How Do We Measure a Pet’s Quality of Life?
Hello there,
When it comes to end-of-life decisions for pets, one of the most important things we must consider is their quality of life. But what does “quality of life” really mean for pets? Is it enough if a pet can perform basic functions like eating, drinking, urinating, defecating, breathing, and walking? Or is there more to it?
Freedom from Pain: A Key Factor in Quality of Life
Most pet owners would agree that freedom from pain or discomfort is a major factor in a pet’s quality of life. Dogs and cats, like their wild ancestors, have strong survival instincts. Many pets can live with chronic pain without showing clear signs, hiding their discomfort due to these instincts. Because of this, simply surviving should not be considered enough to ensure a good quality of life.
Chronic pain can lead to subtle changes in a pet’s behavior. For example, they may sleep more or lose interest in playing or interacting with people. Being aware of these changes can help pet owners recognize shifts in their pet’s quality of life.
The Responsibility of Assessing Quality of Life
Since pets can’t express their feelings in words, it’s up to pet owners and veterinarians to notice the subtle changes in behavior that signal a shift in quality of life. This can feel like a huge responsibility. The stress of making the right decision can weigh heavily on pet owners.
As an internal medicine specialist, I often discuss quality of life with pet owners. Animals with chronic illness may face difficulties with one or more of their normal body functions. However, if treatments or medications can improve those functions, the pet’s quality of life generally improves as well. Even though many chronic diseases may not be curable, they can often be managed. In addition to being free from pain, a good quality of life for pets also includes activities and behaviors that bring them joy.
For example, my Husky loved going to the beach. His happiness was clear every time we were there. This joy is a big part of a pet’s quality of life.
The Challenge of Measuring Quality of Life in Pets
Measuring a pet’s quality of life can be tough because it’s something that can’t easily be quantified. It’s not like counting numbers or checking off a list. Quality of life is a personal, sometimes subjective thing. It’s different for every pet. As pets have become more like family members over the years, more tools have been developed to help us assess their well-being and make these tough decisions.
During my career, I’ve learned many ways to approach the topic of quality of life, both from my veterinary training and experience. These tools help pet owners and veterinarians discuss and understand their pet’s condition more clearly. My goal is to share some of these methods to help those facing difficult decisions about their pets’ health. However, it’s important to remember that these tools should be used alongside the advice and expertise of your veterinarian, who knows your pet’s specific needs.
The “Five Favorite Things” Method
One simple way to assess your pet’s quality of life is to make a list of their five favorite activities. These activities could include things like playing, eating, or cuddling. If your pet stops enjoying or participating in most of these activities, it could be a sign that their quality of life is decreasing.
Why This Method Works
The beauty of the “Five Favorite Things” method is that it recognizes every pet is unique. Just like humans, pets have different likes and preferences. For some pets, food may be a big part of their quality of life, but it shouldn’t be the only measure. For example, Labrador retrievers are often food-driven, but a picky eater like my Chihuahua might not care about food as much. That’s why having at least five different activities on the list is important. It can help to involve family members or anyone else who knows your pet well.
Make the List Based on Healthy Days
It’s also important to create your list based on the activities your pet enjoyed when they were healthy, not while they are already struggling with illness. This helps you compare their current behavior with how they used to act when they were feeling well.
For example, my cat Wesley loved hiding under the sheets when I made the bed. As he got older and his chronic illness progressed, he stopped doing this. Along with other things on his list, like napping in the sun or playing with a laser pointer, I could tell when he was no longer able to do the things that once brought him joy.
While it was incredibly hard to say goodbye to him, using this method gave me peace of mind that I was making the best decision for his well-being.
The Penny Test
During end-of-life care for pets and people, some days are better than others. My grandmother had dementia in her final years, and she cycled on and off hospice care twice. Her weight and appetite fluctuated, and it was hard to know when the right time had come. With a chronically ill or elderly pet, it is just as difficult to know when the right time is. The biggest fear is that we may decide to end our pet’s life too soon, which feels like a huge responsibility.
Sometimes the decision comes not because of one big traumatic change (such as a collapse or seizure episode), but from small changes that worsen over time. Some days they might have more energy, and other days they sleep all day. Some days they finish all their food, and other days they walk away from the bowl without interest. They may urinate in their bed one day but have normal bathroom habits the next. It’s emotionally draining to track all these changes and feel confident that you are making the right decision to euthanize.
Something that may help is to have two jars: one labeled for good days and one for bad days. At the end of each day, you can assess how your pet did in terms of appetite, energy, comfort, bathroom habits, and activity level. You can then put a penny in the correct jar. Over time, it will give a visual representation of whether your pet is still having more good than bad days and if they still have a good quality of life.
Quantitative Guides
These are guides with scoring systems that allow you to assign a numerical value to quality of life. They are valuable for monitoring changes over time. Living with a pet, it can be easy to miss small, day-to-day fluctuations. With pets that have chronic or terminal illness, I recommend using these guides to score their quality of life regularly. This may be monthly, weekly, or even daily, depending on the severity of their disease.
Dr. Alice Villalobos, a veterinary oncologist, was an early practitioner of hospice and palliative care for pets. Her guidelines are the basis of many current quantitative guides. You can find her article and the scoring chart she created here.
In addition, the Ohio State University’s Veterinary Medical Center has an incredible nonprofit program called Honoring The Bond. The information they provide is an incredibly useful resource. I use their quality of life assessment chart often in my practice, as well as with my own pets. You can find this chart and more information on making this difficult decision here.
A Tool, Not the Only Answer
As with any other tool for assessing quality of life, these quantitative guides should be used alongside your own observations and the advice of your pet’s veterinarian. They provide guidance on what to monitor for, as well as help you decide what might be right for you. For more insights, you can watch Dr. Goussev’s interview, where she discusses assessing quality of life and what the process involves. I hope this has been helpful.
Thanks for reading, and until next time,
