🩺 Veterinary HHHHHMM Protocol

Pet Quality of Life (HHHHHMM) Scale

An objective, compassionate veterinary evaluation tool (0–70 scale) created by Dr. Alice Villalobos to help pet parents assess the daily comfort and wellbeing of aging or ill dogs and cats.

1. Hurt (Pain Control)7 / 10

Is your pet's pain successfully controlled? Can they breathe easily? (0 = Unmanageable pain/severe respiratory distress; 10 = Pain-free, breathing calmly)

2. Hunger (Appetite & Eating)7 / 10

Is your pet eating well on their own? (0 = Refuses food even with hand-feeding; 10 = Strong healthy appetite)

3. Hydration (Fluid Intake)7 / 10

Is your pet well-hydrated? (0 = Chronic dehydration/requires frequent subcutaneous fluids; 10 = Drinks normally, good skin elasticity)

4. Hygiene (Grooming & Incontinence)7 / 10

Can your pet stay clean and relieve themselves without soiling their coat or developing bed sores? (0 = Completely incontinent/bed-bound; 10 = Clean, self-grooming, normal bathroom habits)

5. Happiness (Mental State & Joy)7 / 10

Does your pet exhibit joy, wag their tail/purr, interact with family, and play? (0 = Depressed, unresponsive, anxious; 10 = Happy, engaged, eager for attention)

6. Mobility (Movement & Getting Up)6 / 10

Can your pet stand, walk, go outside, or reach their litter box without severe struggle? (0 = Paralyzed/unable to stand without crying; 10 = Active, walks comfortably)

7. More Good Days Than Bad7 / 10

Are the good days outnumbering the bad days? (0 = Continuous suffering/nearly all bad days; 10 = Consistently good, joyful days)

Quality of Life Assessment for Your Dog
48/ 70

Acceptable with Palliative Support (Score: 35–55): Your pet is maintaining an acceptable quality of life, though certain areas (mobility, pain, or appetite) require ongoing veterinary palliative interventions.

Veterinary Benchmark: Score ≥ 35 is considered an acceptable quality of life with supportive care.

Note: This tool is intended as an objective guide to help you track changes over time and have informed conversations with your veterinarian.