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MISSION VIEJO VETERINARY HOSPITAL
Senior Care Health Checklist |
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Signs
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Yes
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No
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| Difficulty climbing stairs | ||
| Difficulty jumping up | ||
| Increased stiffness or limping | ||
| Loss of housetraining; housesoiling | ||
| Changes in litter box habits / inappropriate elimination (cats) | ||
| Increased thirst | ||
| Increased urination | ||
| Changes in activity level | ||
| Excessive panting or changes in breathing patterns | ||
| Circling or repetitive movements | ||
| Confusion or disorientation | ||
| Excessive barking, whining or meowing | ||
| Less interaction with family / hiding more | ||
| Decreased responsiveness | ||
| Tremors or shaking | ||
| Skin and haircoat changes, lumps or bumps | ||
| Vomiting and/or diarrhea | ||
| Coughing or sneezing | ||
| Excessive scratching | ||
| Changes in sleeping patterns / location | ||
| Less enthusiastic greeting or behavior | ||
| Altered appetite | ||
| Weight change (gain or loss) | ||
| Bad breath | ||
| Other (specify) | ||
Dog________ Cat________
Owner________________________
Pet's Name____________________
Pet's Age________
Date____________