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Cathy T
1st June 2008, 07:14 PM
Cross posted with permission. A very sobering story and will make you re-evaluate the safety practices in your home...and on walks. Shelby is notorious for trying to eat gum off the sidewalk :(



I know that many of you already are well aware of the risks of xylitol
(an artificial sweetener used in diabetic foods, mints, chewing gum,
sugar free pudding, jello, etc.) when it comes to our dogs, but
thought this could serve as a reminder... I almost lost 2 of my girls
last night...

I had a friend over yesterday evening, and (without thinking) she put
her purse on the ground, and we ended up chatting in another room for
an hour or two. When we returned to the room in which she placed her
purse, I noticed, to my absolute horror, a *shredded* Orbitz gum box
torn to oblivion all over the floor.

I am well aware of the risks of xylitol ingestion with dogs (as little
as 2 pieces of gum can cause death in a 20 lb dog). I immediately
grabbed my dogs and smelled their breath - the only one with the minty
fresh breath... Izzy, my 10 lb female tri puppy. In a panic, I
accosted my friend as to EXACTLY how much gum she had left in the
package - she thought 3 or 4 pieces. Oh my god.

I immediately induced vomiting (with hydrogen peroxide) and Izzy
vomited violently 4 times - very minty smelling vomit, with small
chunks of the gum. I then rushed both her and Darby (my 3 yo Bl girl -
the only other one with access at the time - she didn't have minty
breath, but I wasn't about to take any chances) to UC Davis for blood
glucose monitoring and treatment.

By the way, for those who don't know, xylitol causes mass insulin
release in dogs, leading to severe, acute hypoglycemia. Dogs can show
symptoms in as little as 20 minutes, or as late as 12 hours: ataxia
(staggering gait), depression, lethargy, confusion, seizures & death.
Even if they survive the hypoglycemia, many dogs experience liver
failure and death 3-4 days later. There is no antidote or "cure." Your
only option is to try and stay ahead of it by giving mass amounts of
glucose to combat the effects of the xylitol until it finally
metabolizes out of their system in 12-24 hours. Also, to check liver
enzymes a few days later to see if your dog is experiencing fatal
liver failure - no real cure or treatment, just supportive care and
prayers.

BOTH Darby's and Izzy's blood glucose levels were shockingly low - in
the mid-50s (so, yes... clearly they both got some gum). We
administered an IV bolus of fluids/dextrose, and because of my
veterinary background, they allowed me to take them home... buying a
glucometer at a drug store en route (this is around 3am at this
point). By the way, they said that if I hadn't induced vomiting with
Izzy when I did... immediately after ingestion, she probably would be
dead right now.

So, for the next 24 hours, I am giving "supportive care:" 10mls of
Karo syrup orally mixed with a little food to each dog every HOUR, and
re-checking blood glucose and giving SQ fluids every 4 hours.

So, it is now 15 hours later, and after 15 "doses" of treatment, they
really haven't improved, but are hanging in there. They both have BG
levels that vary between 57 & 70 (normal is 90-130). Fortunately, they
are not showing any clinical signs of hypoglycemia (staggering,
confusion, seizures, etc). Yes, the glucose hasn't improved, BUT at
least the numbers aren't dropping, and they are acting "fairly" normal
(albeit a bit lethargic & depressed). In theory, the xylitol should
completely metabolize out of their systems in 24 hours. So, as long as
I can keep ahead of it with the karo syrup, we should be OK with the
hypoglycemia side of things.

My biggest concern though, as was in the beginning, is hepatic
insufficiency (liver failure). It's sobering to know that a large
number of xylitol intoxications (even with successful immediate
treatment) are fatal within 4 days due to liver failure... it just
completely breaks my heart. I just hope that, between my catching
this IMMEDIATELY, and inducing vomiting IMMEDIATELY, and having them
treated asap, and the fact the the 3 dogs affected are young and
healthy, that we will beat the odds. I will have liver values run
tomorrow and Monday - that's the only way I'll know if they will be
all right. This is scary because people frankly just don't know
enough about xylitol toxicity (and the mechanisms of effect on the
liver), as it is a fairly new problem since xylitol as an additive in
the US is a fairly new thing.

Xylitol tastes just like sugar, but with fewer calories, so there has
been an EXPLOSION of products in the US with xylitol added in the last
6-8 months. By the way, there has also been a parallel explosion of
xylitol-related deaths in dogs during that same period. I've read that
strawberries & raspberries are natural sources of xylitol - who'd have
thought!?

