Caring for a Dying Dog at Home in Japan: What to Prepare From the Day You Get the Diagnosis
Last updated: August 15, 2026
If you've decided to care for your pet at home near the end, there are four things worth setting up. (1) Know the rough guideline for a resting breathing rate. (2) Decide in advance, during the day, who to call if something changes at night or suddenly. (3) Check how you'd take time off work. (4) Look once at what the arrangements after that day involve, so you're not learning it all in the moment.
- We couldn't find a list of "signs the end is near" in the materials put out by veterinary organizations. What we found instead was a seven-category scoring table
- A resting breathing rate that stays above 40 breaths per minute is generally treated as a warning sign worth noticing
- Paid annual leave doesn't require you to disclose a reason — it can be used to be with your pet near the end, too
Maybe you've just been told your pet doesn't have long, and that's what brought you to this page. The first thing worth saying: there's no right answer between caring for your pet at home and continuing treatment as far as possible. Which one you choose isn't something you decide once — it's something you can keep working through with your regular vet, one step at a time.
This page is written with dogs in mind, but almost all of it applies to cats too — the breathing guideline, how to take time off, and how to think about the arrangements don't really change.
1. Looking for the signs the end is near
At this stage, a lot of people search for how much time is left. Appetite, water intake, body temperature, breathing — lists of signs to check against your own dog, one by one.
The materials put out by veterinary organizations don't include anything that reads like a definitive list of "signs the end is near."Neither a major U.S. veterinary hospital group's owner-facing page, nor the 2023 guidelines from the American Association of Feline Practitioners and the International Association for Animal Hospice and Palliative Care, has a section like that.
This isn't to say the sign-lists people share are wrong. It's just that what the professional guidelines actually offer is something different: a scoring table you fill in for each day, rather than a checklist of signs.
The reason isn't hard to guess. No one can predict how much time is left, but whether your dog is comfortable today is something the person by their side can see, every day.
2. A different scoring table, used instead
The one most widely referenced is the "HHHHHMM Scale," created by a U.S. veterinary oncologist. You score seven categories from 0 to 10 each, where 10 is the ideal state.
Note: this scale was originally built for end-of-life decisions, including euthanasia. If this is hard to read right now, it's fine to skip this section and go straight to the breathing rate guideline below.
| Category | What to look at |
|---|---|
| Hurt | Is pain under control? Can they breathe? Do they need oxygen support? Breathing difficulty is treated as the priority to check, above everything else on this list. |
| Hunger | Are they eating enough? Will they eat if you hand-feed them? |
| Hydration | Are they getting enough fluids? If not, subcutaneous or IV fluids are an option |
| Hygiene | Can you keep them clean, especially after they go to the bathroom? Is their bedding soft enough to prevent pressure sores? |
| Happiness | Do they still show interest or joy in things? Do they respond to family or toys? Consider moving their bed closer to where the family spends time |
| Mobility | Can they get up on their own, or do they need help from a person or a device? The original scale notes that limited mobility doesn't rule out a good quality of life, as long as they're alert and can respond happily |
| More good days than bad | When bad days start outnumbering good ones, that's a sign quality of life may be declining |
A total score above 35 is generally treated as a rough guideline for whether home care can continue. The veterinary hospital group that shares this scale also suggests checking whether each individual category scores above 5.
The score itself may matter less than what you notice while filling it in. The fact that the "Happiness" row asks whether you can move the bed closer to family suggests the scale is meant to prompt action, not just measurement.
3. Know the breathing rate guideline
A resting breathing rate that stays above 40 breaths per minute is generally treated as a warning sign worth noticing. To count it, just count breaths for 15 seconds while your pet is still, and multiply by four.
If your pet looks like they're struggling, don't wait and see — get to a vet as the first priority.
Depending on your vet's judgment and guidance, home oxygen may be offered as an option. We've put together the actual costs in our oxygen rental cost comparison. Most providers combine a base fee of roughly ¥5,000–¥15,000 with a daily rate of roughly ¥650–¥1,980.
4. What "palliative care" means
Sometimes a vet uses the word "palliative care" in the exam room, and it can land hard — like being told treatment is over.
The guidelines define it a little differently, though. Palliative care is also given to pets with treatable conditions — it covers any care aimed at easing symptoms and keeping them comfortable, not just care for pets at the end stage.
