Suspected lily toxicosis in a meerkat (Suricata suricatta): a case report.

Lilies are considered nephrotoxic only to domestic cats, which belong to the family Felidae of the suborder Feliformia. However, a 7-month-old female meerkat, belonging to the family Herpestidae of the suborder Feliformia, presented with oliguria, seizure, tachypnea, self-biting, and nystagmus after it ingested lilies. The meerkat died approximately 40 hr after lily ingestion. Gross and histopathologic lesions consistent with acute renal failure were conspicuous in the animal. The renal lesions were acute tubular necrosis, corresponding to the typical pathological changes of lily toxicosis in cats. In addition, massive hepatocyte necrosis and pulmonary congestion/edema were observed. These findings suggest that lily toxicosis in meerkats is characterized by pulmonary and hepatic failure, in addition to the renal failure observed in domestic cats.

Outcome following gastrointestinal tract decontamination and intravenous fluid diuresis in cats with known lily ingestion: 25 cases (2001-2010).

OBJECTIVE: To describe the outcome of cats treated with gastrointestinal tract decontamination, IV fluid diuresis, or both after ingestion of plant material from lilies of the Lilium and Hemerocallis genera. Design-Retrospective case series. ANIMALS: 25 cats evaluated after ingestion of lily plants. PROCEDURES: Medical records of cats examined at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania with known lily ingestion between July 2001 and April 2010 were reviewed. Inclusion in the study required evidence of lily plant ingestion within the preceding 48 hours. Type of lily ingested, time of ingestion, gastrointestinal tract decontamination procedures performed, and IV fluid diuresis were recorded. The presence or absence of acute kidney injury was determined by evaluating BUN concentration, creatinine concentration, and urine specific gravity. Outcome was defined as survival to discharge, death, or euthanasia. RESULTS: The time from ingestion until evaluation at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania ranged from < 30 minutes to 48 hours. Nineteen cats received gastrointestinal tract decontamination (18 cats at our hospital and 1 cat by the referring veterinarian). Twenty-three cats were admitted to the hospital for IV fluid diuresis, supportive care, and monitoring. Seventeen of these 23 (74%) cats had normal BUN and creatinine concentrations throughout hospitalization. At the time of discharge from the hospital, 2 of the 23 (9%) hospitalized cats had an increased BUN concentration, creatinine concentration, or both. All 25 (100%) cats survived to discharge from the hospital. CONCLUSIONS AND CLINICAL RELEVANCE: In this series of cats treated with gastrointestinal tract decontamination, IV fluid diuresis, or both within 48 hours after lily ingestion, the outcome was good, with a low incidence of acute kidney injury. Future studies are needed to determine the most effective gastrointestinal tract decontamination procedures and optimal duration of IV fluid therapy.

Exposure circumstances and outcomes of 48 households with 57 cats exposed to toxic lily species.

Ingestion of Lilium or Hemerocallis spp. by cats can result in renal failure. The objectives of this study were to determine the foreknowledge of lily toxicity of owners of cats that were exposed to lilies and to obtain historical, clinical and outcome information on the exposures. A survey was done of cat owners reporting indoor exposures to lilies to the Animal Poison Control Center (APCC) during April 2009. Forty eight individuals, (57 cats) were included. Sixty nine percent of cat owners said they could recognize a lily and 27% knew that lilies were toxic prior to their cats' exposures. Most lilies were obtained from grocery or other stores, and were purchased by the owners or as gifts to the cat owners. Owners who were unaware of lily toxicity frequently left the flowers where the cats had access to them, whereas in households where the toxicity was known the cats actively sought out the flowers. Of the cats in this study 93% received prompt veterinary care, and 87% either developed no signs or had brief signs that resolved. Five percent had evidence of renal insufficiency at final follow-up and another 5 percent of cats were euthanized due to renal failure.

Lily toxicity in the cat.

