Quality of Life Scale for Senior Cats

HHHHHMM Scale Assessment Worksheet
AgingCatCare.com. Helping You Care for Your Aging Companion

About the HHHHHMM Quality of Life Scale

The HHHHHMM Quality of Life Scale was developed by veterinary oncologist Dr. Alice Villalobos to help pet owners and veterinarians objectively assess a pet's quality of life. The scale evaluates seven key categories: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More Good Days Than Bad. Each is scored from 0 to 10, with 10 being the best possible score.

A total score above 35 (out of 70) generally suggests an acceptable quality of life. Scores below 35 indicate that quality of life may be compromised and should prompt a conversation with your veterinarian. Regular reassessment helps you track trends over time and make informed, compassionate decisions for your senior cat.

Assessment Worksheet, Copy 1 of 3
Cat's Name:       Date:       Assessed by:  
1

Hurt (Pain Management)

Is your cat's pain adequately controlled? Cats hide pain well, so watch for hiding, a hunched or tucked posture, reluctance to be touched or held, and reduced jumping. Is pain management, including medications and complementary therapies, effective?
0 = Uncontrolled, severe pain 10 = Completely pain-free
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
2

Hunger (Appetite)

Is your cat eating enough to maintain adequate nutrition? Does warming the food or hand-feeding help? Are appetite stimulants such as mirtazapine, or syringe feeding, needed to keep weight on?
0 = Not eating at all 10 = Normal, healthy appetite
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
3

Hydration

Is your cat drinking enough water? Is the cat dehydrated? Many senior cats with kidney disease need subcutaneous fluids at home. Are supplemental fluids or wet food being used to keep hydration up?
0 = Severely dehydrated 10 = Normal, adequate hydration
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
4

Hygiene

Can your cat keep itself clean and well-groomed? Watch for a greasy or matted coat, dandruff, and a soiled rear from litter box trouble. Has your cat stopped grooming? Can you help keep them clean around the litter box?
0 = Matted, unable to stay clean, sores 10 = Clean, well-groomed, no issues
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
5

Happiness

Does your cat express joy or interest in life? Does your cat purr, seek affection, respond to family, or show curiosity about toys and surroundings? Or is your cat hiding, withdrawn, or no longer interacting?
0 = No response, withdrawn, depressed 10 = Happy, alert, and engaged
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
6

Mobility

Can your cat move around without assistance? Can your cat still jump to a favorite perch, navigate stairs, and get in and out of the litter box on its own? Are there stumbling, weakness, or a need for ramps and low-sided boxes?
0 = Immobile, unable to move 10 = Normal, unassisted mobility
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
7

More Good Days Than Bad

When your cat has bad days, are they outnumbered by good days? Is the trend of bad days increasing? If bad days outnumber good days, quality of life may be too compromised to continue.
0 = All bad days 10 = All good days
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10

Total Quality of Life Score

        
/ 70

Scoring Guide

35 – 70
Generally acceptable quality of life. Continue to monitor regularly and reassess as your cat's condition changes. Aim to maintain or improve scores in each category with your veterinarian's guidance.
Below 35
Quality of life may be compromised. A score below 35 suggests your cat may be suffering. Please discuss the results with your veterinarian to explore treatment options, palliative care, or compassionate end-of-life decisions.

Veterinary Discussion Prompts

Bring this worksheet to your next veterinary appointment. Use these prompts to guide the conversation:

  1. What does my cat's current score suggest about their quality of life?
  2. Are there treatments we haven't tried that could improve specific categories?
  3. What changes should I watch for that would indicate a significant decline?
  4. At what point should we discuss end-of-life options?
  5. How will I know when it's time?
Notes from your veterinarian:
 
 
 
 
 

Monthly Quality of Life Tracking Chart

HHHHHMM Scale, 12-Month Record
AgingCatCare.com
Record your cat's HHHHHMM scores each month to identify trends. Use arrows in the Trend column to indicate improvement, stability, or decline.
Cat's Name:  
Date Hurt Hunger Hydration Hygiene Happiness Mobility More Good Days Total Trend
 
 
 
 
 
 
 
 
 
 
 
 

Quality of Life Scale for Senior Cats

HHHHHMM Scale Assessment Worksheet
AgingCatCare.com
Assessment Worksheet, Copy 2 of 3
Cat's Name:       Date:       Assessed by:  
1

Hurt (Pain Management)

Is your cat's pain controlled? Watch for hiding, hunched posture, and reluctance to be touched.
0 = Uncontrolled, severe pain10 = Completely pain-free
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
2

Hunger (Appetite)

Is your cat eating enough? Is an appetite stimulant or syringe feeding needed?
0 = Not eating at all10 = Normal, healthy appetite
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
3

Hydration

Is your cat drinking enough? Are subcutaneous fluids needed for kidney disease?
0 = Severely dehydrated10 = Normal, adequate hydration
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
4

Hygiene

Can your cat stay clean and groomed? Is the coat matted or the rear soiled?
0 = Matted, unable to stay clean10 = Clean and well-groomed
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
5

Happiness

Does your cat show joy or interest? Purr, seek affection, or interact? Or hide and withdraw?
0 = No response, withdrawn10 = Happy and engaged
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
6

Mobility

Can your cat jump to a perch, manage stairs, and get in and out of the litter box?
0 = Immobile10 = Normal mobility
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
7

More Good Days Than Bad

Are there more good days than bad? Is the bad trend increasing?
0 = All bad days10 = All good days
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10

Total Quality of Life Score

        
/ 70

Scoring Guide

35 – 70
Generally acceptable quality of life. Continue to monitor and reassess regularly.
Below 35
Quality of life may be compromised. Discuss with your veterinarian.

Quality of Life Scale for Senior Cats

HHHHHMM Scale Assessment Worksheet
AgingCatCare.com
Assessment Worksheet, Copy 3 of 3
Cat's Name:       Date:       Assessed by:  
1

Hurt (Pain Management)

Is your cat's pain controlled? Watch for hiding, hunched posture, and reluctance to be touched.
0 = Uncontrolled, severe pain10 = Completely pain-free
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
2

Hunger (Appetite)

Is your cat eating enough? Is an appetite stimulant or syringe feeding needed?
0 = Not eating at all10 = Normal, healthy appetite
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
3

Hydration

Is your cat drinking enough? Are subcutaneous fluids needed for kidney disease?
0 = Severely dehydrated10 = Normal, adequate hydration
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
4

Hygiene

Can your cat stay clean and groomed? Is the coat matted or the rear soiled?
0 = Matted, unable to stay clean10 = Clean and well-groomed
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
5

Happiness

Does your cat show joy or interest? Purr, seek affection, or interact? Or hide and withdraw?
0 = No response, withdrawn10 = Happy and engaged
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
6

Mobility

Can your cat jump to a perch, manage stairs, and get in and out of the litter box?
0 = Immobile10 = Normal mobility
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10
7

More Good Days Than Bad

Are there more good days than bad? Is the bad trend increasing?
0 = All bad days10 = All good days
Score:
0
1
2
3
4
5
6
7
8
9
10
___/10

Total Quality of Life Score

        
/ 70

Scoring Guide

35 – 70
Generally acceptable quality of life. Continue to monitor and reassess regularly.
Below 35
Quality of life may be compromised. Discuss with your veterinarian.

AgingCatCare.com. Helping you care for your senior cat with confidence.

The HHHHHMM Quality of Life Scale was developed by Dr. Alice Villalobos, DVM, DPNAP. This worksheet is for informational purposes only and does not replace professional veterinary advice. Always consult your veterinarian when making decisions about your cat's care.