Pet Quality of Life Checklist: 7 Key Signs
When good moments and difficult moments appear side by side, a repeatable checklist can help you organize what you’re seeing — without asking one meal, one walk, or one difficult morning to tell the whole story.
How can you tell whether an aging, chronically ill, or terminally ill companion animal is still having a meaningful life when good moments and difficult moments exist together?
No single sign gives you the whole answer. A pet may eat but hide, greet you but struggle to rest, or walk a little while showing discomfort afterward.
A checklist gives you a consistent way to observe your pet, establish a baseline, use the same scoring approach each time, and notice meaningful changes in normal routines.
The goal isn’t a perfect or final answer. The goal is clearer observation, better questions, and a more focused conversation with your veterinarian.
7 Key Areas to Watch
Different quality-of-life tools use different names and scoring systems, but these practical areas can help you organize what is happening across the whole day.
Rest, pain-related behavior and ability to settle.
Rising, walking and reaching important places.
Appetite, hydration and changes from normal.
Staying clean and managing bathroom routines.
Interest in people, surroundings and routines.
Good days compared with difficult days.
How the different parts of daily life fit together.
Patterns across several days are usually more informative than one unusual morning. Concerning or severe changes still need veterinary attention.
1. The Companion Project
A Structured Starting Point for Uncertain Days
The Companion Project offers a free online Quality of Life Assessment for the uncertain period between ongoing veterinary care and end-of-life decisions.
It organizes observations around physical comfort, mobility and independence, appetite and hydration, happiness and engagement, good versus difficult days, and overall well-being, then provides an immediate score with context.
These categories act like labeled windows into the same day. One family member may notice that a pet is eating, while another sees that the pet no longer joins familiar routines or rests comfortably afterward.
Recording both observations gives the household a shared starting point rather than allowing one encouraging sign to outweigh a broader pattern.
Repeatable observation, organizing concerns, preparing veterinary questions, and creating a shared framework for family discussions.
The assessment does not diagnose conditions, prescribe treatment, provide medical recommendations, or make euthanasia decisions.
When Guidance May Help
The Companion Project also offers an optional private 45-minute video session with a trained Companion Guide.
A session may involve reviewing assessment results, organizing changes into practical topics, discussing uncertainty, and preparing questions for your veterinarian. It can also provide non-medical, non-therapy emotional support during anticipatory grief.
The free assessment can be repeated as circumstances change and is intended for dogs, cats, and other companion animals.
2. Lap of Love Pet Quality-of-Life Assessment and Scale
Lap of Love offers an owner-friendly quality-of-life assessment through a national veterinary hospice network. Its interactive questionnaire provides an immediate score with plain-language guidance.
Printable worksheets and diaries can then be used to record changes between veterinary appointments.
Complete the assessment after a concerning change, then use the diary to record appetite, comfort, interaction, movement, and other daily observations.
Keep Repeat Tracking Consistent
Use the same approach each time. Record the date, note unusual events, and avoid changing your scoring standard from one assessment to the next.
If several family members participate, agree on what each rating means before recording it.
Treat the result as a prompt for reflection and discussion rather than a diagnosis.
Add short notes about routines, difficult moments, and activities your pet still seeks.
Ask which changes may be medically manageable and which require prompt attention.
3. JOURNEYS Quality-of-Life Scale and Online Calculator
JOURNEYS offers a practical way to review quality of life through observable domains. Created by Dr. Katie Hilst, DVM, it is available as a printable PDF and web-based calculator.
Its concrete score descriptions can help owners compare today’s observations with earlier records instead of treating one difficult moment as the entire picture.
Practical Dimensions to Revisit
Restlessness, guarded posture, difficulty settling, or other changes from normal.
Ability to rise, reach preferred places, and use the bathroom safely.
Whether your pet stays clean or increasingly needs assistance.
Changes in breathing, particularly while resting.
Meaningful changes in food or water interest.
Responses to familiar people, surroundings, and preferred activities.
Whether required support can continue safely and consistently at home.
The total can act like a trend line, while your written notes explain what moved it. A score cannot identify whether a change reflects pain, nausea, weakness, anxiety, medication effects, or another problem.
4. Ohio State University Honoring the Bond Resources
The Ohio State University Veterinary Medical Center’s Honoring the Bond resources use handouts, worksheets, and daily diaries to help families follow quality of life over time.
Their focus is the continuing record — including the balance between good days and difficult days — rather than relying on one online result.
Turn daily observations into useful questions
“Did not come to the kitchen at breakfast” gives a veterinarian more useful information than simply recording “seemed worse.”
5. HHHHHMM Quality-of-Life Scale
The HHHHHMM scale organizes seven familiar dimensions into a repeatable 0-to-10 framework: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More Good Days Than Bad.
