﻿ Dolittler's back on the Xylitol attack! (the Rescue Remedy and Tic-Tac edition) | petMD

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Think you already know everything you need to know about Xylitol? Time to re-think this…

In case you haven’t read my back posts on this (here’s the first and here’s another), Xylitol is a natural sweetener sourced from the birch tree. It’s a perfectly healthy substitute for sugar—unless you happen to be a dog…

…in which case your inability to break down this naturally occurring compound means that your blood sugar will drop dangerously after ingesting seemingly minute quantities, triggering seizures. Even one “sugar-free” cupcake can bring upon your demise. If the canine you ingests slightly larger amounts (let’s say two of these cupcakes) your liver may even fail.

Though some countries (most notably the birch-tree haven of Finland) have been using Xylitol since the 1970s, US consumer product manufacturers have only recently gotten in on the action (primarily the result of its favorable pricing relative to other sugar substitutes).

Despite the outcry of a small but vocal group of animal healthcare advocates (foremost among these the ASPCA’s poison control unit), more and more manufacturers continue to accept Xylitol’s emergent charms.

In my last post on this subject I railed against Flintstones and Starbucks. Both brands had recently changed their formulas to include Xylitol in several of their products. (Flintstones in some of their kids’ vitamins and Starbucks in some of their mints.) Neither brand went out of its way to warn its clientele of the change.

This was especially problematic for me as a result of my former allegiance to Flintstones as a reasonable canine multivitamin alternative. I was left to ponder how to reach all of the clients to whom I’d once advanced Flintstones as a safe and effective product for their pets.

So you see, the problem with Xylitol is not merely its presence in products (gums, candies, Jello, cupcakes, etc.). The dilemma it poses lies also in the insidious nature of its exposure when owners don’t realize that human-oriented products they once used safely for their pets (or exposed their pets to accidentally) are no longer safe.

When Fido snarfed up a couple of Tic-Tacs in the past you didn’t flinch, right? You certainly didn’t call the vet to determine the toxic dose of Xylitol and whether immediate medical treatment was necessary. But now that Tic-Tacs now contain Xylitol, will you know to worry? (By the way, you should know that according to the ASPCA’s poison control Tic-Tacs poison more dogs than any other product, partly as a consequence of their extra-high Xylitol levels and partly the result of their ubiquity.)

Kudos in this Xylitol awareness department go to the manufacturers of Trident gum. Though many Trident products contain this ingredient, it says so boldly. Not so with the newest loser product to adopt Xylitol: Rescue Remedy.

You heard that right. This bach flower extract-containing product we often recommend to soothe our dogs’ high-strung souls has succumbed to the Xylitol dogpile. No longer can I safely recommend Rescue Remedy now that its pastilles contain the ingredient. Though its other products have reportedly not yet been tainted by this sweetener’s potentially dog-toxic effects, I can no longer trust the manufacturer to keep its products Xylitol free without fair warning.

Thanks for this news goes to Nancy Freedman-Smith of the Gooddogz blog. Her personal experience with rescue Remedy pastille poisoning led her to call for a boycott on all its products until the manufacturer rescinds its use of Xylitol or applies warning labels to its products á la Trident.

Some might say that I make a mountain of a molehill on this subject.  Some manufacturers have. After all, they say, other countries have used Xylitol for decades, reportedly without experiencing the same canine-toxic effects our American dogs have.

But if our culture has come to accept that some products not intended for dogs are nonetheless safe, and if our culture is one that exposes its canine family members to more consumer products like these (whether accidentally or on purpose), then all of us who claim a vested interest in our families’ health certainly have ample cause to warn an unsuspecting public of its dogs' very real risks…

…and you would think that these vested parties would include the manufacturers of these Xylitol-containing products, too.

 Tic-Tac and Rescue Remedy brand managers: Are you listening?

Image: tic-tac-man :) by gigaman

Comments  30

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  • 06/16/2009 03:35pm

    I just took my dog to the vet when I noticed she was having problems standing.  She started having convulsions after that.  They are giving her glucose and potassium and are monitoring her liver levels.  She had consumed about 30 tic tacs chill exotic cherry.  Does anyone know how much xylitol is in one of these tic tacs?

  • 02/27/2009 03:03pm

    My dog Cody was just posioned my Trident gum she stole from out of my coat. If I had known about Xylitol it would have never been there! I saw NOTHING on the packaging of the gum that warned about the toxic effect it could have on a dog!

    My dog will be released from the hospital today after over a $1000 in treatment, but she will not really be out of the woods until we are able to see if her liver will come out intact. I can only hope that her propensity to swallow things whole and her youth will serve her well in this area.

