Using a Quality of Life Scale for Dogs

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A quality of life scale for dogs can be a helpful way to objectively assess your dog’s comfort, happiness, and overall well-being. Integrative veterinarian Dr. Julie Buzby explains the concept of quality of life, discusses ways to assess it (including sharing her favorite quality of life scales for dogs), and explains what to do when you see your dog’s quality of life beginning to decline.

Dogs play such an enormous role in our lives—as best friends, confidants, and family members. No matter what, we know they love us unconditionally.

However, the sad reality is that we often outlive our beloved dogs. As our dear companions begin to fade away, their quality of life may weigh heavily on our minds. We may watch and worry—questioning whether our beloved companions are still enjoying life.

One way to help answer that question is by using a quality of life scale for dogs. It can provide an objective way for you to evaluate your senior dog’s quality of life and allow you to pick up on small changes in your dog that otherwise may go unnoticed. To understand the quality of life scale, let’s start by defining “quality of life.”

What is considered “quality of life” for a dog?

Quality of life means different things to different people. At its most basic, this term refers to a dog’s daily lifestyle, whether his or her basic needs are met, and how he or she is feeling. A good quality life for a dog may mean:

• Eating and drinking normal amounts (and looking forward to food and treats)
• Being able to play with toys, family members, or other dogs
• Enjoying taking walks, hikes, swimming, etc.
• Resting comfortably and being able to sleep (but not sleeping excessively)
• Enjoying spending time with family members
• Being able to hold urine and feces until getting outside
• Having tolerable pain levels (or ideally no pain)
• Being free of fear or confusion
• Finding enjoyment in favorite activities

Regardless of which activities matter most to you and your dog, the general concept is the same. Every dog deserves to be as happy, healthy, and comfortable as possible. This is the case even—or perhaps especially—in times of illness and during a dog’s senior years.

Quality of life has a wide range of meanings. It is important to assess each pet individually.

Why assess a dog’s quality of life?

It can be natural to think more about quality of life when your dog has been diagnosed with a terminal disease or is struggling with the effects of aging. But these aren’t the only reasons to make a conscious effort to think about your dog’s current well-being. You may also want to consider quality of life when your dog is dealing with these situations:

Chronic medical conditions

Kidney failure in dogs, liver disease in dogs, Cushing’s disease in dogs, seizures in dogs, osteoarthritis in dogs, dental disease in dogs, and other chronic diseases can take a toll on your dog over time.

Lifelong medications

Sometimes side effects or the need to try to convince your dog to take pills day in and day out can become overwhelming.

Need for certain interventions

Some dogs may need specialized care to meet their daily needs. For example, dogs who can’t or won’t eat on their own might need a feeding tube. While this is usually fairly non-invasive, it may impact quality of life for dogs who need tubes constantly replaced or repaired.

As another example, a paralyzed dog may need help moving from place to place or expressing his or her bladder. This can alter quality of life as well, especially if the dog previously enjoyed sleeping on the furniture, romping in the yard, or following someone from room to room.

Changes in hearing or sight

Many dogs who are blind and deaf adjust quite well to their condition. However, even if you do your best to communicate with your deaf dog or help your blind dog, these changes can be difficult for some dogs and may negatively impact quality of life.

Dogs that are deaf or blind can adjust well over time, but some may be too negatively impacted, especially when they have other health concerns.

Cancer treatments

Thankfully, radiation and chemotherapy do not typically affect dogs as severely as they do humans. However, it is still important to be mindful of your pet’s quality of life—both as a result of the treatments, and due to the cancer itself. Cancer can affect a dog’s energy, appetite, sleep schedule, and pain level.

Behavior changes

Canine cognitive dysfunction and the resulting signs of dementia in dogs can greatly impact your senior dog’s personality and confidence. Also, dogs who have severe phobias or separation anxiety may be in a great deal of mental pain, even if they are physically well.

This list is good starting point, but it isn’t comprehensive. When in doubt, talk to your veterinarian to see if he or she thinks you should be assessing your dog’s quality of life on a regular basis.

