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A daily quality-of-life checklist helps you notice changes in your cat and share useful observations with your veterinarian. Use the seven HHHHHMM areas—Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad—as prompts, and compare each day with your cat’s usual behavior. The record can support a care conversation, but it cannot diagnose a problem or decide treatment on its own.
This approach is useful for an older cat, a cat with a chronic condition, or any cat whose behavior has changed. It is also useful before a veterinary appointment: dated observations can show when a change began, whether it is persistent, and which parts of daily life are affected.
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What should you record each day?
Write down what you actually observe rather than guessing at the cause. A cat’s usual habits are the most useful point of comparison: note changes from your individual cat’s baseline, not just whether a behavior seems normal for cats in general. The Merck Veterinary Manual’s HHHHHMM scale organizes observations into seven areas.
| Area | Daily questions | What to note |
|---|---|---|
| Hurt | Does your cat seem comfortable at rest and while moving? Is breathing easy? | Signs of discomfort, a change in movement, or whether prescribed care seems to help. Describe what you see; do not try to diagnose the cause. |
| Hunger | What and how much did your cat eat compared with usual? Did eating seem difficult? | Food interest, approximate amount, and any change in how often your cat eats. |
| Hydration | Did your cat drink about as usual? | Any noticeable change in drinking. Record the observation rather than trying to determine at home whether your cat is dehydrated. |
| Hygiene | Is your cat grooming and staying clean as usual? | Coat changes, soiling, trouble grooming, or changes in urination and defecation habits. |
| Happiness | Did your cat show interest in familiar people, favorite activities, toys, or surroundings? | Engagement, social interaction, or withdrawal from familiar routines. |
| Mobility | Could your cat get up, walk, jump or climb, and reach the litter box as usual? | Hesitation, difficulty, or a change from your cat’s normal movement. |
| More good days than bad | Overall, did today seem better, about the same, or worse than recent days? | Choose one and add a concrete reason, such as eating less than usual or joining a familiar activity. |
These observations reflect areas emphasized in veterinary quality-of-life guidance. The American Animal Hospital Association (AAHA) recommends paying attention to changes such as eating frequency, activity, and social interaction. The 2023 AAFP/IAAHPC feline hospice and palliative care guidelines also identify appetite, movement, grooming, elimination, and behavior as useful changes for caregivers to note.
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How do you assess each HHHHHMM area in practical terms?
Hurt: comfort and breathing
Start by observing your cat quietly at rest, then notice what happens during ordinary movement. Record whether your cat settles comfortably, changes position repeatedly, hesitates to move, or reacts differently when getting up. Note if a prescribed treatment appears to make a difference, without changing the treatment yourself. Breathing belongs in this category because the ability to breathe comfortably is a central quality-of-life concern. Describe visible effort or a change from normal and contact your veterinarian promptly about breathing difficulty rather than waiting for a score to fall.
Hunger: interest, amount, and frequency
Record what food was offered, how much was eaten, and how often your cat showed interest. “Ate normally,” “sniffed and walked away,” or “ate several small portions” is more useful than a conclusion such as “feels nauseated.” Include difficulty eating if you notice it. Eating frequency is specifically useful information for the veterinary team, so keep the same kind of note each day even when the amount is only an estimate.
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Note drinking behavior in relation to your cat’s normal routine. A change may be easy to miss when several people refill bowls or when a cat obtains water from wet food. You do not need to perform a home dehydration test or assign a medical explanation. Simply record a noticeable increase, decrease, or uncertainty and tell the veterinarian what you observed.
Hygiene: grooming and elimination
Look at whether your cat is grooming, whether the coat remains in its usual condition, and whether the cat can stay clean after using the litter box. Record soiling, a coat that looks different, or apparent trouble reaching or using the box. Changes in urination or defecation habits belong in the same note. Reduced grooming can occur alongside illness, pain, or reduced mobility, but the diary should capture the behavior rather than label the cause.
Happiness: engagement and social behavior
Use familiar activities as your reference point. Did your cat seek a person, respond to a usual greeting, watch the surroundings, play, or show interest in a favorite resting place? Also record withdrawal, hiding, or a change in social interaction. A quiet day is not automatically a bad day; the important comparison is whether the behavior differs from this cat’s recent pattern.
