Pet Quality Of Life Questionnaire

Pet Quality of Life Scale – Daily/Weekly Diary

Directions: Use the key indicators of quality-of-life below to help assess your pet’s condition and progression

Use the daily/weekly diary to keep track of your pet’s journey. Fill in the appropriate number for each category and then add the numbers from each category for that day/week. The maximum score is 12.

You can even add bespoke categories that relate to your pet’s particular situation. For example, ‘Heart/Pulse Rate’ or ‘Respiratory Rate’ if your pet suffers from heart failure or lung cancer. You can give half or quarter points if appropriate.

A Mobility B Nutrition (Appetite/diet type) C Hydration/Fluid balance
2 Good Mobility – No difficulty getting around, enjoys walks and going outside

1 Poor Mobility – Difficulty getting up, hard to get in position to do toilet, short walks only

0 Bare Minimum Mobility – Needs assistance, losing footing, toilet/squat/lifting leg not possible, pain medication/anti-inflammatory medications do not help

2 Good Appetite

1 Poor Appetite – Hand feeding, needs enticing

0 No Appetite – vomiting/nausea

2 Adequate intake – drinking as normal (volume/frequency)

1 Poor intake/ or increased in some patients with particular diseases

0 Requires oral hydration/subcutaneous fluids

D Interaction/Attitude (greeting at door, play, cuddles, purring, growling E Toilet habits (frequency, consistency, volume) F Favourite things (specify 3-5 of these e.g. walks, cuddles, ballplay, sitting with you, bird watching)
2 Interacts normally with family and other pets – on own initiative

1 Some interaction with family and other pets – reduced initiative and contact

0 Hides in the closet or under the bed – only contact on your initiative/growls more

2 Normal urination and/or defaecation

1 Reduced/irregular urination and/or defaecation

0 None/no output or very little

2 Normal favourite activities, hobbies, etc.

1 Decrease in doing their favourite things

0 No interest in their favourite things

 

Proposed action and interpretation of QOL scale for total points:

12 – 9: Everything is okay and your pet still enjoys life (and you should too!)

6 – 8: May require intervention, supplementation or adjustment of treatment (contact us to discuss options)

0 – 5: Consider humane, gentle euthanasia (contact us immediately)

DATE: WEEK: A Mobility B Nutrition C Hydration D Interaction E Toilet Habits F Favourite Things TOTAL POINTS
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
 

 

Daily Diary For:

 

 

Start Date:

DATE: WEEK: A Mobility B Nutrition C Hydration D Interaction E Toilet Habits F Favourite Things TOTAL POINTS
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
DATE: WEEK: A Mobility B Nutrition C Hydration D Interaction E Toilet Habits F Favourite Things TOTAL POINTS
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
DATE: WEEK: A Mobility B Nutrition C Hydration D Interaction E Toilet Habits F Favourite Things TOTAL POINTS
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
DATE: WEEK: A Mobility B Nutrition C Hydration D Interaction E Toilet Habits F Favourite Things TOTAL POINTS
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
DATE: WEEK: A Mobility B Nutrition C Hydration D Interaction E Toilet Habits F Favourite Things TOTAL POINTS
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday