Jul 25 2017

XYLITOL – Sugar Substitute

XYLITOL – Sugar Substitute
There are many sugar substitutes being used in foods, medications,
and supplements. There is one, however, that can be deadly for dogs –
XYLITOL. Xylitol is a natural sugar-alcohol found in very small amounts
in many vegetables and fruits. The most common place it is being used
commercially is in chewing gum, breath mints, and dental products
because it also has plaque fighting properties. “Purse digging” is a
common way dogs gain access to gum and mints. Its use has spread
tremendously and it is now being used in some chewable
multivitamins, antacids, prescription drugs, and sugar free foods. These
foods can include some peanut and nut butters, sugar free Jello, certain
brands of ice creams, sugar free candies, and some drink powders. It is
also for sale in bulk for people to bake with at home instead of using
table sugar. Oddly enough, it also has the property of retaining
moisture and for that reason is even used in some skin care products.
Unfortunately, this means that dogs may be poisoned by the
medication or other product they ingest as well as the xylitol
sweetener, making it a two-fold risk.
Xylitol causes damage two ways in dogs. Early in the intoxication
process it causes a dangerous drop in blood sugar by stimulating insulin
secretion. This may be seen as weakness, wobbly gait, depression,
seizures or coma. This effect can begin as early as 10-60 minutes after
ingestion. The liver is the primary organ that metabolizes this chemical
and becomes its target. Liver cell death begins as early as 9-12 hours
after ingestion or can be delayed up to 72 hours after ingestion. The
liver is responsible for creating many of the clotting factors needed to
stop bleeding, so as the liver dies we can see widespread bleeding
throughout the dog’s body both visible and at a microscopic level.
Other signs of liver failure include jaundice, vomiting, diarrhea, and
neurologic symptoms.
There is no antidote for xylitol poisoning. Therapy is supportive only,
but it needs to be started very quickly. If ingestion has been within the
last 1-6 hours, inducing vomiting is recommended. Intravenous fluids
with dextrose are started to battle the dropping blood sugar. This can
be necessary for up to 2 days. Bloodwork to monitor liver health needs
to continue for 3 days. The dog may need fresh frozen plasma to
counteract the tendency to bleed until the liver recovers and starts
making clotting factors again. There are also several nonspecific
supplements that can be given to aid liver healing.
It can be hard to determine how much xylitol your dog has ingested.
It is often considered a “proprietary ingredient” so the company may
not list the quantity that is in its product. If it is in a food product,
ingredients are listed by weight in descending order. If it is listed as
one of the first 3 ingredients you should be worried and call your vet. If
it is in a drug or dietary supplement, these ingredients tend to be listed
in alphabetical order so xylitol is near the end of the list but his does
not mean that there is an inconsequential amount in the product. A
dose of 0.1 grams/kg of body weight is enough to cause life threatening
low blood sugar. A dose of 0.5 grams/ kg of body weight is enough to
cause life threatening liver damage. Most chewing gums and breath
mints contain about 0.22-1.0 grams of xylitol per piece. This is enough
to cause dangerous low blood sugar in a 10 pound dog to give you a
sense of proportionate dosing. If you have any doubts about the
concentration of xylitol in a particular product, you can call the Pet
Poison Helpline at 1-800-213-6680. They have an extensive list of
products that contain xylitol and the quantities in each product so you
can determine if you need to seek immediate veterinary care for your

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