Xylitol poisoning

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The Xylitvergiftung - a serious health disorder by taking up the sugar substitute xylitol (Xylitol, "birch sugar", E 967) - is occurring in some species intoxication . Dogs in particular are prone to this . While the sugar alcohol xylitol only causes a slow and low release of insulin in humans , which is why it is often used in products for diabetics , it triggers very strong insulin release in some mammals such as dogs, cattle, goats and rabbits. After the administration of xylitol, it can be up to seven times as great in the dog as after the administration of the same amount of glucose . This leads to a life-threatening drop in blood sugar levels ( hypoglycaemia ) and liver damage .

In dogs, a dose of 0.1 g per kg body mass is already toxic; in a larger retrospective study, dogs with a xylitol intake of less than 0.3 g per kg body mass had no clinical symptoms. The lethal dose is reached from around 3–4 g xylitol per kg body weight. Consuming a bag of xylitol-containing candies (they usually contain over 90% xylitol) can be fatal, even for a large dog, if the animal does not receive intensive care as soon as possible.

Clinically, vomiting occurs most of all in the case of xylitol poisoning; fatigue, diarrhea and cramps are less common. In the laboratory, hypoglycaemia and an increase in bilirubin and ALT are typical. Acute liver failure can occur with high doses of xylitol . Then bleeding as a result of clotting disorders can also occur.

A decontamination is difficult since xylitol is absorbed very quickly. The induction of vomiting with apomorphine is therefore only promising in a short time window. Experimental xylitol administration resulted in an increase in insulin after just 20 minutes, the maximum occurred 40 minutes after ingestion, and the blood sugar level fell after 30 minutes. Activated charcoal does not bind xylitol sufficiently, so its use is not recommended. Affected animals usually receive intravenous fluid therapy with solutions containing glucose . Patients should be observed in the hospital until the blood sugar level has been in the normal range for 30 hours without therapeutic measures. If the xylitol intake is low, the prognosis is good.

Individual evidence

  1. ↑ a b c d e M. R. DuHadway, CR Sharp, KE Meyers, AM Koenigshof: Retrospective evaluation of xylitol ingestion in dogs: 192 cases (2007-2012). In: Journal of veterinary emergency and critical care. Volume 25, number 5, 2015 Sep-Oct, pp. 646-654, doi : 10.1111 / vec.12350 , PMID 26220654 .
  2. ↑ CM Piscitelli, EK Dunayer, M. Aumann: Xylitol toxicity in dogs. In: Compendium. Volume 32, Number 2, February 2010, pp. E1-E4, PMID 20473849 (review).
  3. ↑ a b E. K. Dunayer, SM Gwaltney-Brant: Acute hepatic failure and coagulopathy associated with xylitol ingestion in eight dogs. In: Journal of the American Veterinary Medical Association. Volume 229, Number 7, October 2006, pp. 1113-1117, doi: 10.2460 / javma.229.7.1113 . PMID 17014359 .
  4. ↑ Xylitol in dogs and small animals.
  5. ^ RD Schmid, LR Hovda: Acute Hepatic Failure in a Dog after Xylitol Ingestion. In: Journal of medical toxicology: official journal of the American College of Medical Toxicology. Volume 12, number 2, 06 2016, pp. 201–205, doi : 10.1007 / s13181-015-0531-7 , PMID 26691320 , PMC 4880608 (free full text).
  6. ↑ Z. Xia, Y. He, J. Yu: Experimental acute toxicity of xylitol in dogs. In: Journal of veterinary pharmacology and therapeutics. Volume 32, Number 5, October 2009, pp. 465-469, doi : 10.1111 / j.1365-2885.2009.01065.x , PMID 19754913 .