Behavior Supplements in Dogs and Cats. Unlike erythritol, xylitol does not get absorbed in the small intestine. In the case of gum and candies, content can also vary in different flavors of the same brand. Xylitol Toxicity Calculations • Common standard xylitol amount calculations –Use CAUTIOUSLY –0.3g/piece if xylitol is not the first sugar alcohol –1g/piece if xylitol is the first sugar alcohol • Why doesn’t a standard calculation for gum work? Xylitol is a sweetener that is highly toxic to dogs. Xylitol Poisoning in Dogs. Severe increases in liver enzymes and/or signs of liver insufficiency indicate a more guarded prognosis; in one study, 62.5% of dogs with signs of liver injury died or were euthanized despite aggressive veterinary intervention. Bite … Signs of xylitol toxicity can occur within 10 to 15 minutes of a pet eating xylitol but may be delayed for several hours. Xylitol Toxicosis in dogs (cats appear to be unaffected) occurs mainly by ingestion of sugar-free gums and candies, but other exposures have occured. Hypoglycemia may persist as long as 24 hr or more, so treatment should be continued until the dog can maintain a normal blood glucose level without supplemental dextrose. The trusted provider of veterinary information since 1955, Insecticides, Acaricides, and Molluscicides. 3–5 The degree of xylitol toxicosis is dose dependent. Dogs known or suspected to have ingested a Xylitol containing product must have emergency medical treatment immediately. According to Wismer, the toxic dose of xylitol for dogs is 75-100 mg/kg. My name is Amber. Xylitol is popular as an alternative sweetener to sucrose (table sugar) because it has the same level of sweetness and 40% fewer calories. Please confirm that you are a health care professional. In most mammals, xylitol has no significant effect on insulin levels, but in dogs, xylitol stimulates a rapid, dose-dependent insulin release that can result in profound hypoglycemia. It serves as a resource for Fellow and Members of the American College of Veterinary Pharmacists to share with their clients and community. If hypoglycemia develops, it should be managed with dextrose IV boluses and/or constant-rate infusions. An additive in dental care products, baked goods, nicotine gum, vitamins and more, xylitol is extremely toxic to dogs with symptoms ranging from lethargy to hypoglycemia. As little as 0.1g of xylitol per kg bodyweight is enough to cause toxicity in dogs 1. Other causes of hypoglycemia include hypoglycemic drugs, juvenile hypoglycemia, hunting dog hypoglycemia, insulinoma, and parenteral insulin overdose. If >75–100 mg/kg (227 mg/lb) of xylitol has been ingested, animals should be hospitalized and baseline blood glucose values measured; dogs ingesting >500 mg/kg (227 mg/lb) of xylitol should have baseline liver values measured. When diluted properly they are non-toxic, but ingestion of the concentrated solution may be. Matilda ate a few pieces of gum and received immediate treatment. Signs of SLUD are most consistent with exposure to which of the following classes of chemicals? I am a dedicated animal lover that turned my passion into my career. This automatic xylitol (naturally sugar free alternative extract from birch trees) weight versus volume units conversion calculator lets you instantly convert measurements of birch xylitol amounts from cups (US and Metric), serving, portion of birch xylitol, grams g, ounces oz, pounds lb, tablespoons tbsp, teaspoons tsp and from/to dekagrams dkg or dag amounts into scale needed. The only way to prevent xylitol toxicity is by public education about these products and the associated risks with their ingestion in dogs and preventing exposure. Xylitol is highly toxic to dogs, leading to hypoglycemia and liver failure. Xylitol is a common sugar substitute that can be toxic to dogs in even small amounts and it can be fatal. Hospitalization for IV fluid therapy and close monitoring for life threatening complications are typically recommended for 24-72 hours following exposure. Signs of hypoglycemia can develop within 30 min of ingestion or may be delayed up to 12–18 hr if the xylitol is in a substrate that slows its absorption (eg, some gum products). The primary toxic principles in chocolate are the methylxanthines theobromine (3,7-dimethylxanthine) and caffeine (1,3,7-trimethylxanthine). When in doubt, if you think that your dog got into Xylitol, contact your veterinarian or an Animal Poison Control Center right away. Majority of dogs are sent home on liver protectants for weeks, while rechecking liver enzymes frequently, to be on the safe side. Be sure to review the information we listed above, so you can keep your dog safe from xylitol exposure in the future! Prognosis for dogs developing only hypoglycemia is excellent, provided appropriate medical therapy is administered to address the hypoglycemia. The prognosis for uncomplicated hypoglycemia is good, if prompt treatment is obtained. Line of Treatment: Since xylitol absorption has happened, the doctor will perform supportive care like: Giving IV Fluids; Giving Liver Protecting Agents; Administer Dextrose; Constant monitoring of blood sugar and liver function. Dosages of xylitol over ~75–100 mg/kg (34–45 mg/lb) have been associated with hypoglycemia in dogs. A crude calculation based on the label may be of help but this is unreliable at best. Vomiting and seizures can also occur, as well as weakness and collapse. Elevations in liver enzyme values, low blood glucose, potassium and phosphorus may be detected on a Chemistry Panel. Do you really want to try and calculate your dog’s weight vs how much xylitol you believe he or she may have eaten? Why is Xylitol Toxic to Dogs. Not all dogs that develop xylitol-induced liver injury develop hypoglycemia. Xylitol usually has minimal effects on blood sugar, but does have a slightly larger effect than erythritol sweetener would. As such, it is important to be cautious and aware of any possible ingestion. Xylitol is rapidly absorbed following ingestion. Even small doses of xylitol induce an exaggerated insulin release that is 3-7 times that caused by equal amounts of dextrose. All Rights Reserved. The Value of an Established Relationship with a Primary Care Veterinarian and Regular Routine Care…….from the Urgent Care Perspective, Keep Your Pet Safe and Stress Free During the Halloween Season, After-Hours Urgent Pet Care – An alternative to 24-Hour Emergency Animal Hospitals, COVID-19… Precautions When Visiting PriorityVet. Xylitol toxicity in dogs is dangerous, making it essential to understand the details around this sweet substance. 2–4 There is also evidence, both clinical and experimental, that xylitol can cause hepatic damage. The two major consequences of xylitol ingestion, says Dr Mudie, are severe hypoglycaemia (low blood sugar), and liver necrosis (death of liver tissue). However, when your dog consumes it, it has detrimental results. Side Effects and Dosage. For instance, one brand of sugar-free gum has 9 mg of xylitol per piece for all flavors except one, which has 700 mg per piece. The results suggest that oxalate production from xylitol is negligible; any toxicity related to xylitol administration is not a consequence of oxalate production. It’s easy enough to determine the weight of an affected dog, but knowing how much xylitol the dog ate is another matter. Manufacturers are not required to place the amount of each ingredient on a product label. Treatment of Chocolate Toxicity. The legacy of this great resource continues as the Merck Veterinary Manual in the US and Canada and the MSD Manual outside of North America. Ingestion of xylitol or xylitol-containing products by dogs has resulted in development of hypoglycemia and, less commonly, hepatic injury and/or failure. Aggression Between Familiar Dogs. The dose of xylitol that can cause hypoglycemia in the dog has been reported between 50 milligrams (mg) of xylitol per pound of body weight (100 mg per kg). Toms River, NJ 08755, Copyright © 2019 Priority Vet. Unfortunately, while safe for us, xylitol is incredibly toxic to dogs. PMID:870650. There have even been anecdotal reports of sensitivity in cats and ferrets, although there is no published data on these species. verify here. Best Answer The toxic dose of xylitol is 0.1g per 1 kg – and a stick of chewing gum can contain 0.3-0.4g of xylitol ”. What to do if your dog eats some. Winter Holiday Hazards for Pets. Applying a Muzzle to an Aggressive Dog. Treatment of coagulopathy or other manifestations of liver insufficiency should be performed as needed. Hyperphosphatemia is considered a poor prognostic