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Quality of Life
Because dogs and cats can be very adept at hiding their ailments, some physical signs to consider which may be indicators of pain/discomfort are increased respiratory rate, increased heart rate, loss of appetite, lack of mobility, incontinence, and disinterest in the family and/or things or activities that were important previously.
The considerable body of research on evaluating a pet's quality of life has been condensed into the following chart.
Quality of Life (HHHHHMM Scale)
Two conditions that I will always recommend either taking the pet into its regular veterinarian or an emergency clinic immediately, or making the decision to let go are 1) when the pet will no longer drink water (dehydration will only worsen their condition and dehydrated pets feel very sick), and/or 2) when the pet is having difficulty breathing, especially open mouthed breathing or abnormally heavy panting. Both of these conditions are very important to address immediately.
Please feel free to contact us if you require some guidance about making this important decision.