Assess your pet's well-being using the clinical HHHHHMM scale developed by Dr. Alice Villalobos.
Is the dog's pain controlled? Is breathing easy? (10 = No pain, easy breathing; 0 = Severe respiratory distress or uncontrollable pain)
5
Is the dog eating enough? Does it need a feeding tube or hand-feeding? (10 = Eating normally; 0 = Complete refusal to eat)
5
Is the dog dehydrated? Do they accept fluids? (10 = Perfectly hydrated; 0 = Severely dehydrated, unable to take fluids)
5
Is the dog clean? Can they eliminate without soiling themselves? (10 = Clean/groomed; 0 = Bedsores or constant soiling)
5
Does the dog express joy? Do they wag their tail or interact with family? (10 = Very happy/responsive; 0 = Depressed, isolated, or anxious)
5
Can the dog move with or without assistance? Are they interested in walks? (10 = Fully mobile; 0 = Complete inability to move/paralyzed)
5
When bad days outnumber good days, quality of life might be too low. (10 = All days are good; 0 = Every day is a struggle)
5
0
Understanding the HHHHHMM Quality of Life Scale
The HHHHHMM scale is a clinical tool developed by veterinary oncologist Dr. Alice Villalobos. It is designed to help pet owners and veterinarians objectively assess the well-being of a dog facing a terminal illness or the natural decline of senior years. Deciding on hospice care or euthanasia is one of the most difficult choices a pet owner will ever make; this scale provides a framework to remove some of the emotional guesswork.
How to Interpret Your Dog's Score
The scale scores seven key areas from 0 to 10, with 10 being the highest (best) and 0 being the lowest (worst). A total score of 70 is a perfect quality of life.
Score 35 or Higher: Generally indicates that the dog's quality of life is currently acceptable. At this stage, continuing with "pawspice" (palliative care) is typically recommended to maintain comfort.
Score Below 35: Suggests that the dog's quality of life may have declined to an unsustainable level. This score often signals that it may be time to discuss end-of-life options or euthanasia with your veterinarian to prevent further suffering.
Example Assessment Scenarios
Consider a 14-year-old Golden Retriever with severe arthritis but a healthy appetite:
Hurt: 7 (Pain is managed with meds)
Hunger: 9 (Still loves treats)
Hydration: 8 (Drinks well)
Hygiene: 6 (Occasional accidents, but stays clean)
Happiness: 7 (Enjoys being petted)
Mobility: 3 (Needs a harness to stand)
More Good Days: 6 (Most days are still cheerful)
Total: 46/70 – This dog is still finding joy in life, despite mobility issues.
When to Consult Your Veterinarian
This calculator is a guide, not a definitive diagnosis. If you see a rapid decline in any single category—especially Hurt (breathing) or Hydration—you should contact your vet immediately. Even if the total score is above 35, a "0" in a critical category like breathing (Hurt) may necessitate urgent intervention.
function calculateQoL() {
var hurt = parseInt(document.getElementById('inputHurt').value);
var hunger = parseInt(document.getElementById('inputHunger').value);
var hydration = parseInt(document.getElementById('inputHydration').value);
var hygiene = parseInt(document.getElementById('inputHygiene').value);
var happiness = parseInt(document.getElementById('inputHappiness').value);
var mobility = parseInt(document.getElementById('inputMobility').value);
var moreDays = parseInt(document.getElementById('inputMoreDays').value);
var total = hurt + hunger + hydration + hygiene + happiness + mobility + moreDays;
var resultArea = document.getElementById('calc-result-area');
var scoreDisplay = document.getElementById('finalScore');
var textDisplay = document.getElementById('resultDescription');
resultArea.style.display = 'block';
scoreDisplay.innerText = "Total Score: " + total + " / 70″;
if (total >= 50) {
resultArea.style.backgroundColor = "#e8f5e9";
textDisplay.innerHTML = "Result: Good Quality of Life. Your pet appears to be coping well. Continue your current care routine and monitor for changes.";
} else if (total >= 35) {
resultArea.style.backgroundColor = "#fff3e0";
textDisplay.innerHTML = "Result: Acceptable Quality of Life. Your pet is maintaining an adequate quality of life, but may require increased hospice care or medication adjustments. Consult your vet about ways to improve comfort.";
} else {
resultArea.style.backgroundColor = "#ffebee";
textDisplay.innerHTML = "Result: Poor Quality of Life. A score below 35 suggests that your pet may be suffering. It is highly recommended that you schedule a consultation with your veterinarian to discuss end-of-life care or euthanasia.";
}
}