Chronic kidney disease (CKD) is the leading cause of death in older cats, but with early detection and good management, affected cats can maintain excellent quality of life for years.
CKD progresses silently at first — cats are experts at masking illness, and owners often only notice problems once 75% of kidney function is lost. This underscores the value of annual blood and urine screening in cats over 7 years. Once diagnosed, quality of life management becomes central: nausea control (maropitant, ondansetron), appetite stimulation, subcutaneous fluid supplementation at home, and blood pressure monitoring all directly improve comfort. Dietary management — transitioning to kidney-appropriate food with reduced phosphorus and controlled protein — meaningfully slows progression. End-stage CKD causes uremic syndrome: nausea, mouth ulcers, and profound malaise. Timely euthanasia before this stage is a welfare priority; recognizing the transition from "managed" to "suffering" requires attentive owners and regular veterinary reassessment.