TOXICOLOGY

consultant on call

The 10 MOST TOXIC Plants

Eric Dunayer, MS,VMD, ASPCA Animal Poison Control Center, Urbana, Illinois

O
from the gastrointestinal tract. Other treat- Clinical Signs
ver their evolution, plants have
ments are aimed at controlling such signs • Initially, vomiting, anorexia, and lethargy
developed numerous toxic agents
as vomiting, diarrhea, and arrhythmias. starting within hours of ingestion; vomit-
to protect themselves from being
ing may subside by 12 hours.
eaten; many of these substances are
extremely poisonous. Even plants that are
LILIES • Renal values (blood urea nitrogen, creati-
Various members of the Lilium genus, nine, and phosphorus) and potassium
considered nontoxic—that is, ingestion
including Easter lilies (L. longiflorum), tiger levels begin to increase by 24 to 72
should not cause serious systemic signs—
lilies (L. lancifolium), stargazer lilies (L. hours.
may result in vomiting and other gastroin-
auratum), and various species of day lilies • Renal epithelial tubular casts and gluco-
testinal disorders. The plants discussed in
(Hemerocallis species); depending on the suria can be seen within 18 hours.
this article are considered to be among the
species, the flower’s stem is about 1 to 8 Treatment
most toxic for dogs and cats; serious illness
feet tall uncut. • Decontamination; fluid diuresis—twice
and death can result from consumption of
• Occur wild throughout North America. maintenance amounts for at least 48
relatively small amounts. These plants are
• Commonly sold as cut flowers or as part hours
commonly found in the home or yard.
of floral arrangements; day lilies are a Prognosis
common landscaping plant. • Guarded with delayed onset of treatment
Identification of a plant may be difficult.
• Toxicosis occurs only in cats. (24 hours or greater) and in presence of
Plants have common names that may differ
Principal Toxin oliguria/anuria.
between various regions of the country. In
• Unknown • Renal function can return but may take
some cases, plants of different species may
• All parts of the plant are toxic (even the weeks; chronic renal failure may be
share common names, making determina-
pollen). sequela.
tion of a genus or species important for
• Causes acute renal failure secondary to
proper identification. If necessary, nursery c o n t i n u e s
acute tubular necrosis.
personnel or a florist can be consulted to
help identify the plant.

GENERAL TREATMENT
CONSIDERATIONS
All cases of toxic plant ingestion are best
treated by early, aggressive decontamina-
tion. (See Procedures Pro, November 2004,
pages 65-70.) Attempts at emesis should be
made in asymptomatic patients, followed by
administration of activated charcoal.
Charcoal administration can be repeated
every 4 to 6 hours while plant matter
remains in the gastrointestinal tract. An
enema given about 6 to 12 hours after
ingestion may further clear plant matter Stargazer lily (L. auratum) Day lily (Hemerocallis)

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consultant on call CONTINUED

