Feline Musculoskeletal Pain Index Feline Musculoskeletal Pain Index Your Name* First Last Your Email* Today's Date* MM slash DD slash YYYY Please take some time to complete the following questions. Please select the one that best describes your cat’s ability to perform the following activities. Walk and/or move easily?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Run?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Jump up (how well and how easily)?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Jump up to kitchen-counter height in one try?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Please rate your cat’s ability to:Jump down (how well and how easily)?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Climb up stairs or steps?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Go down stairs or steps?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Play with toys and/or chase objects?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Play and interact with other pets?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Get up from a resting position?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Lie and/or sit down?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Stretch?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Groom himself or herself?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Interact with you and family members?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Tolerate being touched and/or held?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Eat?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Use the litter box (get in and out, squat, cover waste?* Normal Not quite normal Somewhat worse than normal Barely, or with great effort Not at all Don’t know or not applicable Please mark from 1-10 the number that best describes your cat’s pain over the past two weeks: 1 2 3 4 5 6 7 8 9 10 Please mark from 1-10 the number that best describes your cat’s pain today: 1 2 3 4 5 6 7 8 9 10 CAPTCHACommentsThis field is for validation purposes and should be left unchanged. Δ
