Dog Quality of Life Calculator

Score your dog's quality of life with the veterinary HHHHHMM scale — rate seven categories from 0 to 10 for a total out of 70.

Quick Facts

Method
HHHHHMM scale (Villalobos): seven 0-10 categories summed to a total out of 70
A total above 35 suggests acceptable quality of life is being maintained.

Your Results

Calculated
Total score
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Sum of all seven categories (max 70)
Average per category
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Total divided by 7
Lowest category
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The area needing most attention

Ready

Score each category from 0 (worst) to 10 (best), then calculate.

About the HHHHHMM quality of life scale

This calculator uses the HHHHHMM Quality of Life Scale developed by veterinary oncologist Dr. Alice Villalobos. It is the most widely used bedside tool for assessing whether a seriously ill, aging, or hospice dog is still experiencing a life worth living. You score seven categories from 0 (worst) to 10 (best) and add them together for a total out of 70. The seven H's and M's are Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad.

The formula

The math is a simple sum: Total = Hurt + Hunger + Hydration + Hygiene + Happiness + Mobility + More-good-days. Each category can score 0-10, so the total ranges from 0 to 70. Villalobos suggests that a total above 35 indicates that a dog's quality of life is acceptable and that continued hospice or supportive care is reasonable. A total of 35 or below is a signal to have a candid conversation with your veterinarian about comfort, treatment, and humane options.

What each category means

  • Hurt. Is pain successfully controlled? This includes the ability to breathe comfortably — oxygenation and pain relief are the first priority.
  • Hunger. Is the dog eating enough on its own? Consider whether hand-feeding or a feeding tube is needed.
  • Hydration. Is the dog taking in enough fluids? Subcutaneous fluids may be needed if intake is low.
  • Hygiene. Can the dog be kept clean and free of pressure sores, especially after urinating or defecating? Matting and soiling lower the score.
  • Happiness. Does the dog show interest, respond to family and surroundings, and seem free of anxiety, boredom, or fear?
  • Mobility. Can the dog move without help, or does it need a sling, cart, or assistance? Some owners weigh this less for dogs that are alert and content but immobile.
  • More good days than bad. When bad days begin to outnumber good ones, quality of life is declining and the human-animal bond is affected.

Why this tool exists

End-of-life decisions for a pet are emotionally overwhelming, and it is hard to be objective day to day. A numeric scale turns a diffuse feeling into a repeatable measurement. Scoring the same dog each week and tracking the trend is often more informative than any single day's number: a total that drops from 52 to 41 to 33 over three weeks tells a clearer story than any one snapshot.

Reference points

  • Above 35 / 70: Acceptable quality of life; supportive or hospice care is reasonable to continue.
  • Around 35 / 70: A borderline result that warrants a veterinary check-in and closer daily monitoring.
  • Below 35 / 70: Quality of life is compromised; discuss comfort care and humane end-of-life options.
  • A single very low category (for example uncontrolled pain scored 1-2) can outweigh a decent total — no dog should live in unmanaged pain even if other categories look fine.

Frequently Asked Questions

What is the HHHHHMM quality of life scale?
HHHHHMM is a veterinary quality-of-life scale created by Dr. Alice Villalobos. It scores seven categories — Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad — each from 0 to 10, then sums them for a total out of 70. It is used mainly for aging, chronically ill, and hospice dogs.
What total score means my dog is doing okay?
A total above 35 out of 70 is generally considered an acceptable quality of life, meaning continued supportive or hospice care is reasonable. A total of 35 or below suggests quality of life is poor and it is time to talk with your veterinarian about comfort, treatment options, and humane end-of-life decisions.
Can a good total score still hide a serious problem?
Yes. The total can look acceptable while one critical category — most often uncontrolled pain or the inability to breathe comfortably — is very low. Treat any single category scored 0-2 as a red flag on its own, regardless of the total, and address it with your veterinarian.
How often should I score my dog?
Score on a regular schedule — often daily or weekly for a dog in hospice care — and watch the trend rather than a single number. A steady downward trend over days or weeks is more meaningful than one low day, which might reflect a temporary setback like a missed medication dose.
Does this replace a veterinarian's advice?
No. This is a structured way to organize your observations, not a diagnosis. Share your scores with your veterinarian, who can factor in medical findings, prognosis, and treatment options that a checklist cannot capture.

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