Chronic kidney disease (CKD) is the most common age-related disease in cats, affecting an estimated 30-40% of cats over 12 years old. Long-term management and quality-of-life assessment are critical welfare considerations.
Feline CKD welfare requires long-term monitoring of quality of life alongside disease progression. Cats in early CKD stages may have excellent welfare with appropriate dietary management. As disease advances, welfare assessment must balance the benefits of treatment (extending life, reducing symptoms) against the burden of repeated handling, veterinary visits, and dietary restriction. The HHHHHMM quality-of-life scale (Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, More good days than bad) provides a framework for end-of-life decision-making. Many cats experience prolonged good-quality life with CKD; recognizing when this changes is the key welfare challenge.