When evaluating quality of life, personalized patient and client information is needed to reach an educated, informed, and supported choice that fits not only the pet’s medical condition but also the family’s wishes. In short, quality of life applies not only to the pet; it also applies to the family.
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Suggestions on using this quality-of-life scale:

1. Complete the scale at different times of day to note fluctuations, because most pets do better during the day and worse at night.

2. Ask multiple family members to complete the scale; compare their observations.

3. Take periodic photos of the pet to help remember his or her physical appearance.

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Ask Questions

1. These open-ended questions will help to gauge the family’s time, emotional, and (when appropriate, financial) budgets: Have you ever been through the loss of a pet before? If so, what was your experience (good or bad, and why)?

2. What do you hope the life expectancy of your pet will be? What do you think it will be?

3. What is the ideal situation you wish for your pet’s end-of-life experience (at home, pass away in her sleep)?

 
Read All About It

• AAHA/AAFP pain management guidelines for dogs and cats. American Animal Hospital Association, 2007; https://www.aahanet.org/Library/PainMgmt.aspx

• Pet hospice journal; www.pethospicejournal.com

Social Functions

1. Desire to be with the family has not changed

2. Interacts normally with family or other pets (ie, no increased aggression or other changes)

 
Natural Functions

1. Appetite has stayed the same

2. Drinking has stayed the same

3. Urination habits have stayed the same

4. Bowel movements have stayed the same

5. Ability to ambulate (walk around) has stayed the same.

 
Mental Health

1. Enjoys normal play activities

2. Still dislikes the same things (ie, “still hates the mailman” = 0; “doesn’t bark at the mailman anymore” = 2)

3. No outward signs of stress or anxiety

4. Does not seem confused or apathetic

5. Nighttime activity is normal, with no changes seen.

 
Physical Health

1. Shows no changes in breathing or panting patterns

2. Shows no outward signs of pain (See Read All About It)

3. Does not pace around the house

4. Overall condition has not changed recently​

Results:
​0–8 = Quality of life is most likely adequate. No medical intervention required yet, but guidance from your veterinarian may help identification of signs to look for in the future.

9–16 = Quality of life is questionable and medical intervention is suggested. Your pet would benefit from veterinary oversight and guidance to evaluate his or her disease process.
 
17–36 = Quality of life is a definite concern. Changes will likely become more progressive and more severe. Veterinary guidance will help you better understand the end stages of your pet’s disease process in order to make a more informed decision of whether to continue hospice care or elect peaceful euthanasia.

I am concerned about the following things:

1. My pet’s suffering

2. My desire to perform nursing care for my pet

3. My ability to perform nursing care for my pet

4. My pet dying alone

5. Not knowing the right time to euthanize

6. Coping with loss

7. Concern for other animals in my household

8. Concern for other members of the family (ie, children).

Results:
0–4 = Your concerns are minimal. You have either accepted the inevitable loss of your pet and understand what lies ahead, or have not yet given it much thought. Now is the time to begin evaluating your own concerns and limitations.
 
5–9 = Your concerns are mounting. Begin by educating yourself on your pet’s condition, which is the best way to ensure you are prepared for the emotional changes ahead.
 
10–16 = Your concerns about your pet are valid. Now is the time to build a support system. Veterinary guidance will help you prepare for the medical changes in your pet and other health professionals can begin helping you with anticipatory grief.