Seven areas, each scored from 0 to 10
A total of 35 or higher is commonly used as a guide for continued palliative care. Lower totals commonly prompt a deeper discussion about suffering and end-of-life planning. The score remains a discussion aid rather than a stand-alone decision.
Interpret the Individual Areas Too
Score each domain consistently, then look at both the total and the individual categories. A total can hide a serious problem in one area, especially pain or breathing difficulty.
A pet may receive moderate scores elsewhere while still needing prompt veterinary attention for a concerning symptom.
A total score organizes observations. It does not prove that a pet is comfortable, diagnose a condition, or make a medical or euthanasia decision for a family.
Add a short explanation beside each rating. For example, “Happiness is lower because she no longer responds to visitors” provides more useful context than a number alone.
6. VCA Animal Hospitals Quality-of-Life Resources
VCA Animal Hospitals provides owner-education guidance about quality of life for dogs and cats, including end-of-life observation materials.
Their value is accessibility: families can begin with familiar veterinary educational material and a printable reference before using a more detailed scoring system.
Use the Handout as an Observation Worksheet
Rather than recording “she just isn’t herself,” note what changed, when it happened, and whether the pattern continues.
For a dog, rising, walking, settling, eating, going outside, and responding to familiar routines may help show how comfort and engagement are changing.
What could explain this new behavior, and which signs suggest pain or distress?
Could treatment, pain control, or an environmental adjustment make one difficulty easier?
Which change should prompt a same-day call or emergency evaluation?
How often should these observations be revisited?
Severe breathing problems, uncontrolled pain, or another alarming change should not wait for several days of checklist tracking. Seek appropriate veterinary care.
7. IAAHPC QOL Tools, Pyramid and Tracking Calendar
The International Association for Animal Hospice and Palliative Care provides a resource hub rather than one scoring instrument.
Its collection includes quality-of-life tools, links to other scales, a Pet Quality-of-Life Pyramid, and a printable calendar for treatments, events, and good or difficult days.
Build a Small Toolkit, Not a Pile of Paperwork
Use the same scale consistently so changes across days are easier to compare.
Record treatments, unusual events, and whether the day felt mostly good or difficult.
Consider engagement alongside physical comfort.
Your veterinarian can help identify which signs deserve closer or more urgent tracking.
Using several scoring systems simultaneously can create conflicting results when family members interpret the same behavior differently. A single consistent framework plus useful notes is often easier to interpret.
7-Item Comparison: Pet Quality-of-Life Checklists
Each resource approaches observation differently. The most useful format is one your household can apply consistently and discuss clearly with your veterinary team.
| Tool | Format | Useful For | Not a Substitute For |
|---|---|---|---|
| The Companion Project | Online assessment + optional guided session | Structured observations, repeat tracking and preparing questions | Veterinary diagnosis or treatment |
| Lap of Love | Online questionnaire + printables | Accessible home monitoring and diaries | Veterinary examination |
| JOURNEYS | Calculator + printable scale | Comparing observations over time | Clinical interpretation |
| OSU Honoring the Bond | Handouts + daily diaries | Longitudinal pattern tracking | Diagnosis or urgent medical advice |
| HHHHHMM | Seven-domain 0–10 scale | A common framework for difficult conversations | A stand-alone end-of-life decision |
| VCA | Educational resources + printables | Practical owner observation | Veterinary examination |
| IAAHPC | Resource hub + calendar + pyramid | Building a small tracking toolkit | One standardized clinical score |
Turn Observations Into a Better Veterinary Conversation
A completed checklist becomes more useful when it turns vague worry into specific observations.
Write the date, record unusual changes, and note what your pet actually did rather than only how the day felt. Repeat the assessment periodically using the same definitions each time.
Ask whether pain, nausea, weakness, anxiety, cognitive change, medication effects, or disease progression could be relevant.
Request clear signs that should trigger a call, appointment, or urgent evaluation.
Define observable goals such as resting more comfortably or returning to a familiar routine.
Agree on a follow-up window appropriate for your pet’s condition.
Make an emergency plan before a crisis creates pressure for a rushed decision.
A score should organize observations, not dictate a diagnosis or euthanasia decision. Repeatability, clear notes, and veterinary context matter more than chasing one supposedly perfect number.
Review individual areas before focusing on the total. A mobility change may lead to questions about comfort, flooring, ramps, or support. A change in happiness or engagement may need veterinary interpretation. Appetite and hydration changes may deserve prompt attention even when other areas remain stable.
Careful observation is a form of advocacy when your pet cannot describe how they feel. The purpose of the checklist is to help you bring clearer evidence and better questions to the professionals caring for them.
Turn what you’re noticing into a clearer picture of your pet’s day.
The Companion Project’s free Quality of Life Assessment helps organize physical comfort, mobility and independence, appetite and hydration, happiness and engagement, good versus difficult days, and overall well-being so you can prepare clearer questions for your veterinary team.
Start Your Free Quality of Life Assessment