The decision to pursue additional medical treatments or consider euthanasia for a sick
or chronically ill pet is a hard decision to make for most pet owners. This handout
has been designed to help you rationally evaluate the quality of life of your pet over time. The handouts are designed to be repeated on a regular basis to track subtle changes over time.

Dogs and cats are creatures of habit. In general they all have a few favorite things that give them a purpose in their life and which make them happy. For many animals it is food that motivates them , for others it may be playing ball, hiking or going for car rides or just being in the middle of family activities. Cats may enjoy napping on their favorite chair, watching the birds through the window, sitting in their owner’s lap or unrolling all of the rolls of toilet paper in your bathroom.

Todays Date______________

First, take the time to list your pets Top 4 favorite things to do in life. If you have a geriatric or sick pet list their favorite things to do when they were in their prime. If they are no longer doing these things note whether you think it is a permanent or temporary change in their behavior.

                                                                 Temporary                            Permanent                           Unsure






The inability or the loss of desire of your pet to do one or more of these things is one of THE MOST IMPORTANT FACTORS in deciding how good your pet’s quality of life is at this moment in time. Next, take the time to evaluate the different components of life which are listed in the sections below. These are contributing factors in determining your pet’s comfort or happiness


Write down what percentage of each day you feel your pet appears comfortable and happy _____

Each time you do this worksheet compare this percentage. Is it getting worse over time?

Read each of the following questions in the next 9 sections and write down a score from 0-5 based on your own perception of your pet. 

A score of 0 (zero) means this question does not apply to your pet, a score of 5 means the condition is as severe as it could be.


1. PAIN:
Pain is a major factor which will decrease an animal’s quality of life. Many animals do not verbalize or act obviously painful particularly if the pain is caused by a chronic problem instead they tend to withdraw, hide, or remain immobile. Many animals hide their discomfort which is a survival mechanism passed down from their ancestors. Below are some of the pain responses you are more likely to see.

Consider the following:
____My pet appears to hurt or be in pain or is withdrawn and avoiding interactions.
____My pet limps. (If it didn’t hurt, they 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 his/her body or at a site of a cancer/tumor.
____My pet guards or protects and area of his/her body
____My animal’s posture or gait is abnormal or different than normal. (arched back/shuffling/balance loss/using leg abnormally/walking stiffly/seems weak /reluctant to move/difficulty rising or sitting)
____My pet shakes or trembles sometimes during rest.
____My pet is on pain medication and yet he still seems uncomfortable.

____My pet is more likely to snap or bite when I touch him. This is a new behavior.

____My pet is extremely restless and constantly pacing due to the pain. (multiply score x 2)


Possible medical or nursing interventions may include: starting pain medications,  increasing the dose or adding additional  pain medications to your pets current regimen based on your veterinarians advice, non-traditional medicine (acupuncture, physical therapy), surgical intervention if appropriate. Always be sure that the underlying disease/condition has been treated properly first – consider a second opinion to reaffirm your pet’s current diagnoses.

*Severe pain which is unrelenting or rapidly progressive despite the use of medical or surgical interventions should prompt a decision to euthanize*



Breathing is imperative to life. Having difficulty breathing can be frightening and debilitating to animals. Do not underestimate how quickly breathing issues can progress, how rapidly they can become fatal, or how scary this can be for an animal. Many people do not understand that ‘increased work of breathing’ is seen as an increase in the amount of movement of the chest wall or of the abdomen. This is a strong indication that your pet is struggling to breathe at some level.


Consider the following:

____ My pet is restless and cannot comfortably lie down and cannot lie down in certain positions.  (multiple your score x 2)    

____ My pet’s respiratory effort (the amount of work it takes to breathe) is not normal. Increased movement of the thorax or of the abdomen are examples of working harder to breathe.

____My pet cannot breathe with his/her mouth shut or is making loud noises as he breathes.

____My pet quickly collapses or breathes heavy with exercise

____The sounds that my pet makes in breathing are getting louder over time.

___ Attempts to move or exercise create an appearance of panic, an increase in panting/gasping or an increase in the amount of work it takes to breathe.


Possible medical or nursing interventions include: Medications, corrective surgery, oxygen support, or nebulizing therapy.


