Quality of Life in Dogs with Hepatocellular Carcinoma

Understanding Quality of Life

Quality of life is generally viewed as a combination of factors instead of a single measurement. Think of it as the many parts that make up a dog’s day-to-day experience – physical comfort, appetite and hydration, energy level, mobility, behavior and interaction, and the presence or absence of clinical signs such as vomiting or diarrhea.^{AAHA; Hunter and Downing}

What “good” or “bad” quality of life looks like can be different for every dog.^{Fulmer et al.} Quality of life isn’t a fixed state and can shift over time.^{Mondino et al.} It can help to think about what is normal and meaningful for your dog and whether those things have changed.^Allen

For example, losing interest in food or treats may affect quality of life differently for a dog who has always been a picky eater than for a dog whose favorite part of the day has always been meals and snacks. Similarly, a change in activity may affect quality of life differently for a dog who has always preferred quiet afternoons on the couch than it would for one whose favorite part of the day was going for walks, hiking, or playing.

Factors to Consider When Looking at Quality of Life

Various parts of a dog’s day-to-day experience may provide useful context when thinking about quality of life.^{AAHA; Hunter and Downing} The following are some areas that may be helpful to consider.

Quality of Life Resources

The following resources reflect different ways quality of life may be considered and discussed in veterinary contexts, each offering a slightly different perspective.

Using Quality of Life Tools Thoughtfully

Quality of life tools and frameworks can provide structure for observing changes and thinking about different parts of a dog’s day-to-day life. Some use scoring systems, while others focus on questions, observations, or tracking changes over time.

No single tool can capture everything that matters for every dog. When using a quality of life tool, keep in mind that quality of life is subjective and consider observations alongside what you know about your dog – including their usual behavior, their favorite activities, and changes you've noticed. Keeping notes or tracking good and bad days can provide a way to look back and reflect on changes^Allen and may also help you recognize patterns, including changes that occur around treatments, medications, or other events.

Quality of life tools do not replace veterinary assessment or judgment. Instead, their role is to help organize observations and support conversations with your veterinarian.

Quality of Life: What to Observe Over Time

When tracking quality of life, it can be helpful to pay attention to a few key areas of your dog’s day-to-day experience over time, especially when changes are gradual.

The following points reflect what was introduced above and are meant to support observation and conversations with your veterinarian, not serve as a checklist or scoring system.