Senior Care Questionnaire

Yes

No

Does Your pet display any of the following advanced signs of aging?

Just not acting like himself/herself

Interacting less often with the family

Responding less often or less enthusiastically

Changes in behavior

Changes in activity level

Having difficulty climbing stairs

Having difficulty jumping

Increased stiffness or limping

Drinking more often

Urinating more often

Changes in eating pattern

Noticeable weight gain

Noticeable weight loss

Losing housetraining or litter box habits

Changes in sleeping patterns

Acting confused or disoriented

Changes in skin or new lumps or bumps

Scratching more often or hair loss

Bad breath, red gums or swollen gums

Tremors or shaking

Difficulty breathing

Bumping into things

Cloudiness or bluish color/haziness in the eyes