Xylitol Toxicity in Dogs

Picture of a puppy

The number of dogs being exposed to xylitol has increased over the years, as people have started to watch out their diets a little more. In the past, xylitol was thought to cause just hypoglycemia in our canine friends, but it was recently discovered to produce coagulopathy, as well as acute and potentially life-threatening liver disease.

In this article, we’ll look at what xylitol is, its toxicity, and the clinical signs it causes, as well as whether there is any treatment for the poisoning.

What is Xylitol?

Xylitol has become quite common over the past decade or so. It is essentially a sugar alcohol that’s used as a sweetener in many products, from chewable vitamins and mints to sugar-free gum, baked goods, and even oral care products. It can also be purchased in its individual form (granulated) and can be used for baking or cooking. It is also used as a sweetener for beverages and cereals.

Xylitol is one of the most popular sweeteners utilized in Europe (especially Norway, Finland, and Russia) and Japan. Its use in North America has increased rapidly over the last few years.

Even though xylitol consumption is generally considered safe in people, dogs can develop severe and even life-threatening clinical signs from having ingested xylitol. This substance has the ability to cause hypoglycemia in our canine companions, and this has been known for over 30 years. Many studies have found that it can cause acute liver necrosis.

While xylitol can be produced artificially, what you might not know is that it exists naturally in many edible plants – lettuce and berries – and even in mushrooms. Although it was first identified at the end of the 1800s, it wasn’t used commercially until around half a century later. Finland started producing xylitol during WWII on account of sucrose not being available. Once the war ended and sucrose became available again, xylitol production was resumed. However, commercial interest in the substance reawakened in the mid-1970s when its production became practical. There are now many economical and effective techniques for producing it.

Why did it become so common and what makes it so popular? The short answer to this question is that while xylitol is just as sweet as sucrose, it has just about two-thirds of the calories in the same amount of sucrose. Since it also causes little insulin release in humans, it is generally thought of as being a good sugar substitute for people who are on a diet. It is commonly used by diabetics.

Additionally, it has been shown to inhibit the growth of some types of bacteria and it is also capable of preventing oral bacteria from producing acids that damage the surface of the teeth. That’s why it’s become a staple in many sugar-free oral care products such as gum or toothpaste.

Foods That Contain Xylitol and That Are Dangerous to Dogs

Since xylitol is available for sale in its granulated form, it is used by home cooks when preparing food and baked goods. There are records of dogs developing xylitol poisoning from having consumed cookies, gum, cupcakes, or muffins. Many of the dogs that were discovered to have consumed the substance had to be euthanized or died because of severe liver failure.

While pet parents might be watching their diets with the help of products containing xylitol, they should be watching their dogs, too, so as to make sure that they don’t eat any products that could contain this substance.

How Much Xylitol Poses a Threat?

The dose that can cause hypoglycemia in our canine friends is reported to be approximately 50 milligrams per pound of body weight. The higher the dose that was ingested, the more risk of the liver being affected. Sugar-free gum is the most common source of xylitol poisoning, and that usually happens when it is simply left within reach of dogs. As you can expect, no pet parent would intentionally give gum to their Fido, mostly for fear of causing a digestive blockage.

While some brands of gum have somewhat small amounts of xylitol, it can take around 2 to 10 pieces to cause hypoglycemia or liver failure in a canine. If you suspect that your dog has eaten some sugar-free gum, take him or her to the vet as soon as possible.

Clinical Signs

In people, a dose of 130 grams per day can cause diarrhea, but no other abnormalities were discovered just yet. In dogs, however, it’s a completely different story.

The initial symptom of xylitol poisoning in our canine friends is vomiting. Hypoglycemia can develop over a span of 30 to 60 minutes. In some cases, hypoglycemia might happen later, at about 12 hours after xylitol was ingested. The symptoms can progress quickly from lethargy to collapse, ataxia, and seizures. If you take your dog to the vet, the blood work will show severe hypoglycemia, and in some dogs, serum chemistry abnormalities include hypokalemia and hypophosphatemia.

Some dogs develop elevated liver enzyme activity 12 to 24 hours after the ingestion. They can even develop acute liver failure. Other symptoms of xylitol poisoning include the following:

If your dog eats something advertised as sugar-free, you should check the ingredient list. There are other sweeteners that are not poisonous to our canine buddies, such as maltitol, sorbitol, or erythritol. Even if you are on a diet and don’t need the empty calories of products containing sugar, if you know that your dog is likely to investigate and try to eat your food, it might be a better idea to opt for the sweeteners we’ve mentioned above.

How Can Xylitol Poisoning Be Treated?

There is no antidote for xylitol poisoning, but that doesn’t mean that supportive treatment is going to do nothing for your Fido. If you take your pet to the vet, his or her blood sugar will be the first thing that will be checked. If it is normal, the vet might induce vomiting to try to eliminate the xylitol from your dog’s stomach.

If the dog is hypoglycemic, a bolus of intravenous dextrose is required, after which your pet will be hospitalized and kept under close observation. The rest of the treatment includes IV fluids with dextrose (sugar) supplementation for a minimum of 12 to 18 hours. If during this time, your pet is stabilized, and his/her blood sugar levels become normal, the prognosis becomes optimistic.

