Rifling through the fridge on Monday morning I found a full pack of gum that I‘m sure I never purchased. It was Trident’s cinnamon flavor—and it boasted brightly-colored letters on the label which read: “With Xylitol!”
How the heck this product got into a household with dogs is pretty obvious: The same household had hosted a birthday party for a pack of wild ten year-old children on the previous day. Someone not in-the-know had obviously left it behind.
Unfortunately, the majority of dog owners are still in the dark on the Xylitol thing. Surprisingly, so are vets. Though the canine lethality of this increasingly common household toxin was reported in 2006 in the Journal of the American Veterinary Medical Association, it’s unlikely more than a quarter of vets even glanced at the abstract. (There’s just too much to read, what with the proliferation of journals that seem to reproduce on our desks like so many litters of unwanted kittens.)
In fact, two weeks ago I attended a meeting of the South Florida Veterinary Medical Association (of which I confess I’m now a card-carrying board member). One of the participants held up this month’s trade publication, Veterinary Practice News, its large glossy pages opened to an article on Xylitol toxicity. He urged us all to be aware of this liver-toxic artificial sweetener found in gums, candies and sugar-free pastries.
Now, this is an excellent, responsible thing for this fellow vet to have done. Unfortunately, it also underscored the point that we’re still battling for awareness of this toxin—almost two years after the news hit the presses. The fact that it’s just now made it into the mainstream vet publications is testament to this.
Gratefully, articles have appeared in many consumer-oriented publications, most notably on a prominent page in USA Today (if you read closely, you'll see that Dolittler is mentioned). And many of us in the profession have been doing our part to get the word out. We keep writing these articles and telling our clients, but still it’s not making a dent in the overall awareness level.
Worst of all, new products which include this inexpensive, highly toxic ingredient (a couple of sugar-free muffins can kill as small dog) are still hitting our supermarket shelves. Despite the pet food recall and the public’s heated response to the presence of toxins in their pets’ purportedly wholesome diets, issues of human-food additives killing our pets seem almost wholly ignored by the masses.
Just as the pet food recall’s toxins made their way insidiously into the healthcare arena through symptoms easily confused with other disease processes, Xylitol’s victims suffer a similar misfortune. Until pet owners and their vets know what to look for (seizures, liver failure), until Xylitol awareness becomes widespread and until warning signs and prominent labels appear along with these products (or get outlawed altogether), we’ll surely be seeing more and more of these cases.
I just hope it doesn’t take widespread pet deaths for the public to wake up to Xylitol’s reality. In the meantime, I’ll be tossing out the Trident.
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Man, I knew it could make them sick, but I didn't realize it was toxic.
Yesterday, I found my 7.5# dog under my desk at the office chewing on a piece of bright blue, ABC sugarless gum (It was trash day and perhaps it had fallen out while changing the can liners?) I got it away from her (the whole thing) and thought "that was close". But you know what? She was mopey and sleepy all evening until about 10pm..........My gosh, I guess it was a much closer call than I knew. *shudders*
Thanks for the heads-up Dr. Patty.
Creature of Habit February 14th, 2008 03:54:00 PM
I live in Australia. Here we can purchase a Chlorhexidine-containing water additive for dogs aimed at improving dental health. I looked at the ingredients and it proudly says "Sweetened with Xylitol". On sale at the local vets, no less.
At the time I didn't think to look at the amount of Xylitol it contained but - YIKES!
Is there a “safe” amount of Xylitol for a dog to ingest? (Apart from “nil”, of course.) Even if there is, couldn’t a polydipsic dog exceed that dose?
Alison February 14th, 2008 05:12:00 PM
The case that keeps coming up as prompting the ASPCA Poison Control folks to review xylitol was ours--he was a gorgeous and sweet Welsh Springer Spaniel and he ate two cupcakes with xylitol. They had chocolate frosting which was why his owner presented him almost immediately--she was concerned about the chocolate.
At that time, the only known issue was hypoglycemia--imagine our shock a few days later as he went into liver failure :( This dog was in the 45 pound range, so be aware that a smaller amount than you may expect can be lethal
DrSteggy February 14th, 2008 06:27:00 PM
I was just at the vet the other day and asked about my dog's teeth. He said they didn't need a cleaning yet, but I could buy "C.E.T. AquaDent" to put in my dog's drinking water to fight plaque and freshen breath. The ingredients listed (in this order) are: water, glycerine, xylitol, polysorbate 20, sorbate de potassium, etc.... How can a company get away with producing and selling this stuff??? All you have to do is put a little too much in your dog's drinking water and you have a problem, right? Or maybe just a little bit accumulated over a long period could cause liver failure?? I can't believe this! I am throwing this stuff out. Do you think my vet knows about xylitol toxicity?
Tara February 14th, 2008 06:48:00 PM
I am livid about the continued marketing of these xylitol-containing products in the veterinary marketplace. They hae no place there. I threw all of my CET rinses out after this. They've heard from me. While your vet may know about xylitol, he or she may not have a clue that the CET product contains it. Let them know!
