CAT CHANNEL SICK CAT VET INFO FORM

YOUR CAT'S NAME:

YOUR CAT'S BIRTHDATE/PRESENT AGE:

MALE/FEMALE

NEUTERED/SPAYED AND WHEN? 

AREAS WHERE CAT IS KEPT (PARTICULARLY IF YOU TRAVEL WITH YOUR PET) On a ranch, on a farm, in a barm, swamp area

Is your cat strictly indoors or outdoors?

When was your cat's last vet visit and for what?

Has your cat been vaccinated for FIV and FeLV and when?

What situations apply to your cat and check all that do apply: 

 Has been outside unsupervised ___
Was exposed to a cat with unknown FIV/FeLV status ___
Was in a fight with another cat ___
Lives in a household/apartment/roomates with other cats of unknown FIV/FeLV status ___
Lives in a household/apartment/roomates with a recently adopted cat ___
Was a stray or obtained from a shelter: ____
Any weight Loss ____
Not eating or decreased appetite ____
Not groming or decreased grooming ___
Decreased energy or general weakness ___
Vomiting ____
Diarrhea ____

Urinating _____
Swollen or red gums ___
Pale gums ___
Mouth sores ___
Enlarged sides of neck (lymph nodes)___
Abscesses in mouth or elsewhere ____
Bladder Infections ______

Cystitis ________

Eye discharge or pus ____

Excessive meowing _____

Hiding away and not coming out to eat or drink ____

What medications does your cat take _______

Current and Past Medication Conditoins and Dates _____

 

Cats, as a class, have never completely got over the snootiness caused by the fact that in ancient Egypt they were worshipped as gods.
P.G. Wodehouse (1881-1975)