Biochemistry 460 Case Study

By: Logan Thorson

Patient story• A 30 year old male walks into a veterinarian

clinic carrying his dog. The man says his Springer Spaniel has been throwing up for the past couple of hours and the has become extremely lethargic. He also notes that there were tiny pieces of gum wrapper found amongst the vomit.

What tests should the vet order?

• Chemical blood profile particularly for the liver.• Blood glucose level test

What do the result show?

• Elevated liver enzymes• Severe Hypoglycemia•More vomit in vets office confirm gum wrapper

narrative.

Diagnosis/Treatment

• Xylitol is a sugar alcohol commonly found in gum, toothpaste, food items and beverages and is known to be highly toxic in dogs. The vet determines the dog had consumed a dangerous amount of xylitol from the gum.• The vet orders IV fluids that has

dextrose to raise blood sugar.• Liver protective nutrients are also

administered to support hepatic detoxification (SAMe, NAC).• Induce vomiting (3% hydrogen

peroxide) if you suspect more xylitol from product remains in stomach.

Mechanism of Action

• Xylitol is thought to have its toxic effect through stimulation of the beta cells in the pancreas to produce excess insulin. This phenomena is not seen in humans.

• 1960’s research found peak serum insulin concentrations after ingestion of 1 g/kg of xylitol were 6X greater than those after ingestion of 1 g/kg of glucose. • The excess insulin will cause severe hypoglycemia.• Xylitol and its metabolites are thought to decrease availability of ATP in liver. The loss of cellular

function may result in liver failure.

Increase in dogs headed to Vet ER.

• The increase in cases is thought to be a result of an increased usage of the sugar alcohol in commonly consumed products.

Toxicity in Dogs

• .1g/kg of xylitol is enough to induce life threatening hypoglycemia.

• .5g/kg of xylitol can cause liver failure.

• Xylitol is approximately 100 times more toxic compared to chocolate in dogs.

What to do if your dog consumes Xylitol?

• Call Your VET immediately!!• Pet poison hotline (855-764-7661) offers help in the case a veterinarian is not nearby.• Use of 3% hydrogen peroxide to induce vomiting is last resort if both above measures fail.

References• http://www.vcahospitals.com/main/pet-health-information/article/an

imal-health/xylitol-toxicity-in-dogs/4340• http://www.aspcapro.org/sites/pro/files/xylitol.pdf• http://www.preventivevet.com/hubfs/PV-Chocolate-vs-Xylitol-Gum-3-

Dogs.png?t=1442707021755• http://petsci.co.uk/wp-content/uploads/2016/03/xylitol-and-dogs-re

ported-cases.png