A 16 year old cat does not decline in a straight line. Appetite holds for 3 weeks, then the back legs get shaky, then the litter box is missed twice in 7 days, and by the time the pattern is obvious the last 6 months are gone. A 7 item score, 0 to 5 points per item, 35 points total, filled in once a week, replaces that blur with 7 numbers you can compare. Score every Sunday at 19:00, before the evening meal, and treat the first 3 weeks as a baseline instead of a verdict.
This is a tracking tool, not a diagnosis. It tells you whether the cat in front of you is 2 points better or 4 points worse than the same cat 21 days ago. Weight belongs on the same sheet, because a 5 percent drop in 1 month means more than any single score; the monthly routine is on the senior weight monitoring page.
Why 7 numbers beat a daily impression
Human recall averages. Asked in October how July went, an owner reports a blend of 2 good weeks and 1 bad one, and the bad week quietly disappears. The 0 to 35 total is useful, but 2 finer signals matter more: the slope across 3 consecutive weeks, and any single item that loses 2 points inside 7 days. A cat sliding from 31 to 27 over 3 weeks is telling you something a cat sitting flat at 27 is not. Most cats now reach 15 to 17 years, and the last 24 to 36 months are where the curve bends, which is exactly the stretch a weekly score covers.
The 7 items: what 0, 3 and 5 look like
Score the past 7 days, not the last hour, and use the anchors below so 2 people in the same house do not drift apart by 3 points on the same cat.
| Item | 0 points | 3 points | 5 points | Call if it drops |
|---|---|---|---|---|
| Appetite | 0 of 4 meals finished | 2 of 4 meals finished | 4 of 4 meals finished | 2 points |
| Mobility | 0 of 3 jumps up | 1 of 3 jumps, 45 cm hesitation | 3 of 3 jumps, 45 cm clean | 2 points |
| Litter box | 4 or more accidents in 7 days | 1 accident in 7 days | 0 accidents in 7 days | 2 points |
| Grooming | 0 of 3 body zones clean | 2 of 3 zones clean | 3 of 3 zones, 0 mats | 2 points |
| Social contact | 0 greetings in 7 days | 3 greetings in 7 days | 7 or more greetings in 7 days | 3 points |
| Activity and play | 0 play bursts a day | 2 bursts of 3 minutes | 3 bursts, 10 minutes total | 2 points |
| Breathing and rest | 40 breaths a minute at rest | 26 breaths a minute at rest | 22 breaths a minute at rest | 2 points |
Rules that keep the score honest
- 1 scorer per household, same chair, same 30 minute window on the same weekday; drift of 2 hours is fine, drift of 2 days is not.
- No half points. If you hesitate between 2 and 3, write 2; the scale is meant to be pessimistic, not flattering.
- If 2 people score, they score separately and you keep the lower of the 2 totals, never the average.
- Do not score within 48 hours of a vet visit, a move, a new pet, or a 3 day absence. Mark the week as excluded and score the next one.
- Write 1 line under the total: what changed, what you fed, what you gave. In 12 weeks those 12 lines explain more than the 12 numbers.
The 4 thresholds and the item floor
30 to 35 points is stable: keep scoring weekly, change nothing. 24 to 29 means recheck in 14 days and add 1 fix per week. 17 to 23 means an appointment within 72 hours. 16 or lower means a same week exam plus an explicit quality of life conversation, and at that point the total is a starting point for that talk, not a decision made by arithmetic. The floor rule overrides all 4 bands: any single item at 0 for 2 consecutive weeks earns a phone call that day, even if the other 6 items still total 27. Two consecutive totals under 20 means the trend is the problem, not today's number.
The item that usually moves first
Mobility and grooming lead appetite by roughly 6 to 12 months in most senior cats. Measure the furniture instead of guessing: a sofa seat is often 45 cm, a bed 55 cm, a windowsill 90 cm. A cat that cleared 45 cm at 12 years and hesitates at 14 has just lost 2 points, and 2 steps of 20 cm each will often buy those points back within 10 days. Rear end matting with appetite still at 5 points points to arthritis, dental pain, or a body condition score above 7 out of 9, not to laziness. A cat that stops grooming the lower back is a cat that cannot reach it.
What a score of 22 looks like in practice
A total of 22 with appetite at 3, mobility at 2, grooming at 2, and the other 4 items at 5 is a 7 day plan, not a crisis. Add 2 steps to the 3 favourite spots, cut the litter box entry to 5 cm, warm food to 37 C for 10 seconds in the microwave and stir, move 1 bowl to where the cat already sleeps, and put a 22 to 24 C heat source 1 m from the bed. Rescore on day 7. Reaching 24 to 26 means the fixes worked and you keep them. Sliding to 19 or 20 means book the visit you were postponing. Do not add, stop, or split any prescription on the strength of a score.
Red lines the sheet cannot catch
Skip the scale and call the clinic for: 30 or more breaths a minute at rest, 24 hours with no food, 12 hours with no urine, a new lump over 1 cm, pain that keeps the cat from lying down, 2 seizures in 24 hours, or a collapse. These are same day problems, and a weekly score of 28 does not make them smaller.
What it costs to run
The sheet and a pen cost 0. A baby scale for home weigh-ins is a one time 30 to 50 USD; a senior exam with bloodwork commonly lands between 120 and 250 USD, and the weekly score is what tells you whether to spend that in week 3 or week 9. Budget lines for the whole year are on the cost page.
Do this week
- Print the 7 rows, or draw them in a notebook: 7 columns, 1 row per week, 12 rows total.
- Score tonight at 19:00 for the past 7 days and write the date at the top.
- Weigh the cat on the same scale, same time of day, and put the number in the margin.
- Pick the lowest item and fix only that one for 7 days.
- Score again on day 7 and compare 2 numbers, not 7 impressions.
Frequently asked
Can I use the 0 to 10 HHHHHMM scale instead of this 0 to 5 version?
Yes, and the two are compatible in spirit. The HHHHHMM scale scores 7 criteria at 0 to 10 each for 70 points and is the better known tool for end of life talks. This 0 to 5 version totals 35 points and takes about 90 seconds a week, which is why it survives 12 consecutive weeks. Pick one, keep it for the life of the cat, and never mix totals from the 2 systems in a single trend line.
What if my cat scores 33 but I can feel something is wrong?
Trust the observation over the arithmetic. A total of 33 with a single item at 2 is a real signal, because the floor rule looks at items, not totals. Write what you noticed in the line under the score, score again in 7 days, and if the same item is still at 2, book the visit and bring the sheet with the dates on it.
How long should I keep scoring a cat in hospice care?
Keep the weekly cadence but shift the question. Under palliative care the useful markers are comfort, breathing rate, and whether the cat still seeks contact, so score every 3 to 4 days instead of weekly and look at the 4 day average. Two consecutive scores under 16, or any item at 0 for 3 days, is the point to call the vet who is managing the case.