Tag Archives: Pet Poison Helpline

Urgent Food Poisoning Alert for All Dog Owners

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Recently a 3-year-old Pug named Bruce in Overland Park, Kansas discovered a tin of sugar-free Mentos and helped himself.  Within a half-hour, Bruce was lethargic. Fortunately, his owner connected the dots between the Mentos and Bruce’s rapidly deteriorating condition.

After calling the veterinarian’s office, as he picked Bruce up to rush him out to the car, the dog went limp.  Once at the vet’s office, he had a seizure.  The mints Bruce had eaten contained xylitol, a sweetener that is highly toxic to dogs.  It’s a sugar alcohol extracted from corn and corn fiber, birch, raspberries and plums.

Xylitol is used to sweeten a wide range of products, including sugar-free gum and mints, nicotine gum, chewable vitamins, certain prescription drugs, dental hygiene products and baked goods.

Xylitol can also be purchased in granulated form as a sugar replacement to sweeten beverages, cereals and other foods.

Fortunately for Bruce, the veterinary staff quickly treated him with glucose water and monitored him closely.  He survived the initial crisis, but they don’t know yet if there has been permanent damage to his liver.

The Number of Products Containing Xylitol Is Exploding

Xylitol poisoning in dogs is reaching epidemic proportions according to some sources. The sweetener is being used in an ever growing list of products because it’s as sweet as sucrose, but with only two-thirds the calories of sugar.

It’s less expensive than other sugar substitutes, tastes better and causes little if any insulin release in humans.

Just a few years ago, xylitol could be found in less than a hundred products in the U.S., primarily limited to sugar-free gums, candy and foods.  Today it can be found in a wide range of health and beauty products, food products, over-the-counter drugs and supplements and prescription medications.

Until fairly recently, xylitol was found primarily in products not normally given to dogs. Poisonings were usually the result of dogs like Bruce sampling human foods, candy or gum on the sly.

However, xylitol is now being found in certain peanut and nut butters.  As most dog guardians know, our pets love these creamy butters.  Many people use a dab of peanut or nut butter to hide pills or supplements they give to their dog, or they fill a Kong with the gooey stuff as a special treat.

Peanut and Nut Butters Containing Xylitol

Dr. Jason Nicholas, who runs Preventive Vet, has compiled a list of nut butters containing xylitol:1

Go Nuts, Co. Almond Butter

Almond Butter – Chocolate Almond Butter

Peanut Butter – Dark Chocolate Mint

Peanut Butter – Natural Chocolate Flavor

Peanut Butter – Natural Flavor

Peanut Butter – Organic Maple Flavor

Krush Nutrition Nutty By Nature Peanut Butter Brownie Batter

Nutty By Nature Peanut Butter Cookie Dough

Nutty By Nature Peanut Butter Snickerdoodle Cookie

Nutty By Nature Peanut Butter Thick & Creamy

Nuts ‘N More® Almond Spread – Almond Butter

High Protein + Almond Spread – Almond Butter

High Protein + Almond Spread – Chocolate Almond

High Protein + Almond Spread – Cinnamon Raisin

High Protein + Peanut Spread – Chocolate Peanut

High Protein + Peanut Spread – Peanut Butter Flavor

High Protein + Peanut Spread – Pumpkin Spice

High Protein + Peanut Spread – Toffee Crunch

Peanut & Protein Spread – Sesame Cranbutter

Peanut Spread – Peanut Butter Flavor

Peanut Spread – Toffee Crunch

P28 Foods High Protein Spread – Almond Butter

High Protein Spread – Banana Raisin

High Protein Spread – Peanut Spread

High Protein Spread – Signature Blend

Protein Plus PB Hank’s Protein Plus – Almond Butter

Hank’s Protein Plus – Banana

Hank’s Protein Plus – Caramel Pretzel

Hank’s Protein Plus – Chocolate Chip

Hank’s Protein Plus – Coconut

Hank’s Protein Plus – Honey Maple

Hank’s Protein Plus – Plain

Hank’s Protein Plus – Snickerdoodle

These are specialty nut butters sold primarily in nutrition stores and online, but the fact that xylitol is now being used in these products is a heads-up for dog parents everywhere of the importance of reading ingredient labels.  It’s probably just a matter of time before more mainstream peanut and nut butters also contain xylitol.  As Dr. Ahna Brutlag, associate director of veterinary services for Pet Poison Helpline explains the seriousness of the situation:

“First, dogs fed straight peanut butter as a treat or fed treats baked with xylitol-containing peanut butter may certainly be at risk for harm.

