Hmm is kind of how Romeo feels today. With another day spent on the bed, he still has little energy but seems content to mellow.
After another throw rug was added to connect the path between the bed and the back door, Romeo was more willing to try hopping around and eventually made it up for lunch and an outing to the backyard for potty time. He wasn’t really interested in dinner though, but has eagerly taken the treats we have offered him.
Since he was diagnosed with osteosarcoma almost 7 months ago, we knew the day would come when we’d have to talk about euthanasia. Thankfully, even through amputation recovery and chemo, Romeo has had a good quality of life since diagnosis. But with his dramatic recent decline, thoughts about the end keep edging into our minds.
This spring The Latham Letter, an animal welfare magazine, featured and article about quality of life at the end of life. They discussed pet hospice and tips on the evaluation of whether it is was humane to continue hospice or if it was time to consider euthanasia.
In order to evaluate quality of life, they discussed the HHHHHMM scale. The initials each stand for one aspect to be considered: hurt, hunger, hydration, hygiene, happiness, mobility, and more good days than bad.
Working in a shelter where we offer request euthanasia services to pet owners whose pets are at the end of their lives, this was a helpful tool to share with owners who were struggling with the decision. It’s a tricky balance not wanting to say goodbye too early and not wanting to make a pet suffer unnecessarily, but ultimately it is an individual decision best made by those who know and love their pets.
The entire article (“Quality of Life to the End of Life” by Alice E Villalobos, DVM) is available on the Latham Foundation’s website in their article archive. More information about the HHHHHMM scale is available at Pawspice’s website. Here they go into more detail about each of the Hs and Ms.
I liked the descriptions on Pawspice’s website since they recognized that all these factors shouldn’t necessarily be weighed equally and similar issues in different dogs may also be weighed differently. Individual criteria could carry more weight depending on the impact to the pet’s life.
The example that stood out to me was under mobility. Severe mobility problems may be less of an issue for a small breed dog than more minor mobility issues are for large dogs. Since it is easier for people to help the small dogs get where they need to be they can compensate more easily than large dogs. Having helped a Great Dane learn to walk on three legs, I can relate to this. Had our little 5 pound Julio needed help learning how to walk after surgery, we would have carried him anywhere he needed to be while he learned how to work his body again. That’s not really an option with an uncoordinated 130 pound pooch.
It’s not a cheery subject, but it’s nice to have some guidelines to use when evaluating when pets are nearing the end of their lives.
Anyway, all is not gloomy in this house. We’re not ready to say goodbye to our big guy yet, but since thoughts of euthanasia are rising occasionally, it seemed like a good time to share this tidbit.