Most owners of an old dog end up asking the same question, usually late at night: is it time? There is no test that answers it, and nobody who loves their dog gets it exactly right. What does help is looking at the dog’s days honestly, writing things down, and having the conversation with your vet before a crisis has it for you. This guide is about how.
Start with the days, not the diagnosis
An illness can be serious for a long time while the dog’s life is still good, and a dog with no named illness at all can reach the point where its days are mostly hard. So the most useful record is not medical. Take a calendar and, each evening, mark the day as good or bad. A good day is one where the dog ate, moved around, wanted to be with you and seemed comfortable. A bad day is one where it did not.
This sounds too simple to matter, and it is the thing vets most often wish owners had done. Memory is kind to good days and quick to forget bad ones. When the marks show bad days catching up with good ones, that is the moment to talk to your vet, whatever the diagnosis says.
A scale that gives the conversation a shape
Many vets use a quality-of-life scale devised by the veterinary oncologist Alice Villalobos. It scores seven areas from 0 to 10, and its initials are easy to remember as five H’s and two M’s:
| Area | The question to ask |
|---|---|
| Hurt | Is pain under control, and is breathing easy? |
| Hunger | Is the dog eating enough, even with help? |
| Hydration | Is it drinking enough, or needing fluids? |
| Hygiene | Can it be kept clean, and free of sores? |
| Happiness | Does it still respond to you, its toys, its routine? |
| Mobility | Can it get up, move about and go to the toilet, with or without help? |
| More good days than bad | Taken over the last week or two, honestly |
In the scale as published, a total above 35 is generally taken to mean a life that is still acceptable with good care. Treat the number as a starting point for a conversation rather than a verdict. A single low score can matter more than the total: a dog whose pain or breathing cannot be controlled is not having a good life however well it eats.
The signs that weigh the most
- Pain that medication no longer controls.
- Breathing that is laboured at rest.
- Refusing food for days, or eating only when hand-fed and coaxed.
- Being unable to get up, or to get to the toilet, without lying in its own mess.
- No longer greeting you, or seeking out the things it always loved.
Small dogs are good at hiding how they feel. A dog that still wags at you can still be in pain, and the wag is not a reason to wait.
What to ask your vet
- What is happening, and what is likely to happen next?
- Is the dog in pain now, and can it be managed?
- What would treatment involve, and what would it give the dog: more good time, or more time?
- What signs should make me call you, and what signs mean it is time?
- If this were your dog, what would you be thinking about?
The last question is a fair one to ask, and most vets will answer it honestly. Your vet has been through this with hundreds of families; you are not asking them to decide for you, only to tell you what they see.
Comfort care, while there is time
Between “still fine” and “time to say goodbye” there is often a stretch where the goal changes from curing to comfort. This is sometimes called hospice or palliative care, and it is active work: pain relief adjusted as needed, soft food warmed to bring out the smell, a bed that is easy to get on and off, rugs on slippery floors, help to the garden, and keeping the coat short and clean so it does not mat or soil. Many of the practical changes in our guide to caring for an older small dog matter even more at this stage.
If you decide it is time
Vets have a saying that it is kinder to be a week too early than a day too late. Choosing a calm, planned day, while the dog can still enjoy a favourite walk or food, spares it the emergency that otherwise often comes first. Some things are worth deciding in advance, while you can think:
- Where. At the clinic, or at home: many areas have vets who will come to the house, which is calmer for a dog that hates the car.
- When. A quiet time of day; at a clinic, the last appointment often means no waiting room.
- Who. Whether children or other pets will be there. Being with the dog is not required, but most owners who stay are glad they did.
- Afterwards. Burial or cremation, and whether you want anything kept, such as a paw print or a clip of coat. Paying beforehand means you can leave when you are ready.
Knowing what happens takes some of the fear out of it. Usually the vet gives a sedative first, so the dog is drowsy and relaxed. Then a dose of anaesthetic is given into a vein, often through a small tube placed in a leg. The dog loses consciousness within seconds, and the heart stops within a minute or two; the vet listens to confirm. The eyes usually stay open. Sometimes there is a deep breath or a twitch of the muscles afterwards. These are reflexes in a body that has already gone, not signs of pain.
The guilt, and the grief
Almost everyone wonders afterwards whether they chose too early or too late. That doubt is a measure of how much the dog mattered, not a sign that you got it wrong. Grief can also start before the end, while you are watching a dog decline; that is normal too, and it is fine to talk about it with friends, family or a pet bereavement line.
For the hours and days after, our guide to when your dog dies goes through the practical choices, how to help another dog in the house, and the grief itself.