Dog Quality of Life Scale Calculator (HHHHHMM Scale)
Score your dog on the HHHHHMM quality-of-life scale (hurt, hunger, hydration, hygiene, happiness, mobility, more good days) against the 35-point line.
How it works
Total = Hurt + Hunger + Hydration + Hygiene + Happiness + Mobility + More good days than bad, each scored 0–10 (10 = best) · Maximum 70 · A total above 35 is the scale’s line for acceptable quality of life · Percentage = total ÷ 70
The HHHHHMM scale was devised by veterinary oncologist Dr. Alice Villalobos to help families and vets judge the quality of life of an older or seriously ill pet, especially in hospice or palliative care. You score seven areas from 0 to 10, where 10 is ideal: Hurt (pain control and comfortable breathing), Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. The total is out of 70. On the original scale, a total above 35 points means an acceptable quality of life for continuing care. The calculator adds the scores, tells you whether the total is above 35, and flags every category at 5 or below; some vets also look for a score above 5 in every category. Pain and breathing carry the most weight: a low Hurt score is a reason to call your vet regardless of the total. Under More options you can enter a good/bad day count and your earlier totals to see the trend, which is often more telling than one score. This is a structured way to think and to talk with your vet, not a diagnosis or an instruction to euthanise. Scores are subjective, so try to score with the same person at the same time of day. Unlike a body condition score, which judges weight, this scale looks at comfort and well-being near the end of life.
Worked example
An older dog scores Hurt 6, Hunger 5, Hydration 6, Hygiene 7, Happiness 6, Mobility 4 and More good days than bad 5. The total is 6 + 5 + 6 + 7 + 6 + 4 + 5 = 39 out of 70, which is 55.7% and above the 35-point line, so quality of life is acceptable for now. Three categories (Hunger, Mobility and More good days than bad) are at 5 or below, and Mobility at 4 is the lowest, so those are the areas to discuss with the vet: appetite support, a sling or ramps, and tracking good and bad days.
Sources: Villalobos A. Quality of Life Scale (HHHHHMM), reprinted with permission (scores 0–10, total over 35 acceptable) · VCA Animal Hospitals: Quality of life at the end of life · SimpleDecisionMaker: Dog quality of life calculator (all categories at 5 = 35/70 example)
Frequently asked questions
What is the HHHHHMM scale?
A quality-of-life checklist for pets created by Dr. Alice Villalobos. It scores Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility and More good days than bad from 0 to 10 each, for a total out of 70.
What is a good score on the quality of life scale?
A total above 35 out of 70 is the scale’s line for an acceptable quality of life. Some vets also want every category above 5. A total of 35 or less means important needs are not being met.
How do I know when it is time to euthanize my dog?
No score decides it for you. Signs that it may be time include pain or breathing trouble that cannot be controlled, a total that stays at or below 35, and bad days outnumbering good ones. Use the scale to track changes and discuss them with your vet.
How often should I score my dog’s quality of life?
Every few days, or daily when things are changing quickly. Score at the same time of day and keep a simple good/bad day calendar so you can see the trend.
Can a dog that cannot walk still have a good quality of life?
Yes. Villalobos notes that a pet with limited mobility can still do well if it is alert, happy and responsive and the family can help with slings, carts and care. Mobility is one category out of seven.
Related calculators
This scale supports, and does not replace, an examination and advice from your veterinarian. If your dog is in pain, struggling to breathe or not eating or drinking, contact a vet now.