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
- 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
Try VETbytes for 30 days for free, or subscribe for only £9.99/month or £99.00/year (BSAVA members get 33% off). Sign up today.