What's called "hospice," specifically, is described as a shift in the goal of care — from medicine aimed at curing, to medicine aimed at comfort and quality of life. It's not framed as stopping treatment, but as the goal changing.
The same guidelines count adjusting the home environment as part of that care, too: making food and water easier to reach, making the bed more comfortable, rethinking the location and shape of the litter box. None of that requires a hospital — it's all things you can do at home.
Note: the guidelines quoted here are specifically about cats. They may not apply to dogs in exactly the same way.
5. Talking to your vet about how far to go
Keep them at the hospital, or bring them home? Continue the IV fluids? Run the tests again? At this stage, decisions keep coming, one after another.
Your vet has the answers, but you're the one who decides. To help bridge that gap, here are a few ways to ask:
- Is this treatment meant to make my dog more comfortable, or to extend how long they have?
- If we don't do this, what's likely to happen?
- If I take them home, what can I do myself?
- What options are there right now for easing pain or discomfort?
- If I change my mind partway through, can we change the plan?
That last question is worth asking — it makes things much easier later. A lot of people assume that once they've decided something, they have to see it through.
The guidelines note that support for the family begins the moment they recognize they've reached this stage — not after the pet has passed. That also means it's fine to tell your vet honestly that you're still unsure.
6. Home care or hospital care
We couldn't find data comparing which is better. Since there's nothing to decide it for you, here are just the two axes worth weighing.
- Home — you can stay with them in familiar surroundings and smells, but there's less you can do if something changes suddenly
- Hospital — they can get immediate care for discomfort, but visiting hours and the environment are more limited
You don't have to commit fully to one or the other. Some people keep their dog home during the day and bring them in on harder days. It's worth asking your regular vet whether any nearby clinic makes house calls, too.
Whichever you choose, there will probably be a day you second-guess it. That doesn't mean it was the wrong choice.
7. Decide during the day who to call at night or if things change suddenly
Your pet's condition is most likely to change at night. Rather than scrambling to figure it out once it's dark, there are two things worth doing ahead of time, while it's still daytime:
- Ask your regular vet who to contact outside business hours or on their days off
- Look up the emergency clinic they point you to, and how to get there, once, ahead of time
Having this settled in advance means less time spent scrambling if the moment actually comes.
8. Check how you'd take time off work, ahead of time
Bereavement leave (kibiki, 忌引き) — where it exists as a company policy in Japan — generally applies after a pet has passed away. Few companies extend it to cover the caregiving period itself. The realistic option for taking time off during that period is paid annual leave (yūkyū kyūka, 有給休暇). Japanese labor law doesn't require you to disclose a reason to your employer — "personal reasons" is enough, and it covers time spent on nursing care or accompanying your pet to the vet, too.
Some companies also have a separate leave category for medical visits or caregiving, distinct from bereavement leave. How to check what your company offers, along with example phrasing, is on taking time off work.
9. Look once at what the arrangements involve, before the day itself
If you start researching this in the middle of grieving, you end up doing two hard things — grieving and logistics — at the same time.
Looking through it once now, while you're still steady, tends to make that day a little easier on your future self. You don't need to decide anything right now. Just knowing it exists already helps.
- What to do right after your pet passes is covered in the first three things to do
- Cremation comes with a few different options — communal, individual (unattended), and individual (attended) (see types and differences)
- Typical costs are in cremation costs, and what your local municipality offers is in municipal pickup rates
10. You, the one caring for them
At this stage, a lot of owners aren't sleeping. Checking in the middle of the night, going to work in the morning, checking again when they get home — some people keep this up for weeks.
The guidelines mentioned earlier have a section on supporting the family. What it says is that support begins not after the pet has passed, but from the moment the family recognizes they've reached this stage. It calls the grief that starts while the pet is still alive "anticipatory grief," and lists getting support from a mental health professional as an option for owners struggling with it.
Let someone else take over when you can — family, friends, or a hospital that can keep your dog for a while. There's no rule that says you have to watch through the night, and if something happens on a night you're asleep, that isn't your fault.
What you're able to do during this time is usually less than you think it is. The things you weren't able to do tend to loom larger afterward, looking back. For now, choose whatever you can actually sustain.