Dr. Patty Khuly February 14th, 2008 07:35:00 PM
DrSteggy: I almost always reference the two-cupcake case in my xylitol discussions. I'm so sorry you were part of that horrible event. Did he survive? I'm guessing no.
Dr. Patty Khuly February 14th, 2008 07:37:00 PM
Wow, thanks for reminding us about this. My dog is a day-time companion for my Dad who had a stroke, and also has diabetes. . .so the are always sugar substitutes around and he doesn't always remember the feeding rules.
I always have a stash of healthy biscuits by his chair...but it's no guarantee. I'll have to be extra careful avoiding this Xylitol stuff.
Larry February 14th, 2008 09:00:00 PM
I guess I could ask around with local vets, but a quick search in Finnish didn't find any results in which death by xylitol would be documented. I'm not disputing the fact that it is toxic for dogs - that is a fact.
But Finns have been using Xylitol in gum etc. for at least two decades and I've yet to hear of a death caused by Xylitol. And since the product is good for humans health (especially dental health), banning its use or not using yourselves is foolish.
Of course, as with any other substance intended for human use, access to it must be limited. But no one leaves treats or dog food lying around, now do they?
ramin February 15th, 2008 03:07:00 AM
Dr K--he did not survive. When that case started going horribly wrong we were back on the phone with the ASPCA Poison Control line trying to figure things out. At the time (I think this was 2001 or 2?) no one knew this could happen and there was all sorts of speculation about what was going on. The dog was eventually transferred to Animal Medical Center in NYC since we could not supply the intense 24 hour care he needed at the end. At the time, I think the PC had less than a dozen reported cases of xylitol intoxication, and not all of them ended badly, but they had not really reviewed them all as a group. Once they did, a pattern did emerge.
As far as the reader not finding cases in Finland--this doesn't mean they did not happen, it just means they were not reported. I don't know what resources you have, but we have a REALLY wonderful resource in the ASPCA Animal Poison Control Center--they track poisonings that are directly reported to them all over the country. They will fax you information on weird things that are not written up in easily accessible locations (I still have the stuff they sent me when I had a cat drink liquid potpourri!) and are happy to follow up on cases as they unfold. A lot of what I know about toxicology comes on the fly from them--about the only one we learned in school was how to deal with rodenticides since those are pretty common.
DrSteggy February 15th, 2008 06:40:00 AM
DrSteggy: I have to heartily agree with your assessment of our ASPCA Poison Control as outstanding service providers who take the long view on tracking the epidemiology of intoxication. I've never heard of a similar organization elsewhere who will sit on the phone with you for hours to discuss your crashing case in detail (for only sixty bucks!). If those of you in other countries know of any good PCs in your neck of the woods we'd be grateful if you could let us know who they are.
Dr. Patty Khuly February 15th, 2008 08:29:00 AM
Wow, I've actually seen CET chews recommended in my vet's office, along with a water additive (to be fair, I don't know the brand they sell IS indeed CET). And until this post, I had no idea Xylitol was a toxin to dogs. Emailing my vet right now...once again, you've possibly saved the day, Dr. Patty!!
Shasta February 15th, 2008 10:09:00 AM
There is also a good video of this story at www.MyVNN.com... http://www.myvnn.com/page.asp?id=67&story_id=3...
Tomcat1765 February 15th, 2008 11:02:00 AM
Just a few things I’m wondering about with Xylitol being used in products actually made specifically for dogs.
First of all how long have these products been on the market?
And secondly, while the effects of an acute dose of Xylitol is (fairly) well known and accepted, is there any research or even anecdotal information about the effects on the canine liver of chronic low-level Xylitol consumption?
If these products (that is Xylitol-containing products specifically for dogs) haven’t been on the market for very long, is a great wave of “idiopathic” liver failure in dogs going to become apparent in a few years? If there is a problem presumably some individuals are going to be a lot more vulnerable than others to the effect which could help hide the problem for a lot longer, too.
And why does a dog need to have its water sweetened? I add a chlorhexidine product to my dogs’ water not so much for dental health reasons but to stop the water going “off” – which can happen in a few hours here in summer. I use a product made here in Australia called “Aviclens” which is marketed to keep caged birds’ water wholesome but is recommended for use in all animals’ water. It contains nothing but the active ingredient, and by the looks of it a small amount of some sort of red coloring. The water with the Aviclens added tastes and feels not different from water without.
BTW, Xylitol is not an artificial sweetener but a naturally occurring one, extracted from birch bark commercially but found in some fruits too. This might be why it is still acceptable in these water additives despite its proven record of causing harm to dogs– it is “natural” and therefore regarded as “good” or at least “harmless”. (Don’t get me started on that one! Ggggrrrrrrrrrrrrrrrr!!!!!)
Alison February 15th, 2008 10:28:00 PM
And I'd just like to mention that the poison control hotline was started at the U. of Illinois, and only taken over by ASPCA when it was fully established.
Plug over!
CathyA February 16th, 2008 07:34:00 AM
Is Xylitol also toxic for cats?
Jenny February 16th, 2008 11:30:00 AM
Just a note that Veterinary Medicine had a cover article about xylitol toxicity in December 2006. It was much easier to read than an abstract.
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