What is the HHHHHMM scale?

HHHHHMM stands for Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. Each category is scored 0-10 weekly. Persistent scores below 5 in multiple categories signal that quality-of-life is declining and a conversation with a veterinarian is warranted.

How do I find a mobile vet who provides in-home euthanasia?

Search our Colorado directory by city or county to find compassionate in-home pet euthanasia providers. Each listing shows the veterinarian's credentials, pricing range, and service area.

How will I know it's time?

Q: How many bad days are too many?

There is no single right answer, but a useful rule of thumb is that when bad days begin to outnumber good days over a sustained two-week period, families typically begin discussing end-of-life care with their veterinarian.

A quality-of-life guide for families considering in-home pet euthanasia

The short answer: When more than three of the seven HHHHHMM categories are persistently low for two weeks or longer, families typically begin the conversation with their veterinarian. There is no single right answer — the most reliable signal is when the pet is no longer enjoying the things that previously made them themselves.

The HHHHHMM quality-of-life scale

Developed by Dr. Alice Villalobos and widely adopted by hospice veterinarians, the HHHHHMM scale is the most-used framework for tracking quality of life. Score each category 0-10 weekly. A total below 35/70 is a meaningful signal.

Hurt — Pain: Is pain controlled? Breathing labored? Can the pet be made comfortable with medication?
Hunger: Is the pet eating enough? Showing interest in food? Tolerating feeding well?
Hydration: Is the pet drinking enough? Are sub-Q fluids needed?
Hygiene: Can the pet keep clean? Are pressure sores or matting developing?
Happiness: Does the pet show interest in family, toys, surroundings? Or are they withdrawn?
Mobility: Can the pet get up? Move without help? Avoid falls?
More good days than bad: Over a two-week window, are good days still outnumbering bad?

Five quiet signals families notice first

Beyond the formal scale, families often notice these subtle changes before the larger ones:

The pet stops greeting you at the door. The small daily ritual fades.
They sleep in unusual spots. Away from family, in cooler rooms, against walls.
Eyes look "further away." Less engagement with sights, sounds, faces.
Favorite foods are refused. Especially repeated refusals over several days.
The pet seeks more solitude. Pulling away from the family they used to seek out.

If you're considering euthanasia — which describes you?

If your pet has a terminal diagnosis A consultation with a hospice-trained mobile veterinarian can help you understand what to expect and when. Many families find that the visit itself brings clarity, even if euthanasia isn't decided that day.

If your pet is declining but not actively suffering This is when the HHHHHMM scale is most useful. Track weekly. Many families find the visible decline patterns the scale exposes are what they had been intuitively sensing.

If your pet is in acute crisis right now Call your nearest emergency veterinarian. A mobile vet may also be available same-day for in-home visits. Browse our Colorado directory for nearby providers.

Not sure if it's time? If you book a consultation, the veterinarian will let you know if they do not believe euthanasia is appropriate. Many families find that talking through the quality-of-life questions with a hospice-trained vet brings clarity in either direction.

Browse our Colorado directory

Search by city or county to find compassionate in-home pet euthanasia providers near you.

Colorado directory Mobile veterinarians

Common questions

How many bad days are too many?

When bad days begin to outnumber good days over a sustained two-week period, families typically begin discussing end-of-life care with their veterinarian. The HHHHHMM scale's seventh category — "More good days than bad" — is designed exactly for this.

Is in-home euthanasia better than the vet clinic?

In-home euthanasia removes the stress of a car ride and unfamiliar clinical environment. Your pet remains in their favorite spot. Both options are valid; the choice depends on the family's preference and the pet's mobility.

How much does in-home euthanasia cost in Colorado?

Typical range: $400-$650 per visit. Cremation is separate: communal $135-$350, private $335-$650. Many providers offer payment plans for hospice patients.

Where can I find grief support after my pet's passing?

The Association for Pet Loss and Bereavement (APLB) offers free support groups: aplb.org. Many Colorado therapists and counselors specialize in pet loss; we list local resources on each city directory page.