Lily Toxicosis (Feline)

Ingestion of lilies by cats can lead to acute renal failure.

Common name: Lily poisoning
Scientific name: Lily nephrotoxicosis

Diagnosis

Signalment
The condition affects only cats. There is no sex, age, or breed difference.

Incidence/prevalence
Incidence is unknown. Prevalence may increase at times when lilies are more likely to be in a cat's environment (e.g. Mother's Day, Easter).

Geographic distribution
There is no geographical distribution.

Clinical signs (primary, most to least frequent, scientific term, synonyms)
Vomiting, lethargy, increased or decreased urine production.

Clinical signs (secondary, most to least frequent, scientific term, synonyms)
Anorexia (loss of appetite).

Cause (scientific, common term)
Ingestion of any part of the lily, toxic principle unknown.

Organ system affected (from most to least important)
Kidney, gastrointestinal tract.

Diagnostic tests
Kidney function tests (BUN, creatinine, and phosphorus).

Differential Diagnosis
Kidney failure, ethylene glycol (antifreeze) poisoning, non-steroidal anti-inflammatory drug (NSAID) toxicosis, raisins/grapes ingestion.

Overview

Ingestion of lilies of the Lilium spp. such as Easter lilies, tiger lilies, stargazer lilies, oriental lilies, etc. and Hemerocallis spp. (day lilies) by cats can result in potentially fatal kidney failure within 1-3 days. All parts of the plant are poisonous, even the pollen. A single bite from the plant could be life-threatening for the cat. (These lilies cause kidney failure in cats only; other species, such as dogs, do not appear to be affected.)

Within a few hours of ingesting the lily, a cat will begin to vomit and become lethargic. After about 12 hours, the vomiting stops but the cat will not eat and usually remains lethargic. The cat's condition will deteriorate by about 24 hours as its kidneys fail.

Treatment

Home Care
Prevention is the most effective way of avoiding the problem. Since lilies are frequently found in flower arrangements, make sure that such arrangements are kept away from the cats. If the cats are allowed to go outside, remove any lilies that may be growing in areas they frequent. Once a cat has ingested the lily, they need to be taken to a veterinarian as soon as possible for treatment to prevent kidney failure.

Professional Care
Depending on how long after the cat has ingested the lily, the veterinarian may induce vomiting to try to remove as much of the plant material from the digestive tract as possible. The veterinarian may also administer activated charcoal which may help to bind the toxin and prevent its absorption. Blood work to determine the cat's kidney function will be drawn and monitored during treatment. Finally, the veterinarian will put the cat on a high rate of intravenous fluids to protect the kidneys for at least 48 hours.

Action
At home, do not allow a cat to come in contact with a lily plant. If exposure occurs, even if you just suspect it, take the cat to a veterinarian immediately. Not all plants called lily are true lilies (i.e. not members of Lilium or Hemerocallis), and it is important for cat owners to be familiar with the scientific names of the plants they bring into the home or plant in the yard.

Outcome
If treatment is started early – generally less than 18 hours after exposure to the lily – the cat should recover. However, if the treatment is delayed for more than 18 hours and kidney failure occurs, the prognosis is guarded as the cat may have permanent, potentially fatal, kidney failure.

References/Additional Readings

Volmer Petra A. Easter lily toxicosis in cats. Veterinary Medicine 1999; 94(4): 331. ( accessed at http://www.aspca.org/site/DocServer/toxbrief_0499.pdf?docID=116 December 5, 2007)

Means, Charlotte. Lily Toxicosis. In: Côté E, ed. Clinical Veterinary Advisor: Dogs and Cats. St. Louis: Mosby Elsevier, 2007; 638-639.

Author
Eric Dunayer, MS, VMD
DABVT, DABT

Editor
Sharon M. Gwaltney-Brant, DVM, PhD
DABVT, DABT