Chronic kidney disease affects the majority of cats over 15 years old and requires ongoing management balancing quality of life, symptom control, and realistic assessment of disease trajectory.
Chronic kidney disease in cats causes progressive welfare compromise through accumulation of uraemic toxins causing nausea, lethargy, and reduced appetite, alongside dehydration, hypertension, and anaemia. The experience of nausea in cats is difficult to detect but evidenced by lip-licking, drooling, reduced food interest, and grass-eating. Well-managed CKD allows cats to maintain good quality of life for months to years, with the goals being symptom control, slowing progression, and preserving function rather than cure. Home subcutaneous fluid administration provides significant welfare benefit by maintaining hydration and reducing uraemia, and most owners manage this effectively once trained. Dietary management is important but must balance phosphorus restriction against palatability — a cat that will not eat a renal diet derives no benefit from it. Regular quality of life assessment using validated scales helps owners and veterinarians recognise when palliation is no longer maintaining adequate welfare and end-of-life decisions are appropriate. Timely euthanasia before the cat enters terminal uraemia is a kindness that requires honest communication between veterinarians and owners.