Lily Toxicity: The Silent Killer of Cats

Don't let your floral decor turn into a danger zone for your cats. Join Dr. Sugerman in 'Lily Toxicity: The Silent Killer of Cats' as he navigates the alarming risks associated with lilies, from kidney damage to life-threatening consequences. Gain actionable insights into early detection, treatment options, and proactive prevention strategies to keep your furry companions safe and healthy. Learn how to safeguard your beloved pets and create a safer environment, especially during occasions like Mother's Day. 

In this episode you will:

• Recognize the hidden dangers lilies pose to cats, especially during occasions like Mother's Day
• Understand the toxic components of lilies and their detrimental effects on feline health
• Learn to identify symptoms of lily toxicity in cats, such as vomiting, lethargy, and decreased appetite
• Discover the diagnostic procedures involved in confirming lily toxicity in cats, including blood work and kidney value assessments
• Explore the urgent treatment options available for cats exposed to lilies, including inducing vomiting and IV fluid therapy
• Gain insights into the prognosis of lily toxicity in cats and the importance of timely intervention
• Acquire practical tips and preventive measures to create a safer environment for cats, such as avoiding lilies in bouquets and gardens

Resources:
ASPCA Toxic and Non-Toxic Plants List
ASPCA Animal Poison Control


View This Episode on the Vetsplanation Website

Transcript

Dr. Sugerman: 0:00

Did you know that lilies are responsible for a significant number of cat poisoning cases, especially during this time when people are receiving Mother's Day bouquets? This is a serious issue that needs immediate attention. I'm Dr. Sugerman and in this episode of Vetsplanation, we'll delve deep into the dangers of lilies and how to ensure the health and happiness of both your moms' and their cats. Lily toxicities can be extremely dangerous and lethal to cats. The worst part about this toxin is that they're sold in stores like all around the world with no warning signs to these unsuspecting cat parents. They're found in bouquets, people keep them in their house, and they even are grown outdoors. So this makes this a highly toxic plant found just about anywhere. Let's talk about what a lily actually is too. So don't worry, I'm not a botanist, nor am I even a very good gardener. So I'm not going to delve deep into the facts. But the fact is that there are actually two types of lilies. There are true lilies, and there are false lilies. Did you even know that there was a false lily? For our purposes, we need to know that true lilies are the ones that can actually hurt our kitty's kidneys. False lilies have their problems too. Now that's another podcast for another time. So let's go over what these real lilies actually are. They are from the plant genus called Lilium, and the most common true lilies are the Easter Lily, Japanese Lily, the Ornamental Lily, the Stargazer Lily, the Casablanca Lily, and the Tiger Lily. There are also Day Lilies, which are not truly in the Lilium family. but they still cause kidney failure as well. Like I said before, I do not have a green thumb, so I likely would not be able to pick out a couple of these lilies if you showed them to me. Therefore, there are two great resources. You can go to the ASPCA website, and they have a list of toxic plants, which we'll add a link to in our show notes. It has pictures next to them so you can see what type of plant it might be and identify them. You can also call the ASPCA Pet Poison Control and email them a picture of the plant. I do like to let people know that there is a fee for talking to the ASPCA. It was$95 the last time I checked. It is not government funded, so they have to pay their veterinarians and their staff with those funds. Some insurance companies, though, will cover the cost, and even some microchip companies will cover the cost as well. So just another perk to having pet insurance and microchips. They will look at the plant though and they'll let you know if it's toxic and if you need to take your cat to the vet hospital. They'll also give you a case number, which you should bring with you to give to us because then we call and talk to the veterinary toxicologist. They'll let us know like how toxic is this plant and what do we need to do to treat it. All right, now that we know what true lilies are, let's talk about the plant's toxic components and how they affect our unsuspecting kitties. So unfortunately, literally every part of the plant is toxic. Eating a leaf, chewing on a leaf, chewing on a flower, the pollen from the flower, and even the water that the lily is sitting in are all highly toxic to cats. Even just the smallest amount, like chewing on the plant but not swallowing it, or just getting the pollen on their nose, not even eating it, is highly toxic. You might be wondering, like, how lilies can cause such a toxicity in cats and not other pets and not us, right? We touch the lilies all the time. We're not 100 percent sure why. We do know