Chronic kidney disease (CKD) is the most common age-related condition in cats. Managing it well requires balancing treatment with quality of life to ensure cats remain comfortable.
CKD management in cats raises important quality-of-life questions that go beyond simply maintaining blood values within target ranges. A cat whose kidney values are controlled but who refuses prescription kidney diets, undergoes stressful daily handling, or has multiple daily medications that cause distress may have poorer welfare than a cat with slightly worse values but good appetite and low-stress care. The goal of CKD management should explicitly be the cat's experienced quality of life, not the optimization of laboratory parameters. Home subcutaneous fluid therapy, when cats and owners can manage it comfortably, extends life and improves wellbeing. Honest conversations with veterinarians about the trade-offs between life extension and quality of life are essential to ethical CKD management.