Quality of Life - help with your decision.

When your dog or cat have become old, or are ill and there is no light at the end of the tunnel, then quality of life becomes a prime concern. Are there more good days than bad? When the opposite is true, then we have to start thinking about making it as easy as we can for them. They have done everything they can for us through their lives - it's time for us to return the favour.

If you click here, we have a two part discussion of 'When is the right time to put our Dog or Cat to Sleep?'

Below are two formalised ways to help you make the right decision at the right time.

The H5M2 Scale

Quality Of Life Worksheet.

Work out a score of 1-poor to 10-best for each heading.

Over 35 points is considered an acceptable quality of life.
Under 35 points is unacceptable and medical care must be improved or euthanasia considered.

Score patients using a scale of 1 to 10 for each category. For example score
HURT 3.
HUNGER 2.
and so on for all 7 categories you see below:
Then add all seven numbers up at the end - over 35 usually suggests quality of life is acceptable.

HURT – Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet’s pain successfully managed? Is oxygen necessary?

HUNGER – Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube?

HYDRATION – Is the patient dehydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake.

HYGIENE – The patient should be brushed and cleaned, particularly after elmination. Avoid pressure sores and keep all wounds clean.

HAPPINESS – Does the pet express joy and interest? Is the pet responsive to things around him or her (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet’s bed be close to the family activities and not be isolated?

MOBILITY – Can the patient get up without assistance? Does the pet need human or mechanical help (e.g. a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling?(Some caregivers feel euthanasia is preferable to amputation, yet an animal who has limited mobility but is still alert and responsive can have a good quality of life as long as caregivers are committed to helping the pet.)

MORE GOOD DAYS THAN BAD – This is my favourite because it is more of a feeling. This when bad days outnumber good days, quality of life might be compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is okay.

TOTAL= A total more than 35 points is acceptable.

If this system doesn't work for you, try the second method below:

Adapted by Villalobos, A.E., Quality of Life Scale Helps Make Final Call, VPN,09/2004,for Canine and Feline Geriatric Oncology Honoring the Human-Animal Bond, by Blackwell Publishing, Table 10.1, released 2006.

Assess your pet's quality of life

A second way to think about your dog or cat's quality of life

These are the questions you are probably asking yourself:

Is your dog or cat in pain?
Are they suffering?
Should they be put to sleep?
Has the time come?

It isn’t always easy to assess your pet.

Most vets are highly trained at observing our pets and can help guide you if your pet is in pain or distress.

It’s a bit more difficult to do on your own, especially if you live with them at home. It is easy to miss slow decline in health, or subtle changes in behaviour.

Quality of Life assessment. How to assess your pet.

A guide on what am I looking for?

Tick (or mark Yes or No). When the text says “he”, please read “she” as well.

PAIN

Many animals do not complain in obvious, visible ways.

Many animals (especially cats) will hide their discomfort.

Consider the following:

____My pet hurts.

____My pet limps (if it didn’t hurt, he 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 her body or at a site of a cancer/tumour.

____My pet guards or protects and area of his 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.

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 normal food anymore.

____My pet picks at her food now but never used to do this.

____My pet walks over to his 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 nauseas or vomits.

____My pet is losing weight.

HYDRATION

Hydration status is equally important as appetite. Dehydration can contribute to weakness and not feeling well. Consider the following:

____My pet doesn’t drink as much as she used to.

____My pet frequently has dry, sticky gums.

____My pet is vomiting or has diarrhoea.

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 rectum or in his hair.

____My pet smells like urine or has skin irritation from urine.

____My pet has pressure sores/wounds that won’t heal.

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 used to do.

____My pet falls frequently.

HAPPINESS/MENTAL STATUS

Another important area of consideration is your 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 used to respond to.

____My pet does not want to play with toys or do other things that he used to enjoy.

____My pet seems dull, not alert, or depressed.

GENERAL BEHAVIOR PATTERNS

Changes in normal behavioural patterns are often a key indicator of how your pet is feeling. Consider the following:

____My pet is hiding or sleeping in odd places.

____My pet doesn’t greet me when I come home and he used to.

____My pet is overly clingy and is following me around and he never used to do this.

____My other pets are treating my pet differently and they are overly attentive or ignoring him completely.

____My pet doesn’t care about what is going on around him.

OWNER PERCEPTIONS

Many times you, the ‘parent’ or owner is aware that your pet is suffering but do not want to give up on them. 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 a sentimental (personal) reason.

____ My pet is having more bad days than good days.

Adapted from Quality of Life Scale, Veterinary Practice News, June 2006, pg. 24