How to use the pet quality of life checklist
This is a checklist for sitting down quietly and writing out how a pet near the end of life is doing. Score seven items from 0 to 10 and the tool reports the total and the lowest-scoring item, and adds the direction of travel if you enter last timeβs total. The point is not to collect scores but to pick what to raise with your veterinarian first.
The HHHHHMM scale records hurt, hunger, hydration, hygiene, happiness, mobility and whether good days outnumber bad ones, each from 0 to 10 where 10 is ideal, for 70 points in all. It is widely cited in veterinary hospice care, and the scale itself states that it is a reflection tool rather than a diagnosis. A total above 35 is described as a quality of life that can support continued hospice care. Current as of October 2026.
The trend across days and weeks matters far more than any single dayβs number. This checklist never recommends a moment and never makes the decision for you; at 35 or below the conclusion goes only as far as talking things through with your veterinarian. It is for reference only and does not replace veterinary care. Contact your veterinarian right away if you notice symptoms or suspect a problem.
Frequently Asked Questions
The scale never names a moment at any score. A total of 35 or below is a signal to sit down with your veterinarian and talk about how things are going and what care looks like; the decision stays with you after that conversation.
Comfort swings day to day, and a medication change or a bad night moves the total a lot. Scoring at the same time of day for several days shows the direction, which is why the previous-total field is there.
It scores hurt, hunger, hydration, hygiene, happiness, mobility and whether good days outnumber bad ones from 0 to 10 each, for 70 points in all. It is a reflection tool widely cited in veterinary hospice care.