Dog Quality of Life Scale & Calculator
This free dog quality of life calculator is built on the veterinarian-developed HHHHHMM scale (with a JOURNEYS option) to turn how your dog is doing into a clear score. It's built to be repeated over time — one score is a snapshot, but the trend tells you what's really happening. It supports your decisions; it doesn't replace your veterinarian.
The HHHHHMM Quality of Life Scale by Dr. Alice Villalobos, as described by VCA Animal Hospitals. Each of the 7 categories is scored 1–10 (10 = best), for a total out of 70. VCA says a total above 35, or a score above 5 in every category, suggests quality of life is acceptable enough to continue end-of-life care and support.
1. Hurt
Is pain controlled? Can your dog breathe easily? VCA calls adequate pain control, including the ability to breathe properly, an absolute necessity.
2. Hunger
Is your dog eating willingly? VCA suggests trying hand-feeding first; if that doesn't work, a feeding tube or a blended or liquid diet may be options to discuss with your vet.
3. Hydration
Is your dog drinking enough? VCA notes that fluid given under the skin is an easy, well-tolerated way to supplement what an ailing dog drinks.
4. Hygiene
Can your dog be kept clean and dry, and move away from stool or urine after an accident? VCA also asks about a matted coat and, for bedridden dogs, bedsores.
5. Happiness
Is your dog still interacting with family and their surroundings? VCA asks whether they are experiencing joy or mental stimulation, and notes that dogs communicate with their eyes as well as by wagging their tails.
6. Mobility
Can your dog get around, with or without help? VCA mentions slings, harnesses and wheeled carts as options when a dog can't move on their own.
7. More good days than bad
VCA says quality of life is compromised when there are too many bad days in a row, or when a dog seems 'turned off' to life. Bad days may mean nausea, vomiting, diarrhea, seizures, frustration, unrelenting pain or discomfort, or an inability to breathe.
Score all 7 factors to see your interpretation.
Track trends over time on the App Store →One score is a snapshot. The trend is the truth.
A single number can't tell you which way things are heading. SteadyTails logs your pet's quality of life over time and shows the trend — so you, your household, and your vet see the real picture, not just one hard day. Available now on the App Store.
Free to download · iOS 16+ · Android version coming soon
How to use this scale
Score at the same time of day
Dogs have good days and bad days. In interviews, owners of dogs with osteoarthritis described good and bad days changing how willing and able their dog was to exercise. Scoring at a consistent time helps stop a normal ups-and-downs rhythm from looking like a decline.
Ask everyone who cares for your dog
The person handling the lead sees mobility, and the person feeding sees appetite. Have each caregiver score independently before comparing, so nobody anchors on someone else's number.
Take the trend to your vet
A dated series of scores gives your vet more to work with than "he's been slowing down". Your vet can weigh it against the diagnosis and against comfort options you may not know exist.
The HHHHHMM factors explained
The HHHHHMM Scale (Dr. Alice Villalobos) rates seven areas of comfort from 1 to 10 (10 is best). Here's what each one means for your dog.
1. Hurt
Is pain controlled? Can your dog breathe easily? VCA calls adequate pain control, including the ability to breathe properly, an absolute necessity.
2. Hunger
Is your dog eating willingly? VCA suggests trying hand-feeding first; if that doesn't work, a feeding tube or a blended or liquid diet may be options to discuss with your vet.
3. Hydration
Is your dog drinking enough? VCA notes that fluid given under the skin is an easy, well-tolerated way to supplement what an ailing dog drinks.
4. Hygiene
Can your dog be kept clean and dry, and move away from stool or urine after an accident? VCA also asks about a matted coat and, for bedridden dogs, bedsores.
5. Happiness
Is your dog still interacting with family and their surroundings? VCA asks whether they are experiencing joy or mental stimulation, and notes that dogs communicate with their eyes as well as by wagging their tails.
6. Mobility
Can your dog get around, with or without help? VCA mentions slings, harnesses and wheeled carts as options when a dog can't move on their own.
7. More good days than bad
VCA says quality of life is compromised when there are too many bad days in a row, or when a dog seems 'turned off' to life. Bad days may mean nausea, vomiting, diarrhea, seizures, frustration, unrelenting pain or discomfort, or an inability to breathe.
Prefer a different framework? The calculator above also offers the JOURNEYS Scale (Dr. Katie Hilst), an 8-factor alternative scored out of 80.
