After completing my first day of work experience at a small animal veterinary hospital, one of the most interesting cases that really caught my attention was a cat with lily toxicity. I wanted to look into this a little further before I go back in tomorrow to see how it has progressed.
All parts of the plant, including the pollen and water from the vase, are considered toxic to cats and result in severe acute kidney injury. The exact toxic dose and nephrotoxicant mechanism is still currently unknown; however, the toxicant in the lily is considered water soluble.
Lily nephrotoxicity may cause symptoms such as inappetance, lethargy, hiding, vomiting, diarrhoea, halitosis (bad breath), dehydration, excessive or decreased urination or thirst, seizures and unfortunately death.
The decreased urination can cause hyperkalemia which is high levels of potassium in the blood. Potassium is an essential electrolyte which performs several functions such as:
- regulating nerve impulse and muscle contractions.
- maintains intracellular volume.
- assists in maintaining blood pressure.
- maintains heart function.
- maintains the body’s electrolyte balance and acid/alkali levels in cells and tissues.
- it also plays an important role in heart, skeletal, and smooth muscle contraction, making it an important nutrient for normal heart, digestive, and muscular function.
It is the role of the kidneys to remove excess potassium from the blood via the urine, if they are no longer functioning as efficiently potassium levels can build up. This is the case with lily toxicity as it causes acute kidney failure, causing frequency of urination to also decrease. With too much potassium the heart may begin to beat abnormally and in very severe cases, stop beating all together.
Treatment includes decontamination (like inducing vomiting and giving binders like activated charcoal), aggressive intravenous fluid therapy, anti-vomiting medication, kidney function monitoring tests, blood pressure monitoring, urine output monitoring and supportive care.
Once anuria (where kidneys fail to produce urine) develops, peritoneal dialysis or hemodialysis is the only potential treatment.
Peritoneal dialysis – A dialysis technique that uses the patient’s own body tissues inside the abdominal cavity as a filter. A plastic tube called a dialysis catheter is surgically placed through the abdominal wall, into the abdominal cavity. A special fluid is then flushed into the abdominal cavity and washed around the intestines. The intestinal walls act as a filter between this fluid and the bloodstream. By using different types of solutions, waste products and excess water can be removed from the body.
Hemodialysis – A medical procedure to remove fluid and waste products from the blood and to correct electrolyte imbalances. This is accomplished using a machine and a dialyzer, also referred to as an “artificial kidney.”
I believe this can only be carried out to an animal over a certain weight.