Now, please understand that I am not posting this as a "pity/feel
sorry for me" post - I posted because if it can happen to me, it can
happen to anyone. I was so surprised that so FEW people knew about
xylitol, I felt that I HAD to post... if this educates even ONE person
to the dangers, and saves ONE dog - I could just never forgive myself
for NOT posting!

If you want to cross-post this experience, please feel free! I have
e-mailed it to my own personal list of dog people. The more people
that know about the dangers of xylitol, the better.

This whole experience completely breaks my heart. What a freak
accident - I don't chew gum, and didn't even THINK about the purse on
the floor - consider this "lesson learned!" No purses on the floor,
EVER, in my house from now on (I mean, how many people keep gum &
mints in their purses?!)! I'm still not sure my girls are going
to be OK, and I will definitely keep the list updated... but PLEASE, I
implore you, keep ANY xylitol-containing foods or gum FAR OUT OF REACH
of your dogs (or preferably, just get rid of them!)!! Just 1
piece/stick can be deadly....

And, if you can spare them, any warm positive thoughts or prayers sent
our way would be highly appreciated. Thank you, from the bottom of my
heart.
Warmly,
Christine Moe
Northwynd Cavaliers

Cavvygirl
1st June 2008, 08:25 PM
Thats really scary!!

I didn't know anything about the dangers of artificial sweetner, I really hope her dogs are going to be ok I will say a little prayer for them:(:xfngr:

I think it was amazing how quickly she acted!

jazz
1st June 2008, 08:26 PM
Cathy--I just wanted to add a post-script to this. Xylitol is apparently not just in sugarless gum/candy. I looked at the ingredients on gum that I currently have--the first ingredient is sugar, but xylitol is also listed as well. So even more vigilance needed.

Of course, we're all hoping for the best possible outcome for Christine's girls.

*Pauline*
1st June 2008, 08:43 PM
How did she safely give hydrogen peroxide to her dog to induce vomiting? :confused:

jazz
1st June 2008, 08:55 PM
How did she safely give hydrogen peroxide to her dog to induce vomiting? :confused:

Hi Pauline--I think she used a 12ml syringe (gave 8-10mls) and just squirted it down her throat. It's just horrible what they're going through. She seems to really know what she's doing--so they're in good hands. Just hope there's a happy ending!

*Pauline*
1st June 2008, 09:03 PM
Hi Pauline--I think she used a 12ml syringe (gave 8-10mls) and just squirted it down her throat.

Doesn't that stuff burn? I hope they are going to be ok.

rosiesmum
1st June 2008, 09:29 PM
Doesn't that stuff burn?

I read somewhere recently that a 3% solution of hydrogen peroxide is used to induce vomiting in dogs - it is the weakest solution you can get and since it induces vomiting, the body won't have time to absorb it to cause any damage.

:xfngr: the dogs get better soon.

Cathy T
1st June 2008, 11:13 PM
One of the important things to remember is that Christine knew what she was doing. She has had training so she knew how much and how to give it. One other reminder is that you would never induce vomitting to bring up something solid because of the risk of perforation or serious damage as the item came back up again. This wasn't something that would cause a problem (as say a toy would) coming back up.

Here's a good link that talks about when not to induce vomitting:

http://www.thedachshundnetwork.com/indvomit.htm

MishathePooh
2nd June 2008, 02:17 AM
My sisters dog ate a boat load of raisins (accidentally left by a friend), and she basically just pried his mouth open and dumped the peroxide in (under vet's guidance as to how much). He threw up a ton of raisins on route to the vet, spent a couple days at the emergency vet and was fine (thank God). Peroxide probably saved his life though.

hbmama
2nd June 2008, 04:07 AM
Oh my goodness!! Once again, I am so thankful for this board, as I had NO IDEA about the artificial sweetener toxicity in dogs. Thank you Cathy for posting that. In fact, we had a birthday party here today and one of the guests did put her purse on the floor. Two of the dogs here, including mine had their noses down inside looking for treats. I just picked it up and put it on the table. Yikes, that could have easily have happened to us today. Very frightening to say the least, but education is the greatest prevention.

Kristy
2nd June 2008, 05:59 AM
wow you learn something new everyday! in this case, something VERY important! thank you for the post :) i pray her doggies are okay!

Holly
2nd June 2008, 01:55 PM
Cathy-- I posted the update for you... I figured you must be still sleeping out there on the West Coast! :) Praying for Chrsitine and her babies....


