This cat presented to me after being surrendered to Saving Grace Animal Society. The presenting complaint was that he was urinating everywhere! The cat was very dehydrated. He had a prolonged skin tent and sunken eyes. He was quite lethargic and did not want to stand on his own. His temperature, heart rate, and respiratory rate was normal. His gums were moist (from vomiting) and pink. He had a fairly large bladder and when it was squeezed, he would express clear urine.
The urine was very dilute (isothenuric) and had a few things abnormal about it. There was a mild amount of blood and proteins detected in the urine. The bloodwork showed that he had inflammation in his body and that he was dehydrated. His kidney values (creatinine and BUN) were moderately elevated which can suggest kidney damage or dehydration. A few other values were elevated on bloodwork that were suggestive of dehydration (total proteins, albumin). On ultrasound, the renal pelvis of the kidney also appeared to be dilated.
I am sure youre thinking “why was his urine dilute if he was dehydrated?”. This is because the kidneys are not functioning properly. With the moderate elevation in kidney values in combination with the dilute urine, this is suggestive of kidney damage. The kidneys are not able to adequately concentrate the urine by pulling water back into the body. With the history of this being a sudden onset, we suspected that this cat has acute kidney damage (AKD). Unfortunately, we do not know if lilies were in the house to cause this but this is the typical season in which we see lilies in homes so it is suspected. The cat was hooked up to IV fluids to diuresis the kidneys/toxins. After 48 hours, the bloodwork showed great improvement in dehydration and mild improvement in kidney values. The cat is going to stay on IV fluids for another day and kidney values will be rechecked in 1 week. I have talked about the treatment for AKD in a previous post so instead we are going to discuss…
WHY DO LILIES (Tiger, Day, Asiatic, Easter, or Japanese Show lily) CAUSE KIDNEY DAMAGE IN CATS?
While lily poisoning only causes a mild stomach ache and diarrhea in dogs, it can be a potentially fatal toxicity in cats (and meerkats). Cats typically present for having vomiting, inappetence, and lethargy within 12 hours of ingestion. Then, after 36-72 hours, will develop urinary signs, excessive drinking, dehydration, drooling, tremors, weakness, +/- seizures.
A very small amount of the lily plant ingested can cause damage to the kidneys (renal tubular necrosis). The reason why this happens though is unfortunately unknown… but it is know that the problem is caused by a water soluble toxin meaning that all parts of the plant are poisonous.
PREVENTION Do not have lilies in your home or yard if you have cats or ensure they are out of reach.