How do you use a quality-of-life scale for dogs?

If you determine that you need to assess your dog’s quality of life, a quality of life calculator or scale can be a helpful tool. Most are very user friendly. Typically, they include a list of questions about your dog’s daily life with either a ratings scale or yes/no check boxes.

6 tips for using quality of life scales for dogs

Here are six tips that can help you get the most benefit out of your dog’s quality of life assessment tool:

1. Know the benefits of using the same scale vs. mixing it up

Most of the time, once you find the quality of life scale that is right for you and your dog, it is best to stick with it. Using the same scale repeatedly gives you a baseline and a way to accurately compare results. Also, it means you will become familiar with the criteria. This allows you to unofficially evaluate your dog’s quality of life during your day-to-day interactions.

As a caveat to this, there are times when it can be beneficial to alternate quality of life scales or use multiple ones. That approach can help you get a fresh look at your pet’s quality of life. It may also help you see things that your original scale overlooked.

When measuring quality of life, it is beneficial to start with a monthly assessment initially.

2. Work through the scale regularly.

Every scenario is different for every family, but I usually recommend working through the scale at least once a month initially. As your dog approaches the time when you might need to consider euthanasia, it can be beneficial to use the scale more often—perhaps every week or every day.

3. Evaluate a good day and a bad day to create a baseline.

In the beginning, it is helpful to use the scale on at least one “good day” and one “bad day.” This helps you know what a “good day” looks like for your dog. It can also be a helpful reminder of the things your dog is still enjoying in life, and what is really important to him or her.

On the flip side, having a baseline for “bad days” is also important. That way you have an idea of what it looks like when your dog starts declining.

4. Pick a time (or times) of day to complete the evaluation.

For accuracy, evaluate your dog’s quality of life at the same time of day. Sometimes a dog’s quality of life can vary throughout the day, which may skew the results. For example, if you assess your dog during his or her best time of day and then a week later evaluate during his or her worst time of day, your results will not be as accurate.

There are also times when it can be helpful to use the quality of life assessment scale several times in the same day—perhaps in the morning and again in the evening or at night. This gives you an understanding of how your dog’s quality of life may fluctuate throughout the day.

5. Involve your family and close friends in assessing your dog.

Are you unsure of how your dog is feeling? Concerned you might be missing clues as you observe your dog? You may want to consider asking a close family member or friend to answer a quality of life quiz for your dog. Also, a close friend may provide a more objective opinion.

Keep in mind that it is important to ask someone who knows your dog very well so they can answer the questions.

Sometimes family or close friends who know your pet can help provide an objective opinion.

6. Enlist the help of your vet.

Any time you are unsure of your answers or want help working through a quality of life checklist for your dog, remember that your veterinarian is there to support you. Thinking about quality of life and contemplating when you may need to say goodbye is one of the most difficult decisions you may make on your dog’s behalf. Your veterinarian can be a compassionate and knowledgeable resource for you and your dog during this difficult time.

How do I find a good quality-of-life scale for dogs?

To find a good quality of life scale, don’t hesitate to reach out to your veterinarian. Not only is your veterinary team a great resource, some vets have a particular scale they recommend. Also, you may find a scale on your vet’s own website or social media. If you prefer a hard copy, you can give your vet’s office a call and ask to pick one up.

There are many quality of life quizzes online. Dog hospice, in-home euthanasia services, and veterinary school websites are all great places to find downloadable quality of life scales.

Additionally, you can use one of the scales I recommend:

HHHHHMM Quality of Life Scale

The HHHHHMM Quality of Life Scale (created by Alice Villalobos, DVM, DPNAP) is one of the most common scales. The five H’s stand for: Hurt, Hunger, Hydration, Hygiene, and Happiness. The two M’s stand for Mobility and More good days than bad. Each of these categories has a question that you score on a scale of 1 to 10. The total scale will help you determine if your dog’s quality of life is potentially declining.

