ASPCA®

20013509

Animal Poison Control Center   Opened: Mar 31, 2004 at 04:40 PM CST
  Closed: Apr 29, 2004 at 12:00 PM CDT

Case Follow-up

Please contact us at 888-299-2973 with the outcome of this case. Follow-up data that you contribute assists us in our ongoing efforts to continually improve our treatment recommendations.
 

Persons Involved

Animal Owner Ms. Jane Sample
123 Any Place
City, State 12345-1234
Country
1-999-555-1234
Owner
  
Veterinarian Dr. Sampleone
Emergency Animal Hospital
12345 Any Rd.
City, State 12345-1234
Country
1-999-555-1235
Emergency Veterinarian
  
Veterinarian Dr. Sampletwo
Local Animal Clinic
1234 Anywhere St.
City, State 12345-1234
Country
1-999-555-1236
vetclinic@email.com
Regular Veterinarian
  
 

Agent Involved

Lilium longiflorum

Scientific Name Liliaceae (family) Lilium (genus) longiflorum (species)

Animal Patient Involved

Siamese Cat Susie (Feline Domestic)

Signalment 5.0 yr neutered female weighing 12.0 lb.
Agent Exposure
Lilium longiflorum Observed exposure occurred on Mar 31, 2004 at 03:00 PM CST. Exposure involved 1.0 leaf orally. The exposure was accidental, and occurred at animal owner home.
The agent was obtained from Grocery Store.
[Note (by SMG on Mar 31, 2004 at 03:40 PM): Plant was given to caller at 1 pm today, then they went out until four. Owner observed cat vomiting up part of a leaf just moments after they had arrived home. It is unclear exactly when cat had access to plant between 1 pm and 4 pm today.]
[Note (by SMG on Mar 31, 2004 at 03:40 PM): Easter lilies are associated with an acute renal tubular necrosis and all parts of the plant are considered toxic.]
[Note (by SMG on Mar 31, 2004 at 04:01 PM): Vomiting, anorexia, and depression typically develop within 2-4 hours; BUN, creatinine, potassium, and phosphorus rise 24 - 72 hours post exposure (Volmer, 1999)]
Clinical Findings
Vomiting
{Digestive}		 Begin: Mar 31, 2004 at 03:30 PM CST Status: Mild
- [Note (by SMG on Mar 31, 2004 at 03:40 PM): The cat vomited up part of a green leaf.]
End: Apr 01, 2004 at 03:02 PM CST Status: Normal
 
Serum Creatinine Measured: Apr 01, 2004 at 12:00 AM CST Value: 3.8 mg/dL Status:Elevated
Measured: Apr 02, 2004 at 08:00 AM CST Value: 4.5 mg/dL Status:Elevated
Measured: Apr 08, 2004 at 12:00 PM CDT Value: 2.9 mg/dL Status:Elevated
Measured: Apr 10, 2004 at 12:00 PM CDT Value: 2.6 mg/dL Status:Elevated
Measured: Apr 27, 2004 at 12:00 PM CDT Value: 1.7 mg/dL Status:Normal
 
Anorexia
{General Disorders}		 Begin: Mar 31, 2004 at 07:00 PM CST Status: Moderate
End: Apr 08, 2004 at 12:00 PM CDT Status: Normal
 
Urea Nitrogen Measured: Apr 01, 2004 at 03:37 PM CST Value: 44.0 mg/dL Status:Elevated
Urea Nitrogen Measured: Apr 02, 2004 at 03:37 PM CST Value: 46.0 mg/dL Status:Elevated
Measured: Apr 08, 2004 at 12:00 PM CDT Value: 40.0 mg/dL Status:Elevated
Measured: Apr 10, 2004 at 12:00 PM CDT Value: 18.0 mg/dL Status:Normal
Measured: Apr 27, 2004 at 12:00 PM CDT Value: 16.0 mg/dL Status:Normal
Potential Cause
Lilium longiflorum This substance was considered to have high likelihood of causing the clinical situation because the time course was totally consistent with a reaction to this agent, the amount of the exposure was totally consistent, and the findings that developed were totally consistent with a reaction to this agent.
Patient Care
Planned/Recommended Care
Take Animal to Veterinarian Details:For aggressive supportive care.   Implemented
Activated Charcoal - Cat Details:Follow with repeated doses of activated charcoal +/- a cathartic.   Implemented
Fluid Diuresis Details:Diurese with LRS IV at twice maintenance (130 ml/kg/day) for at least 48 hours. Circumstances:Cat will be transferred to regular clinic tomorrow morning.   Implemented
Blood Urea Nitrogen Details:Obtain baseline BUN and creatinine. Recheck daily as syndrome progresses.   Implemented
Serum Creatinine Details:Obtain baseline BUN and creatinine. Recheck daily as syndrome progresses.   Implemented
Urinalysis Details:Obtain baseline. Recheck daily as syndrome progresses. Circumstances:Blood +1, appearance clear, per the owner.   Implemented
Urine Specific Gravity Details:Obtain baseline and Recheck daily as syndrome progresses. Circumstances:1.006.   Implemented
Monitor at Veterinary Clinic Details:Cat is at risk for anuria and may require aggressive care for several days.   Implemented
Chemistry Profile Details:Has a recheck planned for next Monday, April 15.   Implemented
Unplanned Care
Cyproheptadine - Cat Details:4-mg tablets.    
Outcome Full Recovery , EPA max illness designation: D-C
 

List of Contacts

Mar 31, 2004 at 03:40 PM CST Gwaltney, Sharon M (toxicologist) interacted with Dr. Sampleone (emergency veterinarian) for reason: obtain help.
[Note (by SMG on Mar 31, 2004 at 03:45 PM): Emergency DVM called to obtain assistance with Susie's exposure to an Easter lily.]
Apr 02, 2004 at 02:40 PM CST Gwaltney, Sharon M (toxicologist) interacted with Ms. Jane Sample (owner) , Dr. Sampletwo (regular veterinarian) for reason: monitor case-out.
[Note (by SMG on Apr 02, 2004 at 03:00 PM): Owner called back 48 hours later to report that cat had been transferred to daytime clinic after going to e-clinic on Sunday night. Owner did not have extensive lab information but did know her creatinine levels, which have been steadily increasing. Ms. Sample requested that we call her clinic.]
[Note (by SMG on Apr 02, 2004 at 03:00 PM): Called clinic to discuss case. I spoke with Dr. Sampletwo and reviewed our treatment recommendations.]
Apr 10, 2004 at 06:41 PM CDT White, Lynne A (assistant) interacted with Dr. Sampletwo (regular veterinarian) for reason: update case-in.
[Note (by LAW on Apr 10, 2004 at 07:04 PM): The cat has been at a specialty 24-hour clinic from 4/3 till 4/8. The cat came home on 4/8. The cat is eating now. Another chem profile will be done on 4/15. DVM or owner will call back with more results as they become available.]
April 29, 2004 at 03:19 PM CDT Dolder, Linda K (veterinarian) interacted with Ms. Jane Sample (owner) for reason: update case-in.
[Note (by LKD on April 29, 2004 at 03:32 PM): Owner called in. The cat was released on April 28th with normal BUN and creatinine values. Owner is very thankful for everything that was done.]

Case Status

Closed

This report was generated Aug 19, 2004 at 10:17 AM CDT

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