Lily intoxication in cats
Jody
Braddock, Joanna White and Richard Malik
Faculty
of Veterinary Science and the Post Graduate
Foundation in Veterinary Science, The University of
Sydney, New South Wales, 2006
lthough lilies are flowers commonly used in floral
arrangements, and cats often have access to them,
most cat owners and florists, and indeed many
veterinarians are unaware of lily intoxication as a
potential cause of kidney (renal) failure in cats.
Photo
exhibit (A): A Tiger lily. Very beautiful.
Absolutely deadly for cats.
This is unfortunate as lilies are becoming
especially popular as a gift in the Sydney area, and
the flowers that are sold are exceedingly toxic
to cats. The key to successful treatment of these
cats is early recognition of possible ingestion, and
aggressive management of the ensuing renal failure.
In fact, lily intoxication should be considered as a
diagnostic possibility for any cat, regardless of
age, suffering kidney failure of sudden onset.
More importantly, prevention is much better than
attempted cure, so it is in the interests of cat
owners and cat lovers to make the danger of lily
ingestion WELL KNOWN in the wider community.
Indoor cats, and especially kittens, may be drawn
to floral arrangements, as they are a novel feature
in an otherwise very familiar environment that often
lacks other forms of vegetation. In the course of
investigating the flowers, the cats may play with
and sometimes chew parts of the plant. This could
easily go unnoticed by owners, or may occur while
the cat is alone at home. Similarly, cats with
access to lilies growing outdoors in domestic
gardens may not be observed to contact the plant, so
careful questioning regarding the presence of the
plant or flowers is always warranted when a vet is
investigating kidney failure in cats, especially
when it develops suddenly.
The species of lily that cause acute renal failure
in cats are shown in the blue dialogue box (Table
1).
The toxic substance in lilies that injures the
kidneys has not been identified, but all parts of
the lily are poisonous – flowers, stamen, stem,
leaves and roots. The toxic dose is unknown, but
thought to be reached by ingestion of, or mouthing,
very small amounts of material.
Photo
exhibit (B): It only took this much lily to be
ingested to cause sudden kidney failure in the
kitten shown below
Cats seem to be unique amongst domestic pets in
their susceptibility to this intoxication, possibly
due to differences in their metabolism.
For the same sort of reason, cats also can be easily
poisoned by human medications such as paracetamol,
ibuprofen and aspirin, and these too are lethal for
cats in doses that would be safe for humans.
Interestingly, dogs that consume large amounts of
the plant develop only mild gastrointestinal signs,
while rats and rabbits show no signs of toxicity at
all.
Signs
of lily poisoning
The first
signs of toxicity are vomiting, depression and loss
of appetite. The onset is usually within 2 hours,
and may subside by 12 hours. Although an affected
cat is likely to remain depressed, the patient may
appear to improve, briefly (with or without
symptomatic treatment) as the gastrointestinal signs
abate. It is likely, however, that acute renal
failure will develop within 24 to 72 hour at which
time the cat will become critically ill. At this
time the patient may drink much more than usual, or
become extremely dehydrated. Your vet might feel
painful, enlarged kidneys on physical examination at
this stage. If untreated, cats die in 3 to 7 days.
Diagnosis
and treatment
Your vet can
diagnose the presence of acute renal failure using
blood tests, urine tests, an ultrasound examination
and possibly a needle biopsy of the kidneys.
Although there is no specific test that can identify
lily intoxication as the cause with certainty, there
are characteristic laboratory findings that make the
diagnosis likely if supported by evidence of lily
ingestion (see photograph!!). The treatment for lily
intoxication is intensive and expensive, typically
involving intravenous fluid therapy and
hospitalization for several days. Currently, this
would represent a cost in excess of $1000 to most
owners, and even with the most diligent therapy, a
success outcome is not assured. One very lucky
kitten that was diagnosed very early and treated
aggressively by the authors is shown in the
accompanying photograph. Most cats are not so lucky!
A very
lucky kitten who was successfully treated for kidney
failure following lily ingestion. Most affected cats
are no so lucky!
Summary
Lily
toxicity should always be considered in any case of
acute renal failure in cats. Ingestion of small
amounts of plants or flowers of the Liliaceae family
can cause severe, irreversible kidney failure and
death in cats within 3 to 7 days of exposure. Cats
should therefore never have access to flowers or
plants of this family.
In an
attempt to drive this point home, the Cat
Protection Society is developing a laminated
poster which we would like to see displayed
prominently in every Sydney florist warning
potential customers of this risks such a gift may
pose to unsuspecting cats.
Further reading
Hall
JO. Nephrotoxicity of Easter lily (Lilium
longiflorum) when ingested by the cat.
Proceedings of the Annual Meeting of the American
College of Veterinary Internal Medicine, San Diego,
May 28 – 31, 1992
Langston
CE. Acute renal failure caused by lily ingestion in
six cats. J Am Vet Med Assoc 2002;220:49-52
Volmer PA.
Easter lily toxicosis in cats. Vet Med
1999;94:331 |
