Cat Osteoarthritis Checklist Form

Vet Location

Pembroke Vet
Sajo Farm Vet
Great Bridge Vet

Owner / Pet Information

First & Last Name of Pet Owner

Pet Name

Is your cat showing signs of OA-related pain?

Difficulty jumping up

Yes
No

Difficulty jumping down

Yes
No

Difficulty climbing up stairs

Yes
No

Difficulty climbing down stairs

Yes
No

Difficulty chasing moving objects

Yes
No

Difficulty running

Yes
No

Do you think your cat shows signs of pain?

Yes
No

Have you noticed any changes in your cat’s behavior?

Yes
No

Rate the following on a sliding scale from 0-6, where 0 = my cat couldn’t be less and 6 = my cat couldn’t be more

Energetic & Enthusiastic (Vitality)

0
1
2
3
4
5
6

Active & Comfortable (Comfort)

0
1
2
3
4
5
6

Happy & Content (Emotional Well-being)

0
1
2
3
4
5
6

Your cat’s general behavior history can be helpful

Has your cat’s personality or sociability changed?

Yes
No

Has your cat’s urination or defecation habits changed?

Yes
No

Is your cat hiding more? OR does your cat seem to be “slowing down”?

Yes
No