Feline Behavior Questionnaire

Your Cat's Beginning

How old was your cat when he/she was adopted? (age in weeks, months, or years depending on when adopted)

How many owners has your cat had prior to your adoption?

How long have you had your cat?

Where did you get your cat?

If other, where?

Did you get to meet either of your cat's parents?

Do you have a record of your cat's lineage or genetic profile?

Do you know if either of your cat's parents engages in similar behaviors?

If yes, what behaviors were exhibited and by whom?

Do you know if any of your cat's littermates' are engaging in the same behaviors?

If so, what behaviors were exhibited and by whom?

Your Cat's Home Life

Please list the people, including yourself, currently living in the household now:

Name

Age

Sex

Relationship

Occupation

Name

Age

Sex

Relationship

Occupation

Name

Age

Sex

Relationship

Occupation

Please list all the animals (including all pets, even non-cats)in the household.

Name

Order obtained

Type/breed

Sex

Age obtained in months/years

Age now

Any medical illnesses

Any behavior issues

Name

Order obtained

Type/breed

Sex

Age obtained in months/years

Age now

Any medical illnesses

Any behavior issues

Name

Order obtained

Type/breed

Sex

Age now

Any medical illnesses

Any behavior issues

If any of these pets have been identified as having a medical problem, please specify what the problem is:

If any of these pets have been identified as having a behavioral problem, please specify what the problem is:

Is your cat?

What brand of food do you feed your cat?

How much do you offer at each feeding?

How often do you offer food?

What type of treats do you offer? How much? How often? When do you offer treats?

Do you have catwalks or other elevated areas for play, resting and grooming?

If yes, number and location.

Does your cat regularly use the catwalk?

Do you have cat furniture such as trees, cubbies, bedding, et cetera?

Please list all scratching devices including location:

Does your cat use these devices?

Is there a preferred time for this behavior?

Do the other cats use the scratching devices?

Toiletry Habits

How many litter boxes do you have in your home?

What type(s) of litter boxes do you use?

What are the dimensions (width, depth and length)?

Where are each of the litter boxes located?

What type of litter do you use? Please list the brand name

How often do you change the litter box completely?

Are deodorants or cleaning agents used to clean the litter boxes?

How often do you scoop the litter?

How deep is the litter in each of the boxes?

Do you use liners?

Have you noted if your cat responds differently to any of the above styles of boxes or litters, or sizes of the box and depth of the litters?

What does your cat do in the litterbox?

Does your cat eliminate in the presence of other animals or people, or is the elimination behavior secretive?

Will your cat immediately use a freshly cleaned litterbox?

Has your cat ever had any variation in whether or not she/he covers an elimination (feces, urine) and is any of that variation associated with the presence or absence of any other situation or cat?

Does your cat ever vocalize while eliminating?

Will your cat spray against the back of a covered litterbox?

Does your cat ever use a shower, bathtub or tile floor for elimination?

What other areas are ever used for elimination (urine or feces)/ Please provide a complete list with locations, substrate, and frequency of use.

Does your cat exhibit periodic diarrhea or other gastrointestinal distress?

Do you have any concerns, complaints or problems with your cat urinating in inappropriately in the house?

If yes, where is your cat urinating?

How many times per week is your cat urinating in inappropriate areas?

Is there a certain time of day the inappropriate urination occurs? If so, when?

Is the pattern different on days when you are home compared to days you are not at home?

How many times per day does your cat usually urinate?

Do you have any concerns, complaints or problems with your cat defecating in the home?

If yes, where is your cat inappropriately defecating?

How many times per week is your cat defecating in the inappropriate locations?

Is the pattern different on days when you are home compared to days you are not home?

Does your cat defecate in the litter box?

Primary Behavioral Screen

Did your cat destroy any objects while teething?

If yes, what objects did your cat destroy?

Does your cat destroy any objects by chewing, sucking or eliminating on them?

If yes, what objects does your cat destroy? Please list.

Does your cat mouth, bite, suck or nip people?

Please note which behavior, list all that apply:

Bite

Suck

Mouth

Nip

Lick

Chew

If yes, who does your cat mouth?

Does your cat exhibit any vocalization about which you are concerned?

If yes, What is/are the vocalization(s) and when do they occur?

Has your cat had any changes in sleep habits?

If yes, what are these specifically?

Has your cat had any changes in eating habits?

If yes, what are these, specifically?

Has your cat had any changes in locomotory behaviors or ability to get around or jump on the bed, et cetera?

If you answered yes, what are these, specifically?

Has anyone ever told you that they were afraid of your cat?

If yes, what was the reason for this comment?

What did the cat do that made them say this?

Do you have any concerns about your cat's grooming behaviors?

Does your cat spray urine?

If yes, where? How often?

Please describe, in detail, how you prepare to leave the house when the cat will be left alone. Do you ignore your cat, do you seek her/him out and say goodbye, do you make a fuss, et cetera?

What does your cat do as you prepare to leave?

Stereotypic and Ritualistic Behavior

Stereotypic and ritualistic behavior

Continuously doing any of these behaviors to another individual: please explain

Grooming:

Chewing self

Licking self

Barbering/trimming hair on self

Biting self

Plucking hair from self

Sucking self

Continuously doing any of these behaviors to another individual? Please explain

Hallucinatory:

Consumptive:

Locomotory:

Vocalization:

Pertaining to the above-listed behaviors:

Was there a change in the household or an event associated with the development of the behavior?

