The pet quality of life scale (HHHHHMM): how to know when it's time

A scale to step out of the doubt

Dr. Alice Villalobos, a veterinary oncologist, created a quality of life scale to support pets at the end of life, as part of her "Pawspice" program. Its purpose is not to decide for you, but to replace a blurry impression with concrete observation — and to carry that decision with your vet, never alone.

The 7 factors of the HHHHHMM scale

It's easy to remember: five "H"s and two "M"s. Each factor is scored from 1 to 10 (10 being the best):

• Hurt. Is pain under control? The ability to breathe comes first here: breathing well ranks above all.
• Hunger. Is your pet eating enough, on their own? Do they need help, or even hand-feeding?
• Hydration. Are they drinking enough? Are they dehydrated?
• Hygiene. Do they stay clean, especially after eliminating? Can you spare them sores and discomfort?
• Happiness. Do they still show interest, joy, a response to the family? Or do they seem shut down, anxious, withdrawn?
• Mobility. Can they move without help, get up, go outside or reach the litter box?
• More good days than bad. When bad days lastingly outweigh the good, quality of life is no longer there.

How to use it

Score each factor from 1 to 10, then add them up: the total goes up to 70. As a common benchmark, a pet scoring at least 5 on each factor is considered to keep an acceptable quality of life. It isn't a guillotine: repeat the assessment regularly — weekly, then daily if needed — and write down your results to track the trend. Share them with your vet: the scale means the most when used together.

How to read the result

A falling score, and above all a "more bad days than good" that settles in despite care, are strong signals. The scale doesn't decide for you; it grounds the decision in the reality you observe, day after day, rather than in a moment's emotion. That is precisely what makes it so valuable when everything blurs.

Beyond the numbers

No scale replaces what you know about your pet. You know the little light in their eyes, the things they loved, what made them come alive. When those things fade one by one and no longer return, your intuition often meets what the numbers show. Trust both.

The scale also eases guilt

Assessing quality of life doesn't only help you decide: it helps you live with what comes after. Research shows that people who rely on such a tool feel less guilt. When the day comes, you'll be able to look back and see that your decision rested on facts, not on giving up — and that changes everything in the grief that follows.

When the time comes

If the assessment confirms that suffering outweighs everything and can no longer be eased, offering a peaceful passing becomes a final act of love. You don't have to carry this choice alone: your vet is there to inform it, answer your questions, and support you. If there are children in the home, you can also involve them, in a way suited to their age.

Afterwards: a place to remember

When the time comes to turn your gaze toward everything they were, AmiAmor offers a gentle place to do it: a page in their memory, a photo, a few words, a candle. A place to honour a life, once the decision is behind you.

Frequently asked questions

What is the HHHHHMM scale?

A quality of life scale created by Dr. Alice Villalobos. It scores seven factors from 1 to 10: hurt, hunger, hydration, hygiene, happiness, mobility, and the ratio of good days to bad.

What score means it's time?

There is no cut-off. As a benchmark, at least 5 on each factor reflects a still-acceptable quality of life. A falling total and lastingly more bad days than good are signals to discuss with your vet.

How often should I use it?

Regularly, and more and more often as things change: weekly, then daily if needed. Writing the scores down helps you see the trend.

Does the scale decide for me?

No. It's a tool for objectivity, not a verdict. It informs the decision, which you make with your vet and your intimate knowledge of your pet.