Pelushka Persians

Although lilies are flowers commonly used in floral arrangements, and cats often have access to them, most cat owners and florists, and indeed many breeders and veterinarians are unaware of lily intoxication as a potential cause of kidney (renal) failure in cats.  I have seen many websites where cats and kittens are posed next to flowers which include lilies!

Indoor cats, and especially kittens, may be drawn to floral arrangements, as they are a noel feature in an otherwise very familiar environment that often lacks other forms of vegetation.  In the course of investigating the flowers, the cats may play with and chew parts of the plant, or merely pick up pollen on their fur which they later lick.  This could easily go unnoticed by owners, or may occur while the cat is at home alone.  Similarly, cats with access to lilies growing in the garden may not be observed to contact the plant, so careful questioning regarding the presence of the plant or flowers is always warranted when a vet is investigating kidney failure, especially when it develops suddenly.

The toxic substance in lilies that injures the kidneys has not been identified, but all parts of the lily are poisonous - flowers, stamen, stem, leaves, pollen and roots.  The toxic dose is unknown, but thought to be reached by ingestion of, or mouthing, very small amounts of the plant.

Cats seem to be quite unique amongst domestic pets in their susceptibility to this intoxication, possibly due to differences in their metabolism.  For the same sort of reason, cats can also be easily poisoned by human medications such as paracetamol, ibuprofen and aspirin, as these are lethal for cats in doses that would be safe for humans. 

Signs of Lily poisoning

The first signs of toxicity are vomiting, depression and loss of appetite.  This normally occurs within 2 hours, and may subside by 12 hours.  Although an affected cat is likely to remain depressed, he/she may appear to improve briefly (with or without symptomatic treatment) as the gastrointestinal signs become less.  It is likely, however, that acute renal failure will develop within24 to 72 hours, at which time the cat will become critically ill. He/she may drink much more than usual, or become extremely dehydrated.  At this stage, your vet may be able to feel enlarged kidneys on physical examination.  If left untreated, cats can die in 3 to 7 days.

Diagnosis and treatment

Your vet can diagnose the presence of acute kidney failure using blood tests, urine tests, ultrasound examination and possibly a needle biopsy of the kidneys.  Although no specific test can identify lily intoxication as the cause with certainty, there are characteristic laboratory findings that make the diagnosis likely if supported by evidence of lily ingestion.  The key to successful treatment is early recognition and aggressive management of the ensuing kidney failure.  This is intensive and expensive, typically involving intravenous fluid therapy and hospitalization for several days.  Lily intoxication should be considered as a diagnostic possibility for any cat, regardless of age, suffering kidney failure of sudden onset.

More importantly, prevention is far better than attempted cure, so it is in the interest of cat owners to make the dangers of lily ingestion well know in the community.

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