HHHHHMM Scale — Rate each factor 0 (worst) to 10 (best)
Developed by Dr. Alice Villalobos, this scale helps pet owners and veterinarians assess an animal's quality of life when facing serious illness. Each of the 7 criteria is scored 0-10: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More Good Days Than Bad. A total score of 35+ out of 70 is generally considered acceptable quality of life. Scores below 35 suggest the pet may be suffering and humane euthanasia should be discussed. This tool is a guide, not a definitive answer — your veterinarian's assessment and your intimate knowledge of your cat's personality are equally important in this deeply personal decision.