Chronic kidney disease is the most common cause of illness and death in older cats, requiring early detection and careful long-term management to maintain quality of life across months to years.
CKD causes progressive welfare decline through accumulating uremic toxins, dehydration, nausea, anemia, and hypertension-related complications. Early-stage CKD may cause minimal welfare impact with appropriate management, while late-stage disease causes profound debilitation including uremic encephalopathy, gastrointestinal hemorrhage, and collapse. The chronic nature of the disease requires owners to engage with an ongoing management relationship — monitoring fluid intake, administering subcutaneous fluids, maintaining phosphorus restriction, and monitoring blood pressure. Quality of life can be maintained through much of the disease course with appropriate management, but recognizing the transition from manageable to terminal disease requires ongoing veterinary assessment. End-of-life decision making is a significant welfare consideration, balancing owner attachment against clear quality-of-life indicators.