Liver damage risk in dogs after eating xylitol 2018-2022

Abstract

OBJECTIVE: To evaluate the association between patient history, clinical signs, decontamination methods, and initial point-of-care diagnostics and the development of hepatotoxicity in dogs with xylitol ingestion. DESIGN: Retrospective study between 2018 and 2022. SETTING: University veterinary teaching hospital and private practice emergency hospital. ANIMALS: Ninety-five dogs evaluated by a university veterinary teaching hospital and private practice hospital following xylitol ingestion. MEASUREMENTS AND MAIN RESULTS: Medical records were retrospectively reviewed; signalment, time of ingestion, dose of xylitol ingested, source of xylitol, clinical signs at the time of presentation, and decontamination methods including induction of emesis and administration of activated charcoal were recorded. Point-of-care diagnostics, including PCV and total plasma protein (TP), lactate, blood glucose (BG), and potassium concentrations, were recorded. In total, 47 dogs (49.5%) developed a hepatopathy, 48 dogs (50.5%) did not develop hepatopathy, and no dog developed evidence of hepatic failure. The dose of xylitol ingested was not associated with development of hepatopathy. Dogs that had clinical signs prior to presentation were 1.95 times more likely to develop a hepatopathy than dogs that did not have clinical signs prior to presentation (p = 0.0005). Emesis was induced in 77% of dogs, and dogs that had emesis induced were less likely to develop a hepatopathy than those in which emesis was not induced (p = 0.01). Hypokalemia on presentation was associated with the development of a hepatopathy (p = 0.0353). CONCLUSIONS: This study demonstrates an association between the development of a hepatopathy in dogs and clinical signs prior to presentation, lack of emesis, and hypokalemia on presentation.