What tends to slip first in dogs
WSAVA's pain guidelines note that the gradual behavior changes chronic pain produces can go unnoticed or get put down to aging. These are places where it's easy to under- or over-score, and what to look at instead.
Mobility reads as "just getting old"
Reluctance on stairs, hesitating before jumping into the car, slipping on hard floors, or taking a run-up to stand are mobility scores, not personality. WSAVA's chronic-pain checklist for dogs asks whether they can lie down, sit, jump and exercise. Score what your dog can actually do this week, not what they managed last year.
Night-time restlessness is a comfort signal
WSAVA lists a sleep and night-time restlessness questionnaire among its tools for dogs with arthritis, and a Lap of Love veterinarian notes that panting, pacing and whining in end-stage arthritic dogs usually worsen at night. Pacing, repeated repositioning or waking the household can reflect pain, anxiety or breathing effort, and it belongs in the Hurt score.
Greeting behavior is an honest measure of happiness
VCA asks whether a dog is still interacting with family and their surroundings. A dog who no longer comes to the door, disengages from a favorite toy, or stops asking for contact has had a real change in the Happiness category, even if they still eat well.
A good appetite doesn't rule pain out
Reduced appetite is on WSAVA's list of pain signs in dogs, but it is one signal among many, including reduced play, trouble lying down or jumping, and a sad or withdrawn mood. Score Hurt, Mobility and Happiness on their own merits rather than letting a clean bowl lift the whole score.
Hygiene is about being kept clean and dry
VCA's Hygiene questions are whether the dog can be brushed and kept clean, whether the coat is matted, and whether they can move away from stool or urine after an accident. For a bedridden dog it also asks about turning, padding and bedsores.
Frequently asked questions
What is a good quality of life score for a dog?
On the HHHHHMM scale (7 categories, 1–10 each, 70 total), VCA says a score above 5 in each category, or a total above 35, suggests quality of life is acceptable and that it is reasonable to continue end-of-life care and support. The scale doesn't say more than that about lower scores, so treat a total of 35 or below as a prompt to talk with your vet. Treat the number as a conversation-starter, not a verdict, and watch the trend across repeated assessments.
When is it time to put a dog down?
There is no single score that decides this. VCA says quality of life is compromised when there are too many bad days in a row, or when a dog seems "turned off" to life. JOURNEYS says severe breathing difficulty needs immediate medical attention, and that a low score on any single measure may be a reason to consider euthanasia. Lap of Love describes the right time as a subjective window rather than a single moment. If your scores are low or trending downward, have an open, compassionate conversation with your veterinarian about comfort and options.
How often should I assess my dog's quality of life?
Lap of Love suggests having several family members use its quality of life tools daily or weekly. Pick a schedule, keep to it, and involve the whole household so it isn't one person's judgment. Quality of life often changes gradually, so a consistent record makes a falling trend visible early, while there's still time to adjust care with your vet.
Is this a validated medical test?
No. HHHHHMM and JOURNEYS are conversation tools for families and veterinarians. Dr. Villalobos noted in 2011 that there were no clinical studies of end-of-life quality of life assessment in pets, and a 2023 Italian study of 314 guardians reported that the HHHHHMM model's fit was "partially adequate". For chronic pain such as arthritis, WSAVA recommends validated owner questionnaires, the Canine Brief Pain Inventory and the Liverpool Osteoarthritis in Dogs questionnaire. Neither scale here is on WSAVA's list, so ask your vet about those if pain is the question.
Does this calculator replace my veterinarian?
No. It's a structured, nonjudgmental way to reflect on comfort and to bring an organized record to your vet. It does not provide veterinary advice, diagnosis, or treatment. Your veterinarian can weigh your scores against your dog's specific diagnosis and comfort options you may not know exist.
Sources
- Villalobos HHHHHMM Quality of Life Scale (via VCA Animal Hospitals)
- Hilst JOURNEYS Quality of Life Scale
- Lap of Love — How will I know it's time?
- WSAVA — 2022 guidelines for the recognition, assessment and treatment of pain
- Villalobos AE — Quality-of-life assessment techniques for veterinarians (2011)
- Belshaw et al. — Slower, shorter, sadder: how dog walks change with osteoarthritis (2020)
- Testoni et al. — Validation of the HHHHHMM Scale in the Italian context (2023)