I voted once a year, probably less than that. I don't really take the cats unless they were to get sick or something like that, which hasn't actually happened yet. Roscoe has been there twice since we got him (about 1 year) - the first time just to check him out as soon as we got him, and the second time because he had a cut/mark on him that looked like it was infected. I have been really lucky with my pets, as they never get sick (aside from the occasional hair ball).