I enjoy your publication and appreciate the inclusion of the Alternative Meds Update column by Sherril Sego, FNP-C, DNP, on xylitol [The Clinical Advisor, April 2015, p. 86]. Xylitol is very toxic. In dogs, it can cause vomiting, hypoglycemia, weakness, lethargy, ataxia, seizures, abnormal liver function, liver failure, and coma, all of which can ultimately lead to death.

Because xylitol is found in many household items, including oral hygiene products, gum, candy, baked goods (cookies and muffins), it is vital that these items are stored safely. If a dog is close to a piece of dropped gum, toothpaste, or candy, for example, it can be lethal.

Given that many clinicians are dog owners, dog sitters, volunteers, etc., I suggest that any article on xylitol mentions that dogs are at risk. — BARBARA WALTER, MEd, RNC, GNP, New York City (200-2)

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