I agree that Xylitol is very toxic to dogs (“Xylitol, toxicity, and pets”), and this should be mentioned whenever its use is suggested. Many of our patients treasure their dogs and need them for support and company. The serious, often dauntingly expensive illness or death of a loved companion can have serious consequences for our patient’s health and quality of life. This is no laughing matter. I have had several patients sink into deep depression and failing health after the death of a loved companion animal. How much worse, if they felt responsible for this because it was due to accidental ingestion of something recommended by their trusted clinician?! We must always strive to treat the whole patient, and that means taking such things as lifestyle into account and offering appropriate cautions and education. — NANCY HONEYCHUCK, FNP, BC, Rochester, Minn. (201-5)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.

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