Chronic kidney disease is the leading cause of death in older cats, affecting up to 50% of cats over age 15. Effective management significantly extends quality life and reduces suffering in affected animals.
Feline chronic kidney disease is a condition where the trajectory from diagnosis to end of life can be profoundly shaped by the quality of management. Early detection through routine senior cat blood and urine screening allows intervention before clinical signs develop, and mild CKD managed with dietary phosphorus restriction and adequate hydration can remain stable for years. The welfare dimension of management extends beyond physical health metrics: how a cat experiences veterinary visits, medication administration, and fluid therapy is central to its quality of life. A cat that tolerates home subcutaneous fluids with minimal stress — ideally trained using positive reinforcement — receives a major welfare benefit with minimal ongoing welfare cost. A cat subjected to daily stressful oral medication may have worse overall welfare despite the treatment. Individualized quality of life assessment at each stage is essential: the IRIS staging system provides clinical guidance, but the welfare decision at each transition point requires integrating clinical status with the cat individual response to management.