*Gasping to breathe, excessively working hard to breathe, excessive fatigue from breathing should either prompt an emergency trip to a veterinary hospital for immediate medical care or euthanasia*



Appetite is one of the most obvious signs of wellness. Most animals are vigorous eaters. The loss of interest in food is a strong indicator that there is a problem.

 Consider the following:
____My pet doesn’t eat his/her normal food anymore.
____My pet picks at his/her food now but never did this in the past.
____My pet walks over to his/her food and looks at it but won’t eat or walks away
____My pet doesn’t even want the special foods -treats, human foods, snacks - anymore.
____My pet acts nauseated or vomits when food is offered.
____My pet is losing weight without a valid cause.
____My pet is not eating at all. (If it is for more than 3 days multiple score x2)

Possible medical or nursing interventions include: hand feeding, heating food, adding moisture by soaking food or using canned varieties, careful addition of human foods, syringe feeding, stomach tube placement, medications for appetite stimulation, medications to reduce nauseousness.

Hydration status is equally important as appetite. Without adequate water consumption,
your pet can become dehydrated. Dehydration can contribute to weakness and not feeling well.

Consider the following:
____My pet doesn’t drink as much as he/she used to.
____My pet frequently has dry, sticky gums.
____My pet has persistent vomiting or has diarrhea (fluid loss contributes to dehydration)
____My pet drinks excessively or his consumption of water is increasing over time.                 

Possible medical or nursing interventions include:
add moisture to the diet, subcutaneous fluid administration, medications to control vomiting or diarrhea, bloodwork and a urinalysis to identify treatable medical problems.


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/her rectum or in his/her hair.
____My pet smells like urine or has skin irritation from urine.
____My pet has pressure sores/wounds that won’t heal
____My pet urinates or defecates where he sleeps or when he/she is walking because he has trouble standing up to do so or because he is now regularly incontinent.

Possible medical or nursing interventions include: regular brushing and grooming, frequent bedding changes, frequent sanitary baths, pain medication or adequate padding for areas where the pet spends a lot of time, appropriate wound care, treat the underlying disease/condition.


Changes in normal activity can be due to mobility problems, pain, illness, excessive weight or aging

Consider the following:
____My pet cannot get up or lie down without assistance.
____My pet had a hard time getting around and/or limps and walks slowly/stiffly all the time.
____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/she used to do.
____My pet falls frequently
____ Because of my pets arthritic or spinal cord disease he is now incontinent at times.

Possible medical or nursing interventions include: addition of pain medication(s) or dose adjustment, physical therapy, surgical intervention, acupuncuncture, weight loss.



 Consider the following: 
____My pet does not express joy and interest in life.
____My pet does not respond to the people that he/she used to respond to.
____My pet does not want to play with toys or do other things that he/she used to enjoy.
____My pet seems dull, not alert, or depressed.


Changes in normal behavioral patterns are often a key indicator of how well an animal

Consider the following:
____My pet is hiding or sleeping in odd places.
____My pet doesn’t greet me when I come home and he/she used to.
____My pet is overly clingy and is following me around and he/she never used to do this.
____My other pets are treating this pet differently they are overly attentive or ignoring him/her completely.
____My pet doesn’t care about what is going on around him/her.


Many times an owner is aware that their pet is suffering but does not want to give up
on their pet.

Consider the following:

____If I were in a similar situation I would not want to live
____I would be painful if I had this condition.
____I have made appointments for euthanasia for my pet but I cancelled/didnt show up.
____I am holding onto my pet for some sentimental reason. (ex. the pet belonged to a now deceased family member, the pet helped me through a hard time in my life, etc.)
____ My pet is having more bad days than good days.


If your pets score is greater than 180 than your pet’s quality of life is not ideal.

 If your pet’s score is over 220 he or she is likely not happy. Euthanasia should be considered.

Make notes about your pet’s specific medical condition. Speak to your family veterinarian about potential medical solutions for your pet’s illness.

 Print off this sheet and repeat the survey at regular intervals to compare - perhaps weekly for animals who are close to their life’s end, monthly for animals with a progressive disease problem, tri-annually for geriatric animals. This will allow you to see the progressive changes in your pet’s condition  which are more subtle and help you to make rational decisions based on these observations.