How to have a quality of life conversation with yourself
8 May 2026 · 7 min read · Dr Jasmine Kay Ching Tung
The hardest consultations of my week are rarely medical puzzles. They are the ones where an owner already knows, somewhere, that things have changed, and needs a framework to look at it clearly.
Structured scoring helps because memory is unreliable. When you are with a pet every day, decline is invisible; when you score weekly on paper, it becomes obvious.
The HHHHHMM framework covers Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. Each is scored 0–10, and a total consistently below 35 suggests quality of life is no longer acceptable.
Pain is chronically under-recognised in cats especially. Reduced grooming, hiding, reluctance to jump, and a hunched posture are pain behaviours, not simply 'slowing down with age'.
Write down three things your pet loves. When they can no longer do two of them, that is meaningful information.
Use the Quality of Life Survey on this site weekly and bring the scores to your appointment. It changes the conversation from 'is it time?' to 'here is what has changed over six weeks'.
This article is general education and cannot replace an examination of your individual animal. If your pet is unwell, contact your veterinarian.