In the world of veterinary medicine, there's a silent threat lurking in many common household items: xylitol. This sugar substitute, while safe for humans, can be deadly for our canine companions. As a veterinarian, I often encounter cases of xylitol poisoning in dogs, an issue both serious and preventable. Imagine a routine act, like your dog sneaking a piece of gum, turning into a life-threatening emergency. This article sheds light on the hidden dangers of xylitol, a substance toxic to dogs, found in products from sugar-free gum to certain peanut butter. Please continue reading to learn more about xylitol toxicity in dogs.

What is xylitol?

Xylitol, often known as birch sugar, is more than just a sugar substitute; it's a common ingredient in many household products. This sweetener, extracted from the sap of birch trees, is found in a variety of items ranging from sugar-free gum and baked goods to toothpaste and certain brands of peanut butter. It's a popular choice for humans looking for low-calorie sweetening options. However, what many dog owners may not realize is the danger it poses to their dogs.

In dogs, xylitol is extremely toxic. When they ingest substances that contain xylitol, it can lead to serious consequences. The most immediate concern is hypoglycemia, or low blood sugar, which can occur swiftly and be severe. In more severe cases, xylitol ingestion can even cause liver failure. 

Recognizing products that contain xylitol or birch sugar is an important first step in protecting your dog from accidental xylitol poisoning. This awareness is key to preventing a potentially life-threatening situation for your pet.

What are the common sources of xylitol?

Xylitol is found in a variety of common household products, and its presence is not always obvious. As a dog owner, it's important to know that xylitol-containing products can be found throughout your home. Some common sources of xylitol include:

  1. Sugar-free chewing gum: One of the most prevalent sources. Many sugar-free gums contain xylitol as a primary sweetener.
  2. Dental products: Includes toothpaste and mouthwash. These products often contain xylitol for its oral health benefits in humans.
  3. Sugar-free foods: Items labeled as 'sugar-free' or 'no sugar added', like certain candies, chocolates, and baked goods, may use xylitol as a sweetener.
  4. Peanut butter and other nut butters: Some brands use xylitol as a sugar substitute. Always check the label before sharing any with your dog.
  5. Medications and supplements: Over-the-counter medications, including some chewable vitamins, laxatives, and allergy medications, may contain xylitol.
  6. Packaged goods and snacks: Xylitol can be found in unexpected items like protein bars, yogurt, mints, and even some brands of ice cream.
  7. Diet foods: Products marketed for weight loss or diabetes-friendly diets may use xylitol for its low glycemic index.
  8. Baking ingredients: Xylitol is sold as a sugar substitute for baking, so it may be present in homemade goods if xylitol is used.

How is xylitol harmful to dogs?

When your dog eats xylitol, their body absorbs it quickly and even small amounts of xylitol are toxic to dogs. This substance then makes your dog's pancreas release insulin, up to 7 times more than it would for normal sugar. Therefore, even a little bit of xylitol can cause a big insulin release, and this can lead to a dangerous drop in your dog's blood sugar levels, a condition called hypoglycemia.

Xylitol is also harmful to your dog's liver but we aren't exactly sure of the mechanism. It might be because it uses up a vital energy source in the liver cells, or it might cause damage on a cellular level, called hepatotoxicity.

It's important to know that other sweeteners similar to xylitol, like mannitol, sorbitol, maltitol, and erythritol, don't have the same harmful effects on dogs.

What are the symptoms of xylitol poisoning in dogs?

The signs of xylitol poisoning in dogs are largely related to the signs of low blood sugar, or hypoglycemia.

Signs of hypoglycemia include:

  • Anorexia (loss of appetite)
  • Vomiting or diarrhea
  • Lethargy (lack of energy)
  • Ataxia (loss of coordination)
  • Restlessness
  • Weakness
  • Collapse
  • Seizures
  • Coma

Some dogs with toxicity may show signs of severe liver disease and may include:

  • Icterus (jaundice)
  • Vomiting or diarrhea
  • Abdominal pain

These symptoms can manifest within a specific time frame after xylitol ingestion:

  1. Hypoglycemia symptoms typically appear within 30-60 minutes.
  2. Liver injury symptoms may take 12-72 hours to develop.

How is xylitol poisoning diagnosed?

If your dog has ingested xylitol, seek veterinary care immediately. Your veterinarian will perform a thorough physical examination and may recommend blood tests. These blood tests will check your dog's blood sugar levels to look for hypoglycemia and liver enzyme levels to assess for liver damage.

