When Is It Time to Say Goodbye? A Quality of Life Guide

"You'll know when it's time."

That's what people say. But when you love someone, you don't just "know." You hope. You wait for one more good day. You second-guess everything.

This guide won't make the decision for you. Nothing can. But it can help you evaluate your pet's quality of life objectively, recognize when suffering outweighs joy, and understand that choosing euthanasia can be the most loving thing you do.

The Hardest Truth

Here's what no one tells you: there is rarely a clear "right moment."

Most pets don't pass peacefully in their sleep. If you wait for that, you may wait too long, through suffering you didn't need to witness and they didn't need to endure.

The goal is to give your pet a peaceful death before their bad days overwhelm their good ones. Veterinarians often say: "Better a week too early than a day too late."

The Quality of Life Scale (HHHHHMM)

Dr. Alice Villalobos, a veterinary oncologist, developed this scale to help pet owners evaluate quality of life objectively. It assesses seven factors, each scored 0-10.

How to Score

0 = Completely inadequate 10 = Excellent, normal function

Be honest. Base it on today and recent weeks, not memories of how they used to be.

H - Hurt (Pain)

Ask yourself:

• Is my pet's pain being adequately managed?
• Do they cry, whimper, or moan?
• Are they panting when at rest?
• Do they flinch when touched?
• Are they hiding (cats) or avoiding interaction?

Scoring:

• 10: No discernible pain
• 7-9: Mild pain, well-managed with medication
• 4-6: Moderate pain, partially managed
• 1-3: Significant pain despite treatment
• 0: Severe, unrelenting pain

Note: Animals hide pain. If you're seeing obvious signs, they're likely feeling much worse.

H - Hunger

Ask yourself:

• Is my pet eating enough to maintain their weight?
• Do they show interest in food?
• Can they physically eat (chew, swallow)?
• Do they need hand-feeding or syringe feeding?

Scoring:

• 10: Eating normally with enthusiasm
• 7-9: Eating well with some coaxing or appetite stimulants
• 4-6: Eating less than half of normal, losing weight
• 1-3: Requires force-feeding or feeding tube
• 0: Refuses food entirely, vomits everything

Note: Not eating is one of the clearest signs of a declining quality of life.

H - Hydration

Ask yourself:

• Is my pet staying hydrated?
• Are they drinking on their own?
• Do they need subcutaneous fluids?
• Are their gums tacky (sign of dehydration)?

Scoring:

• 10: Drinking normally
• 7-9: Drinking adequate amounts with encouragement
• 4-6: Requires supplemental fluids occasionally
• 1-3: Requires daily subcutaneous fluids
• 0: Unable to maintain hydration despite intervention

H - Hygiene

Ask yourself:

• Can my pet get up to urinate and defecate appropriately?
• Do they soil themselves or lie in waste?
• Can they groom themselves (cats)?
• Is their skin/coat in acceptable condition?
• Do they have untreatable wounds or infections?

Scoring:

• 10: Maintains normal hygiene
• 7-9: Minor issues, easily managed
• 4-6: Needs regular cleaning, occasional accidents
• 1-3: Frequently soiled, skin problems developing
• 0: Cannot maintain hygiene, develops sores, infections

Note: Pressure sores (bedsores) develop in immobile pets and can be extremely painful.

H - Happiness

This is the hardest to quantify but perhaps the most important.

Ask yourself:

• Does my pet still have moments of joy?
• Do they wag their tail / purr?
• Do they greet me when I come home?
• Do they enjoy being petted?
• Are they still mentally present?

Scoring:

• 10: Normal joyful engagement
• 7-9: Less enthusiastic but still engaged
• 4-6: Moments of happiness but mostly withdrawn
• 1-3: Rarely shows interest in life
• 0: Non-responsive, completely withdrawn

Note: You know your pet. Trust your sense of whether they're "still in there."

M - Mobility

Ask yourself:

• Can my pet get up without help?
• Can they walk to food, water, and bathroom?
• Do they struggle on stairs or slippery floors?
• Are they able to go outside (if that was their normal)?

