One of the more frequently asked questions by dog owners of their vets is “how will I know when it’s time?” Some vets will nod and tell you that you will just know, and others will spout off a quality of life scale based on your dog’s physical and mental well-being, a when to put down your dog checklist. The truth is that in most instances it’s a combination of both of these approaches that will give you the answer you seek.
When to Put Your Dog Down Checklist
The Quality of Life Scale
Most veterinary professionals will refrain from giving their personal opinion when it comes to putting your dog down. They will, instead, tell you what they see from a veterinary perspective and they will follow that up with a series of questions that are generally referred to as the “Quality of Life Scale” (originally developed by Dr. Alice Villalobos of Pawspice Animal Oncology Center, and called the “HHHHHMM Quality of Life Scale”). This is part of what pet owners casually call a “when to put down your dog checklist.”
Why are vets so reluctant to give personal opinions when it comes to putting your dog to sleep?
You may wonder why vets – even a veterinarian who you have known for decades – relies on a quality of life scale when answering your questions about putting your dog to sleep. The reason for this is almost always because your vet feels that as your dog’s guardian, you have more intimate knowledge of their complete well-being.
It's true that your vet can tell you what the tests say; they can tell you what they see. But those things are based on a singular moment in time. As senior dogs or dying dogs approach their final months (or even years), our pets experience good days and bad days, and only someone who experiences the sum total of those good and bad moments, and who has seen that same dog in healthier stages of their life, can form a complete picture of the animal's current well-being.
So why does your vet turn to the quality of life scale?
The “quality of life scale” helps your vet to gauge whether your pet is physically healthy and able to continue their life, but it also prompts you to think about your dog’s actual quality of life based on which you can create the “when to put down your dog checklist.”
Sometimes, pet parents are in denial when it comes to their dog’s current quality of life – usually because they’re afraid to lose their four-legged companion – but the numerical value generated by the quality of life scale provides a less subjective point of reference.
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The Quality of Life Scale: How it Works
While some owners look at the when to put down your dog checklist as a “pedestrian” thing, the quality of life scale is closer to a scientific approach done and looked at by vets that objectively measures your dog’s actual quality of life by quantifying seven important factors of your dog’s overall well-being. Each factor is rated on a 1-10 scale and the seven numerical values are then added together to get a number between 1-100.
The consensus is as follows:
- A total score of 80 or above indicates a happy and healthy pet
- A score above 36 to 79 indicates an acceptable quality of life
- A score of 35 and below is an indicator that your dog’s quality of life is poor, and you should consider euthanasia.
On top of the quality of life scale, this website has a more unique questionnaire for pet owners to make the decision on when to put down a dog with a number of personal questions to answer, and the Ohio State University has also a thorough survey and questionnaire to help pet owners determine when it's time to put down a dog:
The Seven Factors of the Quality of Life Scale
Numerical values are one part of the when to put down your dog checklist, but the vets' quality of life scale also considers seven additional factors alongside the numerical scale for a better assessment:
Is your dog currently in pain? If they are in pain, is that pain manageable by vet care or pet pain medication 75% of the time? If medication is not helping to relieve the dog's pain, how often would you gauge that your pet is in pain?
Signs that your dog is in pain may include:
- Tail tucking
- Licking the affected area
- Vocalizing (barking or whining)
- Being reluctant to move
- An inability to get comfortable (this may be shown by panting)
- Showing a pain response when an area is palpated
Pain is the first and most important aspect of when to put down your dog checklist and life scale to consider, and the rest of assessment will come alongside this factor.
A score of 1 indicates that your dog is in pain most of the time and that pain cannot be relieved through medication or other medical intervention.
A score of 5 indicates that your dog does experience pain, but that pain is managed with medications 75% of the time or more.
A score of 10 indicates that your dog is experiencing no pain at all or is experiencing minimal normal age-related pain.
Is your dog currently eating regularly or are they refusing food? If they are slow to eat or are reluctant to eat, how much interest do they show in food or eating overall? If they are refusing food or vomiting/having diarrhea regularly, are they getting enough sustenance or are you having to hand feed them or use other methods (a feeding tube) for feeding to ensure proper nutrition?
Appetite evaluation is an important part of when to put down your dog checklist and life scale. When evaluating your dog’s hunger, it’s important to consider that your pup may be experiencing nausea as a side effect of medication or illness. If you think that this may be the case, talk to your veterinarian about anti-nausea medications that may be able to relieve nausea and increase your dog’s appetite.
A score of 1 indicates that your dog is refusing to eat regularly and that you are noticing subtle signs of weight loss or signs of malnutrition.
A score of 5 indicates that your dog is eating a little slower than usual, often dividing one meal into multiple portions or simply not finishing a meal like they used to. It may also indicate that your dog is eating fairly well but is reluctant to eat a few times a week.
A score of 10 indicates that your dog is eating normally.
Is your dog currently drinking normally or are they drinking more or less than usual? If their thirst has changed, is there a reasonable medical explanation for this change or is your dog simply not interested in drinking?
Similar as considering appetite for when to put down your dog checklist, when evaluating your dog’s thirst, consider that your pooch may be experiencing side effects from pain or other medication, symptoms of another health condition, or nausea causing them to drink more or less than usual.
A score of 1 indicates that your dog is refusing to drink and is showing signs of dehydration.
A score of 5 indicates that your dog is drinking water but that their usual drinking patterns have changed.
A score of 10 indicates that your dog is drinking normally.
How is your pet’s hygiene? Are they currently maintaining regular grooming habits? Do they experience periodic loss of control of their bladder or bowel? If they do experience bladder or bowel control loss, are they mobile or do they spend periods of time sitting or lying in their own feces? Is your dog completely immobile and incontinent?
