Synonyms: Chewing gum toxicosis Chewing gum poisoning Xylitol poisoning Disease description: Pure xylitol is a white crystalline substance that looks and tastes like sugar. On food labels, xylitol is classified broadly as a carbohydrate and more narrowly as a polyol. It has been used as a sugar substitute and can be found in sugar-free candy, gums and other products. In humans, xylitol has little to no effect on plasma insulin or glucose levels, but in dogs xylitol is a strong promoter of insulin release and can cause severe hypoglycemia with ataxia, collapse and seizures. Hypokalemia can be present and is likely due to potassium shift (insulin drives potassium into the cells). Xylitol can also cause hepatic necrosis and death. 1,3-5 HOW MUCH XYLITOL CAUSES TOXICITY? A cup of xylitol powder weighs about 190 g. 3 Information published on VIN message boards indicates that 0.2-0.4 g/kg IV can cause hypoglycemia. It is suspected that similar oral doses could cause hypoglycemia since it is absorbed well. Chewing gums that are largely or only sweetened with xylitol contain about 1-2 grams/piece. Thus one or two pieces of gum could cause hypoglycemia in a 10 kg dog. 4 HEPATIC INJURY Some dogs develop elevated liver enzymes 8-12 hours post-xylitol ingestion and recover fully. Others develop acute liver failure, hemorrhage, and disseminated intravascular coagulation and often die. The lowest dose to cause hepatic necrosis is thought to be 1.6-2 g/kg. Most of the dogs who developed acute hepatic failure and DIC actually did not apparently show signs of hypoglycemia after ingestion of xylitol. 3 Further observations suggested that these cases became acutely ill about 48 hours post xylitol ingestion and had extremely elevated ALTs (often not measurable), elevated bilirubin, and prolonged PT/PTTs. In some cases of hepatic necrosis, hypophosphatemia was found initially but was followed by hyperphosphatemia in the terminal stages.
Posted on: Tue, 15 Oct 2013 01:29:58 +0000
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