What is Easter lily?
Easter lily (Lilium longiflorum) is a flowering perennial bulb native to Taiwan and the Ryukyu Islands of Japan. Its white, highly-fragrant trumped-shaped flower is highly valued for its beauty. Easter lilies were first introduced to the United States in the 1800s and are now grown commercially around the world.
Easter lilies are not only prized for their beauty but also for their symbolic significance. It is said that the Easter lily has long been associated with Easter, which celebrates the resurrection of Jesus Christ. According to legend, when the tomb of Jesus was discovered to be empty on the third day after his crucifixion, it was said that Easter lilies had sprung up where his tears had fallen. However, there is no basis in historical fact or biblical scripture to back this up. Another more logical reason is that lilies have long been used as a symbol of purity and resurrection in various countries and religions throughout history.
Despite their beauty and symbolic significance, Easter lilies are extremely toxic to cats. In fact, lilies are the most toxic flowers cat owners can bring into the home. All species in the Lilium and Hemerocallis genus, which includes Easter lilies, Stargazer lilies, Oriental lilies, and Asiatic lilies, are nephrotoxic to cats. Even small amounts of the plant can cause severe kidney damage and potentially fatal kidney failure.
Easter lily toxicity in cats
Easter lily (Lilium longiflorum) is highly toxic to cats. The toxic principle is unknown, but exposure causes acute kidney injury in exposed cats. All parts of the plant, including the flowers, leaves, stems, and even the pollen, are toxic to cats. Just rubbing against an Easter lily and licking poison from the coat is enough poison a cat.
The toxin is absorbed in the bloodstream and filtered by the kidneys where it concentrates in the renal tubular cells, causing damage and impairing their normal function.
The clinical manifestations of feline exposure to the Easter lilies is twofold. Initially, the cat will exhibit indications of gastrointestinal distress, followed by the onset of acute kidney injury.
- Loss of appetite
- Increased urination
Easter lilies can cause kidney failure in cats within 24-72 hours of ingestion. The onset can vary depending on the amount of lily ingested and the cat’s individual sensitivity to the toxin. 
- Increased urination may occur initially followed by absent urination
- Abdominal pain
- Bad breath
- Increased or decreased thirst
If urination is absent, potassium levels, which would ordinarily be excreted by the kidneys can develop. Signs of hyperkalemia include:
- Cardiac arrhythmias
- Muscle weakness
Diagnosis of lily poisoning in cats is based on a history of exposure as well as physical examination and a diagnostic workup. If the cat has been exposed to Easter lily (or any other member of the lily family), no matter how small, immediate veterinary treatment is critical.
The veterinarian will have to run diagnostic tests to check kidney function, which will include the following:
- Urinalysis: A urinalysis can provide information about the ability of the kidneys to concentrate urine, the presence of protein or blood, and the pH of the urine.
- Blood tests: These tests measure the levels of creatinine and blood urea nitrogen (BUN), which are waste products that the kidneys should filter out. Elevated levels of these waste products can indicate kidney damage.
- SDMA test: The SDMA test is a rapid blood test that can detect as little as a 25% decline in kidney function. A rapid blood test can evaluate for early kidney damage. For biochemistry tests to pick up kidney failure, 70% of kidney function must be lost, by which time irreversible kidney damage has occurred.
- Imaging: Ultrasound may be recommended to evaluate the size and condition of the kidneys.
Unfortunately, there is no antidote for lily toxicity in cats and treatment is aimed at preventing further absorption, protecting the kidneys and managing clinical signs.
- Gastric decontamination: If ingestion was recent, the veterinarian will induce vomiting or perform gastric lavage (flush the stomach) to remove any remaining plant matter from the stomach, this is followed by administration of activated charcoal which will bind to any remaining toxins.
- Fluid therapy: Intravenous fluids can help flush out the toxins, support kidney function and prevent dehydration and correct electrolyte imbalances.
- Medications: Anti-nausea drugs and gastroprotectants may be necessary to manage gastrointestinal disturbances.
It is important to note that early intervention is critical if a cat has ingested any part of an Easter lily, no matter how small. The earlier the cat receives treatment, the better the outcome.
Alternatives to Easter lilies
Cats and lilies don’t mix, and it is not safe to have lilies in the house or garden if you have cats. Even if the cat doesn’t intentionally chew a lily, exposure can still occur if the cat accidentally rubs against the pollen. If you are looking for cat-safe flowers to decorate your home for Easter, here are a few options that are non-toxic to cats:
- Easter cactus
- African violets
Not all lilies cause acute kidney injury in cats, only Lilium and Hemerocallis genus. Other lily species such as peace lily (Spathiphyllum sp.), canna lily (Canna sp.), calla lily (Zantedeschia aethiopica) and lily of the valley (Convallaria majalis) are toxic to cats, but do not cause acute kidney injury.
The prognosis of Easter lily toxicosis depends on how quickly treatment is initiated and the severity of kidney damage. Cats cannot recover from lily poisoning on their own and must receive medical attention. With prompt and appropriate treatment, many cats can recover from lily toxicity, left untreated, lily ingestion can kill a cat within seven days.
 Osweiler, G. D., Hovda, L. R., & Brutlag, A. G. (2018). Blackwell’s Five-Minute Veterinary Consult Clinical Companion: Small Animal Toxicology. John Wiley & Sons.