Xylitol In Your New Year Resolution
Dr. Michelle Ahmann, staff veterinarian, Veterinary Village
With the new year brings new new resolutions, one of the most common being weight loss. With weight loss comes the desire to cut certain items from our diet, commonly including sugar. Xylitol is a replacement for sugar that is growing in popularity in the United States and it finding its way into more and more items.
What is xylitol? Xylitol is a sugar alcohol that is growing in popularity being used as a sweetener. It is already very popular over in Europe. It has been around since 1891 when a German chemist Emil Fisher produced it. However it can also be found naturally in some edible plants and fungi such as berries, lettuce and mushrooms. Although it has been around for a long time it is only now starting to grow in popularity mainly due to the benefits to people over sugar. Xylitol contains 2/3 the calories of sugar which is of great benefit to people trying to loss weight. Xylitol has also been found to inhibit some growth of certain bacteria which is now being used to treat ear infections in people. Another of the benefits provided by Xylitol for people is that it aids in inhibition of oral (mouth) bacteria to produce acids which lead to tooth decay, hence why it is used in sugar free gum and other oral substances (toothpaste, oral rinses).
So what is the problem with xylitol? While it is a good alternative for making things sweet for people it is highly toxic to dogs. In most species there is a wide safety margin, meaning it will take a lot of xylitol to lead to a toxic effect. The exception to this rule is dogs. In dogs very low levels of xylitol, comparatively speaking, will lead to toxicity. It in fact will drop the blood glucose (blood sugar) of a dog to the point of severe hypoglycemia leading to severe symptoms and even death.
Where is xylitol most commonly found?
- Sugar free gum is the most popular sources of intoxication in dogs
- Nicotine gum
- Chewable human vitamins
- Oral care products
- Baked goods with sweetener over sugar
- Some natural peanut-butter
What are the signs to look for with xylitol toxicity? It has been found that vomiting is generally the first sign to be noted by owners. The second main group of signs is due to hypoglycemia, which has many different presentations depending on the individual animal. The most common signs associated with hypoglycemia are lethargy, weakness, depression, an overall just not feeling well. These signs are caused from xylitol causing an increased release of insulin although there is not enough glucose (sugar) for the insulin to work with consequently leading to low glucose levels. These hypoglycemia signs are typically seen within 30-60 minutes of ingestion. As the hypoglycemia becomes more severe the signs can progress to ataxia (incoordination when walking/moving) and eventually moving to seizures. If continued to be untreated the patient can progress to a coma and even death in a relatively short amount of time. While hypoglycemia is of biggest concern early on and can lead to signifiant/scary signs, xylitol can also lead to hepatotoxicity (liver damage/failure). At this point in time, scientists are not sure why xylitol ingestion leads to hepatotoxicity.
What other things can appear like xylitol toxicity? There are many different reasons dogs can become lethargic and appear to hypoglycemic. The main differentials include such things as an overdoes of insulin, hypoglycemic drugs (glipizide, glyburide), puppy hypoglycemia (patient has little glucose to begin with and uses a large portion), hunting dog hypoglycemia (patient uses up too much glucose from working).
How do we treat xylitol toxicity? First it is best if the owner is able to get a rough idea of how much was ingested by the dog. It is very helpful to bring the package of whatever substance the dog got into if you know what it is. This allows your vet to be able to see how much xylitol is in the amount the patient could have gotten into. This is also very nice information to have for your veterinarian to be able to call poison control and speak with them about this particular case and what is the best management. It is also very important to get your pet to a veterinarian as quickly as possible. If they are not yet showing signs, there is a chance that your veterinarian can make your pet vomit the ingested substance prior to full absorption of the xylitol. Often veterinarians will give activated charcoal to pets that have ingested toxic substances so that the toxic substance will bind with the activated charcoal and will therefore not be absorbed into the blood system which will prevent signs. In the case of xylitol there has not been much indication that activated charcoal will help with absorption and is therefore not indicated in xylitol toxicity, although it will not hurt. Once your animal is at the veterinarian they will likely be hospitalized to aid with treatment and normalization of glucose levels. If you live a long distance from your veterinarian, the best idea is to call them to let them know you are on your way and to get some Karo syrup or honey (high sugar contents) and rub a small amount on your dog’s gums to aid with keeping the glucose up while in the process of making it to the clinic.
Does xylitol affect cats? The affect in cats is not fully known at this time however they do not appear as sensitive as dogs.
Key points? There is an ever growing amount xylitol present in products. Watch for signs of hypoglycemia. Bring your dog to the veterinarian as quickly as possible after ingestion. Bring the product with the label with you to the veterinarian.