Well, if it sounds like skeletons having an **** in a metal trashcan, it is time for a rebuild! In all seriousness though, any of these. If the oil pressure starts wavering from normal. If there are noises that are deep within that won't go away. Mass oil consumption. Metal in the oil. Low compression. Compression that isn't within 10% of each other. When you need to convince your wife so that you can replace those "worn out" parts with "proper replacements".