Xylitol, an artificial sweetener, is now used in many products including sugar-free gum, mints, chewable vitamins, baked goods and many other products. Considered safe in people, it can be fatal to dogs if ingested. Recognized for many years to cause low blood sugar in dogs, it only recently has been found to also be associated with acute liver failure in dogs.

Ingestion of Xylitol in dogs causes release of a much greater amount of insulin than the same amount of sugar, which causes the dog's blood glucose concentration to drop below normal. Sometimes this does not happen until 12 hours after eating a food product containing Xylitol. Some dogs develop elevated liver enzyme activity 12-24 hours after consuming the artificial sweetener. Other symptoms include blood clotting problems and elevated Phosphorus, which is often fatal. The lowest estimated dose associated with liver failure to date is .5g/kg. (Editor's note: This amount is slightly more than a gram, which can mean only 3 to 4 pieces of sugar-free gum can cause acute symptoms or just a frosted muffin).

If your dog ingests gum or any product with artificial sweeteners, read the wrapper carefully, because many sweeteners are not harmful. Inducing vomiting only helps if it is done fairly quickly. Dogs ingesting Xylitol should be seen by a veterinarian immediately. Supportive care is instituted with intravenous dextrose. If the dose is in the range associated with liver toxicity, liver protectants and anti-oxidants are administered.

Mild increases in liver enzymes usually resolve in a few days with supportive care. However, if severe elevations and high phosphorus develop, the prognosis is poor. If you have dogs, check labels --- and keep Xylitol-containing foods out of the home altogether!

It can be a difficult 12 weeks but well worth the effort. If the animal improves, start adding back the old antigens one by one to see if signs recur.