Tucked away inside a gym bag sitting casually atop a chair was a container of Mentos gum. It wasn’t long before Chase, a 6 year old Cockapoo, did what many dogs do best – sniff out the treat and gobble it up. A few hours later Chase started vomiting and shaking, alerting his owner to the fact that something was wrong. It was a Sunday afternoon and Chase’s mom knew BRVC was open for Urgent Care so she brought him in immediately.
Dr. Stefanie Wong examined Chase. When she heard that he had gotten into a container of gum, she immediately suspected xylitol toxicity. Xylitol is a sugar substitute used as a sweetener in a number of candies and gums. Many gums and candies labeled as “Sugar-free” contain xylitol. Xylitol is extremely toxic for dogs. It causes a surge in insulin production which in turn causes hypoglycemia (low blood sugar). Symptoms of low blood sugar include weakness, lethargy, tremoring, collapse and seizures. Xylitol is very damaging to the liver as well. In extreme cases it can cause liver necrosis (liver death) which is often fatal. Time is of the essence when treating a dog who has ingested xylitol – the longer it is in the system the more severe and potentially deadly the damage.
Dr. Wong quickly issued treatment orders to induce vomiting to expel any remaining pieces of gum and to draw a blood sample to process in the in-house laboratory. A phone call was placed to ASPCA Poison Control. ASPCA Poison Control is an important resource for veterinarians. It has an extensive database of toxins and are able to dispense important, life-saving information. They can give the exact toxic dose of a product based on a pet’s weight, as well as what kind of reactions veterinarians can expect to see based on the dose ingested. In this case specifically, they informed Dr. Wong that Mentos gum has a very high level of xylitol in it. This puts the pet at a higher risk for hypoglycemia and liver damage/failure.
Chases did indeed vomit up a piece of gum but his blood work revealed elevated liver values and dangerously low blood sugar. This fact, along with his weakness and shaking, meant that the xylitol was already at work in his body. Dr. Wong treated Chase with IV fluids and dextrose (sugar). The dextrose helps to balance his blood sugar and the IV fluids help flush the xylitol through his system. Activated charcoal is often used to treat toxicity cases since it helps absorb toxins, but Poison Control informed Dr. Wong that is was not useful in xylitol cases. Instead she kept Chase on the supportive fluids and dextrose and started him on a liver support medication to help bolster his liver function. He needed to stay the night for treatment and observation, with his blood sugar levels checked every 2 to 4 hours. His liver values would be checked in 24 hours to see if they were improving and he would be slowly weaned off the dextrose.
In severe cases of xylitol toxicity, several days of hospitalization can be expected. Sometimes more extreme measures are needed to help nurse the patient including plasma transfusions and Vitamin K injections. In the worse case scenarios, where a pet has not received treatment in a timely manner, liver necrosis can set in; at this point there is little that can be done to save the pet’s life. Fortunately, Chase’s owner and BRVC staff acted quickly to help save his life. The following day, Chase was feeling much better and his liver and blood sugar levels were returning to normal. He was able to go home with his grateful family. He returned a few days later for recheck blood work to confirm there was no lasting liver damage. Thanks to the efforts of all involved, Chase is happy, healthy, and enjoying his doggy life!