A Cat's View Veterinary
Hospital

Vomiting form

Name of Cat: ____________________
Age of Cat:___

When did your cat first start vomiting?

Any previous history of vomiting?

Appetite: Increased, normal, decreased
Is she/he interested in food at all?
Is she/he drinking more water lately?
 

Energy/Activity level: Increased, normal, decreased

Weight: Gaining weight, steady, losing weight

Are there behavioral changes such as hiding or irritability?

Does your cat tend to chew on or eat non food items?

How often does your cat vomit? _______Several times a day, once or twice daily, weekly

Does it look like wetted food coming back up or does it look processed?digested?

Is it usually within 30 minutes of eating?

Does it look digested, have bile, or yellow color to it?

Does it ever have blood in it?

Do you see hair in it? Never, sometimes, usually

Is your cat currently receiving any type of medication? Please include supplements including hair ball treatments__________  
Prescription, and over the counter meds

What does your cat eat?

Please include any canned, dry, treats, table scraps

Has there been a change in diet?

Are the stools/feces normal? Diarrhea? If diarrhea, please also fill out the diarrhea questionaire, thank you.

Is your cat using the litter box appropriately? Y/N

Do you have other cats in the household?Do they eat the same food? Y/N Are they vomiting?







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