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Mobility: ordinary movement and access
Observe getting up, walking, jumping or climbing, and reaching the litter box. Write down a hesitation, a new limit, or a change in the route your cat chooses. Do not assume that a movement change proves a particular joint, neurologic, or other problem. The detail helps your veterinarian decide what to examine and whether the home environment or treatment needs attention.
More good days than bad: an overall daily summary
At the end of the entry, mark the day as better, about the same, or worse than recent days. Add one concrete reason so the label remains anchored to an observation: for example, “worse—ate less and did not join the evening routine,” or “better—ate usual meals and climbed to the favorite perch.” This final category is not a replacement for the six specific observations; it is a short summary of them.
How do you use the checklist consistently?
Keep the record simple enough that you can repeat it. A plain notebook or printed diary is sufficient; the Animal Care Associates daily diary is one example of a format for recording observations and progress. You do not need a branded journal or an app.
- Choose a regular time. Make a brief entry at roughly the same point in the day so you can compare recent notes. If something important changes at another time, record it then too.
- Use the same prompts. Review all seven areas, even if nothing seems different. A short “usual” or “no noticeable change” entry is more informative than leaving a category blank.
- Describe behavior, not a presumed cause. For example, write “paused before climbing onto the chair” rather than concluding that your cat has joint pain. Your veterinarian can assess what an observation may mean.
- Keep entries dated. Include the date, approximate time, and who observed the behavior. Dates help distinguish a single unusual event from a continuing trend.
- Note relevant context. Record whether prescribed care was given and whether your cat seemed different afterward, while avoiding any unsupervised treatment change. Mention an unusually stressful household event only if it helps explain why the observation may not represent an ordinary day.
- End with the day’s overall direction. Mark better, about the same, or worse than recent days, and include one specific reason. This helps keep the overall impression tied to observable changes.
- Review at a set interval. Every few days, look back for repeated changes in one category or simultaneous changes in several. Do not erase difficult entries because a later day was better.
- Bring the notes to your veterinarian. Share the record, including the dates and any scoring method you used. Ask which changes matter most for your cat and what to monitor next.
What might a useful daily entry look like?
A useful entry can fit in a few lines: “Tuesday, evening. Hurt: rested comfortably; breathing looked usual. Hunger: ate about half of the usual dinner and returned later. Hydration: no clear change. Hygiene: coat clean; grooming shorter than usual. Happiness: greeted me but did not play. Mobility: walked to the box, paused before the sofa. Overall: worse than yesterday because appetite and activity were lower.” This format separates what you saw from what you think it means and gives the veterinary team several points to discuss.
If another household member saw something different, add that observation with the person’s name or initials rather than averaging it away. A cat may behave differently with different people or at different times, and both accounts can provide useful context.
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Should you give your cat a quality-of-life score?
You can use scores if they make your daily notes easier to compare, but the number is only a prompt for discussion—not a diagnosis or a universal decision rule. Some published forms score categories on a scale of up to 10, but scoring conventions differ. The VCA quality-of-life guidance describes a suggested interpretation in which a score above 5 in each category or a total above 35 indicates acceptable quality of life; those cutoffs belong to that guidance and should not be treated as a rule that applies to every cat or form.
Before scoring, write the descriptive observation. Then, if you choose, use one consistent scale and explain it to everyone who makes entries. Do not switch between a 0–10 form and a 1–10 form without noting the change. A total can conceal an important concern in one area: several high categories can mask a very low pain or breathing score. A worrying breathing change remains important even if the day’s arithmetic looks acceptable.
AAHA states that “These tools are designed to support, not replace, conversations with your veterinarian.” Use the score to show a pattern, not to announce a diagnosis or make an automatic treatment or euthanasia decision. Share both category-level notes and any total with your veterinarian, and identify the exact form or method used.
How can the diary support veterinary and palliative-care conversations?
Bring the diary to routine appointments and whenever you call about a change. A dated record can help the team ask focused questions about appetite, drinking, elimination, grooming, movement, comfort, and interaction. It can also help you remember details that are difficult to describe from memory.
For a cat with chronic pain, the Hurt and Mobility entries can show changes in comfort and function over time. The American Association of Feline Practitioners chronic pain assessment resource can support a pain-related conversation, but a home diary does not measure pain by itself. Ask the veterinary team how to observe your cat and how prescribed care should be monitored.
