Sugar free products have become much more prevalent over the past few years and many of these products contain an artificial sweetener called xylitol. Xylitol poisoning is VERY dangerous for dogs.
By Rob West, DVM,
Emergency + Critical Care
While it’s completely safe for humans, the ingestion of xylitol results in a rapid and severe insulin release in dogs. The insulin release causes a precipitous drop in blood sugar (hypoglycemia) and this can be life threatening. The other syndrome we can observe is acute hepatic necrosis (aka: severe liver failure) with the potential for secondary bleeding disorders. The number of dogs we are seeing on emergency for xylitol toxicity has been on the rise.
Symptoms of xylitol poisoning in dogs include the following:
- Mental depression, weakness or lethargy
- Acute collapse
- Ataxia (walking like your pet is drunk)
- Tremors or seizures
- Rapid heart rate
- Jaundice (yellow tinge to gums and skin)
- Black-tarry stool
- Blood Clotting disorders
Xylitol is found in many household products including the following items:
- Sugarless gum
- Sugarless mints and candies
- Baked goods
- Toothpaste and mouthwash
- Sugar-free vitamins
- Diabetic foods and snacks
- Some over the counter and prescription medications
If your feel your dog may have ingested a xylitol containing product, do not panic!! Be sure to carefully read the label. Bring any packaging to your veterinarian. Many sugar-free items contain other sweeteners such as sorbitol, maltitol, stevia, saccharin, sucralose, aspartame, or others. These are not poisonous to dogs and a trip to the veterinary ER is not needed. In the event of a xylitol poisoning, it becomes imperative that we calculate the dose your pet ingested, if at all possible. The concentration of xylitol in many products, such as gum, can range significantly depending on the brand. Unfortunately, the exact amount can be difficult to determine because manufacturers are not required to furnish this information. Dogs that ingest greater than 0.1g/kg of xylitol are at risk of developing low blood sugar, and dogs ingesting greater than 0.5g/kg are at risk for acute hepatic necrosis (liver failure).
Treatment for xylitol poisoning may include the following.
Decontamination. Depending on when your pet’s toxic ingestion occurred, inducing vomiting may be recommended. Activated charcoal is ineffective in binding Xylitol so it is not indicated as a treatment for xylitol ingestion.
After decontamination, the treatment is based on your pet’s symptoms.
Hypoglycemia is managed with serial blood glucose monitoring, dextrose supplementation and IV fluid support.
If your pet has ingested a liver-toxic dose, signs will generally start to show after about 24-48 hours. Treatment includes:
- IV fluids
- Gastrointestinal protectants such as proton pump inhibitor or H2 blockers
- Anti-oxidants and liver protectants such as SAM-e, mild thistle, or Ursodiol. It is not known if these medications will improve the outcome of xylitol toxicity
- Anti-nausea medications
- Serial monitoring of blood albumin levels and colloid oncotic pressure (COP)
- Monitoring and treatment for any blood clotting abnormalities that can result from liver failure (the liver is responsible for the production of proteins essential in normal blood clotting). Transfusion of fresh frozen plasma may be needed.
- Treatment of Hepatic encephalopathy (HE). HE is a complication of liver failure.
Who to contact in a Xylitol Poisoning Emergency
If you are concerned your pet may have ingested a xylitol-containing food or product, contact your veterinarian or the ASPCA Animal Poison Control Center at (888) 426-4435. There is a $65 charge for calls to the ASPCA Animal Poison Control Center.
Lastly, with any pet poisoning situation, the earlier you recognize and seek veterinary care the better the outcome will be for your furry friend.
With the holidays lasting all throughout the year, an abundance of candy may always present a danger – please try to keep any xylitol containing food (and any other potential toxin) or items inaccessible to your pets!!! Should you need help, remember that Nor Cal Vet provides around-the-clock emergency services as well as specialty services such as Internal Medicine and Surgery to manage and treat your pet’s condition to get them back on their feet!