How do I know when it's time to put my dog down?

The HHHHHMM scale scores seven categories 0-10 weekly: Hurt (pain control), Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. A total below 35/70 — or persistently low scores in three or more categories over two weeks — is the most reliable signal that quality of life has meaningfully declined.

Beyond the scale, families often notice these quieter signals first: the dog stops greeting them at the door · sleeps in unusual spots · refuses favorite foods · pulls away from family interaction. When these patterns persist alongside declining HHHHHMM scores, a conversation with a veterinarian is appropriate.

There is no single right answer. Many families find that booking a consultation with a hospice-trained mobile veterinarian brings clarity in either direction — if the vet doesn't believe euthanasia is appropriate, they will tell you. The HHHHHMM scale informs decisions; it doesn't replace clinical judgment.