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Xylitol: The Silent Dog Killer
15 Dec 2020
Xylitol is widely considered to be a healthy sugar substitute for humans and can be found, in most health-conscious homes and in a range of everyday sugar-free products. This delicious sweetener has 40% fewer calories than sugar with a low glycaemic index, ideal for many people with chronic conditions like prediabetes, diabetes and obesity. The substance is non-toxic and easy to metabolise in humans, but even small doses can kill dogs quickly. Here is my story about my gorgeous Greyhound Dallas and how she almost died from Xylitol poisoning.
I left my home for work at 5 am on a Monday and stopped nearby for petrol at my nearest garage. I realised I had forgotten my laptop charger so returned home to fetch it. Dallas, my newly adopted 2-year-old Greyhound, had moved downstairs to the couch as she always does when I go to work in the morning. Nothing seemed amiss with her in the slightest. I walked upstairs and when I entered my room, I noticed the tub of sugar-free gum that was laying open on my bed. On closer inspection, I could see that the tub was empty, apart from a lonely tropical flavoured gum fixed to the inside of the tub with dog saliva. Bite marks on the outside of the container confirmed Dallas was indeed the culprit. I couldn't find any loose gums inside the home or outside in the garden. She had eaten approximately 20 gums from a sealed tub! I suspected she might need medical attention but what I didn't realise was just how severe this medical emergency was and how little time we had to save her.
I quickly googled "chewing gum ingestion dogs" and clicked on a link describing severe toxicity related to sugar-free chewing gum. At the top of the page, a warning read: "If your dog has ingested sugar-free chewing gum containing Xylitol, stop reading this and seek urgent medical attention." There is so much information related to this topic online, but Xylitol toxicity still remains a little-known fact amongst many experienced dog owners. To my horror, Xylitol was listed as the primary ingredient on this particular brand of gum. There was no indication as to the amount of Xylitol contained in each gum, nor was there any information available online for this well-known brand.
A week prior, during a recent visit to my local Petworld store, I had been discussing pet insurance with a very well informed and helpful employee. She had recommended Tygerberg Animal Hospital (TAH) in Bellville in the event of 24-hour medical emergencies. I had taken the insurance literature home with me to read and to compare with other insurance providers over the weekend. I hadn't yet activated a policy when this emergency arose, which ultimately proved to be very costly (more on this below). I quickly called the emergency line at TAH and spoke to a veterinary surgeon who confirmed my worst fears. This was a severely life-threatening situation and we had little time to act. Dallas' hammock was already installed in the back seat of the car, so I put her inside, put my hazard lights on and drove like the wind. Fortunately, we missed the morning traffic and was able to get her to TAH within an hour of her ingesting the gum. She wasn't showing any clinical symptoms of Hypoglycaemia or poisoning at this stage.
The vet had two primary concerns: Hypoglycaemia and acute liver toxicity. In dogs, Xylitol stimulates immediate and increased insulin release that can lead to severe Hypoglycaemia. A dog's liver is also unable to process this highly dog-toxic substance resulting hepatic (liver) failure or damage that can result from doses as low as 500mg per kg of body weight. Sugar-free gum can have anywhere between 300 - 1500mg of Xylitol per piece.
Dallas was given medicine to help her throw up which resulted in approximately four pieces of half-chewed gum coming out. Her blood sugar levels were indicating signs of hypoglycaemia which TAH was able to treat and manage successfully during her stay. She was put on a drip and her stomach was flushed with charcoal to remove any remaining xylitol, which had not yet been absorbed by her system. The first series of blood tests were performed later that afternoon to determine liver function and the results were shocking! A typical liver enzyme reading, for a greyhound of her size and age, should be in the region of 60 Alanine aminotransferase (ALT) units per litre. Her test showed an elevated ALT level of 567, over eight-hundred percent higher than it should be.
Multiple types of drugs were administered to treat her liver and she remained in hospital overnight. Doctors were extremely concerned as most dogs do not survive this level of xylitol poisoning. It was also difficult to determine the long-term effects this would have on her health and quality of life down the road. The second round of blood tests was performed the following afternoon and showed an ALT reading of 260. This was dramatically less than the initial reding but still highly elevated. She was kept in hospital for another night, under close observation, and I was instructed to collect her the following afternoon.
I nervously anticipated how Dallas would be a react when she saw me. She is the most wonderful, loving and affectionate companion and she usually greets me with a wide grin exposing her top gums. I had only recently adopted her from a Greyhound rescue in Johannesburg where she had been transported to in July after being found abandoned in the Eastern Cape. I had driven up to adopt her in September and this was the first time she had been without me.
When I was reunited with her the next afternoon, she was still sedated and didn’t recognise me right away. Her coat was scruffy, and she still had hard residue in her coat from the medicine they use to help her throw up. I just wanted to get her out of the hospital and into her favourite nature-spot, so she could smell her surroundings and get some reassurance that her life would be returning to what it was before this ordeal.
I had to first pay for her medical bills, ongoing medication and special liver diet which ultimately cost in excess of R 10 000. This is prohibitively expensive for most dog owners and would have been covered under most pet insurance plans. Had she required surgery or a longer stay this bill could have been far higher. The medical care she received at TAH was exceptional and the service and feedback were phenomenal.
Dallas has since recovered remarkably well. Her liver enzyme test was 75 (just over the normal reading of 60) a week after she was discharged from hospital. Having since told this story countless times, including to experienced dog owner’s, I have realised that most people are completely unaware of the dangers Xylitol poses to dogs. Urgent and proactive medical care certainly saved her life, had I not been there to help her she undoubtedly would have lapsed into a coma and died. I was, fortunately, able to cover her medical bills, but this could have easily not been the case and been avoided with regular pet insurance. I have learnt from this mistake and I strongly urge all dog owners to get the appropriate Pet Insurance for their dog. An information push from breeders, shelters, vets and food manufactures could go a long way in preventing this type of emergency from occurring. With upcoming festive celebrations and increased risk of accidental poisoning please share this with your dog-owning friends.
This story is anecdotal and not intended as medical advice. Please consult your veterinarian for medical information related to your dog.