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C2008-41

Dear Christopher Cat

Our elderly cat, Tasha, has slowed down over the past year, despite excellent veterinary care. How will we know when her quality of life has deteriorated to the point that she is suffering?

Christopher Responds

I watched my own family wrestle with this issue not long ago, and I extend my sympathy. It’s difficult to face the end of a beloved family member’s life.

My parents searched their hearts to assess my feline brother’s quality of life, and then they supplemented their subjective evaluation with a tool called the HHHHHMM scale.

This scale assesses seven criteria important in everyday life. Each is assigned a number from 1 (unacceptable) to 10 (excellent.) The criteria are:

  • Hurt: Is Tasha in pain, and if so, how well is the pain managed? Does she have trouble breathing?
  • Hunger: Is she eating well?
  • Hydration: Is Tasha dehydrated? If she needs supplementary fluids injected under the skin, does she tolerate the procedure well?
  • Hygiene: Is she grooming herself? Cats that don’t feel good stop grooming.
  • Happiness: Does Tasha interact with the family? Does she seem depressed or anxious?
  • Mobility: Does she get up and move around without assistance?
  • More good days than bad: Is her life more good than bad?

If Tasha scores at least 35 points, veterinarians consider her to have an acceptable quality of life.

Whenever my feline brother suffered another setback, my parents recalculated his HHHHHMM score. When it was clear that his quality of life was poor, we said goodbye.

I hope the HHHHHMM scale helps you make compassionate decisions on Tasha’s behalf.

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