Quality of Life Scale for Dogs — Free Assessment

When Love Asks the Hardest Questions

There may come a time when you look at your aging dog and wonder, gently, whether they are still enjoying their life. It is one of the most tender and difficult questions a pet owner can face. You are not asking because you love them any less — you are asking because you love them so deeply that their comfort matters more than your own need to hold on.

Assessing quality of life is not about reducing your beloved companion to a number. It is about bringing structure and clarity to something that feels overwhelming. It is about honoring the bond you share by paying the closest attention to how they feel, day by day, moment by moment.

This guide will walk you through practical, compassionate ways to evaluate your senior dog's wellbeing — including the widely respected HHHHHMM scale, daily journaling, and tracking good days versus bad days. None of these tools will make the journey easy, but they can help you feel more grounded and confident in the decisions ahead.

Understanding the HHHHHMM Quality of Life Scale

The HHHHHMM scale was created by Dr. Alice Villalobos, a respected veterinary oncologist who dedicated her career to helping pets and their families navigate end-of-life care. The acronym stands for seven key areas of your dog's daily experience:

• Hurt: Is your dog experiencing pain? Can their pain be managed effectively? A dog whose pain is well controlled will score higher in this category. Watch for signs like whimpering, reluctance to move, panting at rest, or flinching when touched in certain areas.
• Hunger: Is your dog eating enough to maintain their body? Loss of appetite can indicate pain, nausea, or general decline. Note whether they approach food willingly or need coaxing, and whether they can physically eat without difficulty.
• Hydration: Is your dog drinking adequate water? Are they able to stay hydrated without intervention? Dehydration can accelerate decline and increase discomfort. If your dog is not drinking on their own, subcutaneous fluids administered by your vet may help temporarily.
• Hygiene: Is your dog able to maintain basic cleanliness, or are they soiling themselves regularly? Incontinence and the inability to move away from waste can cause skin irritation and distress. This category also considers whether wounds or tumors are being managed.
• Happiness: Does your dog still show moments of joy, interest, or engagement? Do they respond to your presence, enjoy gentle petting, or perk up at familiar sounds? This is often the most intuitive category for owners who know their dog's personality.
• Mobility: Can your dog move around well enough to get to food, water, and outside for bathroom needs? Do they need significant assistance? Mobility challenges alone do not necessarily mean poor quality of life, especially if your dog is otherwise comfortable and engaged.
• More Good Days Than Bad: Looking at the overall picture, are the good days still outnumbering the difficult ones? This final category asks you to step back and assess the trend. It is perhaps the most important question of all.

How to Score the Scale

Each category is scored from 0 to 10, where 0 represents the worst possible state and 10 represents the best. A total score of 35 or above out of 70 is generally considered an acceptable quality of life. Scores below 35 suggest that your dog may be struggling more than thriving, and it may be time to have a conversation with your veterinarian about next steps.

Remember that this score is a guide, not a verdict. Some dogs with lower total scores may still have beautiful moments each day, while others with higher scores may be masking their discomfort. Trust what you know about your individual dog.

The Power of Journaling Your Dog's Days

Our memories are shaped by emotion, and during a difficult time, it is easy to remember only the worst moments or only the best ones. A simple daily journal helps you see the full, honest picture of your dog's life as it unfolds.

You do not need anything elaborate. A few lines each day are enough. Note how your dog seemed when they woke up, whether they ate and drank, how they moved, whether they sought out affection or preferred to be alone, and any moments of joy or distress you noticed. Over time, this record becomes invaluable — not only for decision-making, but as a keepsake of the love you shared during this chapter.

What to Record Each Day

Keep your daily entries consistent so you can spot patterns. Consider tracking these elements:

• Appetite: Did they eat their full meal, half, or refuse food?
• Water intake: Normal, reduced, or needing encouragement?
• Mobility: Moving freely, needing help, or mostly stationary?
• Pain indicators: Any whimpering, panting, restlessness, or guarding?
• Mood and engagement: Tail wags, interest in surroundings, response to you?
• Sleep quality: Resting peacefully, or restless and unable to settle?
• Overall day rating: Good, okay, or difficult?

Tracking Good Days Versus Bad Days

One of the simplest and most meaningful things you can do is keep a calendar where you mark each day with a color or symbol. Green for a good day. Yellow for an okay day. Red for a bad day. This approach, sometimes called the "calendar method," gives you a visual at a glance that is harder to argue with than memory alone.

In the early stages of decline, you may see mostly green and yellow with an occasional red day. Over time, the pattern may shift. When red days begin to outnumber the others — when your dog is having more bad days than good — it is a meaningful signal that their quality of life is declining.

This does not mean you must act immediately on any single bad day. Dogs, like people, have off days. But a sustained pattern of decline deserves your attention and a conversation with your veterinary team.

Looking Beyond the Numbers

Scales and journals provide structure, but they cannot capture everything. You know your dog in ways no tool can measure. You know the spark in their eyes when you reach for the leash. You know the way they used to greet you at the door. You know the small rituals that made them unmistakably themselves.

When those things begin to fade — when the spark dims and the rituals stop — you are seeing something important. Trust that knowledge. It comes from years of love and attention, and it is as valid as any clinical assessment.

Creating Comfort While You Assess

While you are taking time to evaluate your dog's quality of life, there are meaningful things you can do to enhance their daily comfort. Soft, supportive bedding helps ease joint pain. Warmth soothes aching muscles. Gentle routines provide security. These are not just practical steps — they are acts of love.

Having the Conversation with Your Veterinarian

Your journal, your calendar, and your quality of life scores are all powerful tools to bring to your veterinary appointment. They give your vet a window into your dog's daily reality that a brief clinical visit cannot always reveal.

Share your observations openly. Tell them about the good days and the hard ones. Ask questions about pain management, about what changes to watch for, and about what options are available. A good veterinarian will listen without judgment and help you make decisions that honor your dog's comfort and dignity.

If you are not sure where to start the conversation, try saying: "I have been tracking my dog's quality of life, and I would like to go over my observations with you." That simple sentence opens the door to the guidance you need.

You Are Doing This Out of Love

If you are reading this page, it is because you care deeply about your dog's wellbeing. That care, that willingness to ask hard questions and sit with uncomfortable answers, is one of the greatest gifts you can give your companion. You are not failing them by wondering about their quality of life. You are honoring them.

Take each day as it comes. Be gentle with yourself through this process. And know that whatever lies ahead, the love you have shared is not diminished by the difficult decisions that love sometimes asks of us.