How Will I Know It’s Time? Your Senior Pet’s Quality of Life

End-of-life decision-making can be the most difficult part of pet ownership. At Mercer Street Veterinary Hospital, our clients often ask us how they’ll know when their pet is ready, hoping for a clear sign that will help them feel at peace with such a difficult decision, and the final, heartbreaking loss. Unfortunately, obvious signs seldom appear, and may not be noticeable until the pet has suffered for some time. 

Most often, ailing pets are ready long before their human companions, but deep emotional bonds prevent owners from recognizing their beloved pet’s decline. Quality of life (QOL) assessment tools can provide unbiased insight into a pet’s emotional and physical health, and help owners make timely and compassionate decisions about their pet’s final days. 

What is quality of life for pets?

QOL has no set definition, and will look different for every pet, because the assessments are based on the owner’s personal beliefs and understanding of their pet. However, the following categories are typically included when considering an acceptable QOL.

  • Physical comfort — Pain is nonexistent or well-controlled, and doesn’t significantly interfere with the pet’s daily life.
  • Independence  — The pet is reasonably mobile, needs only moderate physical assistance, and has some autonomy or control over their choices (e.g., when to eat, go outside, or change their resting position).
  • Awareness — During awake hours, the pet is engaged and responds to their environment.
  • Basic functions — These include life-sustaining processes, such as eating, drinking, and eliminating, without needing significant assistance or coercion.
  • Favorite things — The pet can engage in their normal, or slightly modified, favorite activities (e.g., take a walk, play with a favorite toy) and perform their characteristic behaviors (e.g., getting excited when a favorite person arrives, barking at the mailman, or begging for table scraps). 

QOL is questioned when pets can no longer perform their daily functions, no longer express interest in their favorite activities or behaviors, or require a high level of supportive care and assistance to achieve basic comfort or complete fundamental processes (e.g., basic hygiene, elimination). 

Of course, these descriptions leave room for individual interpretation, so using objective QOL scales whenever end-of-life decisions are uncertain is important.

Measuring your senior pet’s quality of life

The Mercer Street Veterinary Hospital veterinarians recommend the HHHHHMM Quality of Life Scale for pets. This veterinarian-developed assessment is an effective starting point and a decision-making tool for owners who are considering humane euthanasia for their pet. The HHHHHMM scale features seven key areas that are scored on a scale of 0 (poor) to 10 (excellent). Pets who are scored higher than 35 are considered to have a great quality of life, while veterinary intervention is recommended for those scoring at or below 35. 

The HHHHHMM scale challenges owners and caregivers to look closely at their senior pet’s daily activities and behavior in each category, as well as how much care and support they need, including:

  • Hurt — Pain most greatly impacts a senior pet’s QOL by creating a cascade of physical and emotional effects. Although senior pet owners readily recognize joint pain, pain can also include respiratory distress (e.g., struggling to breathe), uncontrollable nausea, digestive issues, and some cancer types.  
  • Hunger — Your senior pet’s appetite speaks volumes about how they feel. Food refusal and picky eating can indicate an underlying problem or a disease progression. Chronic inappetence can quickly lead to malnutrition or starvation in senior pets, who may need a feeding tube in extreme cases to ensure proper food intake.
  • Hydration — Inadequate water intake and involuntary fluid loss can lead to dehydration in ailing senior pets. Without supplemental fluid therapy (i.e., receiving fluids under the skin) senior pets may suffer from fatigue, disorientation, and organ damage.
  • Hygiene — Dignity must be considered for an ailing pet. Immobilized or weak pets need cleaning and regular care to avoid self-soiling, which can lead to painful urine scald and chronic infections. Pets who cannot change their resting position without assistance may develop complications such as lung collapse (i.e., atelectasis) or pressure sores on their elbows and hocks.
  • Happiness — Fear, anxiety, and depression can negatively affect a senior pet’s health as much as pain. Despite vision or hearing loss, aging pets should be alert, responsive, and aware of their surroundings, seek attention from loved ones, and still enjoy their modified favorite activities. 
  • Mobility — Movement is life for animals, and the inability to move, or to perform basic tasks such as going outside, reaching the litter box, or posturing to eliminate without owner support, can damage a pet’s physical health and their self-confidence. Uncoordinated movements and seizures may lead to serious injury if the pet falls.
  • More good days than bad — Counting your pet’s good and bad days provides a simple barometer for their QOL. When their bad days outnumber the good, the pet likely has reached a turning point, and humane euthanasia is the kindest option to prevent further suffering.

If your pet scores below 35 on the HHHHHMM scale, contact your Mercer Street Veterinary Hospital veterinarian to learn about their end-of-life care options. If your pet receives an acceptable quality of life score but ranks low in one or two categories, let us know—we may be able to enhance their life with supportive care, pain management, or lifestyle modifications. 

If you’re wondering when to say goodbye to your pet, don’t wait for a feeling, a notion, or a sign—use the HHHHHMM Quality of Life assessment, and then share your concerns with your pet’s Mercer Street Veterinary Hospital veterinary team.

By |2023-01-16T00:13:03+00:00January 10th, 2023|Uncategorized|0 Comments

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