    As pet owners we do our utmost to protect our animals from harm and accidents happen. This one would have been far less likely to happen if I had only known the danger seeing as I already know my dog.

  • 01/04/2009 12:33am

    i just bought a tic-tac box tonight, and it said nothing about containing xylitol... i wonder of that means that they changed it....

    contains:sugar,maltodextrin, rice starch, gum arabic,natural and artificial flavors,magnesium stearate,&carnuba wax

  • 12/27/2008 07:36pm

     forgot to add...Bach has also taken the alcohol (now if they can just do this for the 'humans' too) from their 'pet-safe' Rescue Remedy-

    Thanks to all for the Xylitol toxicity info. I know there are several pet owners I know who did not know it's danger...

  • 12/27/2008 07:30pm

    Anyone with common sense should know that the Resue Remedy pastilles are for human consumption only.  They were developed to make it easy for people to take the remedy on the go, without having to dilute in water, or take out a dropper and  to take away the 'alcohol' taste.

    ANY references to uses for animals are to their NON-XYLITOL containing sprays and liquid drops. As with ANY mints, candies (candy drops), etc., we as dog owners have the responsibilty to keep all those products in places safe from our dogs as you never know what sweeteners (we are continually discovering more...) can be toxic to them.

    It is unfair to say that the Bach company is being deceptive in any way. While I agree that for safety's sake it would be best for there to be a larger xylitol labeling on the product and a "not for pet consumption" warning, anyone who does the proper research would know that pet usage by the Bach company has always been per the essences in 'original' form and that as responsible dog owners and consumers it is up to US to check ALL labels.

  • 12/18/2008 01:07pm

    Instead of Rescue Remedy, use FIVE FLOWER FORMULA from fesflowers.com.

    This formula has the exact same five flowers in it that Rescue Remedy does, but FES does NOT use artificial anything in its flower essences.  Also, as a side benefit, FES products are much more reasonably priced, and the glass dropper inside does not have the annoying curve that the Rescue Remedy product does (which makes is more difficult to get the drops to come out).

    FES also sells a great product for animals called:  THE ANIMAL RESCUE FORMULA.

    This is really great for traumatized or rescue animals.


  • 12/11/2008 08:29am

    Sorry, since when did "bach flower extract" constitute an active ingredient?

    I am a vet and have delved deeply into a wide range of alternative therapies, and while I have tried flower essences, I've got to tell you the science behind them is on par with homeopathy and crystals.  Highly effective for their placebo effects.  I am sure the brandy adds to the effect!

    Rescue remedy is highly effective for acute, transient, ephemeral or neurosis derived illnesses.

    The people who use them seem to have "crises" situations about 10x the population norm, and amazingly they survive them thanks to rescue remedy :-)  The rest of us take a deep breath and survive also.


    Love the rest of the blog.

    Keep it real.



  • 12/03/2008 01:15pm

    Nelsons statement on use of Xylitol in Rescue Pastilles re: pets

    There has been some confusion from pet owners recently reported on blogging websites regarding Rescue® Pastilles and animals. Nelsons does not recommend giving Rescue Pastilles (a product intended for humans) to any animal as they contain Xylitol - a natural sweetener found to improve human oral hygiene, but which is not suitable for pets.

    To clear up any misunderstanding, Rescue® Remedy spray and dropper products and Bach Original Flower Remedies do not contain Xylitol.

    We recommend that pet owners should always check with their vet before giving any new health product to their animals.

    For animals within the U.S., we recommend Rescue® Remedy Pet from the Rescue range. Rescue Remedy Pet is a blend of five Bach flower essences in an alcohol-free, glycerine formula. It is available as a dropper purchasable at Whole Foods Market or go to www.rescueremedy.com/pets for additional information.

  • 12/01/2008 07:27pm

    Nancy, I think a big part of the reason flower essences have no negative effects is because, as per your blog, they're basically water and whatever other preservatives you've added.

    "These remedies contain subtle properties from the inherent life force within the flowers from which they came, without any part of the actual plant still remaining in the water."

    I'm not saying anything about the validity of your claims, or about how well flower essences do or do not work. I don't have enough information on them to really know, and I'm not a doctor anyways. I just thought it was worth pointing this out to put your last comment into perspective some.

  • 12/01/2008 05:54pm

    Hi Dr. Patty!
    Thanks for posting this. When I wrote my blog, and called the local offices and had many people call and email, we got ZERO responses. Glad to see you got the ball rolling. I will post this contact info for RR on my blog as well. Thanks again!

