5 Situations When a Quality of Life Scale May Not Help You Make a Euthanasia Decision

The Quality of Life Scale can be a helpful tool to understand our pets better, but it doesn’t always give us the answers we need.

A quality of life (QOL) scale provides general guidelines to help both you and your veterinarian assess your pet's wellbeing. It can also be used to measure palliative care or create/manage a hospice plan for a pet with a life-threatening illness.

While a quality of life scale can be helpful in some situations, there are other times when this scale should not be used to make decisions.

Here are 5 situations when using a quality of life scale is not the best way to determine if it’s time to consider euthanasia

1. When your pet is experiencing distressing symptoms.

Severe pain or respiratory distress are serious issues. When your pet is in crisis, how they rate on a scale is irrelevant to their quality of life. This is the time to get immediate help with medical treatment or humane euthanasia.

2. When two people in the home rate the pet’s condition with significantly different numbers.

As much as QOL scales are called “objective” scales, caregivers are making judgments on parameters that are really quite subjective. It is rare that everyone in the family will see the situation in the same way.

The relationship to the pet and their caretaking can have a large impact on how someone perceives their quality of life. The family member who is away from the house all day may focus on the greeting they receive from the pet when they arrive home and the comfort their pet provides as they destress from a long day. A child in the house may be too young to even understand the concept of euthanasia and may imagine that everything is okay with their pet. When this happens, it is best to use the scale as a jumping-off place for a family discussion, where everyone can provide their input.

3. When a pet’s condition has the potential to develop into sudden distress.

Some diseases and cancers can cause sudden, tragic changes. Congestive heart failure, cancers that are known to cause sudden and serious bleeds, and bone cancers that increase the risk for pathologic fracture are some of the most common.

In these cases, it is important to have an emergency plan and think about how things could go. Is an emergency room visit an acceptable death for your pet? How will you be able to live with the experience of seeing your pet suffering?

For some conditions, the commonly repeated phrase “Better a week early than 5 minutes too late” may be more helpful than a quality of life scale for a euthanasia decision.

4. When the unique situations that affect a pet’s quality of life are not considered.

There are many things that play into a euthanasia decision beyond a pet’s quality of life.

For instance, a pet’s personality, along with their unique ability to cope with their disease, is a huge deciding factor. A small dog’s ability to cope with not being able to walk might be very different than a 90 lb. dog’s ability.

In some cases, the family’s ability to provide the time needed for good caretaking is also an important consideration.

Limitations in the home environment (such as a steep flight of stairs in order to access the outdoors) is also an important consideration that affects a pet’s quality of life.

5. When it doesn’t suit your decision making style.

Human decision-making is a very complicated topic. We all approach important decisions in a personal way. Some of us need to gather as many facts as possible, some of us need to gather as many opinions as possible. Some people thrive with objective reasoning and some sit quietly and try to intuit the answers they need.

For many, reducing a life and death decision to a number on a scale may feel a little cold. If that’s the case, take this QOL scale as just one factor, not the deciding factor.  

The Bottom Line

Quality of life scales offer families a tool to make sure they are looking at all aspects of their pet’s life. They can be an excellent place for families to start the discussion about the end of their pet’s life. They can also help provide a progress report in pets that are experiencing steady, slow declines.

They have their limitations and may not be helpful for all euthanasia decisions.

If you’re struggling to make a decision about your pet’s end-of-life care, we’re here to help. We go beyond a basic scale to assess all aspects of your pet’s life, condition, personality, ability to cope, family factors, home environment, and your unique decision-making style to help you come to a decision that feels right for you and your pet.