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General Pet is your source for advice and information for a happy and healthy pet.
Author: Mary Crandall XYLITOL: DEADLY FOR YOUR DOG Sugar substitute danger
Everyone was home. It was a great weekend of catching up with adult children, enjoying the start of Spring Break with my younger ones, and celebrating Easter with all my children home, a rare occurrence these days. We had a wonderful day on Sunday. After a delicious breakfast, we headed to the beach with our Chocolate Lab, Shenley. I remember watching her run along the shore as she chased the tennis balls we tossed for her. She was such a delight to everyone there. We came home to finish the preparations for Easter dinner. My husband, Greg, gave Shenley a quick bath to get rid of the sand and she lay out in the sun to rest and dry off. Her chocolate brown fur glistened in the sun. As we were getting ready to sit down to eat dinner, my husband said "Where's Shenley?" She never missed a meal, hers or ours! We all stopped what we were doing and searched. One of the upstairs doors was closed and I was sure she was stuck in there, as it sometimes happens. She wasn't. I realized that she was not in the house. I felt a panic that in all the activity (by now we numbered 12 for dinner) that maybe she had gotten out of the side gate. Both gates were shut tight. Maybe a second later, I heard my husband say that he had seen her and that something was terribly wrong. He ran outside followed by one of my daughters and me. Shenley was lying on the ground, not able to move. Greg was at her side and talking to her in a low, calm voice. "What's the matter, girl?'' Her tail didn't move. Her eyes were open but she was not able to respond other than to look at Greg. He told me to call our neighbors who were both Veterinarians to see if they were home and could check her out. I got Dr. Tom LaHue on the phone and he was at our house in minutes. By this time, my husband and son-in-law, Roger, had gotten her onto a blanket and had her on the deck. She was so still. Tom checked her over and said he was pretty sure she was suffering from a neurological disorder and asked us if we had mushrooms or snail bait around that she could get into. We did not have any of these things in our yard. None of us saw her eat anything at the beach, either. Greg went over to see if she had vomited anything and saw some wrappers that at first he thought were from our chocolate Easter candy. My heart sank—my kids were all so conscious of the dangers of chocolate, that I couldn't imagine that Shenley had gotten into any. By this time, Tom's wife, Dr. Paula LaHue, was here and noted that Shenley was beginning to have seizures. I saw the twitching and was very scared. What was happening to our little girl? About this time, our daughter, Caitlin, came out with a wrapper she had found in one of the bedrooms. It was next to a chewed-open Ziploc bag. Another daughter, Emily knew what it was---Ice Breaker gum that she had with her on her plane ride home. She had a baggie of between 2-3 dozen pieces that had been part of a work promotion. Shenley had eaten them all. Caitlin handed the wrapper to Paula who read the ingredient list out loud—the first ingredient was xylitol. She knew it was a sugar substitute. Tom said we needed to get her to the emergency room and made a call to let them know we were on our way. We loaded our dog into the car and left immediately. Emily sat on the floor talking softly to Shenley as we left. The Veterinary hospital is about 15 minutes from home but it seemed like it took forever. Paula called with some news as we drove. She had looked up xylitol online and said that Shenley could be hypoglycemic from eating it and that we should tell them as soon as we got to the ER. Hypoglycemia would account for her symptoms. Shenley's small twitches were becoming stronger and more frequent. Emily and I were very scared and kept trying to be calm for both Shenley and for Greg as he drove down Highway 1. We were more than halfway there when Shenley began to shake violently, her body stiffened, her jaw began snapping, and her legs thrust out. I was sure she was going to die right in front of us. Emily was a mess. I was a mess. Greg had to keep driving. It was horrible. After a while of this violent seizing, Shenley quieted. Her head had jerked itself so that her face was under Greg's seat. I could see that she was still breathing but I was sure that she was not going to be able to survive. We pulled into the parking lot and they rushed out with a cart and got her into the hospital. We were to wait outside and fill out the paperwork while the staff tried to figure out what to do to help our baby. The office staff was so kind. After a while, the Veterinarian, Dr. Kim Delkener, had us come into a room to give us an update on Shenley's condition. Emily kept saying that it was all her fault. My heart was broken for our dog and for Emily. I said another prayer that we would get through this and do the right thing for Shenley. Dr. Delkener said that they were waiting for the ASPCA Poison Control to advise them on how to proceed. Shenley's blood glucose level was 26, normal is 120 or so. This was causing all of her symptoms. They had started an IV with dextrose and had given her extra dextrose to boost her levels. They checked her liver function and her clotting time was elevated, an indication that her liver-produced clotting factors were reduced. Her liver was in trouble as she tried to respond to the effects of xylitol. They would need to give her plasma to counteract these effects. I was in shock—she had eaten many things in her nearly five years with us, including entire packs of gum; with the main side-effect being colorful bits of wrappers in her stool. To think that she was gravely ill from eating gum was difficult to grasp. Dr. Delkener discussed