Dr. Alice Villalobos, the veterinarian who started Pawspice, a quality of life program for terminal pets, has
published a scoring system for life quality called The HHHHHMM scale. The letters stand for: Hurt, Hunger,
Hydration, Hygiene, Happiness, Mobility, and More Good Days than Bad.
1.Adapted by Villalobos, A.E., Quality of Life Scale Helps Make Final Call, VPN, 09/2004,for Canine and Feline
Geriatric Oncology Honoring the Human-Animal Bond, by Blackwell Publishing, Table 10.1, released 2006.
Quality of Life Scale: The HHHHHMM Scale
Pet caregivers can use this Quality of Life Scale to determine the success of Pawspice care. Score patients using a scale
of 1 to 10.
HURT - Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet's
pain successfully managed? Is he/she running/playing as often and vigorously as usual? Does he/she
pant or groom excessively? (often signs of pain)
HUNGER - Is the pet eating enough? Is the pet willing to eat his/her normal dog food, or is only enticed
to eat “treats” or “junk food?” Does hand feeding help?
HYDRATION - Is the patient dehydrated? If you pull up a small “tent” of skin on the pet’s head, does it
snap back into place as yours does? If you push a finger onto the pet’s gums, does it return to normal
pink color in less than 1.5 seconds?
HYGIENE – What does the pet’s coat look like? Does he/she have the same luster and shine to the coat
that was present as a younger animal?
HAPPINESS - Does the pet express joy and interest? Is the pet responsive to things around him or her
(family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid?
MOBILITY - Can the patient get up without assistance? Does the pet need human or mechanical help
(e.g., difficulty rising on a tile floor)? Does the pet feel like going for a walk? Is the pet having seizures
or stumbling?
MORE GOOD DAYS THAN BAD - When bad days outnumber good days, quality of life might be
compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made
aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully
and painlessly, that is okay
*TOTAL
*A total over 35 points represents acceptable life quality