that the lily will break down into smaller components called metabolites that will directly affect the cat's kidneys. We have to assume it is because they have certain enzymes or basically things that break other things down, like lilies being broken down into metabolites, that we and other species do not have. We also don't know what the toxic versus lethal doses are. Or in other words, like how much of the plant will cause sickness versus death. Some cats react differently than others. Some cats eat two leaves and they need minimal treatment, while other cats just bite the leaf and they're so severely affected they have to be euthanized or put on dialysis until their kidneys somewhat heal. And unfortunately, there's just no way to know which cat is going to be affected in which way. So in a nutshell, every part of the plant and water is highly toxic to cats. So let's talk about our symptoms next. Initially, after ingesting the lily, you might see vomiting, lethargy, or meaning like weakness, not wanting to move, drooling, and some decreased appetite. If they vomit up the plant, then that is great. That means that they're going to get less of the toxin than they would if they didn't vomit it up. But it also means they have still absorbed some of that toxin. This is the most common way that people find that their cat ate a lily, by the way, is usually they see it in the cats that vomit. The second most common way is that they see the pollen on their nose. Anyways, in about 12 to 24 hours after ingestion is when we start to see that the toxin affected the kidneys. They have an increased thirst, they're urinating more, and they're really dehydrated. Because that is so fast. I work about a 14 to 16 hour night shift. If I bought my wife or my daughter flowers, there could already be too much damage to the kidneys before I even return home. Alright, next we have true kidney failure. We see that when the cat can no longer produce any urine. Unfortunately, death can occur within about 36 to 72 hours later. So that's about 3 to 6 days after eating the plant. That is such a short amount of time. Alright, let's talk about how we can diagnose lily toxicities. I've said this before but there's really no test that we can do that's going to be an encompassing toxicology test. At least not when they're alive as we've learned with Dr. Watson on the necropsy episode. Therefore we have to look at what the lilies affect. So we perform blood work and look at the cat's kidney values, which are called the creatinine and the BUN. There are other important blood work factors like how dilute the urine is, meaning, like, how close is it to water? Or how high the potassium is? Or another test that's called the SDMA? But the creatinine and the BUN are usually what we monitor the most. So if those are elevated then we are suspicious for our lily toxicity along with several other things like kidney infections or even antifreeze toxicity. The best way that we know that it was a toxin is by your history as a pet parent. Knowing that lilies are in the house or that the cat had vomited up some lily pieces. Alright, what is the treatment for this? If you know that your cat did eat part of the lily, the first thing we attempt to do is to try to make your cat vomit, if they've eaten it within a couple of hours. Cats just don't read the textbooks though. We try to make the cats vomit but usually they only vomit up about 50 percent of the time. It's not for a lack of trying either. It's just that these drugs work more on dogs than they do on cats so they just don't work as well on cats. Some people will give activated charcoal afterwards to help bind it. That's a little controversial depending on who you ask. Some people feel it doesn't bind the toxin while other people feel that it does. So if the cat has pollen on them, then we wash it off with Dawn dish soap, which you can do at home as well. If you see that your cat got into pollen on their face, then wash them up well with Dawn dish soap and then bring them in. It's just going to limit the toxic exposure. Next we need to help flush out those toxins. We do this by placing your cat on IV fluids, meaning fluids that go directly into the veins, which lead to the kidneys. We want to dilute out as much of that toxin as possible. You know how you use like the last bit of soap and you just don't have enough time to go to the store to so instead you just put water into the bottle, shake it up really well, and then use it, right? But it's not quite as potent. Then you've used up all the soap again, you still didn't go to the store, you put more water into it, that's really not as soapy as it was, but it'll do. And then you do this over and over again until basically all you have is water in the bottle. So that's basically what we're trying to do to dilute the toxin from the bloodstream and the kidneys. We want to put as much fluid into their body as possible, as much as it can handle, to make it more like water and less like that toxin. People have asked too, can't I just have my cat drink more water? Unfortunately, there's no