Acute Hepatic Failure in a Dog after Xylitol Ingestion

Abstract

Xylitol is a five-carbon sugar alcohol produced from natural resources frequently used as a sugar substitute for humans. We report the development and successful treatment of acute hepatic failure and coagulopathy in a dog after xylitol ingestion. A 9-year-old 4.95 kg (10

Xylitol toxicosis and serotonin‐like syndrome occurring simultaneously in a dog secondary to ingestion of Natrol 5‐HTP Fast Dissolve Tablets

“…In addition to hypoglycemia, increases in LES (ALT, AST) and CK were noted, and a decrease in total protein and albumin was seen. Alanine aminotransferase (ALT) is a cytosolic enzyme that is released by hepatic cells secondary to hepatic injury or necrosis . Generally, ALT levels increase within 12 hours of a toxic insult, and peak within 24‐48 hours if ongoing injury does not occur .…”

“…The lowest estimated xylitol dose associated with hepatic failure in dogs, as reported by the ASPCA APCC, is 0.5 g/kg . Two possible mechanisms for xylitol‐induced hepatic necrosis have been proposed . The first is that depletion of adenosine triphosphate (ATP) may result in the inability of liver cells to perform normal cellular functions including protein synthesis and maintenance of membrane integrity, which ultimately leads to cellular necrosis.…”

“…3,5 Insulin release is roughly 2.7-7 times greater with ingestion of xylitol when compared to ingestion of the equivalent amount of glucose. 8 According to the ASPCA APCC, hypoglycemia has been reported in dogs with ingestions of less than 0.1 g/kg. 5 Another unique effect of xylitol in dogs is the development of hepatotoxicity, and increases in ALT and AST have been identified in dogs exposed to xylitol concentrations of greater than 1.0 g/kg.…”

“…9 Increases in total bilirubin and GGT, and prolongations in PT and PTT have also been reported. Acute hepatic failure was described in a single case report 8 and a case series. 10 In the former report, the patients' liver enzymes (LES) normalized and a full recovery occurred following supportive care.…”

Propriedades antibacterianas e anticariogênicas do xilitol: uma revisão da literatura

“…In these situations, the treatment is held according to the symptoms, with the administration of serum glucose to maintain glycemia. 16,17 The absence of toxicity in humans has guided the use of xylitol as a sweetener (sugar cane substitute) in several products. Its non-cariogenic effects also justify its use in products like chewing gums and tablets.…”