Scoring:

• 10: Normal mobility
• 7-9: Slowed but still mobile independently
• 4-6: Needs help sometimes (lifting, ramps)
• 1-3: Needs significant assistance, can barely stand
• 0: Cannot stand or move without being carried

Note: Mobility issues compound other problems. A pet who can't move can't eat, drink, or bathroom normally.

M - More Good Days Than Bad

Ask yourself:

• Does today look like a good day or a bad day?
• How many good days vs. bad days have there been in the last week?
• Is the trend going up, stable, or declining?

Suggestion: Keep a simple calendar. Every day, mark a happy face, neutral face, or sad face. After a week or two, patterns become clear.

Scoring:

• 10: Almost all good days
• 7-9: Mostly good days with occasional bad ones
• 4-6: About equal good and bad
• 1-3: Mostly bad days
• 0: Only bad days

Adding Up the Score

Total Possible Score: 70 (10 points × 7 categories)

Score Interpretation:

Important: These are guidelines, not rules. A pet scoring 20 in pain but 10 in happiness is suffering. A pet scoring 40 overall but with one category at 0 may need intervention.

Red Flags That Override the Scale

Some situations indicate it's time regardless of overall score:

• Uncontrollable pain: Despite maximum medication
• Inability to breathe comfortably: Constant struggle for air
• Collapse or seizures: Frequent and uncontrolled
• Complete food/water refusal: More than 2-3 days
• No recognition of family: Complete cognitive decline

When suffering is obvious and unmanageable, numbers don't matter.

Having the Conversation with Your Vet

Your veterinarian is your partner in this decision. They can help you:

• Understand the medical prognosis
• Manage pain and symptoms
• Know what "decline" looks like for your pet's condition
• Set specific markers ("If X happens, it's time")
• Assess quality of life objectively

Questions to ask:

• "How much pain is my pet in, honestly?"
• "What does the decline look like from here?"
• "If this were your pet, what would you do?"
• "What are my options for keeping them comfortable?"

Most vets welcome these conversations and have had them many times.

When You Decide It's Time

Types of Euthanasia Services

At the Vet Clinic:

• Standard option
• Medical environment
• Lower cost
• Quick intervention if anything goes wrong

At Home (In-Home Euthanasia):

• Pet passes in familiar surroundings
• Less stressful for anxious pets
• Family can be present comfortably
• Private and personal
• Services like Lap of Love, Blue Door Veterinary Services

Both are valid choices. Consider what would be most comfortable for your pet.

What to Expect

Modern euthanasia is peaceful:

1. Sedation first: Many vets give a sedative injection so your pet relaxes or falls asleep first
2. Final injection: An overdose of anesthetic is given, usually IV. The pet passes within seconds, painlessly
3. What you'll see: They may take a deep breath, their eyes may stay open, muscles may twitch briefly. These are normal.

You can hold your pet. You can be there. You can also choose not to be present—that's okay too.

Practical Decisions

Before the appointment, decide:

• Will you be present?
• Will you stay afterward to say goodbye?
• Do you want cremation or burial?
• Do you want ashes returned?
• Any memorial you want to do?

Having these decisions made beforehand removes stress from an already heartbreaking day.

The Grief After

Losing a pet is real grief. Don't let anyone minimize it.

What helps:

• Allow yourself to feel it—crying is normal
• Talk about your pet with people who understand
• Memorialize them (photos, paw prints, donations in their name)
• Give yourself time before getting another pet

Resource: The ASPCA Pet Loss Hotline: 1-877-474-3310

Final Thoughts

This decision is an act of love, not failure.

You are choosing to spare your companion from suffering they cannot understand. You are taking on the pain of saying goodbye so they don't have to be in pain any longer.

There is no perfect timing. You will wonder if you waited too long or not long enough. That's normal. That's love.

What matters is that you tried. You cared. And in the end, you chose kindness.

Related: Do Pets Mourn Other Pets? Grief Signs Related: Senior Dog Diet Guide