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Quality of Life

As difficult as it may be, decisions about your pet’s end-of-life care should be thought about early in the process, when your mind is clearer, and you are not facing a crisis.

Determining a pet’s quality-of-life is often used to make end-of-life decisions. It’s important to remember that each pet is an individual – what may be considered poor quality of life in one pet (such as lying around all day) may be normal for another.  The “HHHHHMM Scale” below, can be used at home to help you assess your pet’s quality of life.  Remember, we are here to help – as your veterinary team we are a good resource to help you know objectively when it’s time.

Quality of Life (HHHHHMM) Scale

Using a scale of 0 to 10 where 0 = unacceptable and 10 = excellent, the following questions can help to evaluate your pet’s quality of life.


Is your pet in pain?
Can your pet’s pain be successfully managed?
Is your pet distressed from having trouble breathing?
Is oxygen necessary?



Is your pet eating enough?
Does hand-feeding help?
Does your pet require a feeding tube?



Is your pet dehydrated?
Are subcutaneous fluids once or twice daily enough to resolve the problem?
Are subcutaneous fluids will tolerated?



Are you able to keep your pet brushed and clean, especially after elimination?
Does you pet have any pressure sores?



Does your pet express joy and interest?
Are they responsive to things around them (family, toys, etc.)?
Is your pet depressed, lonely, anxious, bored or afraid?
Can your pet’s bed be moved near family activities to minimize isolation?



Can you pet get up without assistance?
Do they need human or mechanical help (e.g., cart)?
Do they want to go for walks?
Are they having seizures or stumbling?
NOTE: some animals with limited mobility may still be alert and responsive, and can have a good quality of life, as long as the family is committed to quality care.



good days than bad

When bad days outnumber good days, your pet’s suffering is appreciable and quality of life might be too compromised.  When a healthy human-animal bond is no longer possible, you should know that the end is near.




A total of >35 points is considered an acceptable quality of life for pets.

Adapted from:  Villalobos, A. and Kaplan, L. (2007). Canine and Feline Geriatric Oncology:  Honouring the Human-Animal Bond.