In the event that the vet chooses to induce vomiting in your dog, there is no need to use activated charcoal. As you might know, with some types of poisonous foods or substances (such as chocolate, for example), activated charcoal can absorb the contents in the animal’s stomach or bind to the toxic substance. In this case, however, there is no need to resort to this method as activated charcoal isn’t capable of binding to xylitol in a reliable manner.

Careful monitoring of your dog’s blood work is required, and what the vet will look at will be the blood sugar, but also electrolytes and liver enzymes. If you suspect that your dog had access to a potentially liver-toxic quantity of xylitol, he/she might also require liver protectants (such as milk thistle, SAMe, or n-acetylcysteine). To get an idea of how dangerous this substance can be, we’ll tell you that even if your dog seems to recover, he will be prescribed liver protectants for a few weeks following the emergency treatment. Checking the liver enzymes at the clinic might be necessary, as well, especially under the circumstances where your dog has developed liver damage due to xylitol exposure.

As you can expect, there are other toxic substances that can cause symptoms that are similar to those of xylitol poisoning. Hypoglycemia can occur in insulinomas (pancreatic cancer) or when a too high dose of insulin was administered to a diabetic dog. Acute liver necrosis can also be caused by the ingestion of hepatotoxic mushrooms, blue-green algae, and acetaminophen (which can be found in Tylenol), or it can be the result of some infectious diseases. For example, mycoses, toxoplasmosis, infectious canine hepatitis and leptospirosis can be at the root of acute hepatic necrosis, as well. Trauma and heat stroke are two other possible causes. Your vet will try to eliminate any other possibilities so that the correct diagnosis is made.


With prompt treatment, the prognosis is good for uncomplicated hypoglycemia. Mild increases in liver enzyme activities will typically resolve over the span of a few days, so long as the dog receives supportive care. Unfortunately, if severe elevation of liver enzyme activities, coagulopathy, and hyperbilirubinemia are developed, the prognosis is guarded to poor. If the dog ends up in a coma, the prognosis is very poor.

Preventing Xylitol Poisoning

As we might have mentioned, sugar alcohols such as mannitol or sorbitol have little to no effect on either insulin secretion or blood glucose concentration in dogs. Over-ingestion can result in osmotic diarrhea, however, but this is a clinical sign that shows up in cases where people have consumed a too high amount of artificial sweeteners, as well. Other sweeteners such as aspartame, sucralose, and saccharin are thought of as being safe and will not cause significant illness, even if large amounts are ingested.

But how can you protect Fido from xylitol poisoning? Well, you’ll be happy to know that there are several easy preventive measures that you can take in this sense. First of all, be careful where you put your backpack, bag, briefcase, or purse when you get back home, especially if you know that it might contain gum or a lip balm. Don’t leave these items on the floor or on kitchen counters since dogs can be pretty curious and might try to go through the contents of your bag and nibble on things.

If you do sugar-free baking, it is a good idea to store your bulk sweeteners and bake goods away. If, for example, you have friends over and you’ve made a dessert with xylitol, make sure you inform the people in your house that they should by no means feed a piece to your dog. Always remember that dogs are omnivores and they like human foods just as much as we do.

Use only pet-specific toothpaste if you brush your dog’s teeth. Human toothpaste contains xylitol and fluoride, both of which can be toxic to pets. Use a leash and control your pet when you go out for walks, especially if he or she likes scavenging.

If your dog ends up getting into any mints, gum, or nut butter, check the ingredient label right away. If it contains xylitol, get in touch with your vet or call your local Animal ER. There are also pet-specific poison control hotlines you can call if you suspect that your dog might develop xylitol poisoning.

Last, but not least, do consider that xylitol is used in almost any kind of product nowadays. While you might be aware that it is present in some sweets and desserts, did you know that it can also be found in medications, vitamins, supplements, condiments and sauces, as well as protein bars and even body care products?

Here are some other types of products that could pose a threat to your dog and that can contain xylitol.

  • Clothing – especially sporting and adventure gear, where xylitol is used as a cooling agent
  • Cleansing cloths

Personal care

  • Personal moisturizers
  • Pacifier and bottle wipes
  • Facial cleansers and make-up removers
  • Body butter
  • Shaving creams
  • BB cream
  • Deodorant
  • Lip balm
  • Shampoo
  • Sunscreen

Food and edible products

  • Protein shakes
  • Meal replacement drinks
  • Sugar-free soda
  • BBQ sauce, mustard, ketchup, Teriyaki sauce, chipotle sauce
  • Jams and preserves
  • Yogurt
  • Chocolate (which should never be given to dogs, anyway)

Medications, oils, and supplements

  • Antacid
  • Omega 3 and Omega 7 supplements
  • Fish oil
  • Probiotic formulas
  • Chewable vitamins
  • Digestive support

Nut butter

  • Peanut butter
  • Almond spread
  • Sesame spread

As you can see, xylitol is a very common ingredient in many foods and other types of products nowadays. It is imperative for you to check the list of ingredients whenever you buy something that you might also want to feed to your dog. If possible, we advise consuming products that contain xylitol when you’re not at home or when you’re not in your pet’s company.



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