If your dog has a nose for trouble, you’ll want to watch out for xylitol. This natural sugar substitute, which has a toxic effect on dogs, is probably already hiding in your purse, work bag, pantry, or medicine cabinet. This ingredient is becoming more common in everyday products, and reports of xylitol toxicity in dogs are increasing.

Knowing about xylitol’s dangers—and its potential locations—can ensure your pooch stays safe from this sweet-but-deadly ingredient. Use this guide from Lebanon Animal Hospital to identify any xylitol products in your home, and to learn how to recognize and respond to xylitol toxicity.

What is xylitol toxicity in dogs?

Xylitol—also called birch sugar—is a natural sugar alcohol originally derived from birch bark. Xylitol gained popularity as a sugar substitute because of its low glycemic index in humans, natural antibacterial properties, and ability to prevent tooth decay. Unfortunately, dogs are highly sensitive to xylitol, which when ingested, triggers the dog’s pancreas to release a large amount of insulin, causing a severe drop in blood sugar.

In some dogs, acute (i.e., sudden) liver injury occurs after xylitol ingestion, although the reason is poorly understood. Most dogs with advanced liver failure do not survive. 

Are cats vulnerable to xylitol toxicity?

According to the Merck Veterinary Manual, cats are not at risk for extreme hypoglycemia or liver damage from xylitol. Dogs are the only known domestic species to have this sensitivity.

What products cause xylitol toxicity in dogs?

Xylitol is an economical ingredient with many health benefits for people. The products that most commonly cause xylitol toxicity in dogs include gum and mints, although xylitol’s ability to retain moisture has increased its use in snack foods and personal hygiene products. Everyday products that may contain xylitol include:

  • Sugar-free gum
  • Sugar-free mints or candy, including chocolate
  • Sugar-free or keto-friendly baked goods
  • Pudding or gelatin snacks
  • Peanut butter
  • Toothpaste
  • Mouth wash
  • Deodorant
  • Chewable or gummy vitamins and supplements

Because xylitol concentration can vary between products—and between brands or flavors—identifying the product your dog has consumed and bringing the label with you is crucial, so the veterinarian can determine whether their dose is toxic. For greatest peace of mind, keep xylitol-containing products out of your pet’s reach, or out of your home altogether.

What are xylitol toxicity signs in dogs?

Xylitol poisoning signs can present quickly, because hypoglycemia can occur rapidly, 10 to 15 minutes after ingestion. However, dogs may not appear visibly sick from liver injury until 24 to 48 hours after consumption. Initial signs may include:

  • Lethargy
  • Weakness
  • Loss of coordination
  • Seizures
  • Vomiting
  • Depression
  • Unresponsiveness

Changes to liver function and health are detected by blood work, but visible signs may include:

  • Yellowed gums and eyes (i.e., icterus, jaundice)
  • Vomiting
  • Depression
  • Bruising, caused by blood’s inability to clot

If your pet experiences any xylitol toxicity signs, immediately contact Lebanon Animal Hospital or call the ASPCA Animal Poison Control Center for guidance. Have any product packaging ready, as you may be asked for specific item information. If your pet is actively seizing or unresponsive, immediately transport them to Lebanon Animal Hospital or the nearest veterinary emergency facility.

What is the treatment for xylitol toxicity in dogs?

Your veterinarian will diagnose xylitol poisoning based on your dog’s clinical signs and exposure history. If exposure is unknown, blood work and diagnostic imaging may be used to determine an underlying cause for your dog’s illness. 

Xylitol poisoning treatment must begin as soon as possible, and typically involves decontamination by inducing emesis (i.e., vomiting) if the ingestion was recent. Dogs are hospitalized for stabilization and monitoring. Intravenous dextrose may be administered to increase blood sugar levels, although hypoglycemia signs may persist up to 24 hours. Routine blood glucose checks are performed until the dog can maintain stable blood sugar levels without additional dextrose.

Liver function is measured by serial blood work. If elevations or abnormalities are detected, liver protective medications can minimize further damage. Because the liver can regenerate to some extent, dogs with mild liver changes can recover with supportive care. However, liver injury may be permanent, and xylitol-induced liver damage or failure is often fatal.

How can xylitol toxicity be prevented in dogs?

For all its devastating harm, protecting your dog from xylitol poisoning is relatively simple. However, because xylitol use in everyday products is expanding, routine vigilance is necessary. Easy ways to reduce the threat of xylitol poisoning include:

  • Reading product labels 
  • Substituting non-xylitol products when possible
  • Removing xylitol-containing products from your home 
  • Emptying pockets of gum, candy, or mints before discarding clothes or jackets
  • Storing purses, bags, lunchboxes, and coats on wall hooks or in closed cabinets
  • Using only pet-specific toothpaste when brushing your dog’s teeth
  • Storing personal hygiene products in an inaccessible drawer or medicine cabinet when not in use

Xylitol toxicity is routinely among the top 10 pet toxin cases reported to the ASPCA Animal Poison Control Center, but, with increased awareness and product recognition, Lebanon Animal Hospital hopes that ranking will soon decline. If you know or suspect your pet has ingested xylitol or any other pet-toxin, immediately contact Lebanon Animal Hospital. For after-hours care, call the nearest veterinary emergency hospital or the ASPCA Animal Poison Control Center.