Retrospective evaluation of xylitol ingestion in dogs: 192 cases (2007–2012)

Authors

  • Meghan R. DuHadway DVM, DACVECC,

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI
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  • Claire R. Sharp BSc, BVMS (Hon), DACVECC,

    1. Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
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  • Katherine E. Meyers VMD,

    1. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, MN
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  • Amy M. Koenigshof DVM, MS, DACVECC

    Corresponding author
    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI
    • Address correspondence and reprint requests to Dr. Amy M. Koenigshof, D208 VMC, 736 Wilson Rd, Michigan State University, East Lansing, MI 48824, USA.

      Email: koenig27@cvm.msu.edu

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  • Presented in part at the International Veterinary Emergency and Critical Care Symposium, San Antonio, TX, September 2012.

Abstract

Objective

To summarize the signalment, clinical signs, prevalence of decreased blood glucose concentration (BG), prevalence of increased liver values, treatment, and outcome in dogs known to have ingested xylitol.

Design

Retrospective study from December 2007 to February 2012

Setting

Three university teaching hospitals.

Animals

One hundred ninety-two client-owned dogs with known or suspected xylitol ingestion.

Interventions

None.

Measurements and Main Results

The median ingested xylitol dose was 0.32 g/kg (range 0.03–3.64 g/kg). Clinical signs were present in 39 (20%) dogs on presentation to the veterinary teaching hospitals. The most common clinical sign was vomiting (n = 25), followed by lethargy (12). The median duration of clinical signs prior to presentation was 93 minutes (range 0–5,040 minutes). Dogs that developed clinical signs ingested a significantly higher dose of xylitol than those that were asymptomatic. Thirty dogs became hypoglycemic (BG ≤ 3.3 mmol/L [60 mg/dL]) at some time point during their hospitalization. When evaluating all dogs, there was a significant difference between the initial and lowest BGs. Thirty dogs had increased alanine aminotransferase activity or total serum bilirubin concentration. Dogs with increases in alanine aminotransferase activity or total serum bilirubin concentration had a significantly lower nadir BG. All dogs survived to discharge and 158 were known to be alive at 28 days. The rest were lost to follow up.

Conclusions

The prognosis for dogs evaluated by a veterinarian that ingest lower doses of xylitol and do not develop liver failure is excellent. Dogs ingesting xylitol should be hospitalized and monitored for variations in BG, because BG drops in most dogs following presentation. Additional studies are needed in dogs ingesting higher doses of xylitol before correlations between dose and the development of clinical signs or liver failure can be established. Treatment and prognosis for these dogs warrants further investigation.

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