Second, a dog that nabs the entire jar of xylitol-containing peanut butter and happily gorges on his or her treasure without anyone knowing could quickly become extremely ill. If this occurred during the day while the owners were not home, it’s possible the dog could die before people returned.”2

You should be aware of any product in your home containing xylitol, and especially anything you might consider offering to your dog.

Xylitol-Related Dog Poisonings More Than Doubled in 7 Years

Each year as the number of products containing xylitol expands, sadly, so do the cases of poisoning in dogs.  In 2007, the first year the ASPCA Animal Poison Control Center (ASPCA-APCC) started tracking cases of xylitol toxicity in dogs, the Center received 1,764 calls.  In 2014, they handled 3,727 xylitol calls.3

That’s over a 200 percent increase in just 7 years, and includes only the cases called into the ASPCA-APCC.  There are other animal poison control centers that receive calls, as well as unreported cases of xylitol-related illnesses and deaths.

The Toxicity of Xylitol Depends on the Species and Dose

Although xylitol is safe for humans, the sweetener’s effect varies by species.  In people, rhesus monkeys, rats and horses, xylitol causes little to no insulin release.  However, it has the oppositeeffect on dogs, ferrets, rabbits, cows, goats and baboons.  Its effect on cats is unknown.

Humans absorb xylitol slowly, and the sweetener when ingested orally is absorbed at from 50 to 95 percent.  However, in dogs, xylitol is rapidly and fully absorbed within about 30 minutes.  Just a small amount of xylitol can cause a dangerous insulin surge and a rapid drop in blood sugar.

The toxicity of xylitol in dogs is dose-dependent.  The dose required to trigger hypoglycemia (low blood glucose) is approximately 0.1 grams/kg, while the amount needed to cause liver failure is about 0.5 grams/kg.  Most gum and breath mints typically contain .22 to 1.0 gram of xylitol per piece of gum or mint.

This means just a single piece of gum or one mint may cause hypoglycemia in a 10-pound dog.  For more detailed information and graphics on how much xylitol is dangerous to different sized dogs, as well as a comparison of xylitol versus chocolate toxicity in dogs, take a look at this Preventive Vet page.

Determining the Amount of Xylitol in a Product

Currently, product manufacturers aren’t required to list the quantity of xylitol on package labels, and while some companies will reveal the amount in their products, many are reluctant to do so.

In some cases, you might be able to use the placement of xylitol on an ingredient list to estimate how much is in the product.  In the U.S., ingredient lists for foods must be organized in descending order based on weight.  The ingredient weighing the most is at the top of the list.

In most chewing gum ingredient lists, xylitol appears in fourth or fifth place, making it clinically insignificant.  But if it appears as one of the first three ingredients, extreme caution should be taken.  In fact, I recommend dog guardians avoid or very carefully secure any product that contains any amount of xylitol, no matter how small.

When it comes to medications and dietary supplements, U.S. regulations do not require manufacturers to list xylitol by name on package labels.  This is because the sweetener is often categorized as an “inactive” or “other” ingredient, and such ingredients don’t have to be listed in order by the amount contained in the product.

To confuse matters further, when xylitol is named in these products, it is often part of an alphabetized list, which could lead pet owners to assume — perhaps in error — that there is a very small amount in the product.  That’s why it’s best, in my opinion, to either avoid or very carefully store any product that contains xylitol in any amount.  Dr. Nicholas has compiled a fairly comprehensive list of products containing xylitol here.

