For owners
Quality of Life Tracker
Score your pet's wellbeing each week using the HHHHHMM scale. Share results with your veterinary team to guide care decisions together.
About this scale
What is the HHHHHMM scale?
The HHHHHMM scale was developed by Dr. Alice Villalobos, a veterinary oncologist, as a practical framework for assessing quality of life in pets facing serious illness. It evaluates seven dimensions: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad.
Each dimension is scored from 1 (very poor) to 10 (excellent), giving a maximum total of 70. A total score above 35 is generally associated with an acceptable quality of life, though no number can capture the full picture — your vet will consider this alongside your observations.
Score weekly
Set aside a few minutes each week, ideally on the same day, to assess each dimension calmly and honestly.
Share with your vet
Bring a printed copy or summary of weekly scores to appointments. Trends over time are often more informative than a single reading.
Trust your instincts
You know your pet best. If something feels wrong even with a reasonable score, contact your vet. This tool supports — it does not replace — that relationship.
This week's assessment
Move each slider to reflect your pet's current state.
35
out of 70
Hurt
Pain level and management
Score 1–3 may look like…
Constant vocalisation, inability to rest comfortably, guarding a body part, panting at rest, glazed or vacant eyes, or flinching on gentle touch. Reluctance to eat or move may also reflect unmanaged pain.
Score 8–10 may look like…
Resting calmly, responsive to touch without distress, breathing steadily at rest, not vocalising pain. Current pain medication appears visibly effective and the pet seems comfortable.
Hunger
Appetite and nutritional intake
Score 1–3 may look like…
Refusing most or all food, or only eating small amounts when hand-fed with considerable coaxing. Noticeable weight loss or muscle wasting. May need appetite stimulants or assisted feeding to meet basic nutritional needs.
Score 8–10 may look like…
Eating voluntarily and finishing most meals. Body weight is being maintained. Shows interest in food or treats. Nutritional needs are met without force-feeding.
Hydration
Fluid intake and skin turgor
Score 1–3 may look like…
Not drinking adequately; skin "tents" (returns slowly after a gentle pinch) suggesting dehydration. Dry or tacky gums, sunken eyes, or lethargy may also indicate poor fluid status. May require subcutaneous fluids.
Score 8–10 may look like…
Drinking water voluntarily and regularly. Gums are moist and pink. Skin springs back promptly when lightly pinched. No signs of dehydration at home assessments.
Hygiene
Coat condition, wound care, and cleanliness
Score 1–3 may look like…
Coat is matted, soiled, or has pressure sores developing. Unable to self-groom and requires intensive daily owner care to remain clean. Wounds, ulcers, or affected areas are difficult to keep clear of infection.
Score 8–10 may look like…
Coat is clean and well-maintained — with or without owner assistance. No open sores or infected wounds. Pet tolerates grooming and owner is able to keep the affected areas in good condition.
Happiness
Social engagement and interest in surroundings
Score 1–3 may look like…
Withdrawn or unresponsive to familiar family members. Lost interest in toys, walks, or usual activities. Hiding frequently, appearing depressed, or seeming mentally absent for most of the day.
Score 8–10 may look like…
Responds positively to family members, seeks attention or affection, and shows interest in their surroundings. Still enjoys previously loved activities or interactions — even in small or brief ways.
Mobility
Ability to move, posture, and self-care
Score 1–3 may look like…
Cannot reposition without owner help, falls frequently, or is unable to independently reach food, water, or the litter/toilet area. May be lying in waste. Significant muscle loss is affecting posture and comfort.
Score 8–10 may look like…
Able to move sufficiently to meet own basic needs — reaching food, water, and toilet areas. Can change position and shift weight without constant assistance. Posture is reasonably maintained.
More Good Days Than Bad
Overall weekly assessment
Score 1–3 may look like…
Looking back at the past week as a whole, most days were marked by suffering, distress, or little apparent enjoyment. Bad days clearly and consistently outnumber good ones.
Score 8–10 may look like…
Looking back at the past week as a whole, most days included moments of comfort, engagement, or enjoyment — even if brief or limited. Good days outnumber bad ones overall.
No history yet
Save your first weekly assessment above to begin tracking trends.
The HHHHHMM scale is an educational tool and is not a substitute for professional veterinary assessment. Scores should always be discussed with your veterinary team in the context of your pet's full medical history. If your pet's condition changes suddenly, contact your vet promptly rather than waiting for the next weekly assessment.