Chronic kidney disease (CKD) is the most common cause of death in older cats. Long-term management can maintain quality of life for years when the disease is detected and managed appropriately.
Cat CKD welfare management has improved dramatically with growing understanding of the disease and better treatment options. The IRIS staging system provides a framework for graduated treatment intensity matched to disease severity. Early stage CKD with dietary management and monitoring can maintain good welfare for years. More advanced disease requires multimodal management addressing nausea, appetite, hydration, and phosphate accumulation. Home subcutaneous fluid administration, while requiring owner commitment to learn, significantly improves welfare in fluid-responsive cats at relatively low cost. Regular quality of life assessment guides end-of-life decisions, ensuring that treatment continues while genuinely supporting welfare rather than prolonging suffering.