Chronic kidney disease is one of the most common conditions in older cats, with dietary management playing a central but sometimes welfare-contested role in slowing progression and managing symptoms.
Feline CKD management involves genuine welfare trade-offs in nutrition. Prescription renal diets are evidence-based for slowing disease progression, but some cats refuse them, creating a dilemma between disease management and the welfare cost of food refusal in already compromised animals. The consensus among feline medicine specialists is that a suboptimal renal diet the cat will eat is better than a perfect renal diet the cat refuses and becomes anorexic on. This principle of individual patient welfare has informed more flexible current dietary guidance that prioritises palatability and food intake while pursuing phosphorus restriction through other means including phosphate binders. The early stages of CKD are often managed with dietary modification alone, while advanced disease requires multimodal management. Quality of life assessment is increasingly important in CKD management decisions including end-of-life care.