Other diagnostic tests, such as X-rays or ultrasound, may be used to assess any potential organ damage.

How is xylitol poisoning treated?

There is no direct antidote and therefore treatment for xylitol poisoning focuses on stabilizing your dog's blood sugar level, preventing liver damage, and managing any other complications that may arise.

If your dog is experiencing hypoglycemia, supportive care may include:

  • Administering intravenous (IV) dextrose to increase blood sugar levels
  • Monitoring blood glucose levels regularly

If significant liver damage is present or develops, your dog may require additional treatment, such as:

  • IV fluid therapy to maintain hydration and support liver function
  • Medications to help protect the liver from further damage
  • Nutritional support through a feeding tube if necessary

In severe cases, your dog may need to be hospitalized for several days. Hypoglycemia can persist for longer than 24 hours and we typically do not recommend discharging patients from the hospital until their blood sugars have normalized for 4-6 hours without any sugar supplements.

Should you induce vomiting?

If your dog eats something containing xylitol, acting fast is imperative. Xylitol is absorbed quickly by the body, usually within 30 minutes. This means that making your dog vomit (a process called emesis) might not be helpful if more than 30 minutes have passed since they ate it.

Additionally, trying to induce vomiting after this time can be risky, as your dog could rapidly develop low blood sugar (hypoglycemia) during the process, which can be dangerous.

Furthermore, activated charcoal, a common method used to prevent the absorption of toxins, is not effective in cases of xylitol toxicity in dogs.

What is the prognosis for dogs with xylitol poisoning?

The prognosis for a dog after ingesting xylitol depends largely on the severity of the symptoms and how quickly they receive treatment.

  1. Uncomplicated hypoglycemia (low blood sugar)
    • If your dog only develops low blood sugar without any other complications, the prognosis is generally excellent. This is especially true if they get the right medical treatment promptly.
  2. Hepatotoxicosis (liver damage)
    • Dogs that experience liver damage from xylitol ingestion face a more uncertain future. These cases need aggressive treatment, and the prognosis can vary.

In all cases, early intervention and treatment are very important. If you suspect your dog has ingested xylitol, immediate veterinary attention can make a significant difference in their recovery.

How much xylitol is toxic to dogs?

Xylitol is toxic, even in small quantities. The following are toxic dose guidelines as there are individual variations and sensitivities.

  1. Risk of Hypoglycemia
    • Clinical hypoglycemia, a condition where blood sugar levels drop dangerously low, can occur if a dog ingests more than 0.075 to 0.1 grams per kilogram of body weight (75 to 100 milligrams per kilogram). To put it in perspective, for a 10 kg dog, this would be about 0.75 to 1 gram of xylitol.
  2. Risk of Liver Failure
    • More severe, life-threatening conditions like acute hepatic (liver) failure can happen if a dog ingests more than 0.5 grams per kilogram of body weight (500 milligrams per kilogram). So, for a 10 kg dog, this would mean ingesting more than 5 grams of xylitol.

FAQs

Can xylitol kill dogs?

Yes, xylitol is lethal to dogs. While very small amounts may only cause mild symptoms, excessive consumption can lead to severe and potentially life-threatening complications such as hypoglycemia (low blood sugar) and liver damage.

What should I do if my dog has ingested xylitol?

If you suspect that your dog has ingested xylitol, it is extremely important to seek immediate veterinary attention right away. Do not attempt to induce vomiting at home without the guidance of a veterinarian. The prognosis depends on how quickly treatment is administered.

Why is xylitol toxic to dogs?

Xylitol ingestion results in an exaggerated insulin response and release from the pancreas. This will cause blood sugars to go dangerously low, known as hypoglycemia. Additionally, xylitol can also cause liver damage in dogs.


In conclusion, xylitol poisoning in dogs is a serious matter and should be treated as a medical emergency. Shortly after ingestion, xylitol will cause pronounced low blood sugars, called hypoglycemia. This will lead to symptoms such as lethargy, anorexia, lack of coordination, and vomiting. While treatment is largely supportive, immediate veterinary attention can significantly improve the prognosis. To keep your dog safe, make sure to always check ingredient lists for xylitol and keep any products containing it safely out of reach from your furry friend. Knowledge is key in preventing xylitol toxicity in dogs, so stay informed and spread awareness to other pet owners.

Please contact your veterinarian if you are concerned about xylitol and your dog.