Quality of Life at the End of Life for Your Dog

Each pet has certain needs that should be recognized and respected. Quality of life is a way to refer to and discuss the day-to-day life and lifestyle of a dog reaching the end of its life.

If we can successfully meet an ailing or chronically ill dog's basic needs, then we can feel confident that our efforts in preserving life are justified.

What are some of the conditions that might cause a dog’s quality of life to deteriorate?

Most senior pets develop one or more medical conditions that tend to worsen over time. Examples of chronic medical conditions common in older dogs include:

• Blindness. Generally occurs gradually from changes in the lens of the eye.
• Cancer. The risk of cancers of all types increases with age.
• Dental disease: Painful inflammation and infection in the gingiva and oral cavity.
• Chronic renal disease. This degenerative kidney decreases the kidneys’ ability to filter biological waste from the blood.
• Deafness. Generally occurs gradually, over time, as the eardrum becomes less flexible.
• Osteoarthritis. Painful inflammation and deterioration of the joints.
• Overweight/obesity. More than half of senior dogs are overweight or obese, which reduces their quality of life.

Is there a way to objectively measure my dog’s quality of life?

Dr. Alice Villalobos, a veterinary oncologist, developed a quality-of-life scale for dogs that provides guidelines to help owners and veterinarians work together to maintain a healthy human-animal bond. The scale allows you to measure the success of a palliative care or hospice plan for a dog with life-limiting disease, and to fine-tune that care/plan.

Dr. Villalobos' quality-of-life scale looks at seven different categories and scores each parameter from 1 to 10, with 10 being the best. A score above 5 in each category, or an overall score greater than 35, suggests that the dog's quality of life is acceptable and that it is reasonable to continue end-of-life care and support.

What does each category mean for a dog approaching the end of its life?

The categories can be remembered as "HHHHHMM." This list of letters stands for Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad.

Hurt. Adequate pain control, including the ability to breathe properly, is an absolute necessity. Most pet owners do not know that being able to breathe is ranked as an important pain management strategy. A dog may benefit from receiving oxygen at home, and it may not be as challenging to provide as you think. Other methods of controlling pain may include oral or injectable medication.

Hunger. If a dog cannot eat properly or willingly, first try hand-feeding. If this is not successful, it may be appropriate to consider a feeding tube, particularly if oral medication must be given. Blended or liquid diets may offer another alternative.

Hydration. Fluid under the skin is an easy and well-tolerated way to supplement what an ailing dog is drinking. This is not a heroic measure but can help an older dog feel better.

Hygiene. Can the dog be brushed, combed, and kept clean? Is the coat matted? Can the dog move away from stool or urine if it has an accident? Is there a tumor that has outgrown its blood supply and now has an odor or discharge? Often, a dilute solution of shampoo from your veterinarian on a sponge or washcloth can be used to clear dead cells away without causing pain. Your veterinary healthcare team can help work out the details of this kind of care. It is also important to turn bedridden pets regularly, keep them clean and dry, and ensure that they have adequate padding underneath to prevent bedsores.

Happiness. Is the dog experiencing joy or mental stimulation? Dogs communicate with their eyes, as well as by wagging their tails. Is the ailing dog still interacting with family members and with the environment? Placing comfortable beds near family activities helps a dog remain engaged in life. Dogs are social animals and can become depressed when they are separated from their pack.

Mobility. If the dog can no longer move around on its own, it may be time to consider a mobility device. A sling or harness for support may be all that is required. Other options, depending on how much support is needed, include two-wheel carts, four-wheeled carts and wagons. 

Mobility devices allow a dog to stay active. This is particularly important for bigger dogs that cannot simply be carried from place to place. Mobility and hygiene go together when a dog is bedridden. Your veterinarian is an important resource when working through mobility issues.

More good days than bad. When there are too many bad days in a row, or if the dog seems "turned off" to life, quality of life is compromised. Bad days may mean nausea, vomiting, diarrhea, seizures, frustration, unrelenting pain/discomfort, or inability to breathe.

How will I know it’s the right time to consider euthanasia?

Euthanasia is one of the most difficult choices to make for beloved canine friend. It is important to plan for the end of life before it arrives, and the quality-of-life scale can help with that planning. You can help your cat maintain a good day-to-day life experience by using this scale to regularly measure how well your cat's basic needs are being met. The scale can also help you clarify the decision for euthanasia, hopefully relieving anxiety and regret about your beloved cat's end of life.

Can my veterinarian help me decide when to let go?

Yes, veterinarians are often asked to help dog owners with the difficult decisions around euthanasia. Your veterinarian is there to help. There are many medical problems that you may assume cannot be managed, but with the aid of your veterinarian, with supportive care, and with minimal expense, options may be available. Involve your veterinarian and their support staff early, so they can help guide you during this difficult time.