Hygiene plays a very important role in your dog’s overall health and is crucial for the when to put down your dog checklist considerations. If your Fido is unable to groom themselves properly, they may require assistance in their daily grooming habits. If, however, your dog is unable to stand or walk, they may experience pressure sores that can lead to serious infection. If your dog is incontinent and unable to stand or walk, they are also at risk for urine burn or fecal contamination of pressure sores.
A score of 1 indicates that your pooch may spend a lot of time laying in their own waste or they may be unable to urinate or defecate without assistance from you. They may have pressure sores that frequently cause infection, or they may have a fast-growing and inoperable tumor or mass that is causing tissue necrosis or infection.
A score of 5 indicates that your dog may have trouble with elimination, may have periodic incontinence, or may have difficulty with mobility but still be able to move around on their own regularly.
A score of 10 indicates that your dog is grooming, urinating, defecating, and moving around normally.
Is your dog happy? Do they still enjoy the things that they have always enjoyed or do they show less interest? Does your dog still respond to you with enthusiasm – tail wagging, coming to greet you at the door and other regular behavior? Or does your dog show signs of depression, anxiety, or isolation?
When assessing your dog’s overall happiness for the when to put down your dog checklist, it’s necessary to consider signs of canine cognitive dysfunction. Similar to dementia in humans, many older dogs develop symptoms of CCD that can be relieved with modifications to their routine and prescription medication. If your dog shows a pattern in their withdrawn, depressed, or anxious behavior, ask your vet if CCD could be a factor.
A score of 1 indicates that your dog is unhappy, depressed, anxious, and no longer enjoys the things that they used to enjoy.
A score of 5 indicates that your dog does experience “bad days” or periods of anxiety or depression, but overall, they still enjoy the things that they used to.
A score of 10 indicates no decline in your dog’s happiness at all.
Is your dog currently able to walk? If they are walking, do they show signs of pain or arthritis that slow their mobility? If your dog is mobile are they steady on their feet? Does your dog have trouble getting to their feet or are they unable to get up without assistance and dog mobility equipment? Is their mobility affected by something that can be remedied through amputation or surgery?
A score of 1 indicates that your dog is unable to stand or move on their own without your assistance.
A score of 5 indicates that your dog is slower moving than they once were (they may have trouble with stairs etc.), but they are still independent and able to stand or walk alone or with a harness for guidance or assistance.
A score of 10 indicates that your dog is fully mobile with no impediments to their mobility at all.
7. MORE GOOD DAYS THAN BAD
As the final consideration for the when to put down your dog checklist you must compare the past with the present. When considering your dog’s past few weeks, how do their “good days” compare to their “bad days”? Have they had more good days than bad, an equal number of each, or more bad days than good?
A score of 1 indicates that your dog has very few good days compared to their bad days.
A score of 5 indicates that your dog has an equal number of good and bad days.
A score of 10 indicates that your dog is living life as their “normal self” with no (or very few) bad days throughout the year.
Using the Quality of Life Scale
More than a simple when to put down your dog checklist, the vets' quality of life scale for dogs gives pet parents a numerical value that can be helpful in determining their old or ill dog’s current quality of life, but it doesn’t always provide the definitive answer that pet parents are looking for.
For this reason, it’s also important to consider another factor when making the decision to put your dog down – your experience as your dog’s bonded guardian. This is where a more regular pet owners' subjective when to put down your dog list comes in.
When to Put Down Your Dog?
You Just Know…
Dog owners who are going through this tough time of having to say goodbye to their loyal companion for the first time might find themselves confused and at a loss of what to do. For this reason, I thought I'd share my own personal story of how I started researching when to put down your dog checklist examples for a better assessment of our situation.
A Personal Story
In 2017 I had to make the decision to put my beloved companion of fifteen and a half years, a then senile black Labrador, to sleep. For months before as he began to slow down, I fretted over when or whether I would know when his time came and, indeed, whether I could make that choice for him.
I have grown up with dogs my whole life, but there was something about Jet. He was what you would call a “heart dog” – he completed my heart. As he aged, I knew that he would never willingly throw in the proverbial towel; he was too stubborn and too much of a mommy’s boy.
I tried to prepare myself for losing him – reading everything I could, looking at the quality of life scales and when to put down your dog checklist examples, talking to numerous vets, vet techs, behaviorists, and animal end of life care specialists. I wanted someone to tell me the answer to “when is it time?” Everyone had their own answers, but one that I received continually from professionals and friends who worked in pet hospice care is that I would “just know”.
Now, I’m the kind of person who needs definitive answers, “just knowing” wasn’t the answer I was looking for. Still, I held on to a small hope that they were right, that my boy would somehow give me the nod when the time came. When the time did come, there was no nod, but there was a change. It’s hard to put into words, but I knew in that instant what everyone had meant when they said that I’d “just know”.
I hadn’t thought twice about it, but every day for fifteen and a half years Jet and I had learned to read each other’s expressions and body language. I had known at a glance that he was hungry, needed to go outside, wanted to play… and that morning I knew that he was ready to go. It wasn’t something I’d had to read in his face before, but there it was as plain as day. His eyes didn’t glint the way they used to, his usual “old man grumbles” weren’t made with the same gusto, and I knew.
So, if you're worried about the signs and looking for a scientific when to put down your dog checklist, and when instead people just tell you that you’ll “simply know”, even if you’re the kind of person who needs definitive answers, like me, believe me when I tell you that you will, you just will know when it's time.
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