way for them to be able to drink as much water as they would need. Their body is going to tell them that they are not thirsty anymore. Even if you try to like force water down them, it's not going to be enough. So the best way we can get it into them is putting it directly into their IV. So it's recommended to do this for about 48 hours at least. We'll talk about that reason why here in just a second. We always want to get initial blood work. We want to see what your cat's kidney values look like. That BUN and that creatinine. If your cat is not having any clinical signs or you caught it really early, then I suspect that those kidney values will look normal because the kidneys are not affected yet. But this gives us a starting point or what we call baseline blood work. We need to know what your cat's normal is to see if those values do increase. We draw blood again every 24 hours to see if the kidney levels rise. So here's the crazy thing though. The kidneys have to have about two thirds of their function damaged in order for the blood work to show any increases in those values. That's a lot of damage before it shows up in our blood work. When you think about what two thirds is, like really that means more than one kidney because you have two kidneys, if one kidney is affected, that's 50 percent of it. So you have to have more than one kidney affected. You have to have both kidneys affected in order for this to show up in their blood work. So some cat parents feel if the blood work is normal at 24 hours, then they should be fine, and they usually want to take their cat home. Maybe those kidney values are only 50 percent affected at that time, though. If they're taken off IV fluids, then their kidneys will definitely become damaged. Instead, we want to wait that 48 hours. If their values are normal at 48 hours, then we can most likely say that they should be okay. Some toxicologists recommend sending them home and then having you bring your cat back after 24 hours of being off of IV fluids to recheck that blood work in case they do go up after being off of IV fluids. If they don't go up, then they should be in the clear. So this is the best case scenario. You see your cat eat a lily. We make them vomit. We hospitalize them on IV fluids for 48 hours, and the blood work looks great. So they get to return home. 24 hours later, you bring your cat back, and we just recheck the blood work to make sure it's normal. But what happens though when it doesn't go well? The longer the treatment is delayed, the worse the prognosis is. If treatment is delayed by 18 hours or more, it generally leads to irreversible kidney damage. Some cats go on dialysis if they're near a specialty hospital or a teaching hospital that does that, but most hospitals don't have that. Some cats though have kidney levels that are too high and their kidneys just stop working. This means they've stopped producing urine. And without dialysis, this unfortunately means that they should be humanely euthanized so that they don't suffer. I do have a case to talk about. It was this little orange kitty. His name was Marmalade. He was very cute. Best name for an orange kitty I think I've ever heard. He had jumped up on the kitchen table at home, and his cat parents saw that he had orange on his face. They didn't really think too much of it at first because they thought that he'd just gotten into maybe their kid's Play Doh or something. It wasn't until hours later that they were cleaning up and realized that there was nothing out that was orange that he could have gotten into. They also noticed that Marmalade had vomited multiple times around the house. So dad brought him in while mom cleaned up all of the vomit. When I walked into the room, I saw his orange nose and I asked if there was any way that there were any lilies in the house. People think of yellow being the pollen, but it just depends on which type of lily it is. Some lily pollen is yellow and some of it is orange. So, dad said no, that there weren't any lilies in the house, and I asked do you have any bouquets in the house? And he told me that he did just buy a bouquet for his wife last night for her birthday. I asked him if it had a lily in it, and he asked his wife, she sent over a picture, and there it was. One single lily in the middle of a bunch of other flowers, which I feel like is the most common thing that I see. So we talked about how this could be the cause of all of this, and I recommended hospitalizing him. At first, Dad was like pretty hesitant, but I explained why this was so important, and I could tell he really did love Marmalade and was worried. He talked to his wife and they did agree to hospitalize him luckily. I didn't make him vomit since he had already been vomiting so many times at home, it wasn't going to produce anything else for me. The first blood work we performed, luckily, showed that he had normal kidney values. So hopefully that meant it wasn't 18 hours ago when he had bought those flowers. We started him on IV fluids and at a fairly high rate and then we just waited for his 24 hour recheck. When