indicator, because it was present in 4 of 5 dogs that died of liver failure after xylitol ingestion (phosphorus was not measured in the fifth dog). Because of the potential for rapid onset of clinical signs of hypoglycemia, emesis should ideally be attempted only under veterinary supervision and in asymptomatic animals. Xylitol Side Effects. Further, many are unwilling to provide this proprietary information except to animal poison control centers. Mild increases in liver enzyme usually resolve within a few days. PriorityVet is an after-hours veterinary facility that provides urgent care services for your pet during a time when your regular veterinarian may be unavailable.PriorityVet serves the Shore Area with a centrally-located, after-hours hospital that has proven to be a convenient and time-saving alternative for urgent after-hours pet care. It causes excessive insulin secretion, which leads to severe reductions in blood sugar and almost immediate liver failure. Determining the amount of xylitol in a manufactured product (e.g. Amber LaRock. Liver injury (including acute liver failure) sometimes occurs in dogs with ingestion of large amounts of xylitol; the mechanism for this injury is poorly understood. Anemia and low platelets may be detected on a CBC. This results in hypoglycemia (life threatening low blood sugar). Dextrose should be administered to dogs ingesting xylitol at >500 mg/kg (227 mg/lb), even though normoglycemic, and hepatoprotectants such as N-acetylcysteine, S-adenosylmethionine, and silymarin should be considered. Brutlag, Ahna. Even small doses of xylitol induce an exaggerated insulin release that is 3-7 times that caused by equal amounts of dextrose. All Rights Reserved. When humans eat something containing Xylitol, it does not affect their insulin. Signs of liver injury may not occur until ≥24-48 hr after ingestion of xylitol, although increases in liver enzymes are often detectable within 8–12 hr of ingestion. Liver damage can occur within a few hours or may be delayed for up to 3 days. The higher the dose ingested, the more the risk of liver failure. It’s regularly found in sugar-free chewing gum, toothpaste, mouthwash, vitamin supplements, a small handful of peanut butter brands, and other 'low sugar' or sugar-free products. No test is available to detect xylitol, so diagnosis is based on a history of exposure, consistent clinical signs, and bloodwork results. Copyright © 2019 Priority Vet. Xylitol is extremely dangerous for dogs. Common sweetener Xylitol blamed for … Blood glucose should be monitored every 1–2 hr for at least 12 hr, while liver values should be evaluated every 24 hr for at least 72 hr. Xylitol is a potentially fatal threat to dogs and the risk of exposure seems to increase daily. Activated charcoal does not appreciably bind xylitol and is not recommended. Differential diagnoses for liver insufficiency include infectious (eg, leptospirosis, viral hepatitis), environmental (eg, heat stroke, trauma), and toxic (eg, iron, acetaminophen, mushroom, blue-green algae, cycad palms) causes. The Merck Veterinary Manual was first published in 1955 as a service to the community. , DVM, PhD, DABVT, DABT, University of Illinois. Dogs are the only species in which xylitol toxicosis has been reported. Other diagnostics, therapeutic and supportive measures are instituted on a case by case basis. Xylitol is used in a variety of food and non-food products, including sugar-free foods, especially gum and candy, It is also found in toothpaste, oral hygiene products, medications, medication bases, vitamins, supplements, cosmetics, deodorant, skin gels, sunscreen, and hair care products. Depending on the timing of ingestion and any current symptoms, your veterinarian may induce vomiting. However, it takes only a tiny amount to cause medical problems, including fatalities, that any ingestion is a medical emergency. Last full review/revision May 2013 | Content last modified May 2013, © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA), © 2021 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, Overview of Health-Management Interaction: Small Animals. In most mammals, xylitol has no significant effect on insulin levels, but in dogs, xylitol stimulates a rapid, dose-dependent insulin release that can result in profound hypoglycemia. Adopting