Quality-of-life check (HHHHHMM scale)
The hardest question in pet ownership doesn't get answered in one bad moment — it gets answered by a trend. This is the veterinary HHHHHMM scale as a tool you can repeat weekly, so when you talk to your vet, you bring data instead of only doubt.
The scale below was developed by veterinary oncologist Dr. Alice Villalobosand is used in hospice and end-of-life consults everywhere. Score each dimension from 0 (terrible) to 10 (great), honestly, for how things are this week — not the best day, not the worst. A total above 35 is generally read as acceptable quality of life; below that, the scale suggests quality is failing. No number on this page decides anything by itself — it's a structured way to see clearly, and a thing to bring to your vet. The saved history lives only in this browser, on your device.
History (this browser only)
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How vets read the seven dimensions
- Hurt — is pain controlled, including the pain of not breathing well? Breathing difficulty outranks everything else on the scale.
- Hunger — eating enough willingly? Hand-feeding counts; force counts less.
- Hydration — drinking enough, or needing regular fluids?
- Hygiene — able to stay clean; sores from lying, soiling themselves?
- Happiness — interest in you, toys, surroundings; joy versus withdrawal.
- Mobility — able to get up and move enough, with help as needed?
- More good days than bad — the summary question. A calendar with a plain good/bad mark per day answers it better than memory ever will.
Using the number honestly
One score is a snapshot; the pattern across weeks is the truth. A 48 sliding to 41 to 36 tells you the direction even while every individual week felt "okay." Bring the history to your vet and ask directly: "given this trend, what would you do if this were your dog?" Vets answer that question honestly, and many will add a formal quality-of-life consult. When the conversation turns toward goodbye, our guide on euthanasia — costs, the decision, what happens — was written to make the worst day a little less unknown. Two truths from that page worth repeating here: a week too early is kinder than a day too late, and choosing the exit is not causing the ending — the disease did that.
About this guide. Written and maintained by the VetsOpenNow editorial team. We are not veterinarians, and this is general information rather than veterinary advice — it cannot account for your animal's history, species, breed, age or medication. Anything describing a symptom is written to help you decide whether to call a professional, never to replace one. When guidance here differs from what a vet tells you about your animal, follow the vet.
Last reviewed September 2026. Spot something wrong? Tell us — we correct errors quickly.