some of our options. The presence of even one pack of xylitol-containing gum is considered toxic in dogs. Shenley had 2-3 times that much. The volume of material remaining in her stomach would be checked out with an x-ray. According to the Poison Control center, the xylitol in gum continues to be released the entire way down the digestive tract. The remaining gum in her stomach would continue to be a problem. We discussed ways to remove the material from her stomach—lavage, endoscope, or surgery. Lavage involves pumping fluid into the stomach and drawing out whatever is in there. Shenley would need to be sedated and this was also a worry to Dr. Delkener. The x-ray showed that there was still gum and wrappers in her stomach. We were told we could say good-night to our girl and they would keep us informed throughout the evening. Dr. Delkener was quite clear that she did not know how this would go but that they would try their best. Saying goodnight was so sad. I was feeling pretty sure that this might be the last time we would see her alive. They brought the three of us into the ICU and we saw her on a mat in the corner with an IV in her leg. She did not thump her tail or raise her head. She could only look at us if we moved our face in front of hers. The image of Emily bent over her and whispering in her ear still brings tears to my eyes. She felt so responsible for the trauma that Shenley was going through. I said good-night next. I rested my hand on her sweet head and told her how much all of us loved her. I told her I was so sad she was feeling this way and that I wanted her to be well and happy again. As I watched Greg bend over and say good-night, I thought about what a Daddy's girl Shenley was. He picked her up when she was a 6-week-old puppy, while I was visiting my parents with Bess, Grace, and Riley. He had her all to himself for those first few days. Their bond was strong from the beginning. He lingered over her and I began to cry. Soon all three of us were crying. I thought of everyone waiting at home, wishing they could all be with us. We left the hospital, wrapped in each other's arms. It was a solemn ride home. We arrived to a dining room full of tears and sobs as we explained Shenley's illness and the treatment that we hoped would fix her. It was unreal to think that we had all been with her at the beach just a few hours before and now she was lying in a hospital near death. Our daughter, Bess, had to return to school at UCSB. We had a tearful good-bye and promised to call when we had any news. We received an update from Dr. Delkener. The lavage was not working. The gum was too sticky. She was going to try and remove it with an endoscope. She would let us know. She again stated that she did not know how this would turn out. I thanked her for her efforts and hung up. The feeling of disbelief again washed over me. We had another call later in the evening. Dr. Delkener was not successful with the endoscope - the gum was smeared over the wall of the stomach. Surgery was an option, but ill-advised due to her clotting issues. She had called in a specialist, Dr. Jennifer Hendee, who reviewed the case and decided to try a different lavage technique. I felt a little hopeful. They were also going to try glucagon, but would have to go to the local hospital to get it. We heard nothing more for a few hours. The saying that "no news is good news" came to mind. Finally, we received a call from Dr. Delkener, who had told us in the beginning that her shift ended at 8:00pm but who was still at work at 11:30pm doing her best for Shenley. She said that they had gotten as much gum out as was possible. They had checked with the endoscope and were pleased with the result. It had taken nearly three hours of work. I was so grateful that she was still alive and that she had a chance. Dr. Delkener also said that they were going to try giving Shenley glucagon, a hormone that works in a balancing act with insulin to regulate blood glucose levels. I said that they should do whatever they thought would help. The glucagon was obtained from Dominican Hospital and was being prepared for administration before they could try it. Shenley was starting to come to after the procedures she had been through. I felt optimistic for the first time since this ordeal had begun. Dr. Delkener told us the name of the Veterinarian who would be there overnight and assured us that they would call if there was any change in Shenley. They would give her glucagon and see if that helped to regulate her levels. After a restless night, I woke up and called the Hospital at 6:30. I spoke to the woman who had taken care of Shenley that night. She reported that Shenley had gotten up and had eaten breakfast! I started to cry at the news. She also said that the Veterinarian would call us with details. A bit later, Dr. Aglaia Cardona gave me a call with an update. They had started Shenley on the glucagon and she seemed to be responding. Her liver tests were somewhat improved, as well. She was doing better, but she still needed intensive care. She said that I could visit later that day. She also said that the two Veterinarians from the night before, Drs. Delkener and Hendee, had made a heroic effort to save our dog. I woke up Greg with the good news. I knew it still could conclude with a different outcome, but I really felt positive that Shenley would recover. As each of the kids woke up, we shared the encouraging news. We still cautioned them that Shenley's troubles were not over yet. I was allowed to visit her in the ICU in the afternoon. I had two of my kids with me, thinking that we could all see her. The nurse said that it would not be possible for anyone but me to go back. I walked in to find Shenley in her same corner but this time she stood up and wagged her tail when she saw me. She still had two IV lines connected to her, but she tried her best to jump up