Behaviour problems in our pets and in society are a very important issue. To help us resolve the various behaviour problems your pet may have we need to know your pet’s daily activities, so please complete these forms regarding your pet. When completed please return them to the Sturt Street clinic, for the attention of Dr Ruth Duncan. You can also email the questionnaire if that is easier for you to rd@bvp.com.au

Dr Ruth Duncan will then assess the questionnaire regarding the behaviour of your pet and will ring to arrange an appointment to further discuss the matter. Behaviour problems are usually complicated, as such the behaviour consultation takes 30-45 minutes, this involves discussing any medication that may be necessary, and going through the behaviour modification for your pet. The cost of a behaviour consultation reflects this being $155 excluding any medications and blood tests required. If in completing these forms you have any questions please contact Ruth Duncan on 5331 1533.

We look forward to helping you and your pet live happier together.

CLIENT QUESTIONNAIRE - CATSSECTION ONE

Owner

Name Address : State : P/code: Phone B/H

Pet

Name : Breed : Sex : Age : Weight :

Phone A/H :

Have you had pets before? Dogs Cats

Have you had problems with past pets?If yes please explain

How old was your pet when you first acquired it?

How long have you had this pet?

Where did you get this pet? Stray/found Breeder

RSPCA or Shelter service Pet store Friend Newspaper Other (please explain)

Has this pet had other owners?If so how many?

Do you know why the pet was rehomed?

Why did you choose this breed?

Have you had this particular breed before?

Why did you choose this particular pet?

Did you see the mother and father?Did you see the litter mates?

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Was the pet temperament tested?

Do you have contact with any of the litter mates?

Has your pet been spayed or castrated?If yes at what age?Reason for desexing

Does your pet mount?If yes – what (people/other pets/objects) and when

Did your pet show any behaviour changes after desexing?

If your pet hasn’t been desexed do you plan to breed from your pet?Has this pet ever been bred?

If female did she experience any heat cycles before desexing?Age of first heat

Does your pet have any medical problems?

Is your pet taking any medications?

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Please list any other pets in the household

NAME BREED SEX AGE OBTAINED

AGE NOW

Your pet’s relationship to any other pets in the household is best described as Friendly Fighter /Hostile Hider Neutral

Please list all family members living in the house

NAME SEX AGE RELATIONSHIP (self, husband, son, daughter etc)

TIME SPENT AT HOME

Has your household changed since acquiring this pet?If yes how?

Marriage New baby Death in the family Death of a pet Divorce

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Moved Family schedule changed – lost or gained jobs New pet

What kind of home do you live in? Unit Townhouse Apartment House with a small yard House with a large yard Farm

Is your pet (tick any that apply) Allowed to run free - unsupervised Kenneled in a run - all day

when no one is home In a secure back yard Indoors only Outside during the day and inside at night Other – please explain

What percentage of the time does your pet spend inside and outside each day?

How many times is your pet walked each day and for how long (on average)?

Who exercises your pet?

What is your pet’s activity level?

Low Average High Excessive

What type of toys does your pet have?

What games do you play with your pet?How often during the day do you play with toys or play games with your pet inside the house? 1 2 3 45On average how long are these sessions?

How often during the day do you play with toys or play games with your pet outside the house? 1 2 3 45On average how long are these sessions?

What type of exercise does the pet get? On lead Supervised off lead

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Free roaming In yard Playing outdoors Playing indoors

How does your pet react to visitors? Approaches people Jumps on their lap (cats) Bunts or rubs (cats) Hides Stays in the room but does not approach Other – please state

How does your pet behave with familiar visitors?

How does your pet behave with unfamiliar visitors?

How does your pet react to visits to the vet?

Has your pet stayed in boarding kennels or a cattery?If yes, how did they behave?

Has the pet been to a groomer?If yes, how did they behave?

Where does your pet sleep at night? On your bed On its own bed in your bedroom On its own bed in another room which room? Anywhere it wants Outside

Where is your pet if they are alone in the house?

Where is your pet when you have guests?Why?

How often do you feed your pet?

What do you feed your pet - include brands and amounts

Where and what does your pet drink?

Who feeds your pet?

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Where and when does your pet get fed?

Does your pet eat alone?

How often does your pet get treats each day?What do you use?

Does your pet get snacks from the table?How often?

Describe in detail how you prepare to leave the house when your pet is going to be left alone and what your pet does as you prepare to leave the house.

