The story I am about to tell you doesn't have a happy ending. I struggled with whether I would write this at all, but if you're a dog owner, youneed to hear this story. Your dog needs you to hear this story. This story is important. Read it. Remember it. Share it with every pet owner you know. Ask them to share it with every pet owner they know until no one can say, "if I'd have only known, they'd still be here." I write this with the heaviest of broken hearts and the guilt that I didn't know.
This piece is ultimately about Xylitol toxicity in dogs...specifically my dog, Roxy. My sweet, loving, Roxy. I want you to know her and love her like I did, but for what I need you to know today, I am only going to be talking about the last 2 very bad days of Roxy's too short Life.
Everyone knows chocolate is poisonous to dogs. In my home, chocolate is kept on the highest shelves and never in candy dishes. Grapes and raisins aren't allowed. Everything that we knew was poisonous to our pets was monitored and stored away without hesitation. Except Xylitol. It was in my home and I didn't even know it. How could I? I'd never even heard of it.
Xylitol is a sugar substitute found in products such as sugar-free gum, candies, breath mints, baked goods, cough syrup, children's chewable vitamins, mouthwash, and toothpaste, to list a few. Xylitol is estimated to be 100 times more toxic to dogs than chocolate. I didn't know any better.
On a Monday evening my husband and I went out to dinner with friends. When we returned home everything seemed normal. My husband, Jeff, had found an "icebreakers cubes" container that was empty and had been chewed. I don't remember buying that gum, don't remember ever seeing it, and I don't know where it came from. We'd been doing some home renovations and some things were out of place so some old totes were abnormally accessible. That must have been where it came from, I thought. Roxy, my 9 year old dachshund/schnauzer mix is a scavenger. She loves finding old water bottles and other types of plastic to chew on. I look at the container and assume that was what had happened. Even if there were some gum in it, no big deal. She's eaten gum that she's dug out of my purse before, and after a poo, she was as good as new. Worst case scenario she has a bellyache or farts a bubble, right? It wasn't chocolate, it wasn't grapes, it wasn't medication. What was there to worry about? I gave her a look, she was the picture of health. No sore belly, full energy, happy as can be. I helped her burrow into her blanket and off to bed we all went. I didn't know any better.
Day 1 (12 hours after ingestion):
The following morning, my husband went downstairs to feed the dogs which is first on our morning checklist. Roxy was only interested in going outside, as if it were an emergency. This was odd. We let her outside, she peed, came back in, and laid down in her crate. This must be that bellyache I knew she'd have. No big deal. I asked her to come out and eat her breakfast, and she did, and with the same energy and enthusiasm as every day. She ate her entire bowl of food and then wanted to lay back down again. She seemed perfectly healthy: wagging tail, talking, excited about meals and outside time...just a bit out of sorts. I spent an hour working, then checked on her again. This time she was making an awful face. I knew it was the "I'm about to puke face." I checked the vomit and it was normal colored, no blood, no funny things. All normal upset stomach things. 15 minutes later, she puked again. A LOT. Still normal colored. I have a quick thought to google "my dog ate gum" just to see how long the upset stomach should last and if there is anything I can be doing to help her. This is the first time I had ever come across the word "xylitol." I read that some gum contains this chemical and I need to contact my vet immediately. Well now I'm terrified, but not as terrified as I should have been. I didn't know any better.
I call my regular vet. They don't have any appointments available, but she urges me to take Roxy to the emergency vet, even though her only symptoms seem to be an upset stomach. I put Roxy in the car and let the emergency vet know we are coming. I sing to her while she licks peanut butter off my right hand and soaks in the view of the road. Really, she seems fine, but I would rather be safe than sorry. I didn't know any better.
We arrive at the emergency vet and immediately go to triage. The tech takes Roxy's vitals. Roxy is jumping up on my lap, on to the chairs, smiling, wagging her tail, and even let's out one of her cute 'howly' barks that she does when she's really excited. I begin to wonder if I over reacted. I am a chronic over reactor. Perhaps I am wasting the vet's time and my money. Her vitals all look great. The vet comes in and talks to me. She asked me about the empty container of gum that I was concerned about. She tells me that Xylitol toxicity symptoms usually begin to appear 2-3 hours after ingestion. We are well past that now. She tells me the first symptoms that they typically see are related to hypoglycemia. She asked if Roxy has been stumbling or drunk seeming. She had not. She also felt that Roxy looked to be in good shape but wanted to run some blood tests and take a few X-rays to rule out things like bowel obstructions. The vet didn't seem concerned so neither did I. I didn't know any better.
