Chronic kidney disease is the leading cause of death in older cats, requiring careful nutritional management to maintain quality of life during disease progression.
Chronic kidney disease management in cats illustrates the tension between extending life and maintaining its quality. Medical management can stabilize CKD and extend comfortable life significantly, but intensive interventions — fluid therapy, multiple medications, food restriction — must be weighed against the distress they cause the individual cat. The key welfare principle is that management should be driven by the quality of life it provides rather than laboratory values alone. A cat eating, engaging with family, and showing normal behaviors is doing well even with elevated creatinine; a cat refusing food and hiding despite normal-range values may be suffering.