Symptoms of Xylitol Poisoning and Required Treatment

Symptoms of xylitol intoxication in dogs include vomiting, weakness, lethargy, loss of coordination, seizures and collapse.  Hypoglycemia is usually evident within an hour or two after a dog ingests xylitol, but symptoms are occasionally delayed for several hours.

Treatment depends on how quickly it is given.  Vomiting is induced in cases where the xylitol has just been ingested.  Once a dog develops hypoglycemia, IV dextrose must be administered until the animal can self-regulate his blood glucose concentrations, which typically takes from 12 to 48 hours.

In dogs who ingest enough xylitol to cause liver toxicity, liver enzymes must be closely monitored, as evidence of hepatic necrosis can show up one to two days after ingestion. Should the liver begin to fail, the dog will require IV fluids, dextrose, hepatoprotectants (substances to help support and repair the liver), and regular monitoring of blood clotting activity.

When xylitol exposure is caught early in a dog and treated effectively, the prognosis for a full recovery is excellent.  The prognosis for dogs that develop hepatic failure is less optimistic.

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5 Common Human Medications That are Dangerous to Pets

You are a fantastic pet parent. Your fur babies are always clean, well groomed, well feed, and loved.  So when a pet family member becomes sick or injured, you want to make them feel better ASAP, just as you would want for your children.  It’s only a swollen paw — I can give my animal kids a pain killer from my home medicine cabinet, right?  As easy as it would be to reach for a people pill, it’s not such a good idea.  In fact, you can end up causing more problems for pets.

There are other ways pets can get their mitts on human meds, like if you leave a bottle of headache pills or a prescription medication out on the table where pets can reach, or you unknowingly drop a pill on the floor and your dog sniffs it out and eats it.  Both over-the-counter (OTC) and prescription drugs can potentially be dangerous to our animal friends, therefore, we must take care in securing all medications at home and refrain from giving without consulting a veterinarian.  In no particular order, here are five common human medications that are dangerous to pets:

1. NSAIDs

This common household medication called non-steroidal anti-inflammatories (NSAIDs) are ibuprofen and naproxen meds like Motrin, Advil, Aleve, and Naprosyn.  These medications are safe for people, but a single pill or more can cause serious harm to pets. Smaller type animals including dogs, cats, birds, ferrets, and hamsters may develop very serious stomach and intestinal ulcers, even kidney failure.  “The only pain pill we ever recommend is aspirin,” says  Dr. Justine Lee, associate director of veterinary services at the Pet Poison Hotline.

2. Acetaminophen

Tylenol, a popular type of pain medication containing acetaminophen, has been around for a long time, trusted by generations.  While acetaminophen is generally safe for children and adults, it is not for pets.  Even the smallest amount of this med ingested by a cat can cause damage to red blood cells, which leads to the inability to carry life needing oxygen. In large doses, dogs can also suffer from red blood cell damage as well as liver failure.

3. Benzodiazepines and Sleep Aids

Is your pet having trouble sleeping or seem panicky?  Do not give them human medications like Xanax, Ambien, and Lunesta, which are made to reduce anxiety and help people to sleep better.  Pets may experience completely reverse effects.  Dogs appear to be agitated and wired after ingesting sleep aids, and cats could go into liver failure when certain forms of benzodiazepines are ingested.  These drugs can also cause lethargy, disoriented walking, and labored breathing in pets.

4. Cholesterol Drugs

With label names such as Crestor and Lipitor, cholesterol medications are typically not prescribed to pets, but pets can find a way into your pill bottle.  Fortunately, if a pet swallows these meds, they will likely only experience mild vomiting or diarrhea.  But still, keep drugs out of reach as serious side effects from these drugs can come around in cases of frequent use or ingestion.

5. Antidepressants

Antidepressants must only be prescribed to pets by a professional.  A single pill has the power to cause poisoning related illness or death.  Pets overdosing on people antidepressants, like Cymbalta and Prozac, can lead to serious neurological problems including seizures and varying degrees of tremors and elevated heart rate, blood pressure, and body temperature.