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When illness is advanced, ask whether feline hospice or palliative-care support is appropriate. The AAFP/IAAHPC guidelines discuss caregiver observations and comfort-focused care. Your notes can help the team understand which daily activities remain meaningful to your cat and which changes are causing concern. The checklist still does not determine the right decision on its own; that discussion should include a veterinary assessment and your cat’s individual circumstances.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.When should you contact a veterinarian?
Contact your veterinarian about persistent or concerning changes, including pain that seems uncontrolled, reduced appetite or drinking, difficulty moving, changes in grooming or elimination, or withdrawal from familiar interactions. A checklist records what is happening; it cannot identify the underlying cause. Share a single striking change as well as a gradual pattern if either concerns you.
Breathing difficulty deserves prompt veterinary attention. Do not wait for a daily score or a pattern of “bad days” to decide whether to raise a breathing concern. The Merck Veterinary Manual identifies pain control and the ability to breathe as central quality-of-life considerations; its guidance is not a reason to use a score in place of professional assessment.
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How can you tell whether the pattern is changing?
Look across entries rather than letting a single unusually good or difficult day stand for the whole picture. Notice whether the same category is changing repeatedly, whether several areas are shifting together, and whether your cat is still able to take part in familiar routines. Keep the individual details visible: a summary such as “worse this week” is useful, but examples of what changed make the discussion more concrete.
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Compare the cat with its own baseline and with recent days. Eating frequency, activity, social interaction, grooming, elimination, and movement may change at different rates. One category may improve while another worsens, so avoid letting a favorable appetite note cancel out a serious breathing or comfort concern. Conversely, a quiet day should be interpreted in context rather than treated as proof that quality of life has suddenly declined.
There is no need to turn a diary into a complicated recordkeeping system. A few consistent observations can help you explain what is different and when it began. If you are unsure how to interpret a pattern—or a change concerns you—share it with your veterinarian rather than waiting for the checklist to produce a particular score.
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Common checklist pitfalls
- Guessing the diagnosis: “Likely arthritis” or “dehydrated” is an interpretation, not an observation. Record the pause, reduced drinking, or other visible change.
- Using a generic feline standard: Individual baseline matters more than comparing your cat with an imagined average cat.
- Scoring without notes: A number alone cannot show what changed or why.
- Focusing on the total: A total can hide a serious low category, especially pain or breathing.
- Waiting for a threshold: There is no need to wait until a form reaches a particular number before contacting the veterinary team about a concerning change.
- Changing treatment independently: A diary can show that care appears helpful or insufficient, but treatment decisions belong in the veterinary conversation.
- Leaving blanks: Mark “usual,” “not observed,” or “uncertain” so a missing entry is not mistaken for no problem.
- Discarding mixed observations: Keep both good and difficult days. The pattern is more informative than a selective record.
Frequently Asked Questions
Can I use this checklist for a cat with chronic pain?
Yes. The Hurt and Mobility prompts can help you record changes in comfort and movement, but they do not measure pain or replace an assessment. The American Association of Feline Practitioners chronic pain assessment resource can support a pain-related conversation with your veterinary team.
How long should I keep the diary?
Keep it as long as it remains useful, including through periods of treatment or changing health. A short run of dated entries can establish a current baseline, while longer records help show whether a change persists. Do not delay contacting your veterinarian while waiting to collect more days if a change is concerning.
What if my cat has one very bad day and then seems better?
Record both days and describe what happened. A single difficult day can be important, particularly if breathing or comfort changed. Contact your veterinarian for guidance rather than relying on the later improvement to erase the earlier observation.
Should I score every category or just write notes?
Notes are enough. Scoring is optional and can make comparisons easier if you use one consistent method. Always keep the concrete observations alongside any numbers.
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Keep each person’s concrete observations rather than forcing them into a single score. Differences can reflect what each person saw; sharing both accounts with your veterinarian gives more context than an unexplained average.
The Bottom Line
Use the seven HHHHHMM areas every day, write observable changes against your cat’s own baseline, and look for trends without relying on a total score. Pain and breathing concerns deserve prompt veterinary attention. A notebook or printed diary is enough; the record’s purpose is to make a clear, dated conversation with your veterinarian possible.
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