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Dog quality of life scale
If your dog is old or seriously ill, this scale helps you look at how they're really doing, one area at a time. Score each area from 0 (worst) to 10 (best).
Move each slider to match how your dog has been over the last few days, then see the total.
Your answers stay in your browser and are not sent anywhere. This scale supports a conversation with your vet; it is not a diagnosis. Last reviewed October 7, 2026.
How the HHHHHMM scale works
The scale was created by veterinary oncologist Dr. Alice Villalobos and first published in Veterinary Practice News in 2004. Its name comes from the seven areas it scores: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility and More good days than bad.
Each area gets a score from 0 to 10, where 10 is ideal, for a total of up to 70. In Dr. Villalobos' words, "a total over 35 points represents acceptable life quality" to continue hospice care, which she calls pawspice.
| Total score | What it suggests |
|---|---|
| 36–70 | Acceptable quality of life on this scale. Keep scoring regularly and watch for changes. |
| 0–35 | Quality of life may be compromised. Talk to your vet about comfort care and next steps. |
Hurt comes first for a reason: good pain control, including easy breathing, is the foundation of everything else on the scale. A low score in one area, such as appetite or hydration, can sometimes be improved with treatment, so it is worth raising with your vet even when the total looks fine.
On mobility, Dr. Villalobos notes that a dog with limited movement can still have a good quality of life if it is alert, responsive and its family is committed to helping it.
Tips for scoring
- Score how your dog has been over the last few days, not just this moment.
- Score at the same time of day each time, and write down the date and total.
- If two family members score separately, compare the results. Different views are normal and useful to discuss.
- Bring your scores to your vet appointment. A trend over a few weeks says more than one number.
No score can make this decision for you. Your vet can examine your dog, treat pain or nausea, and explain what to expect. If you are struggling with this, many vet schools run free pet loss support lines.
Questions people ask
What is a good quality of life score for a dog?
On the HHHHHMM scale, a total over 35 out of 70 is considered acceptable quality of life for continued hospice care. Higher is better, and a falling trend matters as much as the number itself.
What does HHHHHMM stand for?
Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility and More good days than bad. Each is scored from 0 to 10.
Who created the quality of life scale?
Veterinary oncologist Dr. Alice Villalobos, who first published it in Veterinary Practice News in 2004. Many vets use it for pets with cancer and other serious illness.
How often should I score my dog?
Every few days to once a week works for most families, or whenever something changes. Keeping a dated record makes it easier to see a trend and to talk it through with your vet.