Score seven areas of daily comfort, record favorite activities, and track comfortable versus difficult days before a quality-of-life conversation with your veterinarian.
Quick answer: the HHHHHMM scale looks at Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. The total is a repeatable record, not a decision about euthanasia.
Observation, not diagnosis
Individual problems matter more than a reassuring total
Urgent signs and low domain scores are always shown separately.
Your observation summary will appear here
The result will show every domain separately, flag urgent or low areas, and keep the total in its proper context.
Urgent signs override every score. Contact a veterinarian or emergency veterinary clinic now.
HHHHHMM score record
0out of 70
Record, not verdict
Observation summary
Individual domains
Bring these points to your veterinarian
Favorite activities
Recent day pattern
This calculator cannot decide whether euthanasia is appropriate. Use the individual observations and trend with a veterinarian who knows your dog's condition and response to care.
Educational observation tool only. It does not diagnose suffering, prescribe care, or determine whether euthanasia is appropriate. Urgent symptoms require direct veterinary help.
Patterns over time
Good days, difficult days, and saved assessments
The calendar and assessment history remain on this device. They are not uploaded to an account.
Day tracker
Each date cycles through comfortable, mixed, difficult, and unmarked.
ComfortableMixedDifficult
Saved assessments
Up to 20 summaries can be kept in this browser.
No assessment has been saved on this device.
7 domainsEach scored from 1 to 10
Urgent signs firstNo total can overrule them
Trend, not snapshotRepeat at a consistent interval
Quality of life scale for dogs
What does the HHHHHMM scale measure?
Veterinary oncologist Dr. Alice Villalobos organized seven practical areas into the HHHHHMM framework. Each area deserves its own attention because a total can hide one serious problem.
Hurt
Pain control and the ability to breathe comfortably come first.
Hunger
Appetite, nausea, chewing, swallowing, and adequate food intake.
Hydration
Water intake, vomiting, and the ability to remain adequately hydrated.
Hygiene
Cleanliness, toileting, skin protection, grooming, and freedom from sores.
Happiness
Connection, calm, engagement, and enjoyment of familiar activities.
Mobility
Movement, assistance, and access to food, water, rest, and toileting.
More good days than bad
The overall pattern of comfortable, meaningful, mixed, and difficult days.
Reading the result safely
Three rules matter more than the total
Urgent symptoms stand alone
Breathing distress, collapse, repeated seizures, or unrelenting pain need direct help regardless of every other score.
Look at the lowest area
One score of 2 should not disappear inside six scores of 9. Bring the individual domain to your veterinarian.
Repeat consistently
A dated pattern is more useful than a single assessment completed only on an unusually good or difficult day.
Age and size do not determine the score. Compare each dog with their own normal routines, comfort, and meaningful activities.
Your dog is the baseline
Start with what has always mattered to them
A slow walk may be deeply meaningful for one dog, while another has always preferred resting near the family. Quality of life is not measured by youthfulness or athletic ability.
Write down three to five favorite things before a crisis. If your dog can no longer enjoy most of them, record when that change began and discuss it with your veterinarian.
Do not wait on a score
When urgent veterinary help comes first
A calculator is not an emergency triage service. Contact a veterinarian or emergency clinic whenever your dog is in severe or rapidly worsening distress.
Seek direct help now for signs such as:
Sudden or severe difficulty breathing.
Collapse, repeated seizures, or inability to respond normally.
Unrelenting pain, repeated crying, or distress that cannot be soothed.
Any rapidly worsening problem that you believe may be an emergency.
Veterinary conversation
Questions to ask with your assessment history
Bring the domain breakdown, day pattern, medication list, and notes about what changed.
What signs suggest my dog is in pain, nauseated, anxious, or having trouble breathing?
Which low-scoring areas may be treatable, and how will we know whether support is working?
What changes at home could improve access to rest, food, water, toileting, or family contact?
What symptoms or changes mean I should call immediately instead of waiting for the next appointment?
What is the expected best case, worst case, and likely course of my dog's condition?
When should we discuss palliative care, hospice support, or end-of-life options?
Dog Quality of Life Calculator FAQ
A dog quality of life calculator is a structured observation tool. This page records seven HHHHHMM areas so you can notice patterns and bring specific information to your veterinarian. It is not a diagnosis or an automatic end-of-life decision.
HHHHHMM stands for Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. The framework asks caregivers to score each area from 1 to 10.
The original HHHHHMM framework describes scores above 5 in most areas as an acceptable reference for supported end-of-life care, but the total is not a verdict. One severe problem, especially uncontrolled pain or breathing difficulty, can matter regardless of the total.
No. A calculator cannot determine whether or when euthanasia is appropriate. That decision requires your dog's individual condition, response to treatment, comfort, prognosis, family circumstances, and a direct conversation with a veterinarian.
Choose a consistent interval that fits your dog's condition and veterinary plan, such as every few days or once a week. Repeating the same assessment consistently makes a trend easier to interpret than completing it only during a crisis.
Treat the low category as important. A high total can hide severe pain, breathing difficulty, dehydration, or another major problem. This calculator always lists individual low scores and never lets the total overrule an urgent sign.
Use your dog's normal routines and favorite activities as the baseline. A comfortable day may include adequate rest, food, movement, connection, and enjoyment. A difficult day may involve distress, uncontrolled symptoms, inability to meet basic needs, or loss of meaningful activities.
Contact a veterinarian or emergency veterinary clinic now for sudden or severe breathing difficulty, collapse, repeated seizures, unrelenting pain, repeated crying, distress that cannot be soothed, or another rapidly worsening problem that may be an emergency.
ResearchMethodology and referencesThe framework, safety override, trend guidance, and limitations are tied to veterinary and peer-reviewed sources.
This calculator follows the seven HHHHHMM domains and 1-to-10 scoring framework. It does not turn the total into unsupported quality bands, alter the score by breed or age, or use a score to make an end-of-life decision.
Original frameworkAlice Villalobos, DVM: Quality of Life Scale Helps Make Final CallOpen
Decision support and worksheetOhio State Veterinary Medical Center: How Do I Know It's Time?Open
End-of-life careAAHA: End-of-Life Care for Dogs and CatsOpen
Clinical guidelinesAAHA/IAAHPC End-of-Life Care GuidelinesOpen
Repeated assessmentLap of Love: How to Use a Quality-of-Life ScaleOpen
Evidence reviewQuality of Life Measurement in Dogs and Cats: A Scoping ReviewOpen
Validation contextValidation of the HHHHHMM Scale in the Italian ContextOpen
Observation and conversation aid only. Not veterinary advice. Source-reviewed August 1, 2026. This implementation has not been independently reviewed by a licensed veterinarian.
Supporting context
Continue with age, lifespan, and body-condition guidance
These pages add context but do not replace an individual veterinary assessment.
