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Xylitol toxicosis in dogs

02 June 2018
8 mins read
Volume 9 · Issue 5


Xylitol is a commonly available sugar substitute found in sugar-free chewing gums and as an excipient in some medicines. It is used for its benefits on oral hygiene and its low-calorie content. It is also found in some peanut butters, ice creams and toothpastes, and can be used as a sugar substitute in baking. Xylitol causes hypoglycaemia (due to stimulation of insulin release) and liver failure in dogs, but not in cats, rabbits or rodents. The hypoglycaemia may be rapid in onset but can be delayed if xylitol-containing chewing gum has been ingested. Management of dogs that have ingested xylitol includes gut decontamination, monitoring, correction of hypoglycaemia and liver protectants. Prognosis is good in most cases and death from profound, uncontrolled hypoglycaemia or liver failure is not common.

Xylitol is a 5-carbon sugar alcohol. It exists naturally in low concentrations in fruit and vegetables and is a normal intermediary metabolite in glucose metabolism. It is manufactured by extracting a precursor from hardwoods and is most commonly encountered as a sweetener in a wide variety of foods.

Xylitol is found in numerous products (Box 1). It is used as a sweetener and is frequently found in sugar-free chewing gums (Figure 1) and confectionary where it protects against tooth decay. It is also present in some toothpastes. It has multiple effects on oral hygiene including the inability of oral bacteria to use it as an energy source (Nayak et al, 2014). Although, xylitol is found in some drinking water additives for animals at low concentrations to decrease dental plaque and calculus formation by inhibiting growth of oral bacteria (Clarke, 2006), this is generally not a source of poisoning in pets (Murphy and Coleman, 2012). It is also found as an excipient in some human and veterinary medicines. It is often found in chewable medicines including nicotine gums and lozenges for smoking cessation.

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