Cuckoo Pint Poisoning in Cats

In spite of their toxic properties, cuckoo pint plants are cultivated for their ornamental properties. They have a wide variety of common names including; arum, lord-and-ladies, Adam-and-Eve, bobbins, devils-and-angels, starch root, wake robin, snakeshead, cows-and-bulls, arum lily, wild arum, friar's cowl, and Jack in the pulpit. Because they grow close to the ground, have attractively colored berries, and trap warm air and insects in their flower structures, they may be attractive to cats and other animals. In Europe, where they grow naturally in the woodlands, poisonings of pets and other animals are common.

Cuckoo pint, (botanical name, Arum maculatum), is a tuberous herb that grows close to the ground and is common in Europe. It has purple spotted leaves and male and female flowers that are partly enclosed in sheath-like structures. The plant also has a ring of hair-like structures that trap insects in the plant’s structure, where the male flowers cover the insects in the plant’s pollen. The insects are released, allowing them to spread the pollen to the female flowers of other cuckoo pint plants. The plant also produces brightly colored berries which contain calcium oxalates that are poisonous to cats and other animals. Other parts of the plant contain varying degrees of the same toxic substance and should also be avoided.

Symptoms manifest soon after ingestion or within two hours of consuming the plant and can continue to appear for up to two weeks. Symptoms include:

• Burning of the mouth
• Vomiting
• Diarrhea
• Gastrointestinal distress
• Drooling
• Pain; animal may paw at mouth
• Difficulty swallowing
• Difficulty breathing (due to swelling in the throat in severe cases)
• Head shaking
• Gagging

The cuckoo pint plant contains calcium oxalate, especially in the berries, but also in other parts of the plant. Calcium oxalate is a needle-shaped crystal, contained in the plant material. When the plant is masticated (chewed, broken down), the crystals are released and embed themselves in the oral cavity and gastrointestinal tract of the animal. Because the plant has an acrid taste, it is rare for large amounts of the plant to be eaten.

Some cuckoo pint plants also contain protease (proteolytic enzymes). These enzymes cause the release of histamines and kinins in the body, which cause inflammation and stimulate pain receptors. This enhances the symptoms of the calcium oxalate crystals.

Your veterinarian will perform a physical exam of your cat, taking note of symptoms in the oral and gastrointestinal tract. If your cat has been in an area where cuckoo pint plants might grow, inform your veterinarian. If you observe your cat eating a plant, followed by symptoms, take a sample of the plant with you to the veterinarian. Your veterinarian may also perform other tests, for example blood and urine tests, to rule out other conditions. In areas where cuckoo pint grows naturally, it is a commonly seen plant poisoning and diagnosis is more straightforward than in area where it is not commonly seen.

Your cat’s oral cavity will be rinsed out and medication (Kapectolin) to coat calcium oxalate crystals administered, to prevent them from further embedding in your cat's mouth, throat, stomach, and intestine. Some medications that form a paste in the stomach, which acts as a barrier towards further absorption of the calcium oxalate crystals, may be administered. 

If your cat is dehydrated from vomiting and diarrhea, intravenous fluid therapy will be administered. If breathing difficulties occur due to swelling of the throat, oxygen therapy will also be initiated. 

Because inflammation and irritation are the result of the crystals, an antihistamine may be administered to relieve this symptom. If your cat cannot take medication orally, it will be administered by intramuscular injection.

If you have a cuckoo pint plant in your home or garden that your cat has ingested, it should be removed immediately. Because symptoms of calcium oxalate poisoning can continue to manifest for up to two weeks you will need to carefully monitor your pet for symptoms and follow up with your veterinarian or provide treatment as prescribed. Most cats recover from calcium oxalate poisoning, as it is rare for large quantities to be ingested.