Chronic kidney disease (CKD) is the leading cause of death in older cats. Proactive management significantly extends quality life, but end-stage CKD creates difficult welfare and euthanasia decisions.
CKD management in cats is a welfare success story in veterinary medicine: better diagnostics, dietary management, and home therapies have transformed CKD from a rapidly fatal disease to a manageable chronic condition in many cats. Early detection through regular geriatric health screens enables dietary intervention before significant kidney tissue is lost. Phosphorus restriction and adequate hydration are the cornerstones of medical management. Subcutaneous fluid therapy, which many owners can learn to administer at home, improves hydration, reduces uraemia, and significantly improves quality of life. However, CKD is ultimately progressive, and welfare assessment — tracking appetite, activity, pain, and general comfort — is essential to identifying when quality of life has declined below acceptable levels. Timely, compassionate euthanasia at the right moment is itself a welfare intervention.