Lily Toxicity: Some Decorations can be Lethal

By Apryl Leipold, RVT

Nothing puts a damper on the holiday spirit like spending time in a veterinary emergency hospital;, luckily, most pet owners are aware of the common problems associated with the season. They keep boxes of chocolate out from under the tree, poinsettias and mistletoe out of reach, refrain from feeding their pets highly fatty leftovers or anything containing raisins or macadamia nuts, and don’t decorate the tree with tinsel. However, many are not aware of lily toxicity. Unlike most holiday hazards, untreated lily toxicity is very often fatal in cats.

Dogs can be affected by eating or chewing on some types of lilies, too, but usually show a localized reaction of drooling and/or swollen muzzle or gastrointestinal signs.

Lilies of the Lilium and Hemerocallis genus (including stargazer, Easter, Asian, day and tiger lilies) are beautiful flowers used in bouquets and centerpieces throughout the year. One nibble of a leaf or stem, ingestion of a small amount of lily pollen (while grooming to get the pollen of their coats) or even drinking the water from the container that the flowers are in (the exact toxin is still unknown but it is water-soluble) can send a cat into acute kidney failure.

The first signs of lily toxicity can develop within 6 to 12 hours and include vomiting (if the vomitus contains plant material, the veterinarian well be that much closer to a diagnosis), lethargy, anorexia (loss of appetite), tremors and seizures. Kidney failure can occur within 36 to 72 hours and the symptoms include dehydration, polydipsia (increased thirst), polyuria (increased urination) followed by lowered urine output and then no urine output at all.

Between 18 to 24 hours after ingestion, blood work will show increased BUN, creatinine and potassium levels, and epithelial casts might (but not always) be visible in a urinalysis. Immediate treatment is imperative if an owner suspects her cat was exposed to lilies.

If the exposure was recent (within a few hours), decontamination is recommended. This includes bathing any residual pollen from the coat, inducing vomiting—as an aside; it is extremely difficult to get a cat to vomit when you want him to—and oral administration of activated charcoal.

The cat will need to be hospitalized on IV fluids and injectable stomach protectants for a minimum of 24 hours; however, 48-hour hospitalization is usually required. Periodic blood work is done to assess the kidney values. Nutritional support needs to be started after the cat’s vomiting is under control and administered via syringe if the cat is not eating on his own.

The prognosis for the cat’s recovery is dependent on when treatment was initiated. Mortality has been reported to be as high as 100 percent if cats are untreated for more than 18 hours after the lily ingestion. If caught early, the chances for survival without any residual kidney damage is good.

So what does this all mean for the veterinary assistant? Other than being aware of lily toxicity as a rule-out when a client says her kitty has vomited up plant material, or getting a good medical history that includes asking a client if there are lilies in her environment, all you can do is educate, educate, educate.

If there’s a bulletin board at your hospital, ask the manager if you can post a warning about lilies. Many hospitals send newsletters to their clients; ask if they would include an article about all holiday toxins, especially lilies. If you are included in initial exams of kittens, mention it to the new owners.

Outside of the practice, be proactive. When sending flowers during the holidays, make sure that no lilies are included in the arrangement.

In one article I read while doing research, the author suggested telling the florist that someone in the household you’re sending to is deathly allergic to lilies. There’s no need to mention that the family member has four feet.

Talk to the local florists, nurseries and supermarkets where flowers are sold and ask them to make sure their arrangements aren’t going to homes with cats. Even better, ask them if you can post your bulletin-board flier. (Extra credit if the flier includes the name, address and phone number of your clinic.)

Finally, sometimes the simplest solution is the best Tell your family and friends who have pets of the danger and ask them to pass on the information. With all the holiday dinners, parties and get-togethers, you’ll get the word out and help keep Bella and Figaro home for the holidays.

Apryl Leipold is a registered veterinary technician and works at the Animal Emergency Centre in Studio City, Calif. She entered the field in the early '70s, starting as "kennel help" and working her way up to veterinary assistant. Apryl was among the first in California to take the RVT (then called Animal Health Technician) test under the grandfather clause; she was licensed in 1976. Apryl specializes in emergency medicine.

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