Lilies are commonly kept flowering ornamental plants that are used in holiday celebrations, weddings, and funerals, and in various floral arrangements. Lilies of genera Lilium and Hemerocallis (day lilies) have been shown to cause nephrotoxicity in cats. Confusion arises because so many different plants are called lilies. Members of the genus Convallaria (lily of the valley), while sparing on the kidneys, elicit toxic effects because they possess potent cardiac glycosides similar to digitalis. Even more confusing as to which lilies are toxic is the fact that many hybrids exist. The majority of the public do not know that lilies can be dangerous to cats and, in fact, cannot correctly identify the plants in their own homes. Cats have been shown to be extremely sensitive to the toxic effects of lilies. As little as 2 leaves or part of a single flower have resulted in deaths. It should be pointed out that the whole plant-petals, stamen, leaves, and pollen are toxic. The exact toxic dose and the precise toxins responsible for renal damage are currently unknown. The quick onset of clinical signs suggests a rapid absorption rate of the toxin. The renal tubular epithelium appears to be the target of the toxin. Studies indicate that it is the water-soluble fraction of the lily that is nephrotoxic. In cats, clinical signs of lily intoxication include salivation, vomiting, anorexia, and depression. Polyuric renal failure leads to dehydration and anuric renal failure and death results. No analytic verification of lily ingestion is currently available. Successful treatment includes initiation of fluid diuresis before the onset of anuric renal failure. Once anuria develops, peritoneal dialysis or hemodialysis is the only potential treatment. Differential diagnoses of lily poisoning include any potential cause of acute renal failure in a cat. Prognosis is excellent if fluid diuresis is started before anuric renal failure has developed. The public must be made aware of potentially toxic ornamental house plants.

A comprehensive study of Easter lily poisoning in cats.

This study was conducted with 3 objectives in mind: first, to identify the toxic fraction (aqueous or organic) in leaves and flowers; second, to identify diagnostic marker(s) of toxicosis in cats; and, third, to evaluate the morphologic effects of intoxication. The study was conducted in 2 phases. Phase 1 was to identify which extract, organic or aqueous, was nephrotoxic and also to determine the appropriate dose for use in the phase 2 studies. Results indicated that only the aqueous extracts of leaves and flowers were nephrotoxic and pancreotoxic. To identify the proximate toxic compound, cats in the phase 2 study were orally exposed to subfractions of the aqueous flower extract, 1 subfraction per cat. Results confirmed vomiting, depression, polyuria, polydipsia, azotemia, glucosuria, proteinuria, and isosthenuria as toxic effects of the Easter lily plant. Another significant finding in serum was elevated creatinine kinase. Significant histologic kidney changes included acute necrosis of proximal convoluted tubules and degeneration of pancreatic acinar cells. Renal ultrastructural changes included swollen mitochondria, megamitochondria, edema, and lipidosis. Subfraction IIa3 of the aqueous floral extract contained most of the toxic compound(s). These studies reproduced the clinical disease, identified the most toxic fraction of the Easter lily, and helped characterize the clinical pathology, histopathology, and ultrastructural pathology associated with the disease.

Acute renal failure caused by lily ingestion in six cats.

Acute renal failure was diagnosed in 6 cats that had ingested Easter lily or tiger lily plants. All 6 were treated medically; 2 underwent hemodialysis. Three cats survived the acute episode, and although they had chronic renal failure, they survived for more than 1.5 years. Two cats died despite aggressive medical management, including hemodialysis. One cat was euthanatized shortly after the diagnosis was made. Three of the cats were oliguric or anuric at the time of initial examination, and all 3 died. None of the 3 cats that survived had oliguria or anuria. Various members of the lily family (Liliaceae) can cause nephrotoxicosis in cats, but the toxic principle is not known. Although the prognosis for full recovery of cats with lily toxicosis is poor, long-term survival is possible with supportive care. The prognosis appears to be better for cats with nonoliguric renal failure.