CASTOR BEAN Prognosis • Neurotoxic effects can be seen but these

• Good with prompt decontamination; may be secondary to hepatic failure.
guarded once signs develop • Clinical pathology includes thrombocy-
topenia, bilirubinemia, elevated hepatic
CYCAD PALMS enzymes, and azotemia.
Pathology
• Liver has a nutmeg appearance.
• Acute centrolobular hepatic necrosis
occurs.
• Fibrosis, bile stasis, and fatty changes
develop over time.
• Petechial hemorrhage and renal tubular
necrosis are also seen.
Castor bean plants (Ricinus communis)
Treatment
Ricinus communis • Symptomatic and supportive care for gas-
(castor bean plant); trointestinal and hepatic signs (antiemet-
also known as cas- ics, gastrointestinal protectants, such as
tor oil plant, mole sucralfate, adenosyl for liver signs)
bean, wonder tree Prognosis
• Occurs in the • Poor once hepatic necrosis has occurred
South, South-
west, and RHODODENDRON, AZALEA, LAUREL
California; may Castor beans
be wild or culti- Sago palm (Cycas revoluta) Courtesy Dr. Camilla Lieske
vated for castor oil; plants can stand 3 to
14 feet tall and have large leaves (12 Many species, but principally sago palm
inches or greater). (Cycas revoluta) and fern palm/false sago
• The beans are used as decorative beads. palm (C. circinalis); size varies with species
Principal Toxin and can range from 6 to 30 feet tall with
• Ricin, a glycoprotein long leaves (up to 9 feet).
• Blocks protein synthesis, leading to cellu- • Used as ornamental plants in Florida and
lar death. occasionally in California; can be house-
• Is present in all parts of the plant but plants in northern climates.
most concentrated in the beans. • Sago palms are available as bonsai trees.
• Highly toxic; a single bean can kill a dog. Principal Toxin
Rhododendron (Rhododendron)
• The outer coating of the bean must be • Cycasin, a glycoside, yields methyla-
ruptured (chewed) to release the ricin. zoxymethanol after bacteria metabolism Many species of plants from the Ericaceae
Clinical Signs • Cycasin is present in the whole plant, but (heath) family, including Rhododendron
• May take up to 24 hours to appear; ini- concentration is highest in the seeds; species (rhododendron, azalea, rosebay),
tial signs include vomiting and often ingestion of as few as 1 to 2 seeds can Kalmia species (laurel), Leucothoe species
bloody diarrhea, abdominal pain, weak- cause severe clinical signs and death. (black laurel, fetterbush), Lyonia ligustrina
ness, and ataxia. Clinical Signs (maleberry, staggerbush), Pieris japonica
• Hemoconcentration, leukocytosis, and • Initially, vomiting, possibly beginning (Japanese pieris), Ledum glandulosum
elevated liver enzymes can be seen on within a few minutes of ingestion of the (Labrador tea)
clinical laboratory testing. seeds; vomiting may last for hours. • Ornamental plant found throughout
Treatment • Hypersalivation and polydipsia can be North America; size of plant and leaves
• Decontamination; gastrointestinal protec- seen. varies greatly with species.
tants, such as sucralfate and histamine • Over the next few days, anorexia, diar-
blockers, intravenous fluids, and general rhea or constipation, hepatomegaly, and
supportive care icterus are seen.

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 Principal Toxin • Vomiting and neurologic signs are most FOXGLOVE
• Grayanotoxins (formerly know as common in dogs, although bradycardia Three species
andromedroxtoxin) can also be seen. occur in the
• Toxin blocks the sodium channel in cells; Treatment United States:
principally affects muscle and nerve cells. • Symptomatic care for neurologic and car- Digitalis purpurea
• Whole plant is toxic. diac signs with atropine and/or lidocaine (common or pur-
Clinical Signs Prognosis ple foxglove); D.
• Predominately vomiting, starting within a • Guarded if signs appear lanata (Grecian
few hours of ingestion; diarrhea is rare. foxglove); and D.
• Aspiration pneumonia is a possible AUTUMN CROCUSES lutea (straw fox-
sequela. glove).
• Cardiac arrhythmias are possible. • Occurs wild in
• Neurologic signs may include depression, the Pacific
ataxia, weakness, and seizures. Northwest but is Common foxglove
Treatment grown as an (Digitalis purpurea)
Courtesy Dr. Anthony Knight.
• Symptomatic and supportive care for ornamental Reprinted from A Guide to Plant
Poisoning of Animals in North
vomiting, arrhythmias, and seizures throughout America. Knight AP, Walter RG.
Jackson, WY: Teton New Media,
Prognosis North America; 2001, p 62, with permission.
• Good if seizures or aspiration has not stems can range
occurred from 1 to 6 feet tall with 1- to 2-inch
conical flowers.
Showy autumn crocus (Colchicum speciosum)
YEWS Principal Toxin
Colchicum autumnale (autumn crocus, • Cardenolides, principally digitalis, a car-
meadow saffron); Colchicum speciosum diac glycoside
(showy autumn crocus) • All parts of the plant are toxic, but high-
• Occur throughout the United States; est concentrations are found in the flow-
leaves, which grow from the base, can ers, fruit, and immature leaves.
reach about a foot long; flowers appear • Dried plant matter retains toxicity.
after the leaves have died in the autumn. Clinical Signs
Principal Toxin • Initially, gastrointestinal signs are present.
• Colchicine and similar alkaloids which • Cardiac arrhythmias of any type can
prevent cell division occur.
• All parts of the plant are toxic but high- Treatment
Yew (Taxus)
est concentration of the toxin is found in • Repeated doses of activated charcoal are
Numerous Taxus species the flower, the corm, and the seeds. especially efficacious.
• Occur throughout the United States; Clinical Signs • Supportive care for gastrointestinal signs
often used as hedges; can grow up to 75 • Signs may take 12 to 24 hours to develop • Symptomatic control of arrhythmias (e.g.,
feet high depending on species, but often and initially occur as hypersalivation, atropine for bradycardia, lidocaine for
are trimmed. depression, vomiting, milky or bloody ventricular tachycardia). Digibind (Savage
Principal Toxin diarrhea, and abdominal pain. Laboratories, Melville, NY), a Fab anti-
• Various taxane derivatives or taxines, • Progress to weakness, paresis, and col- body, can be used to bind and enhance
which are negative inotropes and lapse. elimination of digitalis. However, because
chronotropes • Multiple organ failure can occur. Digibind is expensive, use is generally
• All parts of the plant are toxic; deaths Treatment restricted to patients with nonresponsive
following chewing on branches have • Supportive care including IV fluids with arrhythmias and severe hyperkalemia.
been reported in dogs. dextrose and calcium; aspartate should Prognosis
Clinical Signs be given in the IV fluids early in the • Good, unless intractable arrhythmias or
• Death may be so rapid that there are no course of toxicosis. hyperkalemia develops
signs. Prognosis
• Guarded c o n t i n u e s