OSU Quality of Life Scale

I also really like the Quality of Life Scale created by The Ohio State University Veterinary Medical Center. It is similar to the HHHHHMM scale but breaks those 7 broader categories into 25 more specific criteria that you rate individually on a scale of 1 to 5.

Both of these resources provide a dog quality of life scale pdf that you can easily print off and keep for your records. This allows you to look back at your answers from the previous weeks or months and compare them to your dog’s current score.

Using a calendar to mark good versus bad days can be helpful.

Calendar method

A simple and useful way to get a snapshot of your dog’s quality of life is to use a calendar. At the end of each day, decide if it was a “good day” or a “bad day” and write it down on the calendar. Using one color for “good” and another for “bad” can give you a nice visual representation of the days.

If you count up the marks and the bad days are becoming more frequent than the good, your dog’s quality of life might be declining.

DIY Quality of Life Scale

If you do not want to use one of the scales listed above, you also can create a basic scale for yourself. The easiest way to do this is to write down a list of activities that your dog loves to do. If you begin noticing that you start answering “no” when you ask yourself if your dog likes to do those same things, then it is possible that your dog’s quality of life is declining.

Finally, you may use my quality of life assessment below…

How does caretaker fatigue factor into quality of life evaluations?

One of the most important questions on the quality of life assessment above is this one: “Do you become frustrated or exhausted caring for your dog? This question is an important (but difficult) one to ask yourself. Caretaker fatigue is real, and it is relevant to a quality of life discussion. You need to be able to recognize when you start becoming impatient or resentful toward your dog.

No matter how much we love our dogs, caring for them during their senior years or after a terminal diagnosis is hard. This can be especially true in cases where dogs are having accidents or are sick regularly. It also can happen when dogs need assistance moving around and rely on your help for simple tasks, or when cognitive decline has changed their personality and behavior.

I know you love your dog and would do anything to help him or her. But I want you to know that it is okay and normal to become overwhelmed sometimes. If the challenges of caring for your dog are affecting your bond, talk with your veterinarian about ways to help you and help your dog.

What if you realize your dog’s quality of life is declining?

You should also talk to your veterinarian when, based on the quality of life scale results, you suspect your dog’s quality of life is declining. Your vet can help you interpret your dog’s quality of life questionnaire and also assess your dog. Usually this involves looking at how your dog is doing physically and asking you some questions regarding your dog’s behavior at home. The questions may be similar to those on the quality of life assessments.

With this information, your vet may make recommendations regarding how to proceed. Sometimes, there are ways to improve a dog’s quality of life again once it starts to decline. Depending on the situation, these recommendations could include:

Unfortunately, there may come a time when you’ve exhausted all the options. In this situation, you may have to start talking about preparing for your dog’s euthanasia or natural passing.

It will never be easy to say goodbye. Evaluating quality of life over time may help you make the best decision for your pet.

Saying goodbye

The hardest part of being blessed with a dog is the time when you have to say goodbye. No matter how long you have had with your dog, it is never going to be long enough. Many people express that losing a dog is harder than losing a friend. This is because dogs spend every day with us and become our best friends. Your dog is there for you no matter what.

If you are facing the difficult decision between dog hospice care or euthanasia, know that it is okay to not be sure how to proceed and to have a lot of questions. This is a very difficult time for you and your dog. Rely on family, friends, and your veterinarian (or a veterinarian who specializes in end-of-life care) to help you and your dog through this time.

You may also benefit from these articles:

Thinking about your dog’s quality of life is good but hard

As you consider your dog’s final days or months, a quality-of-life scale may give you clarity and direction. You know where your dog was. And you know where he or she is now. But I know it can be heartbreaking at the same time. Sometimes seeing those checks or adding up the score may make your sweet dog’s struggles all the more real.

Know that you are not alone in this. You have friends, family, and your veterinarian in your corner (and your dog’s corner). They are here to help you…be that by filling out a quality of life scale for your dog, offering solutions, or being a listening ear and a shoulder to cry on.

Are you considering your dog’s quality of life?

Please share your story below. We can all support each other.