Sorry, I meant to post this this morning, but things have been a little crazy around here and I just didn't have the time to do it until now - sorry for the delay.


OK... so here's where we stand now. Since I caught the gum ingestion IMMEDIATELY and induced vomiting IMMEDIATELY and sought medical treatment IMMEDIATELY, we were able to keep ahead of the acute severe hypoglycemia (barely, but we did it). Now that my poor babies have downed practically a BOTTLE of Karo syrup (10mls per dog EVERY hour for 24 hours is a LOT of Karo syrup!). They felt like crap yesterday, and their gastrointestinal system is a mess (to be expected, but poor babies). Last night, around the 24 hour mark (again, theory is that xylitol takes 24 hours to metabolize through the system), their glucose stabilized around normal.

Now, I worry about the worst part of all this - the delayed liver toxicity. I've been driving myself crazy researching medical journals - "studies have shown that 80-90% of xylitol ingestion cases WITH immediate SUCCESSFUL treatment of the acute hypoglycemia die WITHIN 4 days." Oh my god. As this is a fairly new issue here in the US - I could only find one small clinical trial (you can easily find it online, as it's the only clinical trial cited on numerous sites)... it involved 8 dogs. All were treated for the hypoglycemia - 100% died. OK.... I REALLY need to STOP researching.

So, last night I was driving myself absolutely insane with the "wait and see" approach, especially after all my internet "research." I NEEDED to know where we stood. Granted, the liver toxicity is a delayed reaction that generally takes 48-72 hours, but I needed to see if there was anything going on thus far.

Both the girls had FULL liver panels run. Although their electrolytes were a little wacky (ummm.... geee.... could that be all the sugar I've been giving?! ), and some of their other numbers were a little off-kilter simply because the serum was 3+ lipemic (also caused by the Karo), their liver values were actually pretty good!! [[Although too early to really have any conclusive result, you can insert a little sigh of relief from me here.]] I even had a clinical pathologist look at the results, and he was shocked in amazement at how good their numbers are after only 24 hours (compared to their initial values the night prior). So, I'm not going to get too confident or cocky, but so far, so good (heck - I'll gladly take ANY good news right now).

The clinical pathologist at UC Davis (who is fortunately VERY familiar with xylitol toxicity) told me we're certainly not out of the woods yet -- to come back and have another full panel run on the girls tomorrow and again on Wednesday. If the results are good on Wednesday, then we have TRULY beaten the odds. I am putting out nothing but POSITIVE thoughts and vibes right now - I refuse to consider anything else.

Everybody DID say that if I hadn't taken the proper steps immediately, both girls would definitely be gone right now (Izzy definitely wouldn't have made it the 20 minutes to UC Davis if I hadn't induced immediate vomiting)... so, if you haven't already - go and buy that stinkin' bottle of hydrogen peroxide NOW and keep it accessible in your kitchen (or wherever)!!! Also, hydrogen peroxide definitely has a "shelf-life," so check the expiration dates on your bottles... if it doesn't bubble vigorously, it won't work.


So, we'll see... I'll definitely keep you guys updated.

THANK YOU SO MUCH, EVERYBODY, FOR ALL OF THE POSITIVE THOUGHTS AND PRAYERS -- IT'S WORKING!!!! PLEEEEEEEASE KEEP THEM COMING THROUGH WEDNESDAY - WE NEED THEM NOW MORE THAN EVER!!!

By the way, if both of my girls pull through this (which is honestly the ONLY option I am considering), we will truly be a medical anomaly. Even the specialists at UC Davis said that these are 2 incredibly strong, young, super-healthy dogs with an amazingly vibrant spirit and love of life (even when horribly sick, those tails never stopped and they smothered the doctors with lavish kisses and adoration after jugular sticks). If anybody can beat the odds, these 2 can (and I adamantly refuse to hear otherwise!!!!!)!

Mom of Jato
2nd June 2008, 02:57 PM
:xfngr::xfngr::xfngr::xfngr::xfngr: Lots of fingers are crossed for you and the dogs for a complete recovery. Please keep us posted, and thank you for informing all of us- this is my first dog, and I had no idea of the danger.

cy1266
2nd June 2008, 06:09 PM
This is so scary! My breeder actually sent this to me this morning and I was going to post it but you beat me to it! ;) I also asked my breeder how to induce vomiting just in case one of mine swallow medicine, etc. that could harm them...I hope her two cavs are okay! :xfngr::xfngr:

Karlin
2nd June 2008, 07:44 PM
This is really scary as I am sure few people know of this danger. I would think gum on the ground wouldn't be as much of a concern as it is usually pretty well chewed and most of the xylitol would likely go out of the gum fairly quickly just as sugar does. But I'll sure be a lot more cautious about watching the ground -- Jaspar goes after chewed gum all the time.

