Use the Quality of Life (QOL) Scale to determine your beloved cat's quality of life
You can use this Quality of Life (QOL) Scale to determine your beloved cat's quality of life, and assess whether to proceed with hospice care or to consider euthanasia.
| Item | Your score | Excellent | Status |
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Faiq Ur Rahman is a web designer, digital product developer, and founder of Toolraxy, a growing platform of web-based calculators and utility tools. He specializes in building structured, user-friendly tools focused on health, finance, productivity, and everyday problem-solving.
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Seven questions, each scored 1 to 10. The total lands somewhere between 7 and 70. That’s the whole tool. It exists because when a cat is seriously ill, “is she still enjoying life?” is the hardest question an owner faces, and having a number to look at makes the conversation with your vet a little less abstract. Score each item honestly. You’ll get a total, a per-item breakdown, and a verdict that tells you whether the score sits above or below the 35-point line vets use as a hospice threshold.
The scale behind this calculator is called HHHHHMM, developed by Dr. Alice Villalobos. It’s a standard tool in veterinary palliative care. The seven letters stand for Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. Each one captures a different slice of a cat’s daily experience, from pain control to whether she can reach the litter box on her own. No item is weighted more than any other. They all matter equally, and the total is what you and your vet work from.
Read each of the seven items and the short description underneath it.
Drag the slider to score each item from 1 (unacceptable) to 10 (excellent). Be honest rather than optimistic.
Watch the total in the results panel update as you move each slider.
Check the verdict banner to see where the score lands.
Look at the per-item breakdown table to spot the lowest scores, which are the areas to raise with your vet first.
Read the interpretation notes for a plain-language summary of what the total suggests.
Copy or share the result if you want to bring it to your next appointment.
Re-score every few days. Quality of life shifts, and the tool is designed to be used over time, not once.
Each of the seven items is scored from 1 to 10, then all seven are added together. The total sits between 7 and 70, with a higher number meaning better quality of life.
Formula: QOL total = Hurt + Hunger + Hydration + Hygiene + Happiness + Mobility + More good days
The threshold most vets use is 35 out of 70. Above 35 means quality of life is considered acceptable for continued hospice or palliative care. At exactly 35, the score sits on the line and a vet conversation is strongly recommended. Below 35, the scale suggests quality of life may be too compromised, and it’s time to discuss options seriously.
| Total score | Verdict | What it typically means |
|---|---|---|
| 56 – 70 | Excellent | Cat is thriving, continue current care |
| 42 – 55 | Good | Good quality of life, keep going |
| 36 – 41 | Acceptable | Above the threshold, monitor closely |
| 25 – 35 | Below threshold | Discuss hospice and palliative options with your vet |
| 7 – 24 | Critical | Cat may be suffering, speak with your vet soon |
One item deserves special mention: Hurt. The scale counts difficulty breathing and unmanaged pain as urgent, separate from the total. A cat with a 4 in Hurt but 9s everywhere else still has a total of 58, which reads as excellent. That’s misleading. Breathing trouble always outranks the number, and it needs veterinary attention that same day.
Per-item status is shown on the breakdown table: 8 or above reads as Good, 5 to 7 as Fair, 3 to 4 as Poor, and 1 to 2 as Critical. The tool also flags your lowest-scoring items so you know where to focus first.
Say your cat is 14, has chronic kidney disease, and has good days and bad days. You score her like this:
Hurt: 6. Pain is mostly managed but she’s stiff in the mornings.
Hunger: 7. She eats, though you have to coax her.
Hydration: 5. The vet mentioned subcutaneous fluids.
Hygiene: 8. She still grooms, with occasional help.
Happiness: 7. She purrs when petted but sleeps more than she used to.
Mobility: 5. Slow to get up, sometimes skips the litter box.
More good days than bad: 6. Roughly 4 good days for every 2 bad ones.
Total: 6 + 7 + 5 + 8 + 7 + 5 + 6 = 44 out of 70.
That lands in the “good” band, above the 35-point threshold. The lowest scores are Hydration and Mobility at 5, which suggests the next vet visit should cover fluid support and joint pain. The number alone doesn’t decide anything. It gives you a starting point for that conversation. Re-score in two weeks and compare.
It’s a seven-item assessment created by Dr. Alice Villalobos for pets in hospice or palliative care. Each item scores 1 to 10, giving a total between 7 and 70. Above 35 generally means quality of life is still acceptable.
Above 35 out of 70 is the usual threshold for continued hospice care. Above 42 reads as good, and above 56 as excellent. Below 35 suggests the cat’s comfort is seriously compromised.
When bad days consistently outnumber good ones, and your cat can no longer do the things she once enjoyed. A score below 35 on this scale, combined with a vet’s assessment, is the usual signal that it’s time to have that conversation.
It’s the threshold vets use to decide whether hospice care is still appropriate. A total above 35 means quality of life is generally considered acceptable. At exactly 35, it’s borderline, and a vet conversation is strongly recommended.
Yes. The scale is designed to be used on any day. If you only score on good days, the total will look falsely high. Track scores across a week or two and look at the pattern, not just one reading.
Sometimes. A cat scoring low because of untreated pain or dehydration may climb back above 35 after a vet visit. The pattern matters most. A score that stays low despite care is a different signal from one that dips and then recovers.
Hurt. Pain and difficulty breathing carry extra weight because they affect everything else. Breathing trouble in particular is an emergency, and it overrides whatever the other six items score.
Every two to three days for a cat in decline, or weekly for a stable hospice case. The scale works best as a tracking tool, not a one-time test. The trend over time tells you more than any single score.
Not on its own. The score is a conversation starter, not a decision. A total below 35 means it’s time to talk seriously with your vet about options, comfort, and what your cat’s daily experience is actually like.
No. It’s a structured way to organise your own observations. Vets assess pain, hydration, and body condition in ways you can’t at home. Use the score to support a conversation with your vet, not to replace one.
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