Using The Hhhhhmm Scale
For the HHHHHMM scale, you can use a range of 1-5. A score of 1 represents a life full of pain and hunger, while a score of 5 represents an ideal life with no suffering.
Mobility: ________________
More good days than bad: ________________
If you are getting consistent scores in the 4s or 5s, then your cats quality of life is probably good enough that euthanasia isnt necessary at the time. However, if youre consistently seeing scores below 3 for any of these categories, then euthanasia may be warranted.
Quality Of Life Questionnaire
The quality of life scale has been formulated based on our personal experiences with thousands of pets and their owners. It is an easy and accessible way to better assess how your pet is doing right now, using your own impressions and information you can gather at home.
This free assessment can help make this difficult time a little easier by giving you more objective criteria on which to base your pets current state of health.
- Unique scale takes into account 10 different facets of your pets current condition.
- Easy to complete, only takes 5 minutes
- Score can be tracked from week to week so an objective assessment of your pets health can be made
We understand how difficult this time can be, and how important it is to feel comfortable and confident in the decision you make. At Transitions we strive to make this time as peaceful and stress-free as possible for you and all your family members.
We are here to answer any questions you may have, and to accommodate your needs as best we are able. We hope this quality of life scale will provide you with peace of mind as you move through this process.
Evaluating Your Pets Quality Of Life
Determining the quality of life for a pet is often used to make end-of-life decisions. Its important to remember that each pet is an individual, and what constitutes a poor quality of life for one pet may be normal for another. Although a pets enjoyment of life depends on a variety of factors, physical symptoms such as unrelenting pain or extreme difficulty breathing should weigh heavily in the euthanasia decision. These factors constitute very poor quality of life, regardless of other factors. As hard as it may be to consider end-of-life decisions, it is recommended that you start thinking about these issues early in the process, when your mind may be more clear. Decisions may seem forced or pressured if you wait until there is a crisis.
In order to determine if euthanising your pet is the right choice in your situation, Dr. Alice Villalobos, DVM, developed a Quality of Life Scale also called the HHHHHMM Scale. This scale will help you be objective during this emotional time and assess your dog on specific quality of life factors that will then let you know if its time to let go of your pet.
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How Can The Level Of Pain Be Determined
Perhaps the best way to evaluate pain levels is to look at the symptom as expressed. For example, some expressions of these changes could be:
- inability to jump or walk well
- limping
- restlessness
- discomfort
Referring to the quality of life scale in as many instances as possible will help the family determine where the cats quality of life is at and reporting that information to your hospice veterinarian to help determine if any modifications in the hospice care plan are warranted. One can never do too many assessments at the end of life. They are our best indicator as to modifications in the care plan.
When To Euthanize A Cat
Using the quality of life scale as one of the primary tools, observing the cats behavior, and honoring the relationship between you both should be very helpful when it comes to the high-stake decisions of end of life. It might help minimize regrets and gently guide the owner into a softer bereavement. Making this decision as a team is the best way possible to share the burden of the end of life and the sadness that comes along with it.
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What Does Each Category Mean For A Cat Approaching The End Of Its Life
Hurt. Adequate pain control, including the ability to breathe properly, is an absolute necessity. Most pet owners do not know that being able to breathe is ranked as an important pain management strategy. Cats hide their pain extremely well. They will become very still if breathing is a problem. Pain control may include oral or injectable medication.
Hunger. If a cat cannot eat properly or willingly, first try hand-feeding. If this is not successful, it may be appropriate to consider a feeding tube for blended or liquid diets, particularly if oral medication must be given.
Hydration. Fluid under the skin is generally an easy and well-tolerated way to supplement what an ailing cat is drinking. This is not a heroic measure but can really help an older cat feel better.
Hygiene. Can the cat be brushed, combed, and kept clean? Is the coat matted? Cats are very sensitive about keeping themselves clean. If they have an oral tumor or back pain, they may not be able to groom and may need help. Waterless shampoo works well to keep the coat clean and a regular ‘lion cut’ can keep the coat short and easy to manage.
Happiness. Is the cat experiencing joy or mental stimulation? Cats communicate with their eyes, as well as by purring. Is the ailing cat still interacting with family members and with the environment? Placing comfortable beds near family activities helps a cat remain engaged in life.
How Do You Assess Your Cats Quality Of Life
How do you know when mounting symptoms and cascading organ failure reduce your kittys quality of life to an intolerable level?Whether your kitty is facing advanced age or a terminal illness, you have an obligation to assess his quality of life and to maintain the best quality possible.
