Questionnaire

1. Does one or more of your cats have any of the following conditions (please tick all that apply)

Kidney problems e.g. chronic renal failure, polycystic kidney disease

Blindness or eye problems that currently or in the future may affect the cat’s ability to see eg high blood pressure, glaucoma

Lower urinary tract problems eg cystitis, bladder stones

Hyperthyroidism (overactive thyroid gland)

Diabetes mellitus (also referred to as ‘sugar diabetes’)

2. How many cats share your home? Please select... 1 2 3 4 5 or more

(This questionnaire has been designed to collect information about up to 5 cats sharing a household. Once you have submitted this questionnaire, you will see a link on the confirmation page which will open a new survey. You can use this link to register additional cats in your household. Please note only Section 2 needs to be completed when using additional questionnaires.)

Please tell us more about your cat(s):

Cat's Name

Date or year of your cat's birth, if known

What breed is the cat? Please select... domestic shorthair (Moggy) domestic longhair (longhaired Moggy) Abyssinian Birman British Shorthair Burmese Maine Coon Oriental Persian Siamese Tonkinese Other (please state)

What sex is the cat? Please select... male entire (Tom - not castrated) male neutered (castrated) female entire (Queen – not spayed) female neutered (spayed)

Brief medical history: please list the medical conditions your cat has suffered from in the past or is suffering from now e.g. renal failure, cat bite abscess, tooth problems, broken leg (please keep this very brief!)

If your cat is registered with a veterinary practice, please enter the practice name (and if possible address and telephone number) below (please don't use commas, just enter in the format Vet Name Vet Practice Address1 Address2 City Post/Zip Code):

Add another cat

CAT 2

Cat's Name

Do you know their date of birth? (dd/mm/yy)

What breed is the cat? Please select... domestic shorthair (Moggy) domestic longhair (longhaired Moggy) Abyssinian Birman British Shorthair Burmese Maine Coon Oriental Persian Siamese Tonkinese Other (please state)

What sex is the cat? Please select... male entire (Tom - not castrated) male neutered (castrated) female entire (Queen – not spayed) female neutered (spayed)

Brief medical history: please list the medical conditions your cat has suffered from in the past or is suffering from now e.g. renal failure, cat bite abscess, tooth problems, broken leg (please keep this very brief!)

If your cat is registered with a veterinary practice, please enter the practice name (and if possible address and telephone number) below (please don't use commas, just enter in the format Vet Name Vet Practice Address1 Address2 City Post/Zip Code):

Add another cat

CAT 3

Cat's Name

Do you know their date of birth? (dd/mm/yy)

What breed is the cat? Please select... domestic shorthair (Moggy) domestic longhair (longhaired Moggy) Abyssinian Birman British Shorthair Burmese Maine Coon Oriental Persian Siamese Tonkinese Other (please state)

What sex is the cat? Please select... male entire (Tom - not castrated) male neutered (castrated) female entire (Queen – not spayed) female neutered (spayed)

Brief medical history: please list the medical conditions your cat has suffered from in the past or is suffering from now e.g. renal failure, cat bite abscess, tooth problems, broken leg (please keep this very brief!)

If your cat is registered with a veterinary practice, please enter the practice name (and if possible address and telephone number) below (please don't use commas, just enter in the format Vet Name Vet Practice Address1 Address2 City Post/Zip Code):

Add another cat

CAT 4

Cat's Name

Do you know their date of birth? (dd/mm/yy)

What breed is the cat? Please select... domestic shorthair (Moggy) domestic longhair (longhaired Moggy) Abyssinian Birman British Shorthair Burmese Maine Coon Oriental Persian Siamese Tonkinese Other (please state)

What sex is the cat? Please select... male entire (Tom - not castrated) male neutered (castrated) female entire (Queen – not spayed) female neutered (spayed)

Brief medical history: please list the medical conditions your cat has suffered from in the past or is suffering from now e.g. renal failure, cat bite abscess, tooth problems, broken leg (please keep this very brief!)

If your cat is registered with a veterinary practice, please enter the practice name (and if possible address and telephone number) below (please don't use commas, just enter in the format Vet Name Vet Practice Address1 Address2 City Post/Zip Code):

Add another cat

CAT 5

Cat's Name

Do you know their date of birth? (dd/mm/yy)

What breed is the cat? Please select... domestic shorthair (Moggy) domestic longhair (longhaired Moggy) Abyssinian Birman British Shorthair Burmese Maine Coon Oriental Persian Siamese Tonkinese Other (please state)

What sex is the cat? Please select... male entire (Tom - not castrated) male neutered (castrated) female entire (Queen – not spayed) female neutered (spayed)

Brief medical history: please list the medical conditions your cat has suffered from in the past or is suffering from now e.g. renal failure, cat bite abscess, tooth problems, broken leg (please keep this very brief!)

If your cat is registered with a veterinary practice, please enter the practice name (and if possible address and telephone number) below (please don't use commas, just enter in the format Vet Name Vet Practice Address1 Address2 City Post/Zip Code):

3. Do you have other pets?

No – we only have cats/a cat
Yes - Please list the numbers of other pets in the home, e.g. 2 dogs, 1 guinea pig

4. Do your cats live: Please select... indoors only indoors with access to a fenced enclosure outside indoors with supervised access to the outside indoors with unrestricted access outdoors only during the daytime indoors with unrestricted access outdoors outdoors only

Other (please state)

5. How many litter boxes are there currently in your home? Please select... 0 1 2 3 4 5 6 7 8 9 10 or more

6. What sort of food does your cat eat? Please select... Dry catfood only Tins, pouches or foil trays of catfood, (wet catfood only) Mixture of dry and wet

Other (please state)

7. Please enter the brand/s of foods that your cat is currently eating e.g. Whiskas, Felix, Hill’s (separate each brand with a comma, i.e. Whiskas, Felix, Gourmet Gold, etc):

8. What does your cat normally drink? Please tick all that apply.

Tap water
Mineral water
Cow's milk
Lactose-free or 'cat milk'
Flavoured water - home-made (eg liquidising a prawn in some water, springwater drained from a can of tuna) or using commercial products
Water from a water fountain
Water from a shower tray, bath or similar
Rainwater collected in puddles, pots or other receptacles

9. How many water bowls are there currently in your home? Please select... 0 1 2 3 4 5 6 7 8 9 10 or more

10. If you have only one water bowl in your household, where is it?

Please select... Double feeder used – water on one side, food on the other side Separate water bowl placed next to the food bowl Separate water bowl placed more than 2 feet (60 cm) from the food bowl

11. Are your cats vaccinated (immunised) against the common cat viral infections (cat flu and enteritis)?

I’m not sure
No, my cats have never received any vaccines
My cats receive vaccines as a kitten but not after this time
My cats are vaccinated when a kitten and then once a year after this, for the rest of their lives
My cats are vaccinated as a kitten, when one year old and then every 3 years for the rest of their lives
My cats have received vaccines in the past but are not up to date on their immunisations

Other (please state)

12. Has your cat/s ever been treated for worms?

Yes
No

What sort of products have you used? Please check all that apply.

Products bought at my veterinarians
Products recommended by my vet but bought at a supermarket or petstore
Supermarket recommended products
Petstore (including online) recommended products

Other (please state)

14. Has your cat/s ever been treated for fleas?

Yes
No

What sort of products have you used? Please tick all that apply.

Products bought at my veterinarians
Products recommended by my vet but bought at a supermarket or petstore
Supermarket recommended products
Petstore (including online) recommended products

Other (please state)

16. Are you aware that some dog flea products are poisonous to cats?

Yes
No

For more information on this topic click here