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

Abstract

Key Clinical MessageXylitol and serotonergic compounds are included in the manufacture of numerous over‐the‐counter products. Both compounds have been documented to cause toxicosis in dogs. This report details the first case of simultaneous xylitol toxicosis and serotonin‐like syndrome in a dog, secondary to ingestion of a single over‐the‐counter product.

Successful treatment of a severe 5‐hydroxytrytophan intoxication using carbon hemoperfusion, hemodiafiltration, and mechanical ventilation in a dog

“…In dogs, 5-HTP intoxication may result in clinical signs that range from mild to a potentially lifethreatening serotonin syndrome that requires prompt and aggressive care. [5][6][7] Two single-case reports have described dogs who developed serotonin syndrome after 5-HTP toxicosis (at estimated doses of 120 and 362.5 mg/kg) and responded well to supportive treatment. 6,7 In a retrospective study, 19 of 21 (90%) dogs with accidental 5-HTP ingestion developed a variety of clinical signs ranging from very mild gastrointestinal signs to severe neurological signs that included seizures, ataxia, and autonomic dysfunctions including hyperthermia, mydriasis, tachycardia, and tachypnea.…”

“…[5][6][7] Two single-case reports have described dogs who developed serotonin syndrome after 5-HTP toxicosis (at estimated doses of 120 and 362.5 mg/kg) and responded well to supportive treatment. 6,7 In a retrospective study, 19 of 21 (90%) dogs with accidental 5-HTP ingestion developed a variety of clinical signs ranging from very mild gastrointestinal signs to severe neurological signs that included seizures, ataxia, and autonomic dysfunctions including hyperthermia, mydriasis, tachycardia, and tachypnea. 5 dog in the present case report ingested a minimum of 550 mg/kg of 5-HTP, which is much higher than the reported minimum lethal dose and the previous single-case reports.…”

“…It also caused widespread changes such as hypotension and a trend of increased Pa co 2 , both of which were observed in the present case. In dogs, 5‐HTP intoxication may result in clinical signs that range from mild to a potentially life‐threatening serotonin syndrome that requires prompt and aggressive care 5–7 . Two single‐case reports have described dogs who developed serotonin syndrome after 5‐HTP toxicosis (at estimated doses of 120 and 362.5 mg/kg) and responded well to supportive treatment 6,7 .…”

“…5 Severe 5-HTP intoxication leading to serotonin syndrome has been reported in dogs. [5][6][7] In dogs, 5-HTP intoxication results in gastrointestinal signs such as vomiting, diarrhea, abdominal pain, and a range of neurological signs including seizures, depression, tremors, hyperexcitability, and recumbency. 4,5 Treatment of serotonin syndrome consists of cessation of serotonergic agents, supportive measures, and administration of benzodiazepines and serotonin antagonists, such as cyproheptadine.…”

“…On the other hand, in veterinary medicine, cases of serotonin syndrome often result from accidental ingestion or overdose of 1 drug 5 . Severe 5‐HTP intoxication leading to serotonin syndrome has been reported in dogs 5–7 . In dogs, 5‐HTP intoxication results in gastrointestinal signs such as vomiting, diarrhea, abdominal pain, and a range of neurological signs including seizures, depression, tremors, hyperexcitability, and recumbency 4,5 .…”