These are just five common human medications dangerous to give to pets or for pets to ingest.  You must remember that any people medication purposely or accidentally ingested in little to excess can pose potential harm or even death to your pet.

If you know or believe your beloved pet has consumed any type of over-the-counter medication, contact your veterinarian immediately.  There are also national poison control hotlines you can call with people who are ready to help you in such an emergency.

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Very Important: Never Let Your Dog Get at Any Product Containing This

Toxic Pet Food

By Dr. Becker

Xylitol is a natural sugar alcohol extracted from certain fruits and vegetables.  Because of its sweet taste and plaque fighting benefits in humans, xylitol is a common sugar substitute found in a diverse assortment of products.  These include sugar-free gum, mints and other candy, baked goods, nicotine gum, chewable vitamins, certain prescription drugs, and dental hygiene products.  Nontoxic amounts are even included in some pet dental products.

Because xylitol has a low glycemic index, it’s also sold in bulk as a sugar substitute for baking and in-home use — which is why the Pet Poison Helpline has fielded calls from owners of dogs that became very sick after eating homemade bread, muffins and cupcakes made with xylitol.

Where Else Is Xylitol Found?

According to the Pet Poison Helpline (PPH), xylitol – which, as many pet owners know, is quite toxic for dogs, causing hypoglycemia and hepatic necrosis – is showing up in an ever-increasing number of surprising places.  New products on the market, including some nasal sprays, over-the-counter sleep aids, multivitamins, prescription sedatives, antacids, stool softeners, and smoking-cessation gums, contain “unexpectedly large amounts” of xylitol, according to Dr. Anna Brutlag of PPH.

Dogs who sample these products get a double dose of toxicity, first from the active ingredient in the product, and secondarily from the xylitol.  This potentially deadly combination can greatly complicate the symptoms, diagnosis, treatment, and prognosis for these animals.

According to Dr. Brutlag, the following “atypical” products contain xylitol.  Some may surprise you…

Over-the-counter medications:

  • Axia3 ProDigestive Antacid (flavored chewable tablets, propriety amount)
  • Children’s Allegra Oral Suspension
  • Fleet Pedia-Lax Liquid Stool Softener
  • Umcka Cold and Flu chewable tablets (homeopathic product)

Dietary supplements, vitamins:

  • KAL Colostrum Chewable, Vanilla Cream (chewable tablets)
  • KAL Dinosaurs Children’s Vitamins and Minerals (chewable tablets)
  • Kidz Digest Chewable Berry from Transformation Enzyme
  • L’il Critters Fiber Gummy Bears
  • Mega D3 Dots with 5,000 IU of Vitamin D3 per “dot” (dissolvable tablet)
  • Stress Relax’s Suntheanine L-Theanine chewable tablets
  • Vitamin Code Kids by Garden of Life (chewable multivitamins)
  • Super Sleep Soft Melts by Webber Natural (dissolvable tablets)

Nasal products:

  • Xlear Sinus Care Spray
  • Xylear Nasal Spray (for adults and children)
  • Xyliseptic Nasal Spray

Prescription drugs:

  • Abilify Discmelt Orally Disinteg­rating Tablets (aripiprazole)
  • Clonazepam Orally Disintegrating Tablets, benzodiazepine
  • Emtriva oral solution (emtricitabine), HIV-1 reverse transcriptase inhibitor
  • Mobic Oral Suspension (meloxicam), nonsteroidal anti-inflammatory
  • Neurontin (gabapentin) Oral Solution
  • Riomet (metformin) Oral Solution, antidiabetic agent
  • Varibar barium sulfate products, liquids and puddings for swallowing studies
  • Zegerid Powder for Oral Suspension (omeprazole), proton pump inhibitor

Foods with xylitol as the primary sweetener (excluding gums and mints):

  • Clemmy’s Rich and Creamy ice cream products
  • Dr. John’s products (hard and soft candies, chocolates, drink mixes and so on)
  • Jell-O sugar-free pudding snacks
  • Nature’s Hollow jams, syrup, ketchup, honey and so on
  • SparX Candy
  • Zipfizz energy drink-mix powders

Toxicity of Xylitol Is Species- and Dose-Dependent

While xylitol is safe for human consumption, the same can’t be said for pets.  In 2011, the FDA released a consumer alert on the dangers of xylitol ingestion in certain animals.  The sweetener’s effect varies by species.  In people, rhesus monkeys, rats, and horses, intravenous (IV) xylitol causes little to no insulin release.  However, it has the opposite effect on baboons, cows, goats, rabbits, dogs, and ferrets. Its effect on cats is unknown.

