Outpatient treatment for lily toxicity in cats

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Researchers at the University of Pennsylvania School of Veterinary Medicine investigated treatment methods for cats exposed to toxic lilies.^1,2 The study compared cats treated as inpatients with intravenous fluids to cats managed as outpatients with subcutaneous fluids. Despite long-held assumptions, results showed no significant difference in the prevalence of acute kidney injury (AKI) between inpatient and outpatient groups.^1,2

“Our findings suggest that outpatient management may be a viable option for some cats exposed to lilies,” Erica Reineke, BS, VMD, professor of emergency and critical care at the University of Pennsylvania School of Veterinary Medicine, said in a news release.¹ “This could be particularly relevant for pet owners with financial limitations, lack of access to 24-hour veterinary facilities, or other cat factors.”

The study investigated the outcomes of 112 cats treated for exposure to lilies, 96 inpatients, and 16 outpatients.² Contrary to prior beliefs, the prevalence of AKI in inpatient cats was 46.9%, compared to 43.8% in outpatient cats.^1,2 It was previously thought that hospitalization with intravenous fluids was necessary for cats exposed to toxic lilies, but because of the study, researchers have a more comprehensive understanding of treating lily toxicity in cats. Reineke is hopeful that these results will assist in expanding treatment options and flexibility, improving patient outcomes.^1,2

According to Reineke, despite a generally higher prevalence of AKI in both inpatient and outpatient groups compared to previous studies, a larger number of cats with AKI showed improvement or stabilization of their condition.¹ Inpatient cats had a 100% survival rate, and outpatient cats had an 87.5% survival rate. Although the difference in survival rates is significant, overall survival was excellent.²

Researchers do caution that the study’s findings should not be interpreted as definitive treatment recommendations, emphasizing the need for larger, controlled studies, to established evidence-based guidelines for lily-toxin management.¹

“It’s crucial for cat owners to understand that all parts of the lily plant are toxic to cats,” Reineke said.¹ “Prompt veterinary attention is essential, regardless of the treatment approach.

In an exclusive interview with dvm360 at the 2024 Veterinary Meeting & Expo in Orlando, Florida, Renee Schmid, DVM, DABT, DABVT, senior veterinary toxicologist and director of veterinary medicine at Pet Poison Helpline, spoke about the dangers of household lilies.³ Echoing Reineke’s warning, Schmid explained that all parts of the lily are considered to be toxic, causing kidney failure in cats.^1,3

References

1. New study sheds light on lily toxicity in cats; outpatient treatment may be viable option. News release. American Veterinary Medical Association. October 17, 2024. Accessed October 21, 2024. https://www.avma.org/news/press-releases/new-study-sheds-light-lily-toxicity-cats-outpatient-treatment-may-be-viable
2. Lam J, Hess RS, Reineke EL. Prevalence of acute kidney injury and outcome in cats treated as inpatients versus outpatients following lily exposure. J Am Vet Med Assoc. 2024. https://doi.org/10.2460/javma.24.05.0355.
3. Coppock K. The danger of household lilies. dvm360. March 17, 2024. Accessed October 21, 2024. https://www.dvm360.com/view/the-danger-of-household-lilies