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How do you measure Quality of Life?

As our pets age, there comes a time when their life may no longer be enjoyable and you need to assess the Quality of Life. This is a personal process and while you can and should be guided by your veterinarian, you are the one who knows your pet best. When the chances of a good quality of life are poor, it is ultimately your decision when or whether to choose euthanasia.

It is important to understand we are responsible for meeting the needs and upholding the rights of our pets.  Many people allow their pet to continue living because they do not know how to make the decision, are scared of it or are not yet ready to let their pets life come to an end.. Ask yourself if your pet is having more bad days than good, if they still doing some activities that they enjoy and are they living with dignity?

Quality of Life is very subjective.  You do need to listen to your feelings and trust that you will know if things are not good. To help you, there is a scoring system for Quality of Life developed by a veterinarian Dr Alice Villalobos called the HHHHHMM scale. It measures Hurt, Hunger, Hygiene, Happiness, Mobility and More good days than bad.

A total of over 35 usually represents an acceptable quality of life. Your vet can help you with this assessment.

Quality of Life Scale: The HHHHHMM Scale
10 being the best and 1 being the worst quality, write the number that you feel
represents your companion on a scale of 1 to 10.
Score Criterion

created at: 2010/09/30
1 - Terrible
10 - No pain

HURT – Is pain controlled? Is breathing easy? (High score). Does pain control still enable a normal life or does it keep them drowsy or unwell? Do they need oxygen to survive- both these would get a low score.

created at: 2010/09/30
1- Won't eat
10 - Good Appetite

HUNGER – Is the appetite good and weight maintained? (High score). Do they need a lot of coaxing or a feeding tube? (Low score)

created at: 2010/09/30
1 - Dehydrated
10 - Well Hudrated

HYDRATION – Are they dehydrated? They may need subcutaneous fluids or fluids by mouth. The more dehydrated the lower the score.

created at: 2010/09/30
1 - Unable to keep clean
10 - Very Clean

HYGIENE – Are they able to be clean and free of smell or discharge and able to eliminate without soiling themselves. Very clean is a high score; always unclean is a low score.

created at: 2010/09/30
1 - Unhappy
10 - Happy

HAPPINESS – Do they want to engage with the family, still go for walks, and respond to favorite toys or people? High scores. Do they seem depressed, withdraw to be on their own, are anxious, bored or fearful? These are low scores. However you can bring an animals bed into the centre of things to improve their social contact (middle score).

created at: 2010/09/30
1 - Can't Move
10 - Good Mobility

MOBILITY – An animal that is not very mobile can still have a good quality of life if they can be helped with a cart, sling or carrying. An animal that cant move on their own and that cant be moved regularly and stimulated with interaction has a low score.

created at: 2010/09/30
1 - Bad every day
10 - Good Everyday

MORE GOOD DAYS THAN BAD – Quality of life is not good when the bad days outnumber the good. You need to set a limit. If the pet is suffering a decision needs to be made. If death comes peacefully and painlessly, that is okay.
*TOTAL *A total over 35 points represents acceptable life quality

Author Dr Barbara Fougere

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