Is there any time of day when the behavior seems more or less intense?

Is there a person or another pet in the presence of whom the behavior seems more intense?

Does your cat respond to his/her name or seem aware of their surroundings while in the midst of the behavior?

Is your cat aware of you calling her/him? If yes, how can you tell?

Can you interrupt or stop the behavior by calling him/her?

By using physical restraint?

List the kinds of things (i.e. noises, treats, toys), if any, that will interrupt the behavior once it has started.

Is there a location in which your cat prefers to perform the behavior?

If so, where?

For ingestion, list what types of objects are consumed. Be as specific as possible.

Does any event or behavior routinely occur immediately before the behavior begins?

If so, what occurs?

Has your cat's general behavior changed in any way since the onset of the atypical behavior?

If yes, please note what the change is.

Has your cat's diet recently changed?

If yes, what changed?

How old do you think your cat was when you first noted the ritualistic behavior?

Is there a pattern to the behavior?

What is the duration, frequency, and characteristics of the events?

Aggression Screen

Does your cat show any signs of growling, yowling, hissing or biting?

If yes, what is/are the signs and when do they occur?

Have you ever been concerned that your cat is "aggressive" to people?

If yes, why?

Have you ever been concerned that your cat is "aggressive" to cats?

If yes, why?

Have you ever been concerned that your cat is "aggressive" to animals other than cats?

If yes, why?

Does your cat hunt or prey on other animals?

If yes, which animals and where?

Has your cat ever bitten or clawed anyone, regardless of the circumstances?

If yes, what are these specifically?

In-Depth Screening

In-depth screen

We want to know what your cat does when you routinely interact with her/him. If you don't know how your cat would react in the following circumstances, please do not try to find out because you may provoke your cat. Please note if the person is a family member, familiar person, or stranger. Please note a dog or cat as a family member, familiar "friend" or stranger.
Key

NR - No reaction
S - Star
B - Bite
H - Hiss, how, growl, vocalize
SW - Swat/ Scratch
P - Piloerect/arch/puff up
TS - Switch or twitch tail
WD - Withdraw
NA - Not applicable

Your cat will do this when:

A person takes your cat's food dish with food in it

A person takes your cat's empty food dish

A person takes your cat's water dish

A person reaches for and picks up food that fell on the floor

A person reaches and takes a real bone from your cat

A person reaches and takes a food treat from your cat

A person grabs and takes a toy from your cat

A person approaches your cat while eating

A person approaches your cat while playing with a toy

Another cat approaches your cat while playing with a toy

A dog approaches your cat while eating

A dog approaches your cat while playing with a toy

A person walks past your cat in a doorway

A person approaches and disturbs your cat while sleeping

A cat approaches and disturbs your cat while sleeping

A person steps over your cat

A person pushes your cat off of the bed/couch

A person reaches toward your cat

A person reaches over your cat's head

A person puts a harness or collar on your cat

A person pushes on your cat's shoulders or rump

A person pets your cat when on a lap

A person pets your cat when not on a lap

A person towel dries your cat

A person gives your cat a bath

A person brushes your cat's head

A person brushes your cat's body

A person trims your cat's nails

A person stares at your cat

A strange person enters your home

Your cat is in the yard and a person passes by

Your cat is in the yard and a dog passes by

A dog enters the room where your cat is

A person picks up and carries your cat

Your cat is at the veterinarian's office

Your cat in a boarding facility

Your cat at a grooming facility

A person yells at your cat

A person physically punishes, such as hit, your cat

A squirrel, cat or small animal approaches your cat

Your cat sees another cat through the window

A person approaches your cat who is at the top of the stairs

A person removes your cat from a hiding place

A person moves their arms or legs under the bed covers

Your cat hears a crying infant

Your cat is in the presence of a 2-year-old child or children

Your cat is in the presence of 6-7-year-old children

Your cat is in the presence of 8-12-year-old children

Your cat is in the presence of 12-16-year-old children

Previous Therapy History

This questionnaire is designed to help us evaluate any role previous treatment may play in either your cat's problems or in their resolution. Please complete to the best of your ability and if our lists are not complete, or you feel that an explanation is warranted, please complete the "comment" section at the bottom.
If you answer yes to any of these questions, please indicate who recommended the treatment and if you attempted it, and indicate the outcome.

Private trainer

Send to a shelter

Place in another home

Kill or euthanize

Take to a board-certified behaviorist (ACVB)

Consult your vet

Consult a non-veterinary behavior consultant

Blow in your cat's face

Buy different toys

Walk your cat on a harness

Use an electronic or shock collar

Throw a tin or can of pennies near your cat

Use a water pistol

Use a laser pointer for play

Use a whistle

Use a fog horn

Hit/smack your cat

Hit with an empty plastic bottle

Banish your cat to another room

Praise for good behavior

Give treats for good behavior

Make your cat an outside-only cat

Declaw your cat

Defang your cat

Use citrus odor on areas you don't want them to go

Anything else that was recommended or tried?

Thank you for taking the time to carefully complete this form.
Information and knowledge are powerful. Gaining this information is the first step in helping your cat to be healthy and happy.
We look forward to reviewing and discussing your answers with you soon.

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