Its also important to determine if the recommended treatment will further deteriorate your cats quality of life. Is the potential benefit worth the cost to your pet? When should you abandon treatment?
Alice Villalobos, a renowned veterinary oncologist, founded pet hospice service Pawspice and has been a pioneer in end-of-life-care for animals for 20 years. In 2004, she developed the Feline Quality of Life Scale , based on the Five Freedoms of Animal Welfare for farm animals in the United Kingdom, to help veterinarians and families assess a pets life quality and help pet owners look at hard-to-face issues.
You can assess your pets QoL on a monthly, weekly, daily, or hourly basis as needed and make end-of-life decisions more objectively. “Focusing on QoL for companion animals with life-limiting disease may avoid futile medicine, over-treatment, and reluctant early euthanasia,” she says.
As I recently learned firsthand, the QoL Scale may help you objectively make one of the most difficult decisions of your life and help allay the guilt that comes with the decision to humanely euthanize your beloved pet rather than force her to linger.
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The Hhhhhmm Quality Of Life Scale For Cats
The HHHHHMM ScaleHurt:
- Limping.
- Licking one spot on his body repeatedly. A cat with cancer experiencing pain may lick his tumor repeatedly.
- Your kitty’s posture is different or unusual.
- Your kitty spends more time resting and interacts with you less than usual.
- Your cat sometimes trembles or shakes while resting.
- Your kitty’s breathing is labored, exaggerated, or abnormal. Your cat’s ability to breathe comfortably is essential.
- Your companion protects or guards one part of her body and will snap if you try to touch it.
- Your cat rests with his eyes open all the time and seems uncomfortable.
Hunger: Hydration: Hygiene: Happiness: Mobility: More Good Days than Bad:
Feline Quality Of Life Scale What You Should Know
The feline quality of life scale serves as a useful guideline to help vets and pet owners work together to make the right decisions as the pets end-of-life approaches. This scale is particularly beneficial at measuring the success of a treatment plan for a cat with a life-threatening condition and allows fine-tuning it to ensure the utmost well-being of the animals.
The quality of life scale introduced by Dr. Villalobos considers seven different categories and assigns scores to each of them from 1 to 10, where 10 is the best. A total score of 70 is considered to be perfect while any number above 35 indicates an acceptable quality of life for the cat and suggests continuing the end-of-life treatment, care and support.
Quality of life is a highly subjective topic but this scale intends to make it possible to measure it quantitatively on a daily basis. You can decide to assess the pets quality of life for every hour, week or month depending on the situation to make the most difficult decision objectively. This scale serves as a guide to your pets end-of-life care and treatment and saves you from the guilt that often comes with the decision of euthanasia.
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Older Cats: How To Assess Their Quality Of Life
We hear it so often in the office when someone brings in an older cat or dog: She was doing fine until the end of last week, but then over the weekend she just stopped eating and drinking, and I dont think shes moved from her bed in the corner for at least 24 hours now. What happened? What symptoms did I miss? Even the best pet parents can end up feeling guilty because they think maybe they werent paying enough attention until their animal is seriously ill.
But the truth is that cats and dogs are remarkably good at hiding pain and even serious illness. Most experts think this is a holdover from their days as wild animals, where exhibiting weakness would make them a target for predators, and its probably also that, unlike humans, pets dont reflect on what a new pain or symptom means they just get on with life.
All of this can make it tough for pet parents to know when an illness needs aggressive treatment, requires palliative care, or is so serious that euthanasia should be considered. This is particularly tough when it comes to cats: Weve all met or lived with house cats who have lived to very ripe old ages of 17, 19 even 21.
Eight Variables For You To Consider:
The JOURNEYS scale addresses eight variables you can use to determine your pets quality of life. Many people will use the scale daily or weekly to see how their pet is doing, and compare the results to see how well the pet has been doing over time. Different family members can take the scale independently and compare results. These discussions can be helpful in getting consensus on how to move forward. It is important to use a quality of life scale as part of a hospice plan for the pet.
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How The Feline Quality Of Life Scale Works
The scale rates seven basic factors from 1 to 10, with 10 being the best possible score. A total score of 70 is perfect, while a total greater than 35 is deemed acceptable for maintaining a good feline hospice or treatment program.
“Modern pain management, high-tech medicine, and good nursing care can restore and maintain QoL, and can extend the period between the diagnosis of a terminal disease and death, Dr. Villalobos says.
When my 18-year-old cat Nixie was fighting pancreatitis, I pulled up the QoL Scale and rated her condition. The first time I used it, Nixie scored 36. A few days later, I could no longer hydrate her with subcutaneous fluids because fluid was collecting in her abdomen, a symptom of heart failure. The score dropped to 33.
