Chronic kidney disease is the leading cause of death in older cats and managing quality of life alongside disease progression is the central welfare challenge.
CKD management is fundamentally about quality of life preservation alongside disease management. Cats in early CKD may be clinically normal but benefit from dietary management. As disease progresses, assessment shifts to regularly evaluating whether treatment burden - including dietary restrictions, medication administration and fluid therapy - is proportionate to welfare benefit. Cats who refuse renal diets face a welfare dilemma between optimal disease management and quality of life from eating food they enjoy. This requires individualised decision-making with owners and vets together prioritising the cat's experience.