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Xylitol Toxicity ~ A Warning to All Dog Owners
AVMA journals ~ JAVMA News ~ Xylitol poisoning                                 October 1, 2006

Cases of Xylitol Poisoning in Dogs Rise

The Animal Poison Control Center of the American Society for the Prevention of Cruelty to
Animals has managed a substantially increased number of cases involving xylitol poisoning in dogs.
Found in sugar-free chewing gum, candy, and baked goods, xylitol is a sweetener that can cause
serious and sometimes life-threatening problems for pets.

The center managed more than 170 cases of xylitol poisoning in 2005, up from approximately 70
in 2004, said Dana Farbman, a certified veterinary technician and spokesperson for the center.
As of August, the center had managed nearly 114 cases in 2006.

An increase in availability of xylitol-containing products may be one reason for the rise in cases,
Farbman said.

While it was previously thought that only large concentrations of xylitol could cause problems in
dogs, lesser amounts of the sweetener may also be harmful, the center reported.

"Our concern used to be mainly with products that contain xylitol as one of the first ingredients,"
said Dr. Eric Dunayer, who specializes in toxicology at the center. "However, we have begun to see
problems developing from ingestions of products with lesser amounts of this sweetener." Dr.
Dunayer said that with smaller concentrations of xylitol, the onset of clinical signs could be
delayed as much as 12 hours after ingestion.

According to Dr. Dunayer, dogs ingesting substantial amounts of items sweetened with xylitol
could develop a sudden drop in blood sugar, resulting in depression, loss of coordination, and
seizures. "These signs can develop quite rapidly, at times less than 30 minutes after ingestion of
the product. Therefore, it is crucial that pet owners seek veterinary treatment immediately," Dr.
Dunayer said. He also said that there appears to be a strong link between xylitol ingestions and
the development of liver failure in dogs.

From the
American Veterinary Medical Association
Xylitol is a sugar alcohol that is used in sugar-free products such as gum and candy, as well as for
baking and is used in the production of certain low-carbohydrate products now on the market.


As early as the 1960's, experiments indicated a link between the ingestion of xylitol and
hypoglycemia in dogs.  However, it has only been recently that the ASPCA Animal Poison Control
Center has begun to receive reports of xylitol toxicosis in dogs.  It is believed that this recent
rise is likely due to the increased use of products containing xylitol in the United States.


Effects of Xylitol Ingestion

In both humans and dogs, the levels of blood sugar are controlled by the body's release of insulin
from the pancreas.  In human xylitol ingestion does not cause any significant changes in insulin
levels or, therefore, blood glucose.  However, in dogs, xylitol causes a fast release of insulin,
which results in a rapid decrease in blood glucose (hypoglycemia).


Clinical Signs

Clinical signs of xylitol toxicity can develop in as few as 30 minutes after ingestion.  Clinical
signs may include one or more of the following:

Vomiting
Weakness
Ataxia (uncoordinated movements)
Depression
Hypokalemia (decreased potassium)
Seizures
Coma
Liver dysfunction and/or failure


Treatment

After ingesting a xylitol-containing product a dog may receive one of more of the following
treatments, depending on the amount of time that has lapsed since the ingestion occurred.  The
induction of vomiting is recommended if performed very soon after ingestion of the
xylitol-containing product but before clinical signs develop.  Frequent small meals or an oral
sugar supplement may be used to manage dogs that have not yet shown clinical signs.  Following the
appearance of clinical signs intravenous dextrose can be used to control hypoglycemia.  It may
also be necessary to treat the patient for low potassium levels (hypokalemia), if indicated.  
Treatment should be continued until the blood glucose levels return to normal levels.


For more information on this and other poison control questions the ASPCA Animal Poison Control
Center can be reached at 888-426-4435 or on the web at
www.apcc.aspca.org.


Knowles Animal Clinics