There's a recent thread somewhere on inducing vomiting I think, but here's a couple of links. It is crucial to be sure you have the 3% solution and also to only use the amount recommended for the weight of the dog:

http://www.petplace.com/dogs/how-to-induce-vomiting-emesis-in-dogs/page1.aspx

This is especially good as it advises when and when NOT to induce vomiting: http://www.dog-first-aid-101.com/induce-vomiting.html

There's a Youtube video that shows how to use a syringe too, but the problem is the amounts explained in the video are for a collie sized dog and you have to actually READ the accompanying info to find the right measurement. The person unfortunately does NOT make it clear that the amount she is talking about are for a larger dog and that the amount would be much less for a small dog. :eek:

Cathy T
2nd June 2008, 08:26 PM
Christine has posted that 8-10 mls will cause a Cavalier to vomit within minutes.

MishathePooh
4th June 2008, 11:13 PM
Any news? I'm worrying...

*Pauline*
4th June 2008, 11:46 PM
I was wondering too...

Holly
4th June 2008, 11:48 PM
Sounds like they will be ok... :) Here is the latest...

OK... just returned from the all-important post-48hr liver panel. This is the one that truly shows the damage done, as it is 72 hours post xylitol ingestion, and 48 hours post hypoglycemia recovery.

Firstly, I want to thank you all for the HUGE outpouring of support, thoughts and prayers. I have received (literally) almost one hundred e-mails from people all over the world wishing us luck (yes, apparently you guys are cross-posting with a vengeance - good!)... I have always been a FIRM proponent of the power of positive thinking, and this has only reaffirmed this philosophy. I honestly think you guys are responsible for saving the lives of my two baby girls.

The doctors are completely baffled, confused and shocked at tonights results. Basically, considering what their blood values were 72 hours ago, their liver values tonight make absolutely no sense. They looked GOOD!!!! The numbers are high, and there some definite liver damage done, but the numbers are still in the high-normal range and are NOWHERE NEAR where they should be.

The doctors are shocked. Tonight, I was told by one of the emergency doctors, "You know, I didn't want to say anything when you first came in, but based on their lab values, I didn't expect either of your dogs to make it, let alone both... I just don't understand how or why they have recovered so quickly! Medically, it doesn't make any sense at all - Izzy & Darby REALLY are medical anomalies... I just don't understand their results!"

Although a couple of other clinical pathologists are looking over the lab sheets tomorrow, I really truly feel we have beaten the odds... and I have YOU GUYS to thank! You guys sent SO MUCH positive energy and love our way... between that and my refusal to accept that my girls might die - we've done it!! Oh my god. I am just emotionally drained and totally in shock right now. I'm sort of in disbelief - I'm not really believing the good numbers, because... frankly... they just don't make sense! But holy freakin' crap, you guys!!!! They really pulled through this!!!

Thank you, with everything in my heart and soul... you guys are amazing, and I TRULY wouldn't have been able to do this (or had the good results) without you. Your e-mails, phone calls, and gracious, selfless offers of help and support mean the world to me. I am so blessed and fortunate to have such a phenomenal supportive network of dear friends - thank you, thank you, thank you....

And by the way, if any of you ever go through something traumatic like this with your furkids, NEVER GIVE UP THE FIGHT, and never accept that the worst might happen! It just might make all the difference in the world with your results!!!

I can finally sleep tonight (with the girls in my arms, of course )... it's funny, as I have huge and exciting (off-subject) news to share with you guys on Wednesday!! I wasn't sure if the "secret good thing" was going to happen, considering the recent crisis with my girls, but I can't wait to share the HUGE news with you all on Wednesday!! Ahhhhhhh... the suspense!

Cathy T
5th June 2008, 02:52 AM
Thanks so much for updating everyone Holly. What a relief that the girls sound like they are going to be okay. Quick thinking and knowing what to do really saved their lives.

I now have a bottle of peroxide and a 10 ml syringe in my car and my home medicine bag.

sallymum
5th June 2008, 11:05 AM
Thank god they are ok. :flwr:

MishathePooh
5th June 2008, 07:57 PM
Thanks for the update, I am *so* relieved and happy that the girls are well.