🐾 Part 2 of 4: How to Assess Your Pet's Quality of Life The scale, its limitations, and the signs no chart can measure
Love & Toe Beans | Pet Quality of Life | Brisbane Home Pet Euthanasia | Greater Brisbane Region
This is Part 2 of a 4 part series on understanding and assessing your pet's quality of life.
Part 1: What Quality of Life Really Means for Your Pet
Part 2: How to Assess Your Pet's Quality of Life
Part 3: When You Are Too Close to See Clearly
Part 4:Making the Decision with Love and Clarity
In Part 1 of this series, we explored what qualityof life really means for our pets, beyond eating, beyond drinking, and beyond the visible signs of survival. If you have not read Part 1 yet, we would gently suggest starting there.
In this blog, we go deeper. We look at the tools available to help you assess your pet's quality of life, including the widely used HHHHHMM Scale, what it does well, and where it falls short. We also explore the signs that no chart can measure, the ones that require patience, presence, and love to see.
📊 The HHHHHMM Scale: A Starting Point, Not a Final Answer
The HHHHHMM Scale is one of the most commonly used tools for assessing pet quality of life. It was developed by veterinarian Dr Alice Villalobos and looks at seven key areas:
H - Hurt Is your pet in pain? Can that pain be managed effectively with medication or other support? Unmanaged pain is one of the most significant indicators of poor quality of life.
H - Hunger Is your pet eating enough to maintain their body condition? Are they interested in food, or does eating feel like a struggle or a chore?
H - Hydration Is your pet drinking enough? Are they showing signs of dehydration such as dry gums, sunken eyes, or loss of skin elasticity?
H - Hygiene Can your pet be kept clean and comfortable? Are they able to groom themselves, or do they need assistance? Are they at risk of developing sores or infections from soiled bedding or fur?
H - Happiness Does your pet still experience moments of genuine joy or engagement? Do they respond to you, show interest in their surroundings, or seem present in the life they are living?
M - Mobility Can your pet move around with reasonable comfort and independence? Can they get to their food, water, and toilet area without significant difficulty or distress?
M - More Good Days Than Bad When you look at the week as a whole, are the good days still outweighing the hard ones? Or has that balance begun to tip?
⚠️ The Limitations of the Scale
The HHHHHMM Scale is a useful starting point. It gives you a framework for thinking about your pet's wellbeing in a structured way, and it can help bring some clarity when emotions make it hard to think straight.
But it has significant limitations, and understanding those limitations is just as important as understanding the scale itself.
A pet can score well and still be suffering.
This is perhaps the most important thing to understand about any quality of life scoring tool. A pet who is still eating, still drinking, still mobile, and still having occasional good moments can score reasonably well on the HHHHHMM Scale while experiencing significant emotional suffering, chronic low-grade pain, confusion, anxiety, or a profound loss of dignity.
The scale measures what is visible and quantifiable. It does not measure what is felt.
It does not account for emotional suffering.
A dog who is eating but spending most of their day pacing, panting, or staring into space. A cat who is mobile but hiding constantly, flinching from touch, and no longer purring. These are signs of significant suffering that may not register clearly on a scoring chart.
It does not account for individual personality.
A naturally stoic dog may show very few outward signs of pain even when they are suffering significantly. A quiet cat may always have hidden and always have been reserved. Without knowing your pet's baseline, a score can be misleading.
It can create false reassurance or false guilt.
A chart that looks okay can make you feel like you are imagining things, that your worry is an overreaction. Equally, a low score can make you feel like you have already waited too long. Neither of these feelings is necessarily accurate.
The scale is a tool. It is not the truth. Your knowledge of your pet, your instinct, and your presence with them every day are just as important, if not more so.
For more on the specific challenges of assessing quality of life in stoic pets, please see our blog "When Their Eyes Still Light Up."
🗓️ The Quality of Life Journal
One of the most practical and genuinely useful things you can do during this time is keep a simple daily journal of your pet's wellbeing. Not a formal document, just a few lines each day that help you track patterns over time rather than getting lost in the emotion of individual moments.
You might note:
🥣 Appetite and hydration, did they eat and drink, how much, with what level of interest
🩺 Signs of pain or discomfort, restlessness, panting, limping, reluctance to move, hiding
💩 Toilet habits, any changes, accidents, difficulty
🛌 Sleep, did they rest comfortably or were they unsettled
🤍 Interaction and engagement, did they seek you out, respond to your voice, seem present
🐾 Moments of joy, tail wags, purrs, interest in food, alertness, playfulness
Then look back over a week or two. Patterns often emerge that are hard to see day to day. A gradual decline in good moments. An increase in difficult ones. Or reassurance that things are more stable than they feel in the hardest moments.
