How to Gauge Your Pet’s Quality of Life
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It can be hard to tell whether your pet is experiencing an adequate quality of life. If they have medical conditions such as arthritis or injuries sustained earlier in life, it can be hard to tell how well they are coping with pain and illness. Pets can get quite good at hiding their pain and may even withdraw so that they will be less of a burden on the family. If you start seeing worrying signs that your pet is experiencing a lot of pain or is depressed, you may want to more formally assess their pain, quality of life, and desire to keep living.
A good quality of life scale is the HHHHHMM Scale which is explained below along with a quality of life scale worksheet for you to use.
1. Hurt
See if they have difficulty getting up. If your senior pet has a lot of difficulty standing up after lying down, they may be experiencing joint or arthritic pain in their back. If your senior pet simply refuses to stand, this can definitely be a sign of pain. You should take note of this sign of pain and talk to your veterinarian about treatment options.
Observe them walking up the stairs. If your senior pet has trouble climbing the stairs, they may have joint pain in their legs or back. If your senior pet is experiencing a lot of pain from arthritis or other conditions, you should take note of this sign of pain and speak to your veterinarian about treatment options.[2]
Sense whether they are withdrawing from life. If your senior pet looks very withdrawn a lot of the time, this may also be a sign of pain. Look to see if your senior pet hides away in the corner when they would normally be interacting with your family. This may be a subtle sign that your pet is in pain.[3]
Feel how they react when you pick them up. If your pet shudders, squeals, or barks when lifted, they may be experiencing pain. You should take note of this symptom and talk to your veterinarian about the experience.
Look for other signs of pain. Your senior pet may try to hide their pain or cope with it in ways that are hard to notice. However, they may also express themselves forcefully. You can look for the following signs of pain:[4]
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Whimpering
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Withdrawal or unusual quietness
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Unusual aggression in response to being approached
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Ears held flat against the head
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Licking of sensitive areas of the body
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Loss of appetite
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Not wanting to walk, run or play
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Stiffness and limping
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Slowness on walks
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Strange reactions to touch
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Personality or other behavioral shifts
Do a pain review. Consider how much pain your senior pet is experiencing in their daily life, including in relation to signs such as difficulty moving, walking up the stairs, standing up, or hiding in the corner. If you have observed these or other signs of pain, your pet may be experiencing a lower quality of life. That said, there is no gold standard for measuring pain in animals and your assessment will be largely subjective.[5] Talk to your veterinarian about your observations and reflections on your senior pet’s pain and see if they have any suggestions for treatment or other options.
2. Hunger
Determine your senior pet’s hunger. If your senior pet is going hungry because of a loss of appetite or inability to eat food, it is a sign of diminishing quality of life. If your senior pet can no longer eat, they may need a feeding tube. Considering the extent to which you are able to manage your senior pet’s hunger, write down a score between 1 and 10. Higher numbers indicate less difficulty with hunger
3. Hydration
Assess hydration. Consider whether you are able to meet your senior pet’s need for adequate hydration. If they are not able to drink water and exhibit signs of dehydration such as dry nose, mouth or gums, you should consult with your veterinarian.[10] If you have run out of options for addressing chronic dehydration and associated symptoms (e.g., dry mouth, vomiting), you should take note of this sign of a diminishing quality of life. Give a score between 1 and 10 to indicate the extent to which your senior pet is managing to stay hydrated.[11]
4. Hygiene
Hygiene. Is the pet having accidents in the house (that is not normal behavior)? Does the pet have trouble getting up and outside in time to poop? Is the pet messing himself because he can’t stand up? Does the pet have pressure sores or chronic diarrhea?
5. Happiness
Reflect on whether your senior pet is happy. If your senior pet has limited mobility because of joint problems, perhaps you have made arrangements to give them someplace to lie down closer to the rest of the family. Pets are social animals so you should make sure you give them the opportunity to be close to the family. If you have tried to lift your senior pet’s spirits in various ways but they still look rather glum or unhappy, you should take note of this sign of a diminishing quality of life. Give a score between 1 and 10 to indicate the level of happiness that your senior pet currently experiences, with a higher score indicating greater happiness.[12]
6. Mobility
Observe mobility. Observe your senior pet’s movement around the house and the backyard. If they have trouble moving around the house, you may want to install aids such as pet stairs to help them get up onto beds or couches. If you have taken measures to improve your senior pet’s mobility but they still struggle getting around the house or yard, this may be a sign of a diminishing quality of life. Assign a score between 1 and 10 to indicate your senior pet’s mobility level, with a higher score indicating greater freedom of movement.[13]
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Take notes on your senior pet’s mobility. If there are particularly difficult situations such as getting into the car or onto the couch, you might be able to use an aid to solve the problem. However, if your senior pet is simply unable to move or rarely moves, it is a sign of a diminishing quality of life.
7. More Bad Days vs Good Days
Add up the proportion of good versus bad days. Reflecting on the last week or month, consider whether your senior pet has had more good days than bad days. A bad day might be a day where your senior pet looks depressed, experiences a lot of pain, or has ongoing health issues. A good day might be a day when they look more like their usual self and show signs of playfulness or affection with other family members. If there are far more bad than good days, it is a sign of a diminishing quality of life. You should assign a score of between 1 and 10, with higher scores indicating a better proportion of good to bad days.[14]
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You could take journal notes on good versus bad days every day for a couple weeks. Then, add up the total number for both good and bad days and compare them in order to make an accurate score.
Add up your total score. The total score should be the sum of the individual totals (i.e., 1-10 scores) for hurt (i.e., pain), hunger, hydration, hygiene, happiness, mobility, and more good days than bad. If your total score is above 35, your senior pet still has a good quality of life. If they scored less than 35 points, you should talk to your veterinarian about your senior pet’s diminishing quality of life and possible medical options, including euthanasia.
Also ask insightful questions to figure out Quality of Life
Imagine whether your pet wants to live. Put yourself in your pet’s paws. Empathetically imagining yourself as your pet, consider whether you would want to continue living. Write down your response in a journal and take it into account in conversations with your veterinarian.
Consider whether your pet still enjoys life. Empathetically imagine yourself in your pet’s paws. Would you still be enjoying life?
For example, you could tell your veterinarian: “If I imagine myself as Sam (insert your pet’s name), I think I would still enjoy life right now. That may change, but I think I would still be enjoying life.”
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You could say: “If I imagine myself as Sam (insert your pet’s name), I think the pain would be too much to handle and I probably wouldn’t be enjoying life anymore.”
Reflect on whether your pet is ready to go. Empathetically imagine yourself as your pet. Thinking about their quality of life score and the pain they experience in their everyday life, consider whether or not they are ready to move on to a better place. Write your response in your journal.
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If you have family or friends who share your pet, you might want to share your reflection on whether or not they are ready to go.
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If you think your pet is ready to move on to a better place, talk to your veterinarian about euthanasia.
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If you think your pet is ready to go, you could tell your veterinarian: "Imagining myself as Sam (insert your pet's name), I can't believe I would want to keep on living with all of the daily pain, not being able to eat, drink water, or play with friends and family anymore. I think it is time to move on."