I talked to him in the morning, his cat mom did find pieces of flower in his vomit, so we know that he did definitely get into it. So we talked more about like the outcomes and possibilities of what could happen and understand that this could be really bad. So at 24 hours, we rechecked his blood work and his kidney levels did go up. So we knew definitely he had gotten into that lily. They were obviously heartbroken to hear this. But we talked about how it wasn't over yet. We still needed to give him more time on IV fluids. And just monitor to make sure that he's still producing urine. If he wasn't producing urine, that's not a good sign. At 48 hours, his kidney levels were even higher though. But again, he was still producing urine, so I told them this may not be the end, and we really could potentially still have some hope because he is still urinating. So I got the 72 hour blood work, and I was really worried to look at it. But to my surprise, his kidney values were actually down. Not even close to normal, but less than they were at 48 hours, and this was a good sign. So if we could get his kidney levels down to normal or close to normal, that would be the best news for him and his family. That also meant, though, he was going to need to stay in the hospital on IV fluids for much, much longer. And his pet parents were definitely worried about funds. But they were able to talk to several organizations who donated to his cause and were able to get him to stay in the hospital. Within six days, Marmalade's kidney values were almost normal again, and he was able to return home. Everyone at the clinic was like so excited, just incredibly happy to see this super cute and friendly little Marmalade be able to go home to his family. I can't imagine if they had waited any longer to come in, they may not have been able to take him home. Luckily, everything worked out in the end. Let's talk about prevention. Really, the best way to prevent this from happening is to not have any lilies around at all. Don't plant them in your garden if you know that your neighbors have cats that go outside or you have cats that go outside. Don't bring them in your house if you have cats. And also if your mom has cats, please make sure the bouquets do not have lilies in them before you bring them to her. The last thing that you want to do on Mother's Day is to have to bring your mom and her cat to the ER. So I'm going to do a quick animal fact for everybody who loves to hear them. Today we're going to do one on zebras, since we did actually have a zebra escape in Washington. So first of all, zebras are part of the equid family, meaning that they are related to animals like horses. That also means that they have a lot of similar traits. They can be really playful. They have a very powerful kick. So powerful that they could actually injure a lion. The lead male is also called a stallion. Females are also called mares. Babies are also called foals. Some interesting things that people may not know is that there are actually three kinds of zebras. There's the Grévy's zebra, which is the largest of them, measuring up to five feet tall and weighing 770 to 990 pounds. They have really large round ears that make them look mule like. There's the Mountain Zebra, which has a dewlap on their throat that actually looks like an Adam's apple. Plus their stripes run vertically on their neck and torso. And then there's the Plains Zebra, which is the most abundant and actually the smallest of them. Some of these guys have brownish shadow stripes between their black stripes, which is super interesting. And of course, everybody knows them for their stripes. Most of the people know that they do use those stripes for camouflage and that they have stripes that are really just as unique as human fingerprints. The stripes differ though depending on where you are. The further south you go on the African plains, the further apart those stripes actually get. They also use their stripes for identification too. So this is especially true to the foals or the babies who need to know what their mom's stripes look like in order to be able to identify her. Other mares usually will not adopt a foal. Therefore, if the foal loses mom, then they're likely not going to be able to eat. So to ensure the foal recognizes mom, she'll distance herself from the herd so that way the baby can just see her and imprint on her. Once Mom knows that her foal has imprinted on her, then she and the baby will usually return to the herd for protection. All right. Hopefully you learned some things about our zebras and lily toxicities, so thank you everyone for joining us and please share this with all your friends that you know who are cat parents so that we can help keep our kitties safe. As always, thank you to Shawn Hyberg for editing the podcast and Kelly Reopelle Dwyer for working on the website. Tune in next week as we talk to Dr. Brantman, the ophthalmologist, about what to watch for with your pet's eyes. Thank you everyone, and please, as always, keep your pets happy, healthy, and safe. We'll see you next week.