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Introduction: Xylitol (xylit) is a sugar alcohol commonly used as a sugar substitute with anticariogenic quality in chewing gum, tooth paste and different kinds of candy. It is also purchasable as birch sugar and used for dietary reasons due to its low caloric value in baking goods and other foods. However, despite its wide use, xylit is extremely toxic for some animals (including dogs) starting at concentrations as low as 0.1 g/kg.
Materials and Methods: A 3-year-old Hovawart presented with apathy, acute vomiting, jaundice and therapy-resistant hypoglycaemia. The dog died 2 days after first signs were observed. An insulinoma had been excluded by ultrasound. Xylitol intoxication was suspected.
Results: Necropsy examination of the progressively autolytic dog revealed a severely friable liver and a moderate jaundice. Liver histopathology revealed a severe hepatocellular necrosis of >95 % of the liver cells. All stains (including Azan, Fouchet's, rhodanid, Turnbull's blue) were negative. The toxicopathological examination of blood samples via gas chromatography–mass spectrometry (GC-MS) detected xylitol.
Conclusions: The present case shows the need for awareness when it comes to species-specific sensitivities to certain substances and their use in everyday lives. When facing therapy-resistant hypoglycaemia one should always consider xylitol intoxication as a differential to an insulinoma. Also, it proves that even if conditions are unfavourable (severe autolysis/heterolysis), it is advisable to perform a toxicological examination.