Most of us know that we could be healthier if we changed some of our eating habits. The same applies to our pets, which are suffering record levels of obesity.
Obesity and diabetes are massive problems for human beings in America. Even the First Lady has jumped on the bandwagon to help reduce obesity and for good reason. People live longer and have reduced rates of several diseases when they improve their eating habits and lose weight. So do our animal friends.
Humans enjoy sweet tastes and scientists discovered that fruits contain an alcohol that tastes sweet. In an effort to help us satisfy our sweet tooth while reducing the amount of sugar we eat, these food engineers isolated the chemical and found it assists people in losing weight and reducing cavities. So far the chemical called xylitol seems safe for people, and many dentists and doctors are suggesting people buy it in granules and use it at home to reduce their consumption of sugar. It's a common sweetener used in candy, gum and baked goods like muffins and breads.
While xylitol is not known to be dangerous to people, veterinarians across the nation are seeing increased rates of serious poisoning in dogs that accidentally ingest even small amounts. Pet owners need to become aware of xylitol in products so they can carefully isolate these items from their dogs. Any dog that ingests xylitol, even in very small amounts, should be seen by a veterinarian immediately.
Once eaten, Xylitol dissolves quickly in the mouth. Dogs are frequently poisoned by ingesting sugar-free baked goods like muffins or candy (gum is a common problem), which they steal out of bowls or off counter tops. As little as 1 gram is toxic to dogs that weigh approximately 20 pounds. Because food labels often do not disclose how much xylitol is contained, it may be hard to determine how much of the toxin was eaten. One cup of granular sweetener contains 190 grams of xylitol. Two to three sticks of xylitol containing gum is sufficient to poison a 20lb dog.
Poisoned dogs may vomit immediately after ingestion as their natural defenses work to eliminate the toxin. Unlike humans, Xylitol can over stimulate the dog's pancreas to release too much insulin, and many dogs will show signs of depression, lethargy and decreased awareness as their blood sugars drop to dangerously low levels. Seizures can occur if their blood sugar drops too low. These more serious signs can occur within a half hour of ingestion in some dogs. Many dogs will not show these immediate problems and their family can incorrectly think that all is fine until 12-18 hours later when more serious and irreversible signs suddenly appear.
Immediate veterinary care is important and your doctor will likely either induce vomiting or pump the affected dog's stomach to remove as much toxin as quickly as possible. Administration of substances that absorb toxins and further prevent their absorption is also useful in early cases. The longer the time between ingestion and seeking veterinary care, the less likely that we can effectively remove the xylitol from the dog's system.
All dogs should have blood work done immediately to evaluate their blood sugar and basic blood chemistries. Many veterinarians also recommend a coagulation test to detect serious bleeding tendencies that result from damage to the liver.
Hospitalization and treatment with intravenous fluids is necessary to dilute toxins and flush them from the system. These intravenous fluids may contain added sugar if needed to correct conditions involving low blood sugar. During hospitalization the veterinarian will want to monitor blood tests and clotting times daily. If severe liver failure occurs then treatment with other agents may be needed but care needs to be used in drug selection so that drugs that damage the liver are avoided.
Traditional Chinese medicine and Western herbal medicine have long used several agents to assist in treating liver failure. It is not known at this time if these herbs are beneficial specifically for xylitol poisoning but they are commonly used by both conventional and integrative veterinarians. The most well researched herb is milk thistle. Milk thistle protects the liver against damage by other toxins and may help these dogs.
Another nutraceutical agent, S-Adenosylmethionine (SAM-e), also first used by holistic doctors, is commonly used to support other forms of liver damage. Vitamin E is liver protective, too. Sadly, at this time we do not know exactly how xylitol injures the dog's liver and until we figure this out we won't be able to recommend the best treatment plan. The above things make sense and should not cause harm at normally prescribed levels.
Ultimately the chances for recovery depend on how much xylitol was eaten, how long it was before the pet began treatment and how well their liver handles the toxin. In dogs that have only mild low blood sugar and slight elevations of their liver blood test values, we often see recoveries in a few days. In more severe cases the condition can progress to severe liver failure and difficulty clotting blood. Such cases may not survive the poisoning.
It is hard for many people to accept how lethal this chemical can be because it is safe for people. Sadly, many people delay therapy because they don't realize this important fact. Also, it would be wonderful if manufacturers would voluntarily put the amount of xylitol in their products on the label. In many cases it is very difficult to determine how much was eaten. Since this is the case it is prudent to treat all ingestions as if they are serious and potentially lethal. See your veterinarian immediately and request aggressive therapy from the beginning.
Knowledge is power and preventing xylitol ingestion is the best policy. Please help me and other veterinarians by spreading the word about it. Tell all your dog owning friends. It's crazy to think that someone's dog could die from a few muffins or pieces of sugarless gum, but it is true. As a veterinarian I am happiest when my patients are well. Let's keep it that way.