Diarrhea Questionnaire for Cats

If your cat is having diarrhea, please answer the following questions as accurately as possible to help your veterinarian determine the cause. If you are not certain about the answer, please indicate ‘not sure'

How long has the diarrhea been present? ______ hours / days / weeks

Has diarrhea become more severe since it started? Yes / No / Same

From the list below, circle each item that applies:

A. Degree and Frequency

• one to two bowel movements per day: diarrhea / normal

• more than three bowel movements per day: diarrhea / normal

• diarrhea is occasional (some bowel movements each day are normal)

B. Consistency

• watery

• consistency of pancake batter or cottage cheese

• semi-formed with the consistency of soft-serve ice cream

C. Blood

• very bloody stool: bright red / dark and tarry

• small amount of blood present: bright red / dark and tarry

• no blood

D. Color

• pale or tan to yellow

• dark brown

• black & tarry

• other:

E. Miscellaneous

• mucus or gel coating on the stool

• pieces of foreign materials present in the stool: __________________________

• loss of bowel control (defecates in the house)

• severe straining when having a bowel movement

Is your cat’s appetite normal? Yes / Decreased / Increased / Not eating at all

What has your cat consumed during the last week? List everything that you’re aware of including dog or cat foods, treats, table scraps, milk/dairy, etc.

Are any of the above foods new to your cat? Yes / No

Does your cat take any medications or supplements? Yes / No   If Yes, what are they?

Could your cat have accidentally gotten some of your medication? Yes / No

Is your cat as active as normal? Yes / No

Has your cat’s water consumption changed? Increased / Decreased / No change / Not Sure

Has your cat vomited? Yes / No   If Yes, how frequently and for how long?

Does your cat have toys it could have swallowed? Yes / No   If Yes, what are they?

Do any other pets or people in the home have diarrhea as well? Yes / No

Does your cat have outdoor access? Yes / No

Does your cat hunt and eat its prey? Yes / No / Not Sure

Does your cat have access to any plants? Yes / No   If yes, please list them: