How can you measure your pet’s quality of life?

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Regular readers of the CPC blog will know that we do not shy away from difficult subjects. We have published articles about euthanasia and the difficulties faced when making that final decision:

We have included articles that look at why our emotional bonds with our pets are so strong.

The writers of the articles have all written from the heart and from their own experiences. Reading the experiences of other pet owner’s struggles in making the decision to euthanase a pet is a help. However, the issue is that there is little practical advice on how to make this decision.

How do you make the difficult decision to have your pet euthanased?

There is no doubt; you will find information of real value in reading about the experiences of other pet owners that have been through this already.

If you are looking for advice that is more specific, we have some tools that will help you to make an informed decision. Most people accept that euthanasia is the best option to end the suffering of a companion animal. However, as veterinary care improves with innovations in pain management, advanced medicines and changes to nursing practices, it is possible to restore or maintain a pet’s quality of life, for longer.

Palliative pet care & quality of life

Palliative care does not aim to cure the patient. Its goal is to manage the patient’s symptoms. This method of care is often an approach that is gentler on the patient than the treatment that is trying to achieve a cure. Common scenarios that lead to palliative care are:

  • The diagnosis of a terminal or life limiting illness
  • The decision to stop curative treatment
  • Symptoms advancing to the point that they interfere with the patients quality of life

Quality of Life

Dog enjoying improved quality of life

The quality of life (QoL) that your pet is experiencing should be central to any decision. All pets should have freedom from:

  • hunger or thirst
  • discomfort
  • pain, injury or disease
  • to express normal behaviour
  • fear and distress

The five freedoms were developed to assess an animal’s living conditions. The RSPCA, ASPCA and other international animal welfare organisations have adopted the five freedoms to support animal welfare.

dog in golden years

Measuring your pet’s quality of life

Whilst the five freedoms provide a guide on quality of life, it does not provide any type of objective measure. There is however a measure we can refer to; the HHHHHMM Quality of Life Scale. HHHHHMM stands for Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, More good days than bad.

The purpose of the scale is to help owners, with the support of a veterinary professional, to measure their pet’s quality of life, often at a time where emotions are particularly raw. By scoring each criterion on a 1-10 scale, a total score of 35 or more indicates an acceptable quality of life.


Quality of Life Scale: The HHHHHMM Scale
Pet caregivers can use this Quality of Life Scale to determine
 the success of care.   10 is good.


Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet’s pain successfully managed? Is oxygen supplementation necessary?



Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube?



Is the patient dehydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake.



The patient should be brushed and cleaned, particularly after elimination. Avoid pressure sores and keep all wounds clean.



Does the pet express joy and interest? Is the pet responsive to things around him or her (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet’s bed be close to the family activities and not be isolated?



Can the patient get up without assistance? Does the pet need human or mechanical help (e.g., a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, yet an animal who has limited mobility but is still alert and responsive can have a good quality of life as long as caregivers are committed to helping the pet.)



When bad days outnumber good days, quality of life might be compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is okay.

*TOTAL*A total over 35 points represents acceptable quality of life

Adapted by Villalobos, A.E., Quality of Life Scale Helps Make Final Call, VPN, 09/2004, for Canine and Feline Geriatric Oncology Honoring the Human-Animal Bond, by Blackwell Publishing, Table 10.1, released 2006.


2 responses to “How can you measure your pet’s quality of life?”

  1. What a great post to help pet parents from a more practical viewpoint. We all know such matters of the heart are gut wrenching and very difficult to make decisions when finding out your pet is terminally ill. This guide really breaks things down in terms of quality of life which I think will definitely help pet parents make the best decision for their individual circumstance.

    • Jon Baily says:

      Hi Kamira, thank you for your feedback. I often read your articles and appreciate your comments on this difficult subject.

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