Hippeastrum puniceum
Amaryllidaceae
Barbados Lily; Amaryllis; Common Amaryllis; Fire Lily; Lily of the Palace; Ridderstjerne; Hippeastrum; Hippeastrum puniceum; Hippeastrum spp.
Amaryllidaceae alkaloids, including lycorine, galanthamine, haemanthamine, tazzetine, hippeastrine, crinidine, and other related alkaloids. The bulb is generally considered the most poisonous part of the plant.
Moderate to severe gastrointestinal upset, vomiting, diarrhea, abdominal pain, drooling, hypersalivation, loss of appetite, anorexia, lethargy, depression, and a general appearance of unwellness. In cases of large ingestion, especially involving the bulb, signs may include low blood pressure, tremors, convulsions, seizures, weakness, paralysis, respiratory depression, cardiac arrhythmias, collapse, and possibly death.
Hippeastrum puniceum, also known as Barbados Lily, Fire Lily, Lily of the Palace, Ridderstjerne, Common Amaryllis, and often simply Amaryllis, is a perennial bulbous plant native to tropical regions of South America, although it has become naturalized elsewhere. It produces 3 to 6 bright green, glossy, strap-shaped leaves that are typically 12 to 24 inches long and approximately 1 to 1 1/4 inches wide, tapering to a point. The flowers are trumpet-shaped and borne in an umbel on a stem. The petals, or more accurately tepals, are orange-red with paler bases.
This plant should not be confused with true Easter Lily, which belongs to the genus Lilium and presents a different and much more severe kidney-toxicity risk for cats. Barbados Lily is an Amaryllidaceae plant and is more accurately grouped with Amaryllis-type bulb plants. Due to the exceptionally beautiful flowers this plant produces, it is a commonplace garden ornamental and potted houseplant in many parts of the world.
The bulb has documented medicinal properties and has been used in traditional contexts against asthma, bronchitis, constipation, and respiratory diseases. It contains several phytochemicals, including galanthamine and lycorine. These compounds are part of the same reason the plant has toxic significance in animals: pharmacologically active alkaloids may have medicinal effects in controlled or studied contexts, but can produce poisoning when plant material is chewed or swallowed by pets.
The plant is toxic to pets because it contains Amaryllidaceae alkaloids, including phenanthridine derivatives such as lycorine, crinidine, and other lesser-known alkaloids. Related alkaloids associated with Amaryllidaceae plants include galanthamine, haemanthamine, tazzetine, hippeastrine, clivacetine, clivonine, cliviasine, and clividine. These alkaloids are often emetic, meaning that they can cause vomiting, although the exact mechanism involved in every species and exposure is not fully understood.
A toxic crystalline alkaloid, lycorine is found in many other members of the Amaryllidaceae family, including surprise lilies (Lycoris) and daffodils (Narcissus). In sufficiently high doses, lycorine can be highly poisonous and may even be lethal when ingested. Lycorine intoxication has both central nervous system and gastrointestinal effects. The typical clinical signs of ingestion include moderate to severe gastrointestinal upset, vomiting, diarrhea, abdominal pain, drooling, inappetence, lethargy, depression, and the general appearance of unwellness.
In cases of large ingestion, particularly when the bulb is involved, more serious signs may occur. These may include low blood pressure, tremors, convulsions, paralysis, respiratory depression, cardiac arrhythmias, collapse, and possibly death. ASPCA identifies Amaryllis-type plants as toxic to dogs, cats, and horses, with lycorine and related compounds as the toxic principles and clinical signs including vomiting, depression, diarrhea, abdominal pain, hypersalivation, anorexia, and tremors. Pet Poison Helpline likewise notes that Amaryllis contains alkaloids concentrated in the bulb and may cause vomiting, a drop in blood pressure, respiratory depression, drooling, and abdominal discomfort.
Lycorine is believed to inhibit protein synthesis and may also decrease ascorbic acid biosynthesis, although the latter is subject to some controversy and is generally considered inconclusive. Regardless of the precise biochemical mechanism, the practical toxicologic concern is clear: the plant can produce strong gastrointestinal signs, and larger exposures may produce neurologic, cardiovascular, or respiratory effects.
As the toxins of Hippeastrum puniceum have an emetic effect, the amount typically ingested is often small, so serious cases of acute intoxication are relatively rare. In the majority of cases, symptoms will be limited to nausea, vomiting, drooling, abdominal discomfort, and diarrhea. Many pets that ingest Hippeastrum puniceum will become ill and begin vomiting before consuming a quantity large enough to cause life-threatening toxicosis.
As with any toxic or potentially toxic plant, exercise common sense and good environmental awareness by preventing pets from gaining access to areas that contain the plant. Particular caution should be used with stored bulbs, newly planted bulbs, bulbs dug up from gardens, or potted Amaryllis-type plants kept indoors, because the bulb is generally considered the most poisonous portion of the plant.