  • 12/01/2008 04:25pm

    I need to get more Pepto for our dog supply cupboard. We've been told in the past by our vet that it's safe to use for occassional tummy trouble  ... They haven't added Zylitol to Pepto too, have they? Does anyone know?

  • 12/01/2008 04:24pm

    Creature of Habit: Yeah, I've had my say with the Virbac folks. Most of their products are excellent but this one employs xylitol gratuitously, IMO. I won't carry it or recommend it. But we do carry their other products.

  • 12/01/2008 01:52pm

    Unlike Emily, I am reading this post now after having bought a dental additive formy dog's water 2 weeks ago. I checked - it has Xylitol in it. I called the Vet (where I bought it!!!!) and they said it was fine in miniscule amouts so I called the 1-800 and got the same blah blah blah.

    Maybe it's fine in trace amounts (1 teaspoon per pint of water). But what is my husband or I aren't paying careful attention and put in too much? My god, we could poison her! Why does a dog even need a sweetening agent to a water additive? That's crazy.

    $20 down the drain. Literally.

  • 12/01/2008 11:39am

    You are right to note that not all natural products are safe under all conditions.  There are probably conditions where almost any natural substance would be contraindicated.  That's the reason I strongly believe that everyone who is response-able for pets and children needs to educate themselves on all these things -- as well as to know your own pet and child. 

    The point I wanted to make is that flower essences are proven (and have been known for years) under clinical conditions to:

    • Not interact or interfere with any other medications or diet (unlike herbal remedies or medications) -- they work through your electrical system instead.

    • Not cause side effects of any kind in any physical or emotional system

    • Cause no harm.  Period.  Either they work for the purpose they're being administered, or they do nothing at all.  It's easy to tell. 

    • Be safe even for newborns (you would want to watch which preservative you're using, however)

    Skepticism is a good thing!  But I'll tell you this:  my biggest fans are former 17-year-old boys whose Moms "made" them take flower essences (after which they call me secretly to ask, "Hey Nance can you give me some more of those flower juice thingies?")

    And for goodness sake please don't just take my word for it (although I AM an authority in my field.)  Do some research on flower essences.  You will not find any documented proof contrary to the claims I am making here. 

    Look, I have no reason to claim anything that is not true or has not been proven.  No one benefits from this and I won't do it.  What I share is based on my work with hundreds and thousands of people and animals, and on the research of my predecessors whose findings match my own. 

    Have I ever had "bad results"?  (E.g., client fail to get the wanted results.)  Yes.  Twice.  One was a drug addict who would not stop taking the substances; the substances were interfering with his consciousness and ability to use the information the flower essences were providing to his system. 

    The other was a cat whose repeated territory marking could not be controlled due to the owner's inability to completely remove all traces of odor from the affected area.  The cat knew that it "should not" spray, but would not be deterred from the faint (and then repeatedly marked) area. 

    Was I sad about those?  Sure!  Everyone wants 100% results.  But 99.99999% is still pretty darn good.

    Mostly?  I am a person who tries to learn at least one new thing every day -- and this column sure helps with that! 


  • 12/01/2008 09:08am

    Re natural/alternetive medicine,  in addition to what Laurel wrote:

    Red flags always go off for me when someone says something doesn't have any side effects at all. To me, it seems that if something is potent enough to do good, then it's also potent enough to do harm (in certain conditions).

    As for natural==safe, I like to remind people that there are many perfectly natural poisons out there...

  • 11/30/2008 07:17pm

    Dr. Khuly, your post today couldn't be more pertinent for me. I took my dogs home to my parents house for the Thanksgiving weekend. They cleaned up the basement where I'd be staying and told me it was good to go. What they didn't realize is that, unlike their saintly boxer, my dogs will open cabinets, dig through pockets, and shred through boxes to get to food. They ended up eating an entire box of macaroni noodles while I was out of the house Friday and shredding some empty cardboard boxes. I almost had a heart attack when I realized that they'd shredded the cardboard sleeve from some Ice Breakers gum - I thought I'd have to rush them both to the emergency clinic. Luckily, my brother assured me the gum was long gone. The packet had been his and he was absolutely sure there was no gum left in it. Whew.

  • 11/30/2008 06:37pm

    Just FYI, I've used the Rescue Remedy pastilles for over a year, and they have always contained xylitol. This is not new.

    The liquid version of rescue remedy does not, contan xylitol it's alcohol and flower essences. It happens to be okay for pets, but it was not formulated for animals, it was formulated for humans. I recently bought liquid RR at the local health food store and I just checked the label and itdoes not contain xylitol, so it does not apear that xylitol is being added to all rescue remedy products.

