Vet AI Scribe for Urgent Care

Biscuit

Sunday, October 18, 2026 at 3:52 PM

Walk-in urgent care — suspected xylitol ingestion

Triage Summary

Recorded by support staff for the attending veterinarian at 3:52 PM.

• 2-year-old neutered male beagle, 12.4 kg.
• Ate an estimated 6 pieces of sugar-free gum from a handbag at about 3:10 PM. Owner brought the packet: xylitol is the first ingredient; amount per piece not stated.
• Bright, alert and ambulatory. Mucous membranes pink; CRT under 2 seconds.
• Heart rate: 112 bpm · Respiratory rate: 28 breaths/min · Temperature: 101.6°F
• Blood glucose (glucometer): 96 mg/dL at 3:58 PM.
• Moved straight to a treatment room.

Subjective

• Ingestion about 45 minutes before arrival; no vomiting yet.
• No other known access to toxins. Ate lunch at noon.
• No previous medical history; up to date on vaccines.

Objective

• Exam: Normal. No tremors or ataxia. Abdomen soft and non-painful.
• Baseline bloodwork: ALT 48 U/L (10–125), ALP 62 U/L (23–212), total bilirubin 0.2 mg/dL (0.0–0.9), PCV 46%, total solids 6.4 g/dL. Platelets adequate on the smear.
• Poison control: Consulted; case number and consult report (PDF) attached to the record. The xylitol dose could not be calculated, so the case is being managed as a potentially hepatotoxic dose. Recommendations: induce emesis, check blood glucose every 1–2 hours for 12 hours, start dextrose if glucose falls, and recheck liver values at 24, 48 and 72 hours.

Assessment

1. Xylitol ingestion, dose unknown — at risk of hypoglycemia over the next 12 hours and of acute liver injury over the next 1–3 days.
2. Currently normoglycemic and clinically normal.

Plan

Time-stamped Case Update

• 4:05 PM — Apomorphine 0.03 mg/kg IV (0.37 mg).
• 4:09 PM — Vomited twice; about 5 pieces of gum recovered with food.
• 4:20 PM — IV catheter placed. Lactated Ringer's with 2.5% dextrose at 30 mL/h.
• 4:30 PM — Maropitant 1 mg/kg SC (12.4 mg).
• 4:55 PM — Blood glucose 88 mg/dL.
• 5:55 PM — Blood glucose 91 mg/dL. Bright, no tremors.
• 6:15 PM — Called the owner: the clinic closes at 10 PM, so transfer to a 24-hour hospital is recommended for the rest of the 12-hour monitoring. Owner agreed.
• 6:40 PM — Transferred to Northside Veterinary Emergency with this record, the poison control report and the bloodwork. Catheter left in place.

For the Receiving Hospital

• Blood glucose every 1–2 hours until 3:10 AM.
• Hepatoprotectant (SAMe) recommended by poison control; not started here.
• Liver values at 24, 48 and 72 hours after ingestion.

Client Communication:
Explained that xylitol can cause a sudden drop in blood sugar within hours and, less often, liver damage over the next few days, so Biscuit needs glucose checks overnight and blood tests over the next three days even though he seems well now. Gave the owner the address of the emergency hospital and advised driving straight there. Discussed keeping sugar-free gum, mints, some peanut butters and baked goods with sweeteners out of reach.

— Dr. Marcus Feld, DVM