Cat Quality of Life Calculator — HHHHHMM Scale
The HHHHHMM scale, developed by oncologist Dr. Alice Villalobos, helps pet owners and vets objectively assess a seriously ill or aging cat's quality of life across seven dimensions. Score each 0–10; a total of 35 or above generally indicates acceptable quality of life.
Score each criterion 0 (worst) to 10 (best). Total ≥ 35 indicates acceptable quality of life.
Good quality of life
- 1
Hurt + Hunger + Hydration + Hygiene
7 + 7 + 7 + 7 = 28 - 2
Total HHHHHMM score
28 + 7 + 7 + 7 = 49A total of 35 or above (out of 70) indicates acceptable quality of life.
How does this calculator work?
Score each of the seven HHHHHMM dimensions (Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, More) from 0 to 10. A total of 35/70 or higher indicates acceptable quality of life; below 35 suggests discussing end-of-life options with your vet. Developed by Dr. Alice Villalobos, 2004.
Formula
How this is calculated
The HHHHHMM Quality of Life Scale was published by Dr. Alice Villalobos in the Journal of the American Animal Hospital Association (2004) and is widely used by veterinary oncologists and palliative-care practitioners. It provides a structured, repeatable way to evaluate a pet's wellbeing without the subjectivity of purely emotional assessment.
Each of the seven criteria — Hurt (pain), Hunger (appetite), Hydration, Hygiene (grooming/cleanliness), Happiness (mental engagement), Mobility, and More good days than bad — is scored from 0 (worst imaginable for that dimension) to 10 (best possible). The maximum score is 70. A total of 35 or above is the threshold at which Dr. Villalobos suggests the animal's quality of life is acceptable and continued treatment or comfort care is warranted; below 35, end-of-life discussions with the vet may be appropriate.
This tool is an informational aid, not a veterinary diagnosis. Scores fluctuate day to day, especially during treatment cycles; tracking the score weekly over time is more informative than a single reading. Always make end-of-life decisions in consultation with a veterinarian who knows your cat's full medical history.
Frequently asked questions
Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More (good days than bad). The scale was developed by veterinary oncologist Dr. Alice Villalobos as part of the Pawspice palliative-care program and published in 2004.
No single number automatically indicates euthanasia. The HHHHHMM scale suggests that a total below 35/70 may indicate unacceptable quality of life, but this decision must involve your veterinarian, who can assess pain levels, prognosis, and treatment options that a calculator cannot capture. Use this tool to start that conversation, not to end it.
For a cat with a serious illness, weekly scoring is generally recommended. Track the trend over time — a consistently falling score despite treatment may be more significant than a single low reading on a bad day. Some owners score daily during a crisis period.
TG we-Calculate Editorial Team. (2026). Cat Quality of Life Calculator — HHHHHMM Scale [Online calculator]. TG we-Calculate. https://we-calculate.com/calculator/cat-quality-of-life-calculator
TG we-Calculate Editorial Team. "Cat Quality of Life Calculator — HHHHHMM Scale." TG we-Calculate. 2026. https://we-calculate.com/calculator/cat-quality-of-life-calculator.
TG we-Calculate Editorial Team, "Cat Quality of Life Calculator — HHHHHMM Scale," TG we-Calculate, 2026. [Online]. Available: https://we-calculate.com/calculator/cat-quality-of-life-calculator
@misc{wecalculate_cat_quality_of_life_calculator, title = {Cat Quality of Life Calculator — HHHHHMM Scale}, author = {{TG we-Calculate Editorial Team}}, howpublished = {\url{https://we-calculate.com/calculator/cat-quality-of-life-calculator}}, year = {2026}, note = {TG we-Calculate} }
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