Quality of Life Assessment

First Name:: First Name:
Last Name:
Patient Name:
Your email:
: At North Rocks Veterinary Hospital, we know that our pets depend on us to speak for them and to ensure their comfort. Recognising when a beloved pet is struggling isn’t always easy. Signs of pain or illness can be subtle, and making decisions during this stage of life can feel overwhelming.
If your veterinarian has asked you to complete this form, it’s because we want to support you in carefully considering all the factors that affect your pet’s quality of life. Our goal is to help you navigate the challenges of ageing, chronic illness, or a terminal diagnosis with compassion and clarity.
This guide is not about rushing decisions, it’s about gently reflecting on how your pet is coping, what brings them joy, and how their health is changing. Many families find it helpful to repeat this assessment over time, as circumstances evolve.
Pain:: 1 Point – Your pet shows no signs of pain. They move freely, enjoy exercise, and rest comfortably.2 Points – Your pet is on pain relief prescribed by a veterinarian and responding well.3 Points – Your pet seems uncomfortable despite medication, or side effects outweigh the benefits. Alternative therapies have not helped.
Demeanour:: 1 Point – Your pet is bright, happy, and enjoys interaction.2 Points – A little more withdrawn or irritable than usual, but still engaged in family life.3 Points – Your pet is mostly withdrawn, hiding, or uninterested in activities they once loved.
Mobility:: 1 Point – Normal activity levels; play and walks remain part of their day.2 Points – Slowing down but managing with support or medication; activity is reduced by about half.3 Points – Greatly reduced mobility; needs help with stairs, standing, or moving around.
Appetite:: 1 Point – Eating normally with a healthy appetite.2 Points – Reduced interest in food; needs encouragement or prefers only favourites.3 Points – Very poor appetite or unable to keep food down due to vomiting, nausea, or diarrhoea.
Hydration:: 1 Point – Drinking normally.2 Points – Drinking more or less than usual.3 Points – Requires assistance (syringing, fluids under the skin) to stay hydrated, or frequently unwell from vomiting/diarrhoea.
Weight:: 1 Point – Stable, healthy weight and body condition.2 Points – Some weight loss or gain; changes are gradual.3 Points – Noticeable or rapid changes (muscle loss, bloating, wasting) despite food adjustments.
Hygiene & Toileting:: 1 Point – Normal toileting and grooming habits.2 Points – Changes in toileting, grooming less, or occasionally needs help staying clean.3 Points – Struggling with incontinence, unable to groom, or requiring significant hygiene support.
Rest:: 1 Point – Sleeping normally and comfortably.2 Points – Sleeping more, occasionally disoriented, but usually settled.3 Points – Restless, anxious, or crying at night; struggles to settle without medication.
: Your Personal Thoughts
This section is for your heart, not for numbers. Please share your uncensored feelings, observations, and concerns.
Caring for a pet with high needs can be exhausting; emotionally, physically, and financially. It’s completely normal to feel conflicted, overwhelmed, or unsure. Please know you are not alone in this journey.
You may want to note:
Are good days still outnumbering the bad?
Does your pet still enjoy the simple things that once brought joy, like food, walks, or a gentle cuddle?
How are you and your family coping?
Your thoughts and feelings are just as important as the checklist above, and they will help guide conversations with your veterinarian about what’s best for your pet and for you.
: Scoring Guide
0–10 points – Your pet’s quality of life is likely acceptable. Keep monitoring for changes.
10–20 points – There are concerns. Speak with your vet about adjustments that may help.
20–25 points – Your pet may be suffering. Please contact your veterinarian to discuss next steps.
: At North Rocks Veterinary Hospital, we walk alongside you during this stage of your pet’s life. Our team is here to listen, support, and help ensure every decision is made with compassion and dignity. Contact us any time you have any questions or concerns.

Quality of Life Assessment

At North Rocks Veterinary Hospital, we know that our pets depend on us to speak for them and to ensure their comfort. Recognising when a beloved pet is struggling isn’t always easy. Signs of pain or illness can be subtle, and making decisions during this stage of life can feel overwhelming.

This guide is not about rushing decisions, it’s about gently reflecting on how your pet is coping, what brings them joy, and how their health is changing. Many families find it helpful to repeat this assessment over time, as circumstances evolve.

Your Personal Thoughts

Scoring Guide

Services

Phone

Address

Opening hours

Parking Front and Back