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Xylitol

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Once thought to cause only hypoglycemia in dogs, this sugar substitute has recently been discovered to also produce acute, possibly life-threatening liver disease and coagulopathy. And the number of reported exposures to xylitol has been increasing.
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In order to study the mechanism of insulin release by xylitol, in vivo experiments were conducted in dogs using radioimmunoassay of insulin. Intravenous administration (0.4 g/kg) of glucose, fructose, sorbitol and xylitol increased plasma insulin concentration significantly in the femoral vein in the following decreasing order; xylitol >glucose>fructose>sorbitol. Injection of mannitol did not affect plasma insulin. After injections of xylitol and fructose, plasma glucose increased slightly, then decreased. Plasma insulin concentration in the pancreatic vein increased promptly after intravenous injection of xylitol, suggesting that the insulinemic effect of xylitol is primarily due to the augmented secretion of insulin from the pancreas. Comparison of insulin-releasing effects of glucose and xylitol in varying doses (0.05–2.0 g/kg) revealed that both substances produced comparable effects at 0.05 g–kg but the effect of xylitol became much more pronounced than that of glucose when doses were increased. The ...
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Der Artikel enthält Literaturangaben über die biologische Wirkung, Toxizität im Tierversuch und die Verwendung von Xylit bei der Behandlung des Diabetes mellitus sowie von Störungen des Leber-Galle-Systems. Auf Grund der Ergebnisse der Untersuchungen des Pharmakologischen Komitees des Gesundheitsministeriums der UdSSR wurde Xylit für die Ernährung und die pharmakologische Verwendung zugelassen. Xylit wird durch Hydrolyse von Pflanzenmaterial hergestellt. Die Verbraucher erhalten das Xylit hauptsächlich durch die Lebensmittelindustrie (Zusatz von Xylit zu Candies und eingedosten Früchten).
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A 9-mo-old neutered male Labrador Retriever developed severe hypoglycemia, collapse, and seizures after consuming a large quantity of sugar-free gum sweetened with the sugar-alcohol xylitol. The dog was treated with i.v. boluses and continuous infusion of dextrose; its condition improved rapidly, but the dog remained mildly hypoglycemic for 11 hours before recovering fully. In humans, xylitol has little to no effect on plasma insulin or glucose levels, but in dogs xylitol is a strong promoter of insulin release and can cause severe hypoglycemia with ataxia, collapse and seizures. With the increased appearance of xylitol-sweetened products in the US, xylitol toxicosis in dogs may become more common.
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This study was performed to determine the effect of a drinking water additive on reducing plaque and calculus accumulation in cats. A two-period, parallel crossover design was used with each period consisting of a 56-day test phase. Results demonstrated that the addition of xylitol to the drinking water was effective in reducing plaque and calculus accumulation in cats.
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8 adult dogs were evaluated for treatment of lethargy and vomiting after ingestion of xylitol, a sugar alcohol used as a sweetener in various products. In addition to vomiting and lethargy, 5 of the dogs had widespread petechial, ecchymotic, or gastrointestinal tract hemorrhages. Common clinicopathologic findings included moderately to severely high serum activities of liver enzymes, hyperbilirubinemia, hypoglycemia, hyperphosphatemia, prolonged clotting times, and thrombocytopenia. Necropsies were performed on 3 dogs and severe hepatic necrosis was found in 2. In the third dog, histologic examination revealed severe hepatocyte loss or atrophy with lobular collapse. Treatments varied among dogs and included IV administration of fluids; plasma transfusions; and, if indicated, administration of dextrose. Three dogs were euthanatized, 2 dogs died, 2 dogs made a complete recovery, and 1 dog was recovering but was lost to follow-up. Although xylitol causes hypoglycemia in dogs, hepatic failure after ingestion has not previously been reported. Because an increasing number of consumer products contain xylitol, clinicians should be aware that ingestion of xylitol can have serious, life-threatening effects.