In the Literature
Lorbach SK, Quimby JM, Nijveldt E, Paschall RE, Scott EM, Reid J. Evaluation of health-related quality of life in cats with chronic kidney disease. J Feline Med Surg. 2025;27(9):1098612X251367535. doi:10.1177/1098612X251367535
The Research …
Quality of life (QoL) assessment has become essential in managing chronic diseases in human medicine, with extensive research showing that patients with chronic kidney disease (CKD) experience significantly reduced physical and mental well-being.1 Identification of modifiable risk factors allows better patient management through improved QoL.2
This study used a validated assessment tool to evaluate health-related QoL in cats with CKD.3 The study included 68 cats with CKD and 24 healthy cats. Caregivers completed a 20-item questionnaire that measured 3 domains: vitality, comfort, and emotional well-being (EWB). Comprehensive clinical data (eg, clinicopathologic and physical examination findings, medical history) was gathered to identify factors associated with decreased QoL.
Results demonstrated that cats with CKD had significantly lower health-related QoL scores in all 3 domains compared with healthy cats. More severe disease (ie, International Renal Interest Society [IRIS] stages 3 and 4) was associated with diminished vitality and EWB scores compared with earlier stages (ie, IRIS stages 1 and 2). Cats with CKD had a median age of 14 years, and healthy cats had a median age of 6 years; when cats >10 years of age were excluded from the CKD group, a significant reduction in QoL compared with healthy cats remained.
Several modifiable clinical factors were significantly associated with decreased health-related QoL. Cats with anemia (hematocrit <27%) had lower EWB scores, with a positive correlation between hematocrit levels and EWB. Abnormal appetite was linked to reduced scores in EWB, comfort, and physical well-being. Constipation was also associated with lower comfort, EWB, and physical well-being scores. In addition, cats administered 5 to 7 daily medications had significantly worse scores across all domains compared with those receiving no or 1 medication.
Identification of modifiable factors suggests that targeted interventions addressing anemia, appetite problems, constipation, and medication burden could potentially improve QoL for affected cats.
… The Takeaways
Key pearls to put into practice:
This study demonstrated that caregiver-reported behavioral observations can effectively measure QoL changes in cats with CKD. The instrument used for assessing QoL in this study had been previously validated for use in healthy cats and cats with various chronic conditions,3,4 but this was the first evaluation to validate its use in cats with CKD, thereby providing an objective tool to help guide treatment decisions and monitor response to interventions in this patient population.
CKD significantly impacts QoL in cats. In this study, all cats with CKD showed reduced vitality, comfort, and EWB scores compared with healthy cats, and more severe disease (ie, IRIS stages 3 and 4) was associated with greater impairment, particularly in EWB.
Anemia, poor appetite, constipation, muscle wasting, and polypharmacy (≥5 medications administered daily) were independently associated with decreased QoL scores, suggesting these conditions should be priority targets for clinical management.
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