The short answer is “yes”! Beautiful flowers like lilies seem as though they would be harmless, but every aspect, even the pollen, is toxic to cats. It is suspected lilies are toxic to dogs, too, but research has not been able to support that claim.
Common lilies you probably have heard of include the day lily, tiger lily, Easter lily, and stargazer lily to name a few. Lilies in the Lilium and Hemerocallis families will be the ones discussed specifically in this post. Lilies in these two families cause damage to the kidneys, but other types of lilies can cause toxicity to the heart as well.
Lilies are so toxic because any part of the plant or pollen contains the toxin to cause damage. The leaves tend to be the most commonly eaten or chewed on, but the flower is the most toxic part. It does not take much ingestion of the plant or pollen to cause toxicity. Even water with pollen and/or containing plant material is toxic to cats. When cats are presented to their veterinarian for a known or suspected lily ingestion, sometimes the cats are even bathed because they can have pollen on their fur. This little amount of toxin can be ingested when a cat grooms itself.
Some cats can show signs of lily toxicity within a few hours of ingestion. This includes lethargy/depression (some cats may hide), vomiting, and decreased or no appetite. Also, an increase in thirst and/or urination can be seen. For other cats, it can take up to 6-12 hours to see the full effects. For this reason, if you even suspect your cat came in contact with a lily, but aren’t sure – it is important to seek the care of a veterinarian because the sooner the cat is treated, the better the outcome.
If the toxin continues to affect the body, tremors or seizures can also be seen. Due to the kidneys affected, some cats can have little to no urine production, which is always abnormal and requires seeking veterinary care a.s.a.p. Some cats can show clinical signs initially and seem to get better, but then the clinical signs return 12-24 hours later and worsen. Don’t be fooled by a cat that appears to get better. When in doubt, have your cat checked by a veterinarian.
There is no specific test to check for lily toxicity. Your veterinarian will want to check the kidneys by doing some common blood tests, which will give an overview of your pet’s organ function. An increase in the blood urea nitrogen (BUN) and creatinine values in addition to an elevated potassium and phosphorus level can indicate kidney damage. Also, a urinalysis may be performed to check for urinary casts (cylinder-shaped pieces that can be made up of different cells), but these may not show up in the urine until 12-18 hours after ingestion.
Once your pet is evaluated by a veterinarian, they may want to induce vomiting to get up any part of the plant that may still be in the stomach. There are only a few medications indicated to induce vomiting in cats and they are all injectable medications that are administered at the vet. DO NOT USE HYDROGEN PEROXIDE to make a cat vomit. This can cause severe inflammation and possible ulcer formation in the GI tract.
Your veterinarian may also want to give activated charcoal orally to your pet. This can help bind any residual toxin in the GI tract, however, this is never 100% and can have some side effects. The decision to use activated charcoal is best left to your veterinarian as every case is different.
Lily toxicity does not have a specific antidote, but treatment is aimed at protecting the kidneys. This is done by aggressive intravenous (IV) fluids along with monitoring the electrolytes, kidney values, and urine production. Cats are also given injectable medications for the upset stomach as many can be nauseous or have vomiting secondary kidney damage. If a pet had a known (or very suspicious for) ingestion of the lily toxin and the blood work values are normal, depending on when the blood test was run, this does not necessarily rule out the possibility of kidney damage. For the cats who have had recent exposure, your veterinarian will want to check blood work to get baseline values for the kidneys. This means to get what your pet’s “normal” kidney values are, so when the blood test is re-checked, they can compare the two tests for any changes to the kidneys.
We sometimes treat pets with fluids that go under the skin (subcutaneous) instead of intravenous (IV). In the case of lily toxicity, subcutaneous fluids will not be enough to help the kidneys. Substantial IV fluids and hospitalization is the best way to protect the kidneys to give them a fighting chance. Also, monitoring the electrolytes while on IV fluids is important and changes can be made to the type of fluids that are used to keep the electrolytes normal. This can’t be done effectively with subcutaneous fluids.
For those cats experiencing tremors or seizures, anti-seizure medications can be given, but patients with neurologic signs like this can have concerns about large ingestion of the toxin.
Patients typically need up to 72 hours of hospitalization, IV fluids, injectable medications, and monitoring. Depending on how patients respond to treatment and what the re-check blood test shows will tell us the most about your pet’s kidney function.
Thankfully, for cats that were treated with early and aggressive treatment, survival rates can be up to 90%. Many of those cats did not have long-term kidney issues, however, that is a possible risk for cats with lily toxicity. The key is for early treatment (less than 18 hours after ingestion) and for those cats who were treated after 18 hours, their prognosis was poorer.
The best prevention may seem obvious. Keeping lilies out of the house altogether is best as making sure lilies outside are not accessible to outdoor cats. Not everyone knows how toxic these plants can be, so spread the word to let them know!