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House-Soiling Questionnaire
Your Name
*
Pet's Name
*
Phone Number
*
Is your cat urinating outside of the litter box?
Yes
No
What is the volume that they are urinating? (i.e. more, less or the same as their usual amount)
Is your cat defecating outside of the litter box?
Yes
No
Where does it happen (location in the house, near windows/ doors, near walls)?
How often does it happen?
**In addition to urinating or defecating outside the Litter Box, does your cat still use the Litter Box? If yes, please indicate how often they use the litter box in comparison to going outside of the litter box.
When did this issue start?
Does your cat have a previous history of not using the litter box? If yes, please provide details.
Have there been any major changes to the environment?
House (construction/renovations/moving
New additions in household (new baby or pet)
Food
Visitors
Cleaning products (laundry detergent, fabric softener, soap, etc.)
Litter box (litter or location of box)
Daily routine
If applicable, please describe details regarding environment changes:
**If there has been changes to the daily routine please indicate the changes that were made and describe your current daily routine below:
How many and what type of animals are there in the household?
Does your cat go outside?
Yes
No
Describe the litter box in terms of size, height, litter type used, how many litter boxes, location of litter boxes, covered litter box or not, is a liner used?:
How often do you scoop the litter out?
How often do you fully empty and clean the litter box?
Does your cat typically cover their urine and feces in the litter box?
Yes
No
Does your cat scratch the outside of the litter box or in the air when using the litter box?
Yes
No
Does your cat perch on the edge of the pan to urinate or defecate?
Yes
No
Have you noticed any discoloured urine? If yes, please describe.
Is your cat vocalising while urinating or defecating?
Yes
No
Have you noticed your cat straining while urinating or defecating?
Yes
No
Any other information we should know?
Δ
Appointment & Refill
About Us
Why Choose Us
Our Veterinarians
Meet Our Team
New Clients
Community Involvement
Services
Dental
Diagnostics
Surgery
Wellness Plans
Pet Health
Pet Health Library
How-To Videos
Pet Insurance
Feedback Survey
Pet Food Recalls
Online Resources
News
Blog
After Hours Consults
Contact
Health Questionnaires
Shop Online
