Cat Health: Toxin Update I: Lilies

They are lovely to look at, but you should know that the lily harbours a secret threat to our fuzzy feline friends. A herbaceous menace to the cat world, numerous members of the lily family can lead to feline fatalities should their two paths cross. Sadly, this is one of the most common toxicities seen in veterinary practice and this tragic fact is why I have decided to tackle this topic first in my feline toxin update.

In my household, I steer clear from keeping any member of the lily family in my house, and have been known to relegate lily housewarming gifts outside (and even then on a high ledge where no other cats can access it). The threat from these plants is so serious and my cats’ lives so important to me, it’s not worth the risk.

While all lilies are potentially dangerous to cats, the common ones associated with intoxication include: the Tiger lily, Peace lily, Stargazer lily, Easter Lily, Rubrum Lily, and the Asian Lily.

The main route of intoxication occurs when the cat ingests any part of the lily plant, including petals, stems, and leaves. The toxicity level is so high that even a tiny portion of plant can be enough to seriously affect the cat. Even just chewing on the plant can be enough to elicit the toxin’s devastating effects. The toxin’s target is the kidney and ingestion of lily plant leads to acute kidney failure.

Symptoms of lily intoxication tend to arise quickly and can be seen thirty minutes to two hours after ingestion. The cat can be depressed, unwilling to eat, and may vomit. Vomiting tends to be less of a sign as time continues, and many people mistakenly believe that their cat is recovering. Don’t be fooled.

As the poison continues to invade the cat’s system, the toxic effects become more focused on the cat’s kidney. That means signs become more kidney oriented as well. These cats can experience severe kidney pain. As well, they often will demonstrate increased thirst, as the kidney struggles to filter the blood and excrete toxins into the urine. Over prolonged periods without treatment, these cats can even become anuric, which means their kidney dysfunction is so serious they cannot make urine. Without prompt aggressive medical treatment, complete renal shutdown and failure can occur within a few days, and is followed by the death of the cat.

The timeframe for treatment is a small one, so immediate veterinary care is required if you have seen your cat interact with a lily plant and you fear any ingestion has taken place. Often in medicine, there are few true emergencies when compared to the number of lingering ailments. In this instance, I assure you that this is one of those emergency times. No matter the time, day or night, if your cat has ingested plant material from a lily, see your vet. I would strongly advise not waiting until the next morning or until after work to take your cat into your vet. The clock is ticking and the longer the cat is left untreated, the less likely survival becomes.

Upon arrival to the veterinary practice, you might not know what to expect. As I am sure you have gathered this far, this is a serious poisoning and will require aggressive treatment and hospitalisation of your cat. It is worth noting at this stage, that even with prompt intensive treatment, your cat’s prognosis is guarded. The key prognostic indicators to predict the cat’s chance for survival will be how soon treatment was started, and how their kidneys respond to treatment. Obviously, cats with previous kidney compromise (i.e. some old cats will have reduced kidney function due to old age) may have less chance of recovery.

At the vet’s, you will need to provide your veterinarian with as much history as possible, including the plant exposure and approximate timeframe since ingestion. Typically, the veterinarian will examine your cat and perform an emergency blood test. Two specific parameters the vet will be checking are the blood’s urea and creatinine. These two parameters reflect kidney function, and high values for these suggest a kidney insult and/or damage. The vet may also choose to check a urine sample, to access the kidney’s ability to concentrate urine. This is important because dilute urine is a warning that the kidney is struggling to function. In some instances, the vet may elect to do a kidney ultrasound or take a sample of the kidney (either via needle sampling or biopsy) but these are uncommonly done as part of an initial work-up for lily intoxication.

The blood work is key in these cases, as it provides a ‘Ëœsnap-shot’ picture of the kidney’s (and the whole body) functional state. If intoxication has occurred, the urea and creatinine will be high. This knowledge is helpful in two ways. First, it confirms our fear of intoxication and tells us that hospitalisation and treatment are imperative. Secondly, as a snapshot, this first blood sample acts as a base line. As we treat the cat, we will be able to ascertain whether we are getting on top of the kidney insult by comparing future blood samples against it.

The hallmark of treatment of these cats is aggressive immediate fluid therapy. This will help flush out the toxin, as well support the kidney as it tries to maintain its blood filtering and urine producing responsibilities. While the cat is receiving this treatment mainstay; they may also receive analgesia, nutritional support and in some cases dialysis, but these requirements will vary depending on each cat’s needs.

It’s worth mentioning again, lily intoxication in the cat is a serious poisoning. These cats need emergency treatment ASAP. But know that even with treatment a cat with lily intoxication has a guarded prognosis. We can only do our best by catching exposure early and treating quickly and aggressively. The rest is up to the individual cat’s kidneys and fate.

If you own cats, I would advise you to either not allow lilies into your home or do so only in a controlled manner. Prevention is the best option when it comes to avoiding lily intoxication. Personally, I feel that while lovely, the risk lilies offer in a cat friendly household is just not worth it. I wouldn’t trade any of my cats’ lives for any bouquet of flowers.

Key Points:

  • Prevention is better then cure: Don’t keep lilies in your home or keep them in a controlled manner.
  • Don’t Wait: If you suspect lily ingestion (or even chewing), contact your vet ASAP. Remember it only takes a small bit to poison a cat.
  • Intensive Care: Treatment should be immediate and aggressive, but the prognosis is guarded.