Describe your pet’s reaction as you leave and when you return to the house

Describe a typical 24 hours in your pets life – wakes, sleeps, exercised etc

12 am midnight

1am

2am

3am

4am

5am

6am

7am

7

8am

9am

10am

11am

12pm noon

1pm

2pm

3pm

4pm

5pm

6pm

7pm

8pm

9pm

10pm

11pm

Any other comments?

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SECTION TWO - PROBLEM BEHAVIOURS

The main behaviour problem your pet has – mark those that apply

House soiling Fighting - household pets or neighbours pets Meowing Aggression towards people Scratching furniture Eating wool/nonfood items Other – please state

For each of the problems listed above that you are concerned about please fill out the following questions – separately for each problem

Describe the problem

How old was your cat when you first noticed the problem?

How frequently does the behaviour occur? daily/weekly/monthly etc

In what circumstances does the behaviour occur?

When did the behaviour become serious?Why?

Has the behaviour changed in frequency or intensity?

What have you done to try and correct the problem?

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For each problem that you are concerned about please describe the following –Most recent incident – date, time, location, people involved etc

Second last incident – as above

Third last incident – as above

Which of the following statements applies to you? I am here out of curiosity, the problem is not serious I would like to change the problem, but it is not serious The problem is serious, I would like to change the problem, but if it remains the same that’s alright The problem is serious and I would like to change it but if it remains the same I will keep my pet The problem is very serious and I would like to change it but if it remains the same I will euthanase my pet.

Elimination Behaviour

Does your cat use a litter tray?

How many cats share a litter tray?

Will your cat spray against the back of a covered litter tray?

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Does your cat have a preference for any of the trays provided?If yes, which ones?

Does your cat ever eliminate in the house, but not use the litter tray?If yes, does your cat urinate defaecate both

Where in the house does your cat eliminate apart from in the litter trays?

How often does your cat use these other area for elimination?

If your cat uses other areas of the house for elimination how do you clean these areas, what cleaning products do you use?

Does your cat use the bath/shower?

Describe the position of your cat when it eliminates outside the litter tray (standing up/crouching/sitting etc)

How many litter trays do you have in the house?

Does your cat have access to outside?

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Please fill in the following regarding each individual tray

LITTER TRAY

KIND OF LITTER USED

POSITION IN THE HOUSE

TYPE OF TRAY USED

EXAMPLESAWDUSTSHREDDED NEWSPAPER

BATHROOM COVERED

ONE

TWO

THREE

FOUR

FIVE

How often do you clean the trays?

How do you clean the trays? List any products used in the cleaning or deodorising process.

Do you use liners in the tray? If yes are they scented?

Does your cat eliminate in the presence of other animals or people? Is the elimination behaviour secret?

Will your cat immediately use a freshly cleaned litter box?

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Does your cat ever vocalise while eliminating?

Describe how your cat uses the litter tray (does it scratch to cover the faeces, does it stand in the tray, does the cat dig? etc)

Which of the following statements applies to you? I am here out of curiosity, the problem is not serious I would like to change the problem, but it is not serious The problem is serious, I would like to change the problem, but if it remains the same that’s alright The problem is serious and I would like to change it but if it remains the same I will keep my pet The problem is very serious and I would like to change it but if it remains the same I will euthanase my pet.Stereotypic or Ritualistic Behaviour

Describe the behaviour Grooming (chewing, biting, licking self) Hallucinatory (staring, tracking, attacking invisible prey) Consumptive (consuming rocks, dirt, other objects, sucking wool) Locomotory (circling, chasing, freezing, scratching) Vocalization (barking, howling, growling)

Was there a change in the household or an event that seemed to be associated with the development of the behaviour?

Is there a time of day or location when the behaviour occurs? When? Where?

Is there a person the behaviour seems to occur in conjunction with? Who?

Has your cat’s general behaviour changed in any way since the onset of the atypical behaviour? i.e. become more aloof, more aggressive

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What is the attitude of your cat while performing the behaviour? Distressed, self-absorbed, fearful etc

Can you distract your cat during the behaviour? If so how? calling, physical restraint etc

Is there a pattern to the behaviour?Duration: days, weeks, monthsFrequency : hourly, daily, weekly, monthly, sporadicPattern :after meals, in the morning (be specific)

What do you do when the behaviour starts?

Which of the following statements applies to you? I am here out of curiosity, the problem is not serious I would like to change the problem, but it is not serious The problem is serious, I would like to change the problem, but if it remains the same that’s alright The problem is serious and I would like to change it but if it remains the same I will keep my pet The problem is very serious and I would like to change it but if it remains the same I will euthanase my pet.

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