    There is a new version of liquid rescue remedy especially fomulated for pets that is alcohol free.

    Just because the original liquid version of RR is okay for pets does not mean that people should assume that all RR products are okay for pets, especially since they were formulated for people, not pets. People need to use common sense when considering using products designed for humans for their pets and read labels.

    The rescue remedy web site clealy states that the pastilles are not suitable for pets.

  • 11/30/2008 06:18pm

    Nancy, Wow, bringing back a memory for me! I had ordered/received a variety of essences from you/Green Hope Farm years ago---"pre computer" , possibly late 80's, preserved in vinegar/shiso bases....

    I'll have to visit your web site!

    Barb Albright/NH

  • 11/30/2008 02:53pm

    First of all thank you so much for bringing the xylitol issues to the forefront. The more widely the information goes, the more dog lives are saved.

    On the flower essence issue, though, I do have some excellent resources to offer, as I am (among other things) a Certified Flower Essence Practitioner who specializes in creating custom blended flower essence formulas for people and animals.

    Readers may like to know that there are several great alternatives to Rescue Remedy, with preservatives you can trust. Perelandra makes an excellent formula that belongs in every household with kids or pets: ETS Plus. (ETS stands for Emergency Trauma Solution.) This one resets your trauma circuits if they get triggered -- and I have seen with my own eyes some other amazing healing things it does. (Try this one on paper cuts!) You can get this preserved in either brandy or white vinegar; my corgi prefers the brandy.)

    Green Hope Farms has a combination formula called Animal Emergency Formula, created just for the special needs of animals. It comes preserved in a red shiso (vegetable/vinegar) base that most animals tolerate well for taste ~ it's completely safe.

    In my work I often create custom blends for animals, which can be ordered with your choice of preservative: red shiso, brandy, white vinegar, or glycerine (made from coconuts.)

    Meanwhile if readers have further questions about flower essences, their use, safety, effectiveness, and more, please visit my blog Dances With Flowers (http://www.danceswithflowers.com) to learn more and get links to sites where you can order the items you're looking for. My blog also has a big section explaining the science behind why flower essences work, so some of the above comments will be answered there too.

    Thanks also for the opportunity to shed a little more light on the flower essence piece of this issue. Oh and just as an aside, it's been years since I've used anything from the Nelson Bach company; for some reason the quality of their products has deteriorated. If I need any of the Bach flowers now, I just get them from other trusted suppliers instead.

    The main thing we ALL need to do as responsible pet owners is to be vigilant about what's in everything. Manufacturers seem to change ingredients frequently, not always making those changes obvious. It pays to look each time and stay on top of the news in blogs like this one. It can save your beloved pets' lives!

    For safer holidays for all our pets,

    Nancy Boyd
    Certified Flower Essence Practitioner

  • 11/30/2008 12:23pm

    Dr. Patty: You're so right about extra-label use. That was boneheaded of me.

    But I don't see the point in using treatements that don't outperform placebo and/or work via an understood mechanism. Things like medicinal herbs that work in ways we can test and understand aren't "alternative" medicine to me; they're just medicine.

    Do you think labeling changes are indicated for supplements and the like?

  • 11/30/2008 09:04am

    Linda: not all Flintstones...just some. So you have to look. I've gone back to recommending plain old Pet Tabs or Vetri-Science's Canine Plus. My dogs love the latter's chewiness--even better when it comes straight from the fridge.

    Ramen Connoisseur: We don't know how Xylitol affects cats. In dogs it stimulates insulin release, causing the blood sugar to plummet. In cats we just don't know. Having said that, it seems the ASPCA's poisn control is not receiving complaints related to Xylitol toxicity in cats, whereas dog toxicity is definitely on the rise.

  • 11/30/2008 08:59am

    Laurel: The supposed active ingredient is bach flower extract, though I, too, wonder whether the alcohol plays a larger role than the extract. It does, however, seem to be effective for some pets.

    "I do think you're overreacting (the product isn't labeled for pets, is it?), and if my vet had ever recommended this stuff to me I'd've refused to buy it and considered changing vets."

    On this statement I must defend my profession. If we were forced to practice veterinary medicine using only products labeled for the specific species we'd have almost no drugs to work with. Human preparations are the minstay of our pharmacies because there are no veterinary equivalents.

    On the use of alternative medicine in general: Acupuncture is absolutely science based, as is a lot of herbal medicine, including the use of the bach flower extract in Rescue Remedy. Yes, this latter product may be marketed by a human being I'd not likely agree with on any medical subject, but there is some work to indicate that bach flower extract is soothing and safe.

