Xylitol toxicity in pets

substance: Xylitol

categories:

Spices

symptoms:

Anorexia / Coma / Depression / Diarrhea / Icterus / Lethargy / Melena / Seizures / Tremors / Vomiting / Weakness

# Description

Xylitol is a sugar substitute commonly found in sugar-free gum, candies, toothpaste, baked goods, vitamins, supplements and various household products. While safe for humans, xylitol is highly toxic to dogs and other animals. Even small amounts can cause a rapid insulin release in dogs, leading to a dangerous drop in blood sugar (hypoglycemia) and, in severe cases, liver failure. Symptoms of xylitol poisoning in dogs include vomiting, weakness, loss of coordination, seizures, and in extreme cases, can be fatal. It’s crucial to keep any products containing xylitol out of reach of pets.

# Toxicity

all

Hypoglycemia 0.1-0.2 g/kg
Severe hypoglycemia 0.2-0.5 g/kg
Hepatotoxicity 0.5< g/kg

# How it works

Xylitol triggers hypoglycemia by causing a rapid release of insulin from the pancreas. Its impact on liver cells, though not fully understood, may involve either depletion of energy molecules (like ADP and ATP) or production of harmful reactive oxygen species during liver metabolism. Symptoms can appear within 10–15 minutes of ingestion, with the liver as the primary site for xylitol processing.

# Symptoms

Mild hypoglycemia:

Vomiting, weakness, lethargy, depression, anorexia.

Severe hipoglikemia:

Vomiting, weakness, lethargy, depression, anorexia, tremors, seizures, coma, ataxia, collapse.

Hepatotoxicity:
Vomiting, diarrhea, icterus, melena, petechiae, hepatic encephalopathy,

# Treatment

Check blood glucose before beginning decontamination.

If ingestion occurred within 1–2 hours and the patient shows no symptoms, induce vomiting. Avoid this if hypoglycemia is present to prevent aspiration and seizures.
In cases of large ingestion, delayed vomiting (up to 6 hours) may help after treating hypoglycemia, as xylitol can linger in the stomach.
Activated charcoal is not recommended due to poor binding with xylitol.

Monitor blood glucose every 1–4 hours for 6–8 hours, adjusting frequency as needed.

Administer dextrose boluses if hypoglycemia occurs (BG <60 mg/dL), using 0.5–1.5 mL/kg of 50% dextrose diluted with saline, given over 1–2 minutes IV.
IV fluids with 2.5–5% dextrose to support hydration and blood glucose.
Feed small, frequent meals if the patient isn’t vomiting to prevent hypoglycemia.

No Antidote: No known antidote exists for xylitol.

Liver protectants may be used, especially in large ingestions (>0.5 g/kg):

SAMe: 18 mg/kg PO daily
Silymarin: 5–10 mg/kg PO daily
Vitamin C: 30 mg/kg PO or SQ every 6 hours
Vitamin E: 50–600 units per dog daily
N-acetylcysteine: 140 mg/kg once, then 70 mg/kg every 6 hours for 7–17 doses
Vitamin K1: 3–5 mg/kg PO or SQ daily

Fresh frozen plasma: 10–20 mL/kg IV if DIC or coagulopathy

Use antiemetics like Maropitant (1 mg/kg SQ daily) as needed for GI symptoms.

# Prognosis

Xylitol ingestion can be life-threatening, so seeking veterinary care immediately is crucial for the best outcomes.

Symptoms

Poisons