There's no right way to spend the time that's left
Some people keep to their usual routine. Others go through old photos. Neither one is more correct than the other, and you don't have to push yourself to do anything in particular.
You can also read stories from other owners who have walked this same road. And if a day comes when you find yourself thinking "I should have been there," there's also If you weren't there at the end.
Frequently asked questions
Can I care for my dog at home until the end?
Yes. There isn’t a right answer between caring for your dog at home until the end and continuing treatment as far as possible — it’s a decision to work through with your regular vet. Even if you decide on home care, it’s worth keeping up regular check-ins or house calls so you can catch sudden changes in your dog’s condition.
What should I do if my dog seems to be struggling to breathe?
A resting breathing rate that stays above 40 breaths per minute is generally treated as a warning sign worth noticing. To count it, just count breaths for 15 seconds and multiply by four. If your dog looks like they’re struggling, don’t wait and see — get to a vet as the first priority. Depending on your vet’s judgment, home oxygen may be offered as an option.
Can I take time off work to be with my dying pet?
Yes. In Japan, paid annual leave (yūkyū kyūka, 有給休暇) doesn’t legally require you to disclose a reason to your employer — "personal reasons" is enough. In a survey of people who had actually taken time off after losing a pet, 73.3% took one or two days (Daiichi ipet Insurance survey, n=1,000). Some Japanese companies do offer pet bereavement leave (pet kibiki, ペット忌引き), but whether it covers time spent caring for a dying pet varies by company, so it’s worth checking with HR ahead of time.
What should I do right after my pet passes away?
The first step is keeping the body cool with ice packs while you decide on cremation arrangements. The full steps and costs are covered on our page for what to do on the day.
Are there signs that a senior dog’s time is near?
We looked at the materials put out by veterinary organizations, and didn’t find anything that reads like a definitive list of "signs the end is near." What we found instead was a scoring table covering seven categories — pain, appetite, hydration, hygiene, happiness, mobility, and whether good days outnumber bad ones — scored 0 to 10 each, day by day. No one can predict how much time is left, but whether your dog is comfortable today is something the person by their side can tell.
My vet mentioned palliative care — does that mean treatment is over?
Not according to the guidelines. Palliative care is also given to pets with treatable conditions — it covers any care aimed at easing symptoms and keeping them comfortable. What’s called "hospice" is described as a shift in the goal of care, from curing to comfort and quality of life. It’s framed as the goal changing, not as treatment stopping.
Is it better to care for my dog at home or leave them at the hospital?
We couldn’t find data comparing which is better. Home means familiar surroundings and being by their side, but less you can do if something changes suddenly. Hospital means immediate care for discomfort, but more limited visiting hours and environment. Some people keep their dog home during the day and bring them in on harder days. It’s worth asking your regular vet whether they offer house calls.
How should I talk to my vet about how far to go with treatment?
Three questions to build around: "Is this treatment meant to make my dog more comfortable, or to extend how long they have?", "If we don’t do this, what’s likely to happen?", and "If I take them home, what can I do myself?" It also helps to ask "If I change my mind partway through, can we change the plan?" — that one makes things much easier later.
Sources
We aren't veterinary professionals, so this section only summarizes what these sources say. The originals are linked below.
- The seven-category scoring table (HHHHHMM Scale): Quality of Life Scale (PDF). Based on an approach published by veterinarian Alice Villalobos in 2004, formalized into this table for her book (Blackwell Publishing, 2007), and later revised for the International Veterinary Academy of Pain Management (IVAPM)'s 2011 guidelines.
- How to read the scale (5 points per category, 35 points total as a guideline): VCA Animal Hospitals, "Quality of Life at the End of Life for Your Dog" (Dr. Tammy Hunter, Dr. Robin Downing; updated August 14, 2024). This page doesn't include a "signs the end is near" list either.
- Definitions of hospice and palliative care, adjusting the home environment, and support for the family: 2023 AAFP/IAAHPC feline hospice and palliative care guidelines (American Association of Feline Practitioners and International Association for Animal Hospice and Palliative Care, 2023). These guidelines are specifically about cats.
- The breathing rate guideline, cooling procedures, and the leave-taking figures come from the research on the daily care, bereavement leave, and what to do on the day pages.
- No statistics or research comparing home care to hospital care at the end of life were found.
If you spot an error on this page, please write to [email protected] — we'll check it and fix it.