I sat in the waiting room and watched patient after patient come and go. I'm still confident we will immediately be leaving after her test results are complete. The vet finally calls my name but instead of talking to be in the lobby like everyone else, she asks to speak to me in what I now call "the very bad news room." I'm unfazed and unaware. Roxy was in great condition before she went back for her testing. The doctor first tells me the good news. The x-rays showed no blockages. Yay! That's good. I'll take it. But then her voice changes and she tell me Roxy's liver enzyme levels are alarming and that she probably did get into the gum from the container I found. I still don't really know what this means. I had only just learned this "Xylitol" word 2.5 hours ago. She had another concern. Roxy's blood was not coagulating. When she was stuck for her blood tests, she wouldn't stop bleeding. The doctors face begins looking a bit more sullen and my mood begins to match. I still didn't understand what this meant. Just a regular symptom? Easy to treat, right? No, this meant Roxy was in liver failure. Her body needed to be able to use at least 20 percent of her liver to coagulate her blood. Roxy's liver was working less than that. She completely skipped the hypoglycemia and went straight to liver failure. I asked what her prognosis was and all the doctor could say is... "guarded." Which means It could go either way, as in... not making it is quite possible. The dog that was acting herself and almost overly excited just 2 hours earlier might not survive. *world begins to flip* I didn't know any better.
We made a plan to begin treatment immediately, to medicate the liver so that it could filter out the toxins as fast as possible and begin to heal. If it even could do either of those things. This was my only hope. My only treatment option. There is no anecdote or cure for Xylitol poisoning. Roxy would need a plasma transfusion to help with the coagulation and will most likely be staying for at least 4 days. Ok deal. The estimate was higher than the cost of my wedding ring or entirety of the loan balance on my husband's car. That's fine. I will empty my pockets to save my best friend.
I went to check on Roxy in her medical suite to tell her I wasn't leaving her and that I would be right back, but she wasn't the same dog that I sent back for X-rays just 2 hours earlier. Something changed. She looked tired and weak, and there was blood dripping from her nose. I barely touched her paw and had blood on my hand. I drove to the hospital where my husband works to update him, cry on his shoulder, figure out where we would be pulling money from to cover costs. He never questioned me. He would have given me all his money to save her too. He was optimistic because he'd been at work all day and hadn't yet read up on the Xylitol monster. Or maybe he had, he just didn't want me to worry more than I had too. Too late. I didn't know any better.
I sat in my car in the parking lot for hours. Too scared to go home and be away from Roxy. Too scared to visit her at the animal hospital for fear of reality...the reality of her rapid decline. As I sat there, I googled everything I could about Xylitol Toxicity. On 20 pages of google, the highest survival percentage I could find after the liver is affected was 20%. Shit. I googled "my dog survived xylitol." I got a few stories from people who were aware of xylitol and were able to begin treating immediately after ingestion. I didn't find a single story where a dog survived after coagulation problems. Not a single one. I cried in my car alone for a undeterminable amount of time.
When my husband got off work, he went with me to visit her. She perked up when she heard his voice. We loved on her, nuzzled faces with her, talked to her about all the things we would do when she gets better, and tucked her in to a perfect burrow for a good night's sleep. She was stable. Hanging in there. Her eyes were bright and she was completely aware of the things and people around her. That was the best I could have hoped for at that point. I didn't know any better.
The night doctor told me she wouldn't be calling me for anything unless she needed my approval for an additional plasma transfusion ($) or in the event Roxy's health declines. She did call me that night. Roxy's blood still wouldn't coagulate so she would need another transfusion around midnight and another first thing in the morning. The report I got back was that she handled the transfusions well, but still no changes positive or negative. I woke up bright and early, and a bit optimistic because she had made it through the night. It had to start getting better now, right? Spoiler alert: it only gets a whole lot worse. I didn't know any better.
