Deciding to euthanise your companion animal is the most difficult decision we ever make as pet owners. Even if we can see our pet no longer has the same quality of life they once had, it is still heart wrenching to know when it's time to say goodbye. Since our pets can’t communicate with us, knowing when your pet is experiencing an adequate quality of life isn’t always clear cut. Older, unwell or injured pets naturally try to hide the signs that they are ill as a defence mechanism, so it's common to first see signs for conditions that have had a chance to progress.

That's why we must rely on their actions and the advice of veterinary professionals to help guide us. For example, if you begin to notice signs that your pet is experiencing pain or is unlike their normal happy self, you can assess their pain and health condition to determine their quality of life. To help you to assess your pet's quality of life, Patch and Purr will discuss the signs to look out for, the scale of measuring and how to know when it might be the right time to consider euthanasia.

What is Quality of Life?

Quality of life is a term used by veterinary specialists that describes a pet’s well-being, including physical, behavioural and mental. Under the use of a veterinarian, the term helps us understand whether a pet is happy, in pain, is declining in health or suffering. Unfortunately, although we wish they could, pets can’t tell us how they feel. However, sometimes with diligence, we can pick up on signs that indicate when a pet’s health or quality of life is diminishing.

We know our pet better than anyone else, so if you notice unusual behaviour in your pet, it’s important to make a note of it. If it is truly unusual, like a pet missing meals for more than a couple of days, or your pet is becoming aggressive or flinching away from you, it could indicate something is wrong with your pet and they’re potentially in pain.

How Can I Measure My Pets Quality of Life?

Developed by renowned veterinary oncologist Dr Alice Villalobos, the quality-of-life scale can indicate when it might be time to consider euthanasia. The scale is generally used with pets with a hospice care plan or life-limiting disease; it provides pet owners and vets with the guidelines to tune their care plan throughout their palliative care. 

The scale looks at seven different categories and scores each parameter from 1 to 10, with 10 being the best. On the scale, any score above five or an end score greater than 35 indicates that the pet's quality of life is acceptable.. The categories to be measured can be remembered as "HHHHHMM." This list of letters stands for Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad.

The Quality of Life Scale: The HHHHHMM Scale

1. HURT

Being in pain, no matter if it's a person or pet, can negatively affect our happiness and quality of life, mainly chronic and ongoing. However, it can be controlled through oral or injectable medication. Since breathing on the HHHHHMM scale is ranked as an integral aspect of pain management, your pet's ability to breathe comfortably is an essential factor to consider. 

2. HUNGER

Whilst not all pets will gorge when given a chance; some will continue to eat and eat. This is thought to be based on the “scarcity” biology retained from our pet's ancestors. If your pet is a foodie, but you’ve recently noticed they’re no longer begging you for food around the dinner table, it's something to take note of. If a pet has lost its appetite, there could be many reasons, ranging from dental issues, illness, and picky taste buds. If this is unusual behaviour, and your pet is unwillingly eating, you can try hand-feeding. If this is difficult, a feeding tube is an alternate option. 

3. HYDRATION 

Is your pet dehydrated? To test, you can use your thumb and forefinger to gently pinch a patch of skin on the back of their head. If hydrated, the skin will bounce back once released. But if skin moves slowly, it's a sign of dehydration. Adequate hydration is essential for health, so for pets not drinking enough, daily use of subcutaneous fluids can substitute fluid intake.

4. HYGIENE 

Is your pet able to clean itself and move away from any bathroom accidents it may have? Some pets with tumours growing outside the body also experience discharge that will need to be cleaned. This can be done using warm soapy water and a washcloth. If your pet is recovering from surgery, an injury or illness, and is bedridden, they’ll need to be turned frequently to avoid pressure sores. Animals with their fur shaved are also prone to this as they are missing the cushioning it was providing. If you have wooden flooring, make sure your pet is resting on padded bedding to help alleviate and prevent bedsores. 

5. HAPPINESS 

Is your pet experiencing joy or mental stimulation? Pets communicate with their eyes and body language, like wagging their tails and slow blinking in cats. Think back to when you were last sick; you are generally less happy during this time. Pets aren’t too different when they are in pain. To perk your pet up, you can place their bedding closer to where the family gathers. As social “pack” animals, dogs want to be included in the family and may become depressed if separated and can’t engage with the family. 

6. MOBILITY 

If your pet is struggling to mobilise independently, there are mobility devices available to help. Slings or harnesses offering support may be all that's required in some circumstances. For pets needing a little more support, two-wheel carts, four-wheel carts, and wagons are available. With the assistance of some new wheels, your pet can remain active and happy. If your dog is bigger, this is especially important since lifting them is more physically taxing and difficult for some owners. 

7. MORE GOOD DAYS THAN BAD 

When anyone has a chronic medical condition, both human and animal, it's realistic to accept that not every day may be a good day. Living with a health condition is turbulent, and some days are sometimes pain-free and energetic, and others you might find that your pet needs some time to rest and slow down. However, when there are too many bad days in a row, a pet's quality of life can be compromised. So what do we mean by bad days? Unmanaged pain, nausea, diarrhea, seizures and poor ability to breathe comfortably are all factors that can dampen the joy of life. 

How Frequently Should a Quality of Life Assessment Be Performed?

Planning for the end of life is an upsetting reality of being a responsible pet owner. Yet, it is a noble and compassionate commitment pet owners can make to their pets. A weekly assessment is sufficient to assess your pet’s happiness and health with the quality of life scale. With consistent evaluation, you and your veterinarian will be able to track your pet’s quality of life over time. 

If your pet's condition deteriorates, we recommend a daily evaluation. If your pet's condition reaches a point where you see a decline in numerous factors on the HHHHHMM Scale, it's time to talk to your veterinarian about altering their hospice plan. With this conversation, additional measures like increasing pain relief can be discussed. If all efforts are exhausted, it may be necessary to consider euthanasia to protect your pet from substantial pain. 

How Will I Know it’s the Right Time to Consider Euthanasia?

No one wants to picture their pet in pain or consider the possibility of euthanasia. But it is crucial to plan for the end of life before that time arrives. At Patch and Purr, we know how upsetting it is to make important decisions about your pets’ health. As an adored family member, our blog covers how you can navigate these topics with your household. 

With the guidance of The Quality of Life scale and your veterinary professional, your decision can be made with careful consideration and compassion, which we hope will relieve any anxiety or doubt about your pet's end of life. At every Patch and Purr location, we provide various pet aftercare options. In our care, you can be assured there is an option to suit you and your families preferences and requirements. 

The information contained in this article is general in nature and does not take into account your personal situation. You should consider whether the information is appropriate to your needs, and where appropriate, seek professional advice.