As our pets age, we think about the impending reality of our lives without them. Many of us push away these thoughts, but as a responsible and compassionate pet owner, you should learn to recognize your pet’s discomfort, pain, and suffering signs. In addition to being veterinary professionals, our Scripps Ranch Veterinary Hospital team members are pet owners, and we understand the many emotions you feel when making difficult end-of-life care decisions for your beloved pet. If you face the challenge of making a humane decision about your pet’s end-of-life care, we recommend these guidelines from the hurt, hunger, hydration, hygiene, happiness, mobility, more good days than bad (HHHHHMM) scale, a commonly used quality-of-life scale, which veterinarian Dr. Alice Villalobos developed to prevent senior pets’ unnecessary pain and suffering, and to help you assess their quality of life.
What is a quality-of-life scale for pets?
A quality-of-life scale allows you to evaluate your pet’s wellbeing, to make appropriate—but no less difficult—decisions regarding their end-of-life care. When your senior pet ages, and their health declines, they rely on us to decide when to let them go, and end their suffering. Making this agonizing decision can cause you to second-guess yourself constantly. You can use an objective quality-of-life scale at home to assess the factors contributing to your pet’s comfort and wellbeing.
What does a quality-of-life scale for pets consider?
Quality of life considers key elements that make life survivable, comfortable, and enjoyable. A quality-of-life scale helps you assess your pet’s appetite, mobility, energy and pain levels, and overall wellbeing. Each of the seven HHHHHMM criteria receive a score of 0 to 10, and the total score offers you a clear understanding of your pet’s health and wellbeing. Of course, you should also discuss your pet’s quality of life with your veterinarian. The HHHHHMM quality-of-life scale assesses the following:
- Hurt — Pets are exceptionally good at hiding their discomfort, and their initial pain signs tend to be subtle. However, as your pet’s pain becomes more severe, their signs become increasingly apparent when they exhibit behavioral changes. Most senior pets develop osteoarthritis, and the condition’s pain may cause them to limp, and have difficulty walking, rising, and lying down. A pet in pain often struggles to jump up to their favorite cozy couch spot, maneuver the stairs, and eliminate properly. While osteoarthritis is senior pets’ most common pain-causing condition, other health issues can make them feel discomfort. When assessing your pet’s pain, consider whether their discomfort is being well-managed, or whether medical and alternative therapies are no longer working. Chronic pain can significantly decrease a pet’s quality of life.
- Hunger — Often signaling a pet’s underlying health problem, a decreased appetite leads to low energy, weight loss, and weakness. If your pet has a chronic condition, your veterinarian may prescribe an appetite stimulant or medications to manage disease side effects such as nausea. Your veterinarian may recommend your pet receive nutrients through a feeding tube or syringe. However, when your pet loses all interest in food, or is in too much pain to eat, they do not take in enough nutrition to maintain bodily processes, and their quality of life suffers.
- Hydration — In addition to nutrition, adequate hydration is essential to a pet’s quality of life. Although not a long-term solution, fluid can be administered under a dehydrated pet’s skin. Think about whether your pet can keep water down, or whether they are vomiting so profusely they are unable to stay adequately hydrated.
- Hygiene — Hygiene evaluates your pet’s ability to keep clean and tidy, and is an indicator of their overall health. Pets with decreased mobility and elimination issues may have problems staying clean. To prevent your immobile pet from developing pressure sores, you must regularly roll their body from side to side. Hygiene is a factor in your pet’s overall comfort, and you must seriously consider this factor when assessing their quality of life.
- Happiness — You know your pet best. Does your pet appear happy, and find joy in their favorite activities? Do they interact with your family, or do they prefer solitude? Think about what brings your pet joy, and consider whether they show an interest in or continue to enjoy these activities.
- Mobility — A pet’s mobility decreases with age, and you can help them continue to move around through the use of slings, harnesses, wheel carts, and wagons. Mobility and hygiene are linked, and when a pet is immobile, keeping them clean can be challenging and, at times, impossible.
- More good days than bad days — Consider all aspects of your pet’s health when assessing their quality of life. When your pet’s bad days outnumber their good days, you know your pet is suffering, and their quality of life has been extremely compromised.
Assessing your senior pet’s quality of life can be difficult, and we encourage you to reach out to us for support when you need to hear an objective voice. Contact our Scripps Ranch Veterinary Hospital team for help evaluating your pet’s comfort and happiness.