Day 2. The last day:
9am, I visit. She doesn't look well. She looked so weak but she perked up when she saw me and my husband even got a tail wag. Her eyes followed you and got big and bright. Not as big and bright as healthy Roxy, but she was still in there. Fighting. I promised her long walks and unlimited cuddle time when she was healed. I met with her ICU doctor for the day. She assured me she wouldn't be treating her if she didn't feel there was hope. She talked to me through my tears mostly. At times I could barely put sentences together. If you'd thought through any part of this story that I was keeping it together you are sorely mistaken. The doctor had a "real talk" with me about Roxy's condition. Her liver numbers just weren't improving, but with Xylitol poisoning, it gets worse before it gets better. Today was just going to be a day of waiting to see if she could gain more function in her liver and get her blood to coagulate. She mentioned that they extracted an IV tube and it seemed to have stopped bleeding on it's own and was healing. This gave me a glimmer of hope. Her biggest fear was that Roxy could hemorrhage or that the toxins could spread to her brain and cause neurological damage. Either of these situations would make survival impossible. I tried to put that out of my mind and focused on the fact that just for that moment she was still here, alert, and fighting. To be honest, I always knew this would end poorly. I felt it in my heart. I knew how bad Xylitol was now. If I wasn't visiting with her, I was researching xylitol stories. I was preparing myself for the worst.
I visit only one more time while the ICU doctor is still there. There are no new updates. Roxy is stable. Everyone is rooting for her. Liver values haven't improved, blood isn't coagulating and she is still at a risk for hemorrhage and neuro problems. She had come out of her cage and walked for a minute to use the bathroom so there was another small glimmer of hope. Earlier that morning she didn't even want to stand. She still followed me with her eyes and quietly "whined" when I pet her. This is how she would always talk to me when I told her she wasn't allowed to bark. There's that hope. Damn hope. I didn't know any better.
My husband and I went back only one more time ever (that's right, this story is about to get even more sad.) That evening we tucked her in, told her goodnight and that she is loved immensely. I held my face to hers and told her that if she just couldn't make it, I understood, and that my grandmother would keep her company if she had to go. They have the same feisty, sweet souls after all. I asked her to please stay if she could because I wasn't ready to live without her. "You're the best girl and I love you so so much."
She couldn't stay. I never saw Roxy again.
End of Day 2:
Just before midnight on Wednesday evening I got the call. The "we'll only call you if she goes drastically downhill" call. She went so fast. She was either hemorrhaging or the toxins suddenly spread to Roxy's brain and caused neurological damage. She was now blind, scared, and quickly deteriorating. I didn't want them keep her alive until I could see her, not in that condition. In fact they didn't know if they could EVEN IF I WANTED THEM TO. I didn't want her to suffer another moment. I asked the doctor to tell her that she isn't alone and that she is loved and to let her go as quickly as possible. I had to legally agree to have them administer euthanasia and agree to cremation between uncontrollable sobs. I could tell the doctor was sad too. Everyone who'd ever met Roxy loved her.
I sat in a dark room in my house with my husband and we both cried for hours. I'd never seen my husband cry. The silence from Roxy's absence was instantly apparent. She was easily the smallest creature in our home but her personality took up the most space. I had prepared myself to make the call to euthanize. I never wanted suffering. I hadn't prepared myself to live without her. A piece of me is gone with my best friend. I know one day I will be able to remember the good parts with joy in my heart. These last few days were so dark, it's hard to think outside them.
3 days ago my best friend was standing on the back of the couch hunting lizards who live outside the window in our cucumber garden. Today she is gone.
I need to say a huge thank you to the staff at The Charleston Veterinary Referral Clinic, who gave Roxy the best care possible and made sure she felt loved and cared for in her final moments...and also for treating me with kindness and tenderness and offering me unlimited tissues on the worst 2 days of my life.
Once agan, I kindly ask that you share Roxy's story with every pet owner you know. Ask them to share with their friends and continue on until Xylitol is widely known amongst pet owners as extremely dangerous. Keep products containing Xylitol out of your home or at least out of a dog's reach. It can take as little as 2 pieces of gum to cause liver failure. I wish I would have known. There would have never been Xylitol in my home, and even if there accidentally was, I would've known to get immediate help. Roxy would still be here today living out the life Xylitol stole from her.
If you would like to help us raise awareness of Xylitol poisoning, please consider purchasing a #fortheloveofROXY tee from our online store. All proceeds will initially help my husband and I with Roxy's remaining medical costs. All profit's beyond that will go into Roxy's fund to help spread awareness of the dangers of xylitol, and other local pet-friendly causes. More importantly, someone who may not read this article, may stop to read the shirt your'e wearing, potentially preventing another innocent life lost.
Thank you for taking the time to read our story.
With love to Roxy,
Amanda, Jeff, Theo, Ziggy, Knowledge, and Gus Janecek.