For pet parents, beware that Xylitol, a natural sweetener that can be toxic to animals, can be found in toothpaste.

Xylitol is a natural sweetener derived from the bark of the birch tree.

In humans, it has little effect on insulin release or blood sugar levels. This attribute is referred to as a low glycemic index. Xylitol’s sweetness is comparable to sugar but it has about half the calories.

Because of this it has found its way into a variety of products, including sugarless gum, chocolate, peanut butter and toothpaste. It's also sold as a stand-alone sugar substitute.

Virtually any place you would expect to find sugar or sugar substitutes, and even in a few you would not, Xylitol may be present. And that may be a bad thing for your pets.

That’s because in cats, and dogs, Xylitol triggers a sudden and sometimes massive release of insulin. This can lead to depression, vomiting, uncoordination, tremors, seizures, coma and death.

One of those places the sweetener may be found is in medications, especially those that are compounded for use in pets. Compounding is where a drug is reconfigured from its original manufactured form and customized for a particular patient.

This is common practice in veterinary medicine because there is a tremendous size variation among our patients, and because many of the drugs used on pets are actually developed and manufactured for use in humans. Sometimes they need to be converted into smaller pills or liquid doses.

One example is a medication called Gabapentin, which is a sort of a new kid on the block, in the veterinary world.

Gabapentin was originally manufactured for humans and used as an anti-convulsant, as well as a pain medication.

It has lately gained wide acceptance as an effective tool in our arsenal to treat pain in animals. It is most effective when combined with an opioid pain reliever, and/or a nonsteroidal anti-inflammatory drug (NSAID). But one problem with Gabapentin is that it tastes bad.

The best pain medication in the world will not work if you cannot get it into the pet. Painful conditions, as well as many others, are often chronic, requiring the administration of medications for indefinite periods of time.

It may not be long before they get wise to the pills hidden in their snacks, which may mean forcing the pills into the back of their throats. But once a pet associates a bitter taste with the medication, it can become nearly impossible to give it.

One solution has been to reconstitute the drugs into a liquid form that tastes good. The problem is that one of the sweeteners used in Gabapentin and other drugs is Xylitol. So the drugs you are treating for one problem may be putting your pet at risk of another.

So, in addition to the various foods you have around the house, the medications may pose a risk as well, even at the appropriate dosages.

Pet owners must ask their pharmacists if Xylitol was used in the compounding or manufacture of any drug they dispense.

Veterinarians should make it clear when writing, or calling in prescriptions, that this drug is for a pet and that it cannot contain Xylitol.

Many of the drugs we prescribe are dispensed by human pharmacies. Therefore pharmacists must be aware of the ingredients of the drugs they are dispensing to the animal portion of their clientele to insure that the treatment is not worse than the disease.

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