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at a glance
LILY OF THE VALLEY Nerium oleander, also known as laurel rosa,
• If no significant systemic signs are
laurel blanco, laurel colorado, rosa laurel expected, treat vomiting and
• Not native to North America; found in the diarrhea.
South and California • If ingestion is recent and
• Frequently planted as roadside hedge or significant systemic signs are
backyard ornamental; can grow from 7 to possible:
20 feet tall. - Decontaminate via emesis
Principal Toxin - Administer multiple doses of
• Cardiac glycosides activated charcoal.
• Toxicity often due to ingestion of - Give an enema 6 to 12 hours
dead/dry leaves; green leaves are bitter after ingestion.
and less likely to be eaten; when the leaf • If clinical signs develop:
dies, the sugar moiety is released from - Administer IV fluids
Lily of the Valley (Convallaria majalis) Courtesy Dr. the cardiac glycoside, which improves - Control vomiting
Camilla Lieske palatability. - Administer gastrointestinal
Convallaria majalis Clinical Signs protectants (if indicated)
• Grown as ornamental throughout United • Initially vomiting and diarrhea (the latter - Monitor for and control
States; plant has broad, erect leaves (4 to may contain blood) arrhythmias as needed
8 inches) with small, bell-shaped flowers. • Signs may progress to cardiac arrhythmias - Consider Digibind in cardiac
of any type (similar to digitalis toxicity). glycoside toxicity if nonrespon-
Principal Toxin
sive arrhythmias or hyperkalemia
• Cardenolides, potent cardiotoxins Treatment occurs
• Toxin is concentrated in the roots, but all • Symptomatic care for gastrointestinal
- Monitor renal and hepatic
parts of the plant are toxic. signs values; electrolytes
Clinical Signs • Arrhythmias should be treated sympto-
• Initial signs are gastrointestinal with matically (e.g. atropine for bradyarrhyth-
vomiting and hypersalivation; diarrhea is mias, propranolol/lidocaine for tachy- Principal Toxin
less common. arrhythmias); consider use of Digibind. • Brunfelsamidine, a neurotoxin that caus-
• Cardiac signs include bradycardia and Prognosis es seizures
other arrhythmias. • Good with aggressive therapy • All parts of the plant are toxic.
• Seizures may also occur. Clinical Signs
• Death may be sudden without any prior YESTERDAY, TODAY, AND TOMORROW • Coughing, gagging, and nystagmus can
signs. be seen within minutes to hours; tremors
Treatment and seizures, usually characterized by
• Same as for foxglove extensor rigidity (may resemble those of
Prognosis strychnine toxicity)
• Good, unless intractable arrhythmias or Treatment
hyperkalemia develops • Supportive care with IV fluids
• Control seizures with diazepam, barbitu-
OLEANDER rates.
Prognosis
Yesterday, today, and tomorrow (Brunfelsia grandi-
• Guarded; signs can last for days and
flora) Courtesy Dr. Anthony Knight complete recovery may take weeks. ■

Brunfelsia australis. Photograph shows B. See Aids & Resources, back page, for
grandiflora; flowers are identical to those of references, contacts, and appendices.
B. australis but appear in clusters whereas
in B. australis they are spread out over
plant.
• Ornamental found mainly in the South;
Oleander (Nerium oleander) Courtesy Dr. Linnaea Stull
grows as a shrub or small tree.

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