The HHHHHMM Quality of Life Scale, developed by Dr. Alice Villalobos, evaluates seven key factors to help you assess whether your pet's quality of life is acceptable. Each factor is scored 1–10, with a total score over 35 generally indicating an acceptable quality of life.
The Seven Factors
Hurt
Is pain being managed? Can the pet breathe comfortably?
Hunger
Is your pet eating enough? Maintaining body weight?
Hydration
Is your pet staying hydrated? Skin that tents indicates dehydration.
Hygiene
Can your pet be kept clean and free of sores or odor?
Happiness
Does your pet express interest in life, interact with family, or show joy?
Mobility
Can your pet move enough to satisfy basic needs without suffering?
More Good Days Than Bad
When bad days outnumber good ones, quality of life may be unacceptable.
This scale is a guide, not a diagnosis. Please speak with your veterinarian for a professional assessment.
Knowing when it's time is one of the hardest decisions a pet owner ever faces. There is no single right answer — but there are signs that can help guide you.
Signs Quality of Life Has Declined
- Unable to eat, drink, or keep food down
- Chronic pain that medication cannot adequately control
- Difficulty breathing or persistent respiratory distress
- Loss of mobility — unable to stand, walk, or change position
- Loss of interest in surroundings, family, or favorite activities
- Incontinence without awareness, causing distress or skin sores
- More bad days than good days over the past week
If you are unsure, speak with your regular veterinarian. They know your pet's medical history and can offer a professional opinion. When you feel the time has come, Circle of Life is here to help.
The loss of a pet is a genuine and significant loss. Grieving is not only normal — it is a reflection of the love and bond you shared. There is no right way to grieve, and no timeline you are expected to follow.
What You May Feel
- Sadness, emptiness, or a sense that something is missing
- Guilt — even when you made the most compassionate choice possible
- Anger, denial, or difficulty accepting the loss
- Physical symptoms like fatigue or difficulty sleeping
Ways to Honor Your Pet
- Create a small memorial at home with photos or a keepsake
- Write about your pet — a letter, journal entry, or memory
- Plant a tree or garden in their memory
- Make a donation in their name to a local animal shelter
- Allow yourself time — grief does not follow a schedule
If grief feels overwhelming, please consider speaking with a licensed counselor or therapist who understands pet loss. Many offer grief support specifically for this experience.
For many children, the loss of a pet is their first experience with death. How you handle this moment can shape how they understand love, loss, and care for years to come.
Tips for Different Ages
- Young children (2–5): Use honest, simple language. Avoid phrases like "went to sleep" which can cause confusion or fear. "Our pet died and we won't see them anymore" is clear and gentle.
- School-age children (6–12): Answer questions honestly. Children this age often want to understand why. Let them participate in goodbyes if they choose.
- Teens: Give them space to process in their own way. Some may want to talk; others may need time. Validate their grief without minimizing it.
Should Children Be Present?
This is a personal family decision. If a child wants to be present and you feel it is appropriate, many families find it meaningful. Our doctors are experienced in creating a peaceful environment for everyone in the room. There is never any pressure.
After the Visit
- Create a small ritual together — a drawing, a photo album, a goodbye letter
- Acknowledge their feelings openly and without judgment
- Let them know that sadness is okay and shows how much they loved their pet
How do I know when it's time?
Signs include inability to eat or drink, unmanageable pain, loss of mobility, or more bad days than good. Speak with your regular veterinarian about a quality-of-life assessment. When you feel it's time, we are here.
Will my pet feel any pain?
No. A sedative is given first to ensure your pet is fully relaxed and comfortable before the final injection. The process is completely painless and peaceful.
How long does the visit take?
Most visits take 30 to 60 minutes. The procedure itself is brief, but we allow unhurried time before and after for your family.
Can all family members be present?
Yes. Everyone who wishes to be present is welcome, including children. Your doctor will follow your family's lead throughout.
What happens to my pet's body?
That decision is entirely yours. We can coordinate with local cremation providers, or your pet may remain in your care for home burial. We walk through every option without pressure.
Is this an emergency service?
No. Circle of Life is not an emergency service. If your pet requires immediate medical care, please contact your regular veterinarian or the nearest emergency animal hospital.
Have a question not covered here? We're happy to help.
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