I was willing to nurse Nixie 24/7 and mortgage my house to pay to keep her going, but her QoL had deteriorated. By continuing to force-feed and medicate, I would only be prolonging her misery. Thankfully, the QoL Scale opened my eyes, and that day I released my Heart Kitty. My life hasnt been the same since, but I know I didnt prolong her pain for my own benefit.
Heres how to interpret the seven stages of the Quality of Life Scale:
How Will I Know Its The Right Time To Consider Euthanasia
A healthy human-animal bond requires a two-way exchange, and when that exchange is gone, the time for humane euthanasia has arrived. It is important to plan for the end of life before that time arrives, and the quality-of-life scale can be an integral part of that planning. You can help your cat maintain a good day-to-day life experience by using this scale to regularly measure the parameters that evaluate how well your cat’s basic needs are being met. The scale can also help you clarify the decision for euthanasia, hopefully relieving anxiety and regret about your beloved cat’s end of life.
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Quality Of Life Scale For Cats A Complete Guide
When evaluating a cats quality of life, the HHHHHMM scale is used extensively. This scale is used to determine the overall situation of a cat and whether its appropriate to put them down. Here are some factors that go into assessing a cats quality of life.
A cats quality of life is an important indicator of its welfare, and the HHHHHMM scale helps in objectively determining QOL by assessing factors such as Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More Good Days Than Bad.
An objective review of your cats quality of life, with the help of these factors, can help guide your decisions with your cats overall wellbeing in mind. If you can come up with the right scores on each of the above-mentioned factors, you should have the right course of action on hand.
Data Collection For Objectives 1 2 And 3
The University of Glasgow School of Veterinary Medicine Ethics and Welfare Committee approved the work and written informed consent was obtained from the owners for the participation of their animals in these studies.
Data were collected from owners of 56 cats with a diagnosis of OA attending first opinion practises, feline specialist practises, and the University of Glasgow Small Animal Hospital for previously conducted field studies relating to the feline VetMetrica HRQL instrument . Additionally, data were collected from 84 cats diagnosed with OA attending the Royal Canin Healthy Ageing Clinic, University of Liverpool and participating in the Cat Prospective Ageing and Welfare Study . The latter is a longitudinal cohort study, established in 2016, to monitor pet cats during the ageing process. Cats are enrolled from the ages of 710 years and then followed prospectively by health evaluations on a biannual basis. Data are collected on physical, biochemical and clinical parameters, as well as QOL. All 140 owners completed at least one VetMetrica HRQL assessment online. In addition to the 20 questions comprising the VetMetrica instrument, owners were asked the following questions, personalised to their cat, in order to ascertain the owners’ impression of their cat’s QOL:
1. How would you rate quality of life?very poor/poor/good/very good.
2. Is currently in perfect health?Yes/No.
These questions were independent of the 20 items comprising the HRQL assessment.
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Quality Of Life Scale For Cats Updated 2021
Facing the pets mortality is a concern that no parent wants to talk about. However, if your cat has been diagnosed with a life-threatening condition or is growing too old, euthanasia should be a kind thing to do. Owners are often confused about identifying the right time to put their pets down. Though vets recommend waiting for the signs, the Quality of life scale is a tool that helps us ensure we are doing it at the right time.
The quality of life scale helps you understand how the symptoms and organ failure affects your poochs life. There are many situations that require assessing its quality of life to be able to maintain the best possible. It also helps determine whether a specific treatment deteriorates the cats quality of life further and decide whether you should continue or abandon the treatment.
Quality of life assessment is specifically useful for owners of pets in their end of life phase. There are many quality of life scales available and each of them is pretty easy to implement. One of the most used tools is the HHHHHMM scale developed by the founder of a pet program Pawspice, Dr. Alice Villalobos. It was created with the aim of helping parents use comprehensive ways to track the pets well-being.
Knowing When To Treat Wait Or Make A Big Decision
Older cats tend to suffer from a number of serious illnesses, from renal failure and heart disease to diabetes and cancer. Some of these, like diabetes, can be controlled with strict regimens of medication others, like hemangiosarcoma, require surgery and the prognosis can be uncertain.
How do you determine which course of action is the best for your cat? It can be hard to think clearly when a beloved pet is ill.
Weve found that it can be helpful to use this Quality of Life Scale . It helps you think through the different dimensions of your cats day-to-day life, and help you come to a more objective assessment of their true quality of life. And it makes it easier to observe and document your cats activity over a few days, which is crucial to really understanding whats happening with your cat.
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