Quality of Life Scale

When your dog is nearing the end of his/her life, the emotional weight that falls upon you can be tremendous. The
endearing habits, the joy, the unquestioning devotion your animal gave you fill your heart as you confront the expected loss.

Many of us view our dog as a beloved member of the family to whom we have made a commitment to care for.
Unfortunately, there may come a time when this honorable commitment takes a different path. The medical options may be exhausted or the continued care might be unmanageable or too expensive and the best you can do for your dog is to let go.

The hardest decision you may have to make is determining when the quality of your dog’s life is compromised to the point where it’s not worth going on. It’s especially difficult to determine when is the right time with dogs because we just don’t always know when they are suffering and ready to leave this life. My veterinarian always told me that I would know when the time was right, but I’m not sure that’s necessarily true in all cases.

You may second guess your decision – did I wait too long? Was my dog suffering and I didn’t know it? Could he have had
a few more weeks? As long as you do not allow your dog to suffer, you made the right the decision.

The Quality of Life Scale contained in the section below is presented to help guide your decision. I hope it will provide you with peace and comfort at this difficult time.

The decision to pursue additional medical treatments or consider euthanasia for a sick
or chronically ill pet is a hard decision to make for many pet owners. This handout
has been designed to help you consider the quality of life of your pet and to help make
you aware of some of the additional options that exist if it is not the right time for
euthanasia. Answer each of the questions in each section with a yes or no.

PAIN

Pain control is essential. Many animals do not complain in obvious, visible ways when they hurt. Many animals will hide their discomfort. Consider the following:
____My pet hurts.
____My pet limps. (If it didn’t hurt, they wouldn’t limp.)
____My pet pants frequently, even at rest.
____My pet’s respirations are forced, exaggerated, or otherwise not normal.
____My pet licks repeatedly at one site on his/her body or at a site of a cancer/tumor.
____My pet guards or protects and area of his/her body and may snap if that area is approached or touched.
____My animal’s posture is abnormal or different than normal.
____My pet shakes or trembles sometimes during rest.
____My pet is on pain medication and it doesn’t work.

Possible interventions for yes answers: start pain medication, change pain medications,
combinations of pain medications from different drug classes, surgical intervention,
non-traditional medicine (acupuncture, etc.), treat the underlying disease/condition.

APPETITE

Appetite is one of the most obvious signs of wellness. Most animals are normally vigorous eaters. Consider the following:
____My pet doesn’t eat his/her normal food anymore.
____My pet picks at his/her food now but never used to do this.
____My pet walks over to his/her food and looks at it but won?t eat or walks away from the food.
____My pet doesn’t even want good stuff (treats, human foods, snacks) anymore.
____My pet acts nauseated or vomits.
____My pet is losing weight.

Possible interventions for yes answers: hand feeding, heating food, adding moisture by
soaking food or using canned varieties, careful addition of human foods, syringe
feeding, stomach tube placement, medications for appetite stimulation, medications for
nausea.

HYDRATION

Hydration status is equally important as appetite. Without adequate water consumption,
your pet can become dehydrated. Dehydration can contribute to weakness and not
feeling well. Consider the following:
____My pet doesn’t drink as much as he/she used to.
____My pet frequently has dry, sticky gums.
____My pet is vomiting or has diarrhea (fluid loss can also contribute to dehydration).

Possible interventions for yes answers: add moisture to the diet, subcutaneous fluid
administration, medications to control vomiting or diarrhea.

HYGIENE

Animals that don’t feel well, especially cats, do not have the energy to maintain normal hair and skin. Consider the following:
____My cat doesn’t groom herself any more.
____My pets hair is matted, greasy, rough looking, dull, or foul smelling.
____My pet has stool pasted around his/her rectum or in his/her hair.
____My pet smells like urine or has skin irritation from urine.
____My pet has pressure sores/wounds that won?t heal.

Possible interventions for yes answers: regular brushing and grooming, frequent
bedding changes, adequate padding for areas where the pet spends a lot of time,
appropriate wound care, treat the underlying disease/condition.

ACTIVITY/MOBILITY

Changes in normal activity can be due to mobility problems, pain, illness, or aging (arthritis). Consider the following:
____My pet cannot get up without assistance.
____My pet had a hard time getting around and/or limps.
____My pet lays in one place all day long.
____My pet does not want to play ball, go for walks, or do the things he/she used to do.
____My pet falls frequently.

Possible interventions for yes answers: pain medication addition or adjustment, physical therapy.

HAPPINESS/MENTAL STATUS

Another important area of consideration is the pet’s mental status and happiness. Consider the following:
____My pet does not express joy and interest in life.
____My pet does not respond to the people that he/she used to respond to.
____My pet does not want to play with toys or do other things that he/she used to enjoy.
____My pet seems dull, not alert, or depressed.

GENERAL BEHAVIOR PATTERNS

Changes in normal behavioral patterns are often a key indicator of how well and animal feels. Consider the following:
____My pet is hiding or sleeping in odd places.
____My pet doesn’t greet me when I come home and he/she used to.
____My pet is overly clingy and is following me around and he/she never used to do this.
____My other pets are treating this pet differently, they are overly attentive or ignoring him/her completely.
____My pet doesn’t care about what is going on around him/her.

OWNER PERCEPTIONS

Many times an owner is aware that their pet is suffering but does not want to give up on their pet. Consider the following:
____I wouldn’t want to live if I were in a similar situation.
____I would be painful if I were in a similar situation.
____I have made appointments for euthanasia for this pet cancelled or didn’t show up.
____I am holding onto this pet for some sentimental reason. (ex. the pet belonged to a now deceased family member, the pet helped me through a hard time in my life, etc.)
____ My pet is having more bad days than good days.

Count the number of yes and no answers that you have marked.
____Yes
____No

Unfortunately, there isn’t a simple point system or scale that will tell you exactly what do
for your pet. However, the more yes answers you have, the more likely it is that your pet
has a poor quality of life. This list has been significantly expanded and altered from an
article on quality of life. The original scale uses 50% as a cutoff. If this information is
extrapolated, it would imply that more than 21 yes answers means your pet has a
diminished quality of life. If this is the case, you have two options:
1. Make major changes to try to improve your pet’s quality of life (like some of the
things listed above) or 2. Euthanize your pet to relieve his/her suffering.

The information provided is for educational purposes only and is not
intended to take the place of your regular veterinarian. Please do not hesitate
to contact your regular veterinarian if you have questions regarding your pet.

Very loosely adapted from Quality of Life Scale, Veterinary Practice News, June 2006, pg. 24.

Karen Blakeley, DVM, MPH
1 December 2006

July 26, 2011 by Lisa  
Filed under Blog