Chronic kidney disease (CKD) is the most common serious illness affecting older cats, and its management requires a careful balance between medical intervention and quality of life considerations.
Managing CKD in cats requires ongoing welfare assessment rather than simply treating laboratory values. Cats with CKD may experience nausea, reduced appetite, weakness, and the discomfort of fluid imbalance — experiences that profoundly affect quality of life. Dietary management, while important, must be balanced against palatability: a cat that refuses a renal diet and loses significant weight may be worse off than a cat on a standard diet that maintains body condition. Subcutaneous fluid therapy is well-tolerated by most cats and owners report seeing rapid improvements in alertness and appetite after administration. Blood pressure monitoring and antihypertensive treatment are critical to prevent target organ damage. Quality-of-life assessment tools help owners and veterinarians recognise when the balance has shifted toward suffering, supporting timely and compassionate end-of-life decisions.