Consuming less than one leaf can produce severe toxicosis in cats. Vomiting, anorexia, and depression generally occur within two hours of ingestion. The vomiting may subside by 12 hours, but the anorexia and depression continue as blood urea nitrogen, creatinine, potassium, and phosphorus concentrations rise 24 to 72 hours after exposure. Epithelial casts and glucose can be detected in the urine within 18 hours. Renal failure has been reproduced only in cats.
Renal failure appears to be due to necrosis of renal tubular epithelial cells.
The basement membrane remains intact, and tubular epithelial cells can regenerate with prompt, agressive treatment. Postponing treatment for longer than 18 hours after exposure can result in renal failure and death. Anuric cats have a poorer prognosis, but renal function has been restored in some cases after peritoneal dialysis. Personal communication, Utah Veterinary Diagnostic Laboratory, Utah State University, Logan, March 1999. Reprinted with permission from the April 1999 issue of Veterinary Medicine .