Immediate Response to Barbados Lily Ingestion
- Remove the Source: Prevent further ingestion by removing the plant, bulb, leaves, flowers, stems, soil-contaminated bulb fragments, or any remaining plant material from the pet’s reach.
- Identify the Part Ingested: Determine whether the pet chewed leaves, flowers, stems, or the bulb. Bulb ingestion is more concerning because alkaloids are often more concentrated in the bulb.
- Remove Plant Material from the Mouth: If ingestion was recent and it is safe to do so, remove visible plant matter from the mouth and flush the mouth thoroughly with water.
- Do Not Wait for Severe Signs: Vomiting, drooling, diarrhea, abdominal pain, lethargy, tremors, weakness, low blood pressure, respiratory depression, abnormal rhythm, collapse, or seizures should be treated as concerning signs.
- Contact Veterinary Help Promptly: Contact a veterinarian, emergency veterinary clinic, ASPCA Animal Poison Control, or Pet Poison Helpline promptly, especially if the bulb was chewed or swallowed, if the amount is unknown, if symptoms are present, or if the pet is a cat, puppy, kitten, small animal, elderly animal, pregnant animal, or medically fragile.
Inducing Vomiting and Decontamination
- Spontaneous Vomiting is Likely: Because lycorine and related Amaryllidaceae alkaloids have emetic effects, many animals will vomit naturally after ingestion.
- Do Not Induce Vomiting Casually: Unless the ingestion is recognized very early and the amount involved is large or especially concerning, home-induced vomiting is often not recommended because the toxin itself commonly causes vomiting and repeated vomiting can worsen dehydration or aspiration risk.
- Inducing Vomiting in Dogs Only: If ingestion was very recent, the dog is alert, breathing normally, able to swallow, and not showing weakness, collapse, tremors, seizures, severe depression, repeated vomiting, respiratory distress, or neurologic signs, a veterinarian or animal poison-control professional may recommend inducing vomiting with fresh 3% hydrogen peroxide.
- Cat Warning: Hydrogen peroxide should not be used to induce vomiting in cats unless a veterinarian specifically directs it. Cats are more prone to irritation and complications from hydrogen peroxide, and home vomiting attempts may create more risk than benefit.
- Veterinary Decontamination: When significant amounts are involved, especially bulb ingestion, and there is danger of prolonged vomiting or nongastrointestinal effects, gastric lavage may be indicated. Activated medical charcoal may be useful in adsorbing these alkaloids, but its use may be limited if the animal is already vomiting or if symptoms have been delayed.
Symptoms Requiring Emergency Care
- Digestive Signs: Repeated vomiting, diarrhea, abdominal pain, drooling, hypersalivation, loss of appetite, or refusal to eat or drink.
- Neurologic Signs: Tremors, weakness, convulsions, seizures, paralysis, severe depression, collapse, or abnormal mentation.
- Cardiovascular or Respiratory Signs: Low blood pressure, pale gums, abnormal heart rhythm, respiratory depression, difficulty breathing, collapse, or signs of shock.
- Bulb Ingestion: Any known or suspected ingestion of the bulb should be treated as higher risk than chewing small amounts of leaves or flowers.
Veterinary Treatment
- Supportive Care: Treatment is symptomatic and supportive because there is no specific antidote for lycorine or related Amaryllidaceae alkaloids.
- Fluid and Electrolyte Monitoring: If vomiting and diarrhea are extensive, patients should be monitored for dehydration, electrolyte loss, and the need for fluid therapy.
- Cardiovascular Monitoring: In large ingestions, hypotension and cardiac arrhythmias may occur, so blood pressure and heart rhythm monitoring may be needed.
- Neurologic Monitoring: Animals showing tremors, convulsions, seizures, weakness, paralysis, or collapse require urgent veterinary observation and treatment.
- Liver Monitoring: In cases where animals have ingested a large amount, hepatic damage has been reported, and liver function may need to be monitored.
- Bring a Sample: If possible, bring a sample or photo of the plant, flowers, bulb, packaging, or plant tag to help confirm identification.
Prognosis and Recovery
- Most Cases: Most exposures are expected to be limited to gastrointestinal upset because the plant’s emetic effects often cause the animal to vomit before consuming a life-threatening amount.
- Higher-Risk Cases: Prognosis is more guarded when the bulb is eaten, when the amount is large, or when neurologic, cardiovascular, respiratory, or hepatic signs develop.
- Prevention: Keep potted Amaryllis-type plants, stored bulbs, garden bulbs, and discarded plant material away from pets, especially dogs that dig, chew, or investigate bulbs.