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VetVine Client Care

Posted On Jun 23, 2025

Updated On Jul 16, 2025

Lilies - Lovely But Dangerous

Emergency & Critical Care

Contributed by Melissa Holahan, DVM, DACVECC

Consider this case presentation ...

“Tiger,” a 2-year-old female spayed DSH feline presents to your hospital with a history of vomiting and anorexia. The owner reports that "Tiger" is an indoor cat with occasional access outdoors. Twenty-four hours prior the owner saw "Tiger" playing around her flower garden. When questioned further she revealed that part of her garden includes these flowers:

A close up of a flowerAI-generated content may be incorrect.

On exam, "Tiger" is mildly dehydrated with abdominal discomfort. Blood work reveals mild azotemia (BUN 75 mg/dL; Creat 4.5 mg/dL). Urinalysis shows glucosuria and a urine specific gravity of 1.020. 

"Tiger" has clinical signs of lily toxicosis. Signs of lily toxicosis typically include:

  • Gastrointestinal: vomiting, ptyalism, anorexia, diarrhea

  • Signs attributable to acute kidney injury: PU/PD, oliguria, anuria, renomegaly, abdominal or renal pain, oral ulceration

  • Neurologic signs: ataxia, disorientation, head pressing, tremors, seizures

  • Pancreatitis

  • Paw and facial edema

  • Non-specific: dehydration, hypothermia or fever, lethargy, depression, ventricular premature contractions, death

Clinical pathologic abnormalities may include:

  • Complete blood count: anemia, leukocytosis (stress leukogram vs. inflammatory response)

  • Serum chemistry: azotemia (some reports of a disproportionately elevated creatinine compared to BUN), hypocalcemia or hypercalcemia, metabolic acidosis, hyperphosphatemia, hypokalemia or hyperkalemia, elevated liver biomarkers (ALT, AST, ALKP, and total bilirubin)

  • Urinalysis: glucosuria, proteinuria, hematuria, decreased USG, and the presence of epithelial and granular casts


What is your treatment plan and what prognosis will you give the owner? 

Treatment plans should include:

  • Decontamination (inducing emesis and administering activated charcoal in the absence of neurologic status)

  • Diuresis with intravenous fluid therapy, and supportive care

  • Recheck renal values 2-3 days after being off fluids and monitor patient closely
    • Continued follow-up should be based on current renal values and clinical signs

It was previously thought that gastrointestinal decontamination and intravenous fluids had to be initiated within an 18-hour window for the best outcome. However, we can have a good outcome if treatment is initiated within 48 hours of exposure with a low incidence of acute kidney injury.  


Reference: Bennett, AJ, Reineke, EL. Outcome following gastrointestinal tract decontamination and intravenous fluid diuresis in cats with known lily ingestion: 25 cases (2001–2010). J Am Vet Med Assoc 2013;242:1110–1116.

Originally posted on July 29, 2014