Decisions about end of life and euthanasia and evaluating quality of life are common struggles we all face when our pets age or experience serious illnesses. It is sometimes hard to set our feelings aside and see the situation objectively, and many pet owners worry that they will either wait too long or not long enough to make a decision.
To help pet owners navigate these decisions with more clarity, two quality of life scales have been developed for pets: The JOURNEYS scale and the HHHHHMM scale. These scales are not meant to be a set of strict rules for decision making, but are intended to help give pet owners a way to think about the various factors that affect their pets’ well-being as a whole to help guide decision making.
The JOURNEYS scale identifies 8 variables to consider:
- Jumping or Mobility
- Ouch or Pain
- Uncertainty and Understanding (for you, the pet owner)
- Respiration or Breathing
- Neatness or Hygiene
- Eating and Drinking
- You (the pet owner)
- Social Ability
Each variable has an assigned value of 10 possible points. For example, a pet who cannot stand on their own might be assigned a J score of 1, a dog who can do their typical activities but for a shorter period of time than they used to might be a 5, and a dog who has totally normal activity might be a 10.
You can find a printable version of this scale with examples of scoring other variables on the Minnesota Pets website at http://www.mnpets.com/blog/quality-of-life-scale, including a log that can be used daily or weekly according to your preference. Either a very low score in one or more areas, a low total score, or an overall declining score can indicate it may be time to consider euthanasia.
The HHHHHMM scale is also based on assigning a value of 0-10 to several different variables. This scale defines the variables as:
- More Good Days than Bad
This scale objectively defines a score of 35 as being the minimum for a good quality of life; however, remember that this is not meant to be used to pressure yourself into making decisions but rather to give you a tool to think about your pets’ quality of life and see trends over time. You can find a printable version of this scale at the Pawspice website at http://pawspice.com/clients/17611/documents/QualityofLifeScale.pdf
End of life decisions are difficult for everyone. I sincerely hope these scales can help you all feel more comfortable making these decisions with your own pets, but please feel free to call the clinic and speak to any of the doctors or staff if you are struggling.
Karen Christopherson DVM CVA