Glossary

Quality of life scale

A scoring tool owners and vets use to judge an ill or elderly dog's comfort and decide when to consider euthanasia.

Also called: HHHHHMM scale, quality of life assessment, Villalobos scale, good day bad day chart, QOL scale

A quality-of-life scale turns a worrying, emotional question into something concrete. The best-known is the HHHHHMM scale by veterinarian Alice Villalobos. It rates seven areas from 0 to 10: hurt (pain and breathing), hunger, hydration, hygiene, happiness, mobility, and more good days than bad. A total above about 35 is generally taken to mean quality of life is acceptable.

Other versions use simple questions, such as whether the dog still enjoys favorite things, eats, moves without distress and greets the family. Many owners keep a calendar and mark each day good or bad.

A scale is a guide, not a verdict. Scores should be repeated over days and shared with the vet, who adds a medical view. It does not give the answer, but it helps the family stay honest and calm when facing end-of-life choices.

Last reviewed November 8, 2026

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Related terms

Euthanasia The humane, painless ending of a dog's life by a veterinarian, chosen to prevent suffering when quality of life can no longer be maintained. Pet hospice Comfort-focused care for a dog with a terminal or very advanced illness, aiming at good days and little pain until the end. Canine cognitive dysfunction A brain aging disorder in older dogs, similar to dementia, that causes disorientation, sleep changes and loss of learned habits.