Xylitol poisoning in dogs in less than a minute with VETbytes

Would you know how to handle a case of xylitol toxicity? Get straight to the point of care with VETbytes’ treatment action plan. Read the ‘Key Points’ checklist in under a minute before the client arrives and know that you are up-to-date and ready for action!

• Ingestion can cause hypoglycaemia, hepatic failure or both
• Dogs that ingest > 0.05–0.1 g/kg are at risk for developing hypoglycaemia
  This usually occurs 30–60 minutes after ingestion
• Dogs that ingest > 0.5 g/kg are at risk for developing hepatotoxicosis and acute hepatic failure. This usually occurs 1–3 days after ingestion
• Can estimate that 1 cup of xylitol contains 190g and 1 piece of gum contains 0.3-1g of xylitol
• Emesis is indicated unless the animal is showing signs of hypoglycaemia or has ingested 100% xylitol products more than 30 minutes prior to presentation as clinical signs may develop during decontamination, risking aspiration
• Charcoal is NOT recommended as xylitol is readily absorbed from the gastrointestinal tract and binds poorly to charcoal
• Administer dextrose to hypoglycaemic patients at a dose of 0.25–0.5 g/kg 50% dextrose i/v over 10 minutes (0.5–1 ml/kg 50% dextrose)
• Hepatoprotectants are indicated in patients that have ingested hepatotoxic doses, e.g. SAMe, Silybin or N-acetylcysteine. There is however no strong clinical evidence to prove their efficacy
• Additional treatments may include management of coagulation defects and gastroprotectants although evidence is scarce that hepatic disease is a direct cause of gastroduodenal ulceration and erosion

Don’t be caught out!

• Dogs may present with acute hepatic failure without having shown initial signs of hypoglycaemia
• Asymptomatic dogs with known ingestion of xylitol should be hospitalised for at least 72 hours in case of delayed-onset hypoglycaemia which may be seen when gum is ingested, or in case of development of hepatic failure without hypoglycaemia

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