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Published May 11th, 2022
Lily toxicity in cats
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One of the most severe, and saddest, toxicities to cats comes in the form of beautiful flowers - the plants in the Lilium and Hemerocallis lily genus group. The Lilium genus includes imported or cultivated flowers such as Easter Lily, as well as native species in California such as Bolander's, Panther, Shasta and redwood lily. The Hemerocallis genus also includes exotics species such as Tiger and Day lily.
These flowers are often included in florist bouquets and kept inside the home, where curious cats might sniff at the fragrant flowers or chew on long leaves. Secondary methods of exposure can occur when a cat self-grooms the heavy pollen off their fur, or drinks from the vase water. Unfortunately, all parts of these plants are very toxic to cats, with the flowers being the most toxic, causing kidney failure within a matter of hours. As much as we know about lily toxicity in cats, we still do not know the actual chemical principle that causes kidney failure. If a cat ingests a few flowers, kidney failure and death can occur within hours. More commonly, a smaller amount of the plant is ingested, resulting in sudden or acute kidney failure within 12-36 hours and if untreated, death occurs within 3-5 days.
Signs of kidney toxicity include vomiting, depression and lethargy, and decreased or no appetite - and often these occur within 2 hours of exposure. Generally, the signs might then resolve for several hours to 1 day, giving a sense of false security that all is well. However, the damage to the kidneys continues to progress and full-blown severe failure results in 12-36 hours after exposure. These symptoms include not eating, initially urinating and drinking in large volumes that progresses to not urinating or drinking at all, muscle tremors and weakness or wobbliness, and even seizures.
Treatment can be successful, and the key to success is early and very aggressive action - in the form of diagnostic tests and supportive care. Obviously, there's a head-start to the process if you know that your cat has been exposed to lilies - and exposure means that there are lilies present in the house (or on the property in the case of outdoor cats). Tests include blood and urine panels to evaluate kidney and secondary electrolyte status. Treatment includes intravenous fluids, anti-nausea medication, anti-seizure medication if appropriate, and gut protective medications. If known ingestion has occurred and it is early enough, the emergency veterinary team might make the cat vomit, to reduce absorption of the toxin. These cats need to stay in a 24-hour veterinary hospital for continued treatment and monitoring, and this might be for 2-5 days.
The prognosis for this toxicity is very poor, with death occurring in 50-100% of cases if treatment is not sought early enough. However, one veterinary study showed a 90% survival in cats for whom aggressive treatment was started within 18 hours of exposure.
Not all "lilies" cause this level of kidney failure. Other plants known as lilies that are not members of Lilium or Hemerocallis can also cause toxicity but in a different way - these include Peace and Calla lilies, and Lily of the Valley.
So, as a general rule, lilies and lily-like plants do not mix well with cats. Dogs might get an upset stomach from eating leaves or flowers, but do not have the same severe reaction in their kidneys as cats - another example of the mantra "cats are NOT small dogs"! Cat owners should not bring these flowers inside the house. If you are buying flowers for another, you might ask the florist to remove these if your friend is a cat-owner. If you have a regular florist, you might mention that it would be valuable information for customers to know about this horrible toxicity to our feline friends.
Here is the ASPCA link to dangerous lily plants for cats:

Dr. Mona Miller lives in Lafayette with her son, two cats and yellow Labrador. She attended UC Berkeley as an undergraduate, and received her DVM from UC Davis. She has been happy to call Lafayette home since 2001. She can be reached via email at MonaSDVM@aol.com. She welcomes questions from readers that may get incorporated into a column.

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