Humans absorb xylitol slowly, and the sweetener when ingested orally is absorbed at from about 50 to 95 percent.  However, in dogs, xylitol is rapidly and completely absorbed within about 30 minutes.  Just a small amount of xylitol can cause a dangerous insulin surge and a rapid drop in blood sugar.

The toxicity of xylitol in dogs is dose-dependent.  The dose required to trigger hypoglycemia (low blood glucose) is approximately 0.1 grams/kg, while the amount needed to cause hepatic necrosis (liver failure) is approximately 0.5 grams/kg.  As a point of reference, most chewing gums and breath mints typically contain .22 to 1.0 gram of xylitol per piece of gum or per mint.  This means just a single piece of gum or one mint may cause hypoglycemia in a 10-pound dog.

Determining the Amount of Xylitol in a Product

Product manufacturers aren’t required to list the quantity of xylitol on package labels, and while some companies will reveal the amount in their products, many are reluctant to do so.  Incredibly, some have even asked veterinarians to sign a confidentiality agreement before divulging how much of the sweetener is in a particular product.

Fortunately, the Pet Poison Helpline has been working to get this information from manufacturers, and has been relatively successful.  So if you need to know the amount of xylitol contained in a specific product, the Helpline suggests you call them first at 1-800-213-6680.

In some cases, you might be able to use the placement of xylitol on an ingredient list to estimate how much is in the product.  In the U.S., ingredient lists for foods must be organized in descending order based on weight.  The ingredient that weighs the most is at the top of the list.  According to Dr. Brutlag, in most chewing gum ingredient lists, xylitol appears in fourth or fifth place, making it clinically insignificant.  She says if it appears as one of the first three ingredients, however, extreme caution should be taken.

I’ll go a step further and recommend that dog guardians avoid or very carefully secure any product that contains any amount of xylitol, no matter how small.

When it comes to medications and dietary supplements, U.S. regulations do not require manufacturers to list xylitol by name on package labels.  This is because the sweetener is often categorized as an “inactive” or “other” ingredient, and such ingredients don’t have to be listed in order by the amount contained in the product.  To confuse matters further, when xylitol is named in these products, it is often part of an alphabetized list, which could lead pet owners to assume – perhaps in error – that there is a very small amount in the product.

So I’ll repeat my recommendation to dog owners to either avoid or very carefully store any product that contains xylitol in any amount.

Symptoms of Xylitol Poisoning and Required Treatment

Symptoms of xylitol intoxication in dogs include vomiting, weakness, lethargy, loss of coordination, seizures, and collapse.

Hypoglycemia is usually evident within an hour or two after a dog ingests xylitol, but symptoms are occasionally delayed for several hours.  Treatment depends on how quickly it is given.  Vomiting is induced in cases where the xylitol has just been ingested.  Once a dog develops hypoglycemia, IV dextrose must be administered until the animal can self-regulate his blood glucose concentrations, which typically takes from 12 to 48 hours.

In dogs who ingest enough xylitol to cause liver toxicity, liver enzymes must be closely monitored, as evidence of hepatic necrosis can show up one to two days after ingestion.  Should the liver begin to fail, the dog will require IV fluids, dextrose, hepatoprotectants (substances to help support and repair the liver), and regular monitoring of blood clotting activity.

When xylitol exposure is caught early in a dog and treated effectively, the prognosis for a full recovery is excellent.  The prognosis for dogs that develop hepatic failure is less optimistic.

——- Source

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