📋 For our downloadable Quality of Life Tracker, click here.
🟢🟡🔴 Good Days, Okay Days, Bad Days
Another gentle and practical approach is to simply categorise each day.
🟢 A good day - your pet ate well, seemed engaged and comfortable, had moments of genuine pleasure or connection
🟡 An okay day - some struggles, but also some joy. Not their best but not their worst
🔴 A bad day - significant pain or distress, refusal to eat, withdrawal, confusion, or an overall sense that they are not okay
After two weeks, look at the pattern. If good days are becoming rare, if okay days are the best you can hope for, or if bad days are becoming the norm, that is important information.
🐾 The Signs No Chart Can Measure
Beyond the scale and the journal, there are signs that require something more than a checklist to see. They require knowing your pet, being present with them, and being willing to look honestly at what you are seeing.
The spark. As we discussed in Part 1, there is an indefinable light in a pet's eyes that tells you they are still present and still themselves. Watch for whether that spark is still there, and notice if it begins to fade.
Their relationship with you. Do they still seek you out? Do they respond to your voice and your touch? Do they seem to know you and want to be near you? Or does there seem to be a distance that was not there before?
Whether they seem like themselves. Every pet has a personality, quirks, habits, and ways of being in the world that are uniquely their own. Are those still present, even in a gentler form? Or does your pet seem like a diminished version of themselves, or someone else entirely?
Stress purring. It is worth noting that in cats, an increase in purring does not always signal contentment. Cats sometimes purr when they are in pain or distress as a self-soothing mechanism. If your cat's purring has increased alongside other signs of discomfort, it is worth paying attention to.
Subtle signs of pain. Pets, particularly cats, are masters at masking pain. Look for:
🐾 Reluctance to be touched in certain areas
🐾 Flinching or tensing when handled
🐾 Changes in posture, a hunched back, a tucked abdomen, a lowered head
🐾 Panting or rapid breathing that is not related to heat or exercise
🐾 Restlessness, an inability to settle or find a comfortable position
🐾 Withdrawal from family and favourite spots
🐾 Changes in facial expression, a tightened brow, half closed eyes, a tense jaw
Dignity and independence. Can they still move to where they need to go? Can they toilet without soiling themselves? Can they groom, or are they relying entirely on you for hygiene? When independence and dignity begin to slip significantly, it is worth reflecting honestly on what that means for your pet's experience of their days.
🌿 Putting It All Together
Assessing your pet's quality of life is not about finding a perfect score or reaching a definitive answer. It is about gathering information, from the scale, from the journal, from your daily observations, and from your deep knowledge of who your pet is, and allowing that information to form a picture.
That picture will not always be clear. There will be days when things look better than expected, and days when they look worse. There will be moments of genuine joy alongside moments of real difficulty.
What you are looking for, over time, is the overall arc. Is your pet moving toward more comfort and more joy, or toward more suffering and more difficulty? Is the balance shifting, and if so, in which direction?
You do not need certainty to act with love. You need presence, honesty, and the willingness to keep looking even when looking is hard.
Continue to Part 3: When You Are Too Close to See Clearly
🧡 We Are Here to Help
If you would like support assessing your pet's quality of life, please reach out. Dr Emma offers free phone Quality of Life consultations and in-home consultations across the Greater Brisbane Region for $198. There is no pressure and no judgement, just honest and compassionate guidance.
📞 1800 823 267 🌐 www.loveandtoebeans.com.au
📚 For more resources on pet quality of life, please visit our resources page.
📋 For our downloadable Quality of Life Tracker, click here.
Previous in the series:
Part 1: What Quality of Life Really Means for Your Pet
Part 2: How to Assess Your Pet's Quality of Life
Next in the series:
Part 3: When You Are Too Close to See Clearly
Related reading:
"But They're Still Eating and Wagging Their Tail"
"But My Cat Is Still Eating and Purring"
"When Their Eyes Still Light Up"
"When Doing Everything Isn't Always the Kindest Choice"
"When Silence Speaks Volumes: Understanding Pet Body Language"
🐾 With love,
Love & Toe Beans
Love & Toe Beans provides Quality of Life consultations, gentle in-home pet euthanasia, pet cremation, and grief support across the Greater Brisbane Region including Brisbane, Logan, Redland Bay, Ipswich and Moreton Bay.