on me. I was amazed to see her looking so much better than the night before. Her voice was raspy from all the tubes that had been used down her throat. I sat next to her and she finally relaxed and plopped down next to me and rested her head on my lap. I stayed with her for about 20 minutes. She wanted to follow me out. We were home later that day when Dr. Lillian Good called with another update. Her liver tests were looking better. They were going to try to start weaning her from her IV meds, the glucagon and the dextrose. If her levels were stable without these drugs there was a possibility that she could come home with her oral meds. We all felt much better going to bed. It is now Tuesday, April 10, 2007. Shenley has been in the ICU at Pacific Veterinary Specialists since Sunday at about 6:00 in the evening. Caitlin had to return to Seattle last night without seeing Shenley but she is coming back in less than two weeks. Bess and I have talked several times with status reports about Shenley. Jen and Roger are back to work in San Francisco and Jen is sending out an e-mail of our experience so others will be warned. Emily is staying home until Sunday and is getting over feeling bad about it being her gum that caused all this grief. Grace and Riley can hardly wait to see their dog again. Greg and I are so grateful for the care we all received at Pacific Veterinary. It is looking like Shenley is going to survive this episode. Dr. Good called a bit ago to say that Shenley did not tolerate being weaned off glucagon during the night, while under the care of Dr. Chris Robison. She would probably need to spend another night there on IV meds. Her liver tests are "not too bad" and her bilirubin is normal. She is going to see how she does today without the glucagon. There are many things that have contributed to our hopeful state. I think of all the pieces that needed to happen in order for her to be where she is today. If Greg had not taken a moment in the chaos of putting a holiday meal on the table to wonder out loud where Shenley was, if we hadn't all stopped and looked for her, if the LaHue's hadn't been home, if we hadn't found the gum wrapper, if Paula hadn't read the ingredients and looked them up on google, if the staff at Pacific Veterinary hadn't been so thoughtful with their treatment, we would not have our dog alive today. Our family is so grateful for the outstanding care Shenley has received from everyone on the staff at Pacific Veterinary. All of this happened because of an ingredient in chewing gum that is beginning to be used in many low-calorie foods that we consume. There are many sugar replacements on the market. Xylitol is just one of them. There are also many reports online about the dire effects this substance has on dogs. If you Google "xylitol and dogs" you will be flooded with stories similar to ours. We have had a lucky outcome, so far. It is chilling to think of the pets that have died from swallowing this product. I wrote this for a few reasons: first, to set down the experience on paper for my own record. Secondly, and more importantly, to provide a detailed warning to anyone that has a beloved dog to check their purses, home and car for products containing this ingredient. Xylitol almost killed our Shenley. It has killed other pets. It has been documented. I urge everyone to look at the ingredient list on gums, breath mints, toothpastes, low-cal baked goods, and other items for this ingredient. The best thing we can do is to get this out of our environment and to let manufacturers know that we do not want this in our food. The second best thing we can do is to warn everyone to keep this stuff away from your dog. This has been a horrible ordeal for all of us. It reminds us that our pets are totally dependent on us for all their needs. Dogs will continue to eat things they shouldn't. The most they should expect is a reprimand and maybe a tummy ache, not a life-threatening illness.
Mary Crandall gregmary@pacbell.net (831)688-5337
UPDATE Today is Wednesday, April 11, 2007. Shenley is still a patient at Pacific Veterinary Specialists. She was successfully weaned off the glucagon yesterday, but still needed dextrose through an IV. Her other liver-support medications are now oral. If we can get her off her IV, she can come home. Emily and I were able to visit her last evening. She looked great. She was so happy to see us and vice versa. Greg will wait to see her when we bring her home. She is always so sad when he is out of her sight under normal conditions and we figured it would be really hard for her to see him for a little while and then have him leave. We still do not know if her liver can function without the help it is receiving now. That will be revealed in the days to come. The Veterinarians are cautious in their reports to us. I looked up more information on the ASPCA web site. I have a better understanding for this caution now. We will not know the outcome of this for a while.
UPDATE Today is Thursday, April 12, 2007. Shenley's liver appears to be OK according to her last test. She is still having trouble regulating her blood glucose level so she is still in the hospital. We are very pleased with her progress to date and are hopeful that she will be home soon. Please don't let this happen to your dog.
FINAL UPDATE Shenley is coming home!! I received a call at 5:00pm this evening and her levels are stable enough for her to come home. Our happy ending is definitely due to the skill and care of the many people at Pacific Veterinary Specialists. We can not thank them enough. I will continue to send this to as many people as I can think of in the hope that more people become aware of this and protect their dogs. Xylitol is being used in so many products these days. If people choose to use this product, they need to be vigilant in its use.
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