Chronic kidney disease is the leading cause of death in older cats. Dietary phosphorus restriction and appropriate protein levels are the cornerstones of nutritional management that slows progression and maintains quality of life.
Cats with advanced CKD experience nausea, dehydration, oral ulcers from uraemia, hypertension-induced blindness, and profound weakness. Early dietary intervention — transition to a kidney-specific diet before uraemic signs develop — delays these outcomes significantly. Welfare-centred management involves managing nausea with anti-emetics, appetite stimulants where appropriate, and regular blood pressure monitoring to prevent hypertensive retinal detachment. Quality-of-life assessment at each visit guides the timing of discussions about palliative transition and euthanasia decisions to prevent prolonged suffering.