry food Describe food * Have you changed the food recently? * Yes No How many litter boxes are in your home? * Type * Open Hooded or covered Automatic Liners used Deodorizers used Average size in cm or inches * Who scoops the litter box? * How often? * Twice daily Daily Weekly OtherOther Type of litter used * Fine grain (clumping) Non-clumping clay Coarse granules Wood or paper-based pellets Scented Silica granules or beads Corn- or wheat-based Garden soil OtherOther How often do you wash the litter box and what cleaning products do you use? * 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 If your cat defecates when house-soiling, how would you describe the stools? Normal Small and hard Soft and watery Blood/mucus Formed in part, then softer OtherOther How long has the house-soiling been occurring (years/weeks/months)? Do you remember the first incident? * Yes No If yes, please describe What kind of surface is targeted? * Carpet Wood Vinyl Bedding/clothing Bath/shower/sink/basin A particular family memberA particular family member OtherOther Is the cat targeting vertical surfaces with urine? * Yes No If yes, what volume is being passed? How often is the house-soiling occurring? * Once daily Multiple times daily Weekly OtherOther How has the frequency changed since the problem started? * Increased Decreased Remained the same Don't know 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/pet Other (including work/school schedule changes, please provide details) * Please detail what you have been doing to clean the soiled areas * 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 No If yes, please describe punishment Is your cat easy to medicate? * Yes No What are your preferred formulations for any medications? * Pills Medication in food Oral liquids Transdermal gel (where available) Basic house floor plan: Draw a basic house floor plan on a separate sheet and upload below 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. a = Litter box locations b = House-soiling locations c = Windows and doors d = Scratching post locations e = Food and water bowl locations f = 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). File Upload Drop a file here or click to upload Choose File Maximum file size: 52.43MB This questionnaire accompanies the ‘AAFP and ISFM Guidelines for Diagnosing and Solving House-Soiling Behaviour in Cats’, published in the Journal of Feline Medicine and Surgery, July 2014, Volume 16, pp 579–598. Captcha Submit If you are human, leave this field blank.
