Chronic kidney disease is the leading cause of death in older cats, affecting the majority of cats over 15 years. Understanding management options and quality of life considerations helps owners navigate this common but complex condition.
Feline CKD causes a spectrum of welfare impacts that change over the course of the disease. Early CKD may cause minimal welfare compromise — increased thirst and urination are the most obvious signs, and affected cats often feel well. As disease progresses, the accumulation of uraemic toxins causes progressive nausea, reduced appetite, and malaise — the cat equivalent of feeling chronically unwell. The challenge for owners is that these changes are gradual and easily attributed to "normal aging." The welfare investment required for well-managed CKD is substantial: regular blood and urine monitoring, dietary management (prescription diets that cats often resist), subcutaneous fluid therapy, and multiple medications. But this investment yields real welfare returns: cats with well-managed CKD maintain appetite, appropriate weight, grooming, and engagement with family life for significantly longer than cats receiving inadequate care. The endpoint question — when to provide euthanasia — requires the same honest, ongoing quality-of-life assessment as any other terminal condition, with particular attention to whether the cat is experiencing more comfortable days than distressing ones.