Has your cat been coughing?: |
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If so, when did it first start?: |
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Estimate number of times a day your cat is seen coughing?: |
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Is the coughing sometimes associated with production of a hairball?: |
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Is your cat sneezing?: |
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Has there been any vomiting?: |
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Have you noticed your cat breathing hard at rest?: |
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Is there now, or has there been any discharge from the nose?: |
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Please describe discharge if any.: |
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Are there other cats in the household?: |
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Are any other cats affected?: |
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Does your cat seem to have times when it is difficult to breath?: |
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Please list all medications and frequency for the past month: |
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Has anyone given your cat Tylenol/Acetaminophen?: |
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Is your cat's appetite?: |
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Diet: including treats and supplements?: |
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Is your cat's energy level?: |
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Does your cat seem to have lost weight?: |
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Does anyone in the household smoke?: |
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Type of cat litter used?: |
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Is your cat's litter dusty?: |
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Is your cat: |
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Are you interested in holistic alternatives?: |
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