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Pet Quality of Life Calculator

Based on HHHHHMM Scale by Dr. Alice Villalobos, DVM

Last Updated: April 2026|Based on IRIS, AAHA, and current veterinary guidelines

Based on HHHHHMM Scale developed by Dr. Alice Villalobos, DVM, DPNAP — source

Hurt

Pain assessment and management

Severe, uncontrolled painNo pain, comfortable
0 / 10

Hunger

Appetite and interest in food

Refuses all foodEating normally
0 / 10

Hydration

Water intake and hydration status

Severely dehydratedWell hydrated
0 / 10

Hygiene

Grooming and cleanliness

Unable to stay clean, has soresClean, well-groomed
0 / 10

Happiness

Mental and emotional state

Depressed, no interestJoyful, responsive, engaged
0 / 10

Mobility

Ability to move and exercise

Cannot stand or moveMoves freely, wants to walk
0 / 10

More Good Days

Overall quality of daily life

Mostly bad daysMostly good days
0 / 10
0 / 70

Your pet's comfort may be significantly compromised. We recommend speaking with your veterinarian.

What Is HHHHHMM Scale?

The HHHHHMM scale is a revolutionary tool in veterinary palliative care, developed by Dr. Alice Villalobos, DVM, a renowned veterinary oncologist and pioneer in end-of-life care. First published in "Canine and Feline Geriatric Oncology" in 2007, this assessment framework has become gold standard for evaluating pet quality of life across veterinary practices worldwide.

Endorsed by leading veterinary organizations including International Association for Animal Hospice and Palliative Care (IAAHPC) and International Veterinary Academy of Pain Management (IVAPM), HHHHHMM scale provides veterinarians and pet parents with a structured, evidence-based approach to making difficult decisions about pet care and end-of-life planning.

The scale evaluates seven key areas of a pet's well-being: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and "More Good Days Than Bad." Each criterion is scored from 0 to 10, with a total possible score of 70. This comprehensive assessment helps ensure that no single aspect of a pet's comfort is overlooked during critical decision-making processes.

What makes HHHHHMM scale particularly valuable is its balance between objective measures and subjective observations. While some criteria like hydration and mobility can be assessed more objectively, others like happiness and overall quality of days require careful observation and intuition from those who know pet best. This holistic approach captures the full picture of a pet's well-being, going beyond mere medical metrics to include the joy and comfort that define quality of life.