Lily poisoning and kidney failure in cats

Many of us love the Lily flower and plant for their beauty but a lot of cat owners may still not realise how deadly this species of plant can be.

All parts of the lily plant ( flowers, pollen, leaves) are considered highly toxic to cats. Even a tiny amount can do serious damage and be fatal. Cats will stand a better chance of survival and no long term kidney damage if veterinary treatment is administered as soon after eating the plant as possible. All fatalities in cats because of Lily poisoning are due to acute renal failure, other deaths reported are cats that have had to be euthanased.

This is the factsheet provided to me by my Vets after my cat ingested a very smalll amount of a Lily leaf. My cats treatment involved diuresis ( increasing urine flow by placing her on a drip) and absortion of as much toxin from the stomach as possible by using charcoal.

I have also included information about kidney disease and symptoms. Unfortunately kidney disease is very common in cats with as much as 18% of the cat population being affected and as it is a major concern for cats who have had lily poisoning I thought it would be useful to include.

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LILY POISONING IN CATS ( from the VPIS - veterinary poisons information services)

The indications that these plants were seriously poisonous to cats were realised in the USA in the early 1990s, but it is only in the last few years that the fact has been widely recognised in the UK. It was only in 2004 that enquiries about exposures to lilies in cats truly registered in the annual statistical reports of the Veterinary Poisons Information Services ( VPIS). In both 2005 and 2006 exposures to lilies was the second most likely cause of referral involving cats made to the VPIS, and whilst ingestions by dogs and house rabbits have also occirred relatively frequently these appear not to have the devastating cosequences of exposures in cats.

The increased reporting to VPIS may reflect increased public awareness but also the fact that lilies are now regularly included in floral arrangements and bouquets than perhaps they once were. Analysis of the location of the referred incidents reveals that these exposures were almost exclusive to house-bound cats.

An average of 7-8% of cases reported over 12 years have resulted in death. All these fatal outcomes were due to acute renal failure. However fatal cases may be under reported as outcome data for all referrals are incomplete.

It appears that most varieties of the Lilium species are poisonous to cats, and also the day lily. All parts of the plants, including the flowers and pollen are capable of causing poisoning with as little as one leaf having the potential to cause fatality according to some sources.

LILIES KNOWN TO BE NEPHROTOXIC TO CATS: ( nephrotoxity - toxic to the kidneys)

Day Lily - hemerocalis spp
Asiatic Lily - Lilium asiatica
Tiger Lily -Lilium Tigrinium
Easter Lily / Longiflorum Lily- Lilium longiflorum
Japanese showy Lily - Lilium hydridum
Stargazer Lily - Lilium orientalis
Rurum Lily - Lilium Rubrum
Western or Wood Lily - Lilium umbellatum

Peace lilies are not toxic in the same way as they are not true lilies, although if ingested by cats they will cause severe gastrointestinal irritation and oral irritation, characterized by profuse salivation and inflamed oral mucuos membranes and throat, owing to their oxalate content.

Ingestion of small quantities of Lilium or Hemerocalis material by cats will probably result in clinical signs developing. About 60% of cats will show clinical signs. The most common early signs were vomiting, which occurred in about 59% of the cases, inappetance, anorexia and depression/ lethargy. Other signs such as hypersalivation, twitching, hyperthermia, abdominal tenderness were seen more rarely.

The principle toxin present in the plants has not yet been identified but it seems that the compond is rapidly absorbed as clinical signs are usually apparent within 2-6 hours. It is also unclear how the toxin works but repots suggest that it causes severe damage to the epithelial cells of the renal tubes that results in cell loss and polyuria. Dehydration resulting from excessive fluid loss may then lead to anuric renal failure. Signs of renal failure are usully apparent by 24 hours.

Tests show that a dose of approximately eight leaves has similar effects from ingestion of only one flower. Ingestion of eight flowers causes death within 4 hours of ingestion.

The early promotion of diuresis (increasing urine production) appears to elimninate the toxin and limit tissue damage. Mortality is high if such treatment is not initiated within 18 hours of ingestion, and prognosis is very poor if anuria (failure in the secretion of urine) has developed. Unfortunately many presentations occur too late for effective management to be started.

Cats that are successfully treated and that survive the initial challenges may have long term renal insufficiency as a consequence of lily nephrotoxity.

VPIS TREATMENT PROTOCOL

Treatment should be iniated for ingestion of any quantity of any part of the plants by cats

If the animal is presented to surgery within 2 hours then consider gastric decontamination by inducing vomiting or performing gastric lavage. Also the administartion of adsorbants such as activated charcoal.

Prompt administarion of intravenous fluids is neccesary to prevent the developement of renal impairment.

This fluid therapy should be aggressive and should be continued for 24-48 hours minimum.

Where possible monitor renal function

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KIDNEY DISEASE

The chance of Kidney failure developing increases with age in dogs and cats. and it doubles between 10 and 15 years of age. Renal failure is recognised more frequently in certain breeds.
The kidneys are made up of many thousands of tiny units that filter blood, remove waste substances and maintain the correct concentrations of fluid and minerals within the body. Some of these filter units disappear with age and are not replaced. A whole range of factors can cause kidney disease/ damage. These include :

Increases in thirst and urine production

Decreased appetite

Weight Loss