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

Alice J. Bennett BVSc1 and Erica L. Reineke VMD, DACVECC2
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  • 1 Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 2 Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

Abstract

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.

Abstract

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.

Contributor Notes

Dr. Bennett's present address is Division of Anaesthesiology and Perioperative Intensive Care, Veterinärmedizinische Universität Wien, 1210 Vienna, Austria.

Address correspondence to Dr. Bennett (alice.bennett@vetmeduni.ac.at).