  • 11/30/2008 07:04am

    What's the active ingredient in Rescue Remedy? My research suggests there's a fair amount of brandy in there, which might account for the calming efect, but is not something I want to give a dog, child, or myself (I'm alcoholic) without knowing about it. I understand that chiropractic for horses and acupuncture for dogs is all the rage now, but I don't trust pseudoscience and I fail to see why anyone should.

    There's a common misconception that "natural" or "alternative" medicines are OK to try because they can't do any harm. That simply isn't so. I do think you're overreacting (the product isn't labeled for pets, is it?), and if my vet had ever recommended this stuff to me I'd've refused to buy it and considered changing vets.

    Unless, of course, the vet could answer my question above. What's the active ingredient? How does it work? Why on earth would I want to use, medically, a substance invented by a man who didn't accept that germs cause disease?

  • 11/30/2008 04:58am

    I did not know that some Flintstones now contain Xylitol! I have previously used them in the past for my dogs. What multivitamin are you recommending to your patients now in lieu of Flintstones?

  • 11/29/2008 09:57pm

    I was just shopping for dental rinse for dogs and found that one of the major suppliers' brand has xylitol in it.

    Thanks to the blogs, I didn't buy it!

  • 11/29/2008 04:52pm

    Anyone know if xylitol is toxic to cats as well? One of my cats used to be feral, and has a penchant for people foods most cats (including my other two) wouldn't touch with a ten foot pole. He is especially fond of sugary items.. which makes me a little nervous with xylitol use becoming more ubiquitous. I'm pretty sure he could be trusted with a box of Tic Tacs or a pack of gum, but if this stuff makes it into actual food, that could be a problem. I try hard to keep things out of his reach, but he's ridiculously smart and resourceful, and sometimes manages to get his paws on it anyway. (I once busted him sitting inside the trash can I'd once thought was cat-proof.. drinking leftover pancake syrup. Bad kitty.) I know dogs are far more likely to get into the stuff than cats, but I'm having a hard time finding *anything* about cats.

  • 11/29/2008 02:04pm

    not to get on a xylitol bash-wagon but frankly how much is ok? or is it none to be safe? The reason why I ask/wonder is because my 10 year old had an adverse reaction to liquid Metacam. I assumed it was the sorbitol in the liquid. My package insert and the MSDS report did not have the list of inert ingredients. When I called the 800 number I was surprised to hear xylitol. When I asked if that was going to change, the messenger on the phone gave me a song and dance about the miniscule amount. My dog was only  prescribed it for post-op pain but I do know of other dogs that take it routinely.

  • 11/29/2008 01:40pm

    I think Rescue Remedy is trying to get around this by marketing a pet only line of Rescue Remedy.  Instead of alcohol, the pet line uses glycerine and water as the base.  (And no xylitol.)  Frankly, I've wondered whether the alcohol free versions are as effective as the non-alcohol versions.  The pet version is specifically marked for pets.  My real problem with them is that ingredients lists by suppliers on Amazon don't list all of the ingredients.  Plus, there appear to be more than one type of pastilles flavor out there.  Bach has put a notice about not giving the pastilles to dogs on their website.  Now they need to get the word out to their distributors, or put something on the packaging.

    With the spread of new sweetners, it's no longer safe to assume that human quality foods are always safer for animals than pet marketed items.  It might have been marketing hoopla in the past, but it looks like an idea to start teaching pet owners now.  Please read ingredient lists before you buy is a good idea for all food, actually.

  • Xylitol, Sugar Alcohol
    01/14/2011 05:24am

    Just read this article and comments. Immediately, I ran to the medicine cabinet where we keep our Labrador Retriever's grooming supplies. Lo & Behold! Guess what is in his toothpaste? Yep you guessed it! Sorbitol, also known as Xylitol. This product is specifically marketed as pet toothpaste: EZ DOG Pet Toothpaste; manufactured by: Triple-Pet
    (www.triplepet.com); distributed by Benedent Corp., Houston, TX 77282-0567, 800-450-4977

    Hmmm..Did I hear someone mention accountability?

  • Sorbitol
    03/04/2012 04:09pm

    I realize this is a rather old article but Just had to post this info.

    Late last year I purchased a bottle of, Petrodex Dental Rinse and been using it on a irregular basis. Well what a unpleasant surprise to read the ingredient label Sorbitol being the number 3 ingredient listed.

    A rather large pet supply company like Sentry HC should know better and be ashamed if they weren't.

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