XYLITOL: HOW SWEET IT IS(N’T)
How many of you enjoy the benefits of sugarless gum and /or mints? Why not?  They taste great, offer fewer calories (great if you’re watching your weight or are a diabetic) and in some cases can even help prevent tooth decay and be beneficial with some disease processes in humans.  Sounds almost perfect, right?  For people yes, for your sweet tooth dog, it can be potentially lethal.

Xylitol is a relatively newer product in the United States, but has been used in Europe for decades. Xylitol is used in gums and candies, and also in prepared foods as a sugar substitute. It is derived from natural sources, and can be listed in the ingredients as simply “carbohydrate.”  In the Human body, Xylitol takes many hours to be metabolized and since it does not require insulin, sugar spikes are avoided. However, in the canine body it is very rapidly metabolized and the pancreas “confuses” the sweetener with real sugar, causing an insulin release. This results in the ”real” blood sugar plummeting and can mean weakness, disorientation, tremors and even seizures. These hypoglycemic symptoms can be seen in as little as 30 minutes from ingestion and can last for 12 hours or more.

But wait, there’s more: The other reaction that this “natural” product can cause is destruction of the liver tissue (called Hepatic necrosis). This can take much longer to develop (roughly 8-12 hours after first eating the offending sweet) and not all pets will be affected by this frightening development. But those that are could face complete liver failure and internal hemorrhage due to the loss of the   blood’s clotting abilities. In a few cases, a condition known as DIC (Disseminated Intravascular Coagulopathy) can occur. This is a pathological form of  coagulation; damaging areas instead of protecting them. The process uses clotting factors to such an extent that generalized bleeding is the result.  Once started, it is very difficult to reverse.

HOW MUCH IS TOXIC?
For the hypoglycemic episodes, as little as 0.045 grams per pound can result in the dangerous drop in blood sugar. This roughly translates into one and a half sticks of gum ( small sticks, like Trident, for instance) for a 10 pound dog. For the same 10 pound dog to have liver issues, it’s about ten times that amount (or 15 sticks of gum)

WHERE IS IT?
Xylitol is used in many sugar free gums, candies, toothpaste, and mints. It also can be in prepared sugar-free foods as well, and labels are not always clear: Assume any sugar free food may contain this unless otherwise stated!

WHAT DO I DO?
If you suspect that your dog has ingested Xylitol, immediate veterinary care is essential. Ideally, the patient should be seen within 30 minutes, and emesis should be induced to remove the contents from the stomach. Because of the risk for hypoglycemia (low blood sugar) an IV dextrose solution should be started and continued for 24 hours minimum. During hospitalization, liver function, glucose and blood clotting test should be run at regular intervals for up to 3 days to assess liver health and glycemic status. . Potassium levels should also be watched, as an elevated level is often associated with a poor outcome.  Depending on the severity of the toxicosis, antibiotics and stomach protectants may be used as well.

If your regular veterinarian is unavailable, utilize the Veterinary Emergency Clinic closest to you.  Another number to have handy is National Animal Poison Control Center.  ( ASPCA) 1-(888) 426-4435

They will assign a case number to you and help your veterinarian with treatment plans and have access to a huge amount of information on many common and uncommon toxins.  There is a fee for this service (approximately $60.00) but can be well worth it in the information they provide.

Since Xylitol has been introduced, the cases of canine poisoning have more than doubled.  While working at the University, I saw several cases of xylitol toxicity.  Average stay in the ICU was for 48 hours and the cost was substantial.( roughly $2,000.00) In this case, an ounce of prevention is definitely worth a pound of cure.

There is no antidote, only symptomatic treatment.

Xylitol’s effects on cats are currently unknown.

Note: dental products for dogs containing Xylitol are considered safe when mixed exactly according to package directions.  If you have various sized dogs, always use the dosing for the small dog.

Other un-commonly known toxins for dogs include: Grapes, raisins, macadamia nuts, garlic, onions.