Chronic kidney disease is the most common cause of death in older cats, requiring lifelong management focused on maintaining quality of life and addressing the symptoms that cause daily suffering.
CKD causes cumulative welfare impacts that increase as the disease progresses. Nausea from uremic toxin accumulation reduces appetite and causes vomiting. Fatigue from anemia makes previously active cats lethargic. The inability to concentrate urine creates extreme thirst. In advanced disease, uremic encephalopathy causes confusion and neurological symptoms. Many cats experience this progression over months to years with quality of life declining gradually. The welfare-focused approach acknowledges that the goal is comfortable time, not maximum duration. The timing of euthanasia when quality of life cannot be maintained is itself a welfare decision that should be made proactively rather than waiting for crisis.