a Shelter Dog. Xylitol is a common sweetener that is used in sugar-free foods. This sometimes fatal toxicosis has unfortunately become all too common with the advent of trendy gums, such as Ice Cubes, Orbit and some Trident products, which contain large amounts of the toxic sweetener. Behavior. Coagulation profiles may also be abnormal. If you have pets, be extremely cautious about products containing xylitol as they are highly toxic to dogs and cats. The liver injury can lead to blood clotting disorders, anemia and neurologic symptoms.. Signs of hypoglycemia (low blood sugar) generally occur within 30-60 minutes of ingestion and may include: Signs of liver injury may occur 12-72 hours after exposure and may include:. Xylitol-gum quantites are calculated based on a concentration of 1 gram of xylitol per piece of gum, and a xylitol dose of 0.5g/kg resulting in liver failure. Oshinsky RJ et al; J Nutr 107 (5): 792-804 (1977) Hazardous Substances Data Bank (HSDB) The absorption of (14)C -labelled oxalic acid was studied in Wistar rats, CD-1 mice and NMRI mice. Barking Problems in Dogs. It takes only a very small quantity to poison a pet. The dog has started showing symptoms of xylitol toxicity, means xylitol absorption has already happened in dog. Xylitol is rapidly absorbed following ingestion. Xylitol is a serious toxicity which is becoming more prevalent due to the widespread use of xylitol-containing human products due to its potential health benefits in humans and many uses. Prevention of Xylitol Toxicity in Dogs. The dog will need hospitalization for at least a … Here is the calculation we used: Amount of Xylitol per stick of Trident Original gum: 0.17g (170 mg) Number of sticks per pack: 18 (yes, it was unopened and he likely ate the whole thing) Billy’s weight: 20 kg (44 lbs) Result: 170 mg/stick X 18 sticks / 20 kg = 153 mg/kg. Remember, time is of the essence and your pet may need immediate help! As we humans try and trick ourselves that we are eating healthy by avoiding products that contain sugar and sourcing those that contain the sweetener called Xylitol. Although the concentration of theobromine in chocolate is 3–10 times that of caffeine, both constituents contribute to the clinical syndrome seen in chocolate toxicosis. Dosages of xylitol over ~75–100 mg/kg (34–45 mg/lb) have been associated with hypoglycemia in dogs. The main possible side effect of xylitol is stomach upset. This, combined with the typical uncertainty and variability of the amount of product ingested, usually necessitates that the pet owner contact the poison control center, in addition to visiting their veterinarian. Xylitol Toxicity is becoming more and more of a concern for our companion pets. Toxic Disinfectants: What to Use and What Not to Use Around Your Pets. gum, candy) can be challenging to pet owners and veterinarians. A dog consuming more than 0.5g/kg of xylitol is at risk of liver failure and should receive immediate veterinary attention 3. Some dogs ingesting xylitol at dosages >500 mg/kg (227 mg/lb) may develop severe hepatic insufficiency or failure, the mechanism of which is unknown. It is not required that xylitol be listed in any particular order on the labels of medications and supplements, so appearing low on the list of ingredients doesn't necessarily mean that there is not a toxic amount in the product. at three doses (100, 500 and 1,000 mg/kg body weight). These dosages have been considered toxic and can cause liver failure or even death in dogs. Treatment for Xylitol Toxicity. Lesions of dogs succumbing to liver injury have included hepatic necrosis with loss of normal hepatic architecture. If your dog ingested a dose approaching the liver-toxic amount of Xylitol, the use of liver protectants is guaranteed. With xylitol poisoning, it is imperative to calculate whether a toxic dose has been ingested. In order to understand Xylitol toxicity, we first need to know how insulin works in the body. Dogs that develop bleeding or neurologic abnormalities have a generally poor prognosis. Interestingly, because it has antibacterial properties, some oral health products for dogs and cats designed to be placed in drinking water contain xylitol. The most common source of xylitol poisoning that Pet Poison Helpline* gets calls about comes from sugar-free gum. We do not control or have responsibility for the content of any third-party site. These days, animal poison control centers receive thousands of calls across North America about accidental xylitol poisoning in pets, with many more going unreported. Time is of the essence! Approximately 75% of the liver needs to be injured or damaged before an elevation in values or change in function is expected. Sugar Alcohols are Anything But Natural . Wismer said some manufacturers consider the level of xylitol in their products to be proprietary information and refuse to disclose it. Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. Insulin is a hormone released by the pancreas to control blood sugar. In dogs, doses > 0.1 g/kg are considered toxic and result in profound, sudden problems. Applying Eye Drops with Low Stress Handling . Rabbits, cows, baboons and horses have also demonstrated sensitivity, although to a lesser extent. Pet Poison Control is a public health outreach providing information on common household toxins and prescription medication. The link you have selected will take you to a third-party website. Higher doses (> 0.5 g/kg) of xylitol have been associated with acute hepatic necrosis. Please set up a consult with us, call ASPCA Pet Poison Control, or try the online chocolate toxicity calculator to determine if your pet is at risk for severe illness. (*Note that the amount of xylitol in gum is highly variable, and not always noted on the packaging. 226 Route 37 West, Suite 14 Xylitol causes significant insulin secretion in dogs, resulting in hypoglycemia. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. • Xylitol amounts can … Clinical signs of liver injury include depression, vomiting, icterus, and coagulopathy; other findings include hyperbilirubinemia, thrombocytopenia, and hyperphosphatemia. Avoid buying products that contain the toxic sugar substitute Xylitol or keep them out of reach of dogs. Even small doses of xylitol can quickly become fatal to your pup if left untreated . Xylitol toxicity seems to be dose-dependent. The acronym SLUD stands for salivation, lacrimation, urination, and defecation, which are the clinical signs associated with muscarinic cholinergic overstimulation caused by certain toxins. Clinical signs of hypoglycemia include vomiting, weakness, ataxia, depression, hypokalemia, seizures, and coma. Xylitol was dissolved in deionized water and administered p.o. This site complies with the HONcode standard for trustworthy health information: Because toxicity can be expected up to 72 hours after xylitol ingestion, liver values in dogs should be checked up to 3 days or longer if elevated or increasing at any point. Xylitol content of manufactured food products varies considerably between different brands. Xylitol is a sugar alcohol used to sweeten sugar-free products such as gums, candies, and baked goods. Much more so even than cats, although there have been some reports of xylitol poisoning in cats too.. Xylitol poisons our dogs by triggering a large release of insulin. lethargy, incoordination, restlessness and collapse. Seek veterinary care immediately if you think your dog may have ingested Xylitol. Particularly when we know that xylitol toxicity does have the potential to be toxic in dogs? Dogs that develop liver toxicosis have a more uncertain prognosis and require aggressive treatment. This results in hypoglycemia (life threatening low blood sugar). Diagnosis is based on clinical findings and history of exposure. The signs of xylitol toxicity in dogs; The action to take; Prevention; At the beginning of the century, only a few cases of xylitol toxicity in pets had been reported. And more of a pet eating xylitol but xylitol toxicity calculator be of help but this is unreliable at best boluses constant-rate. Started showing symptoms of xylitol poisoning, it has detrimental results sugar, ingestion! The trusted provider of veterinary information since 1955, Insecticides, Acaricides, and hyperphosphatemia to! Other causes of hypoglycemia include vomiting, icterus, and hyperphosphatemia cause hepatic damage diluted properly they are toxic... Hyperbilirubinemia, thrombocytopenia, and Molluscicides and/or failure these species contain the toxic sugar substitute that can be an in... 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