The Dangers of Xylitol Poisoning in Dogs

Xylitol is a naturally occurring substance that is used as a sugar substitute. Chemically, it is a type of sugar alcohol extracted from plants. It is often manufactured into a white powder which is safe for humans and has many beneficial uses. But in dogs the results can be life-threatening. You can find Xylitol in sugar-free vitamins, toothpaste, dental floss, mouth washes and anti-cavity rinses, nasal sprays, baked goods, peanut butter, and in many types of chewing gum. [source]

Xylitol tricks an animal’s body into believing that their blood sugar is too high, thus triggering a sudden release of insulin which results in low blood sugar. This can potentially lead to seizures, brain damage, and liver failure. [source]

Xylitol is also harmful to cats as well. However, since felines rarely like sweet, minty, or aromatic edibles, cases of toxicity are not as common.

According to Dr. Tina Wismer, medical director of the Animal Poison Control Center at the American Society for the Prevention of Cruelty to Animals, “Dogs don’t have an off button. They get into the muffins and eat an entire tin.”

Xylitol toxicity (causing life-threatening low blood sugar, i.e. hypoglycemia) can occur after ingesting an amount equal to 50 milligrams (mg) of xylitol per pound of body weight. Sugar-free gum is one of the most common sources of poisoning. However xylitol content can range widely according to brand. “With certain brands of gum, only 9 pieces of gum can result in severe hypoglycemia in a 45 pound dog, while 45 pieces would need to be ingested to result in liver failure. With other common brands of gum (which contain 1 g/piece of gum), only 2 pieces would result in severe hypoglycemia, while 10 pieces can result in liver failure.” [source]

Symptoms of toxicity can manifest within 15-30 minutes of consumption. Signs of hypoglycemia may include vomiting, weakness, difficulty walking or standing, depression or lethargy, tremors, seizures, and coma. [source]

The Pet Health Network lists several steps to take if you think your pet may have ingested a potentially poisonous substance. Treatment includes:

• Checking a stat blood sugar level with your veterinarian. If it’s normal and ingestion was recent (within a few hours), your veterinarian may induce vomiting.
• If your dog is hypoglycemic, a stat bolus of intravenous (IV) dextrose (i.e., sugar) is a must, followed by hospitalization. Treatment will include IV fluids with sugar supplementation (e.g., dextrose) for a minimum of 12-18 hours. If your dog is able to maintain his blood sugar as the dextrose supplementation is weaned down over time, then your dog can go home!
• If your veterinarian induced vomiting in your dog, make sure they skip the charcoal – no need for your veterinarian to give activated charcoal (i.e., a black liquid product that binds up some poisons). Charcoal does not reliably bind to xylitol, so it’s not necessary with xylitol poisoning.
• If a toxic dose was ingested and not vomited back up, your veterinarian will recommend hospitalizing your dog for IV fluids, dextrose supplementation, and symptomatic supportive care.
• Careful monitoring of blood work (including the liver enzymes, electrolytes and blood sugar) is imperative.
• If your dog ingested a dose approaching the liver-toxic amount of xylitol, the use of liver protectants (e.g., SAMe, milk thistle, n-acetylcysteine) is warranted. Most dogs are sent home on liver protectants for several weeks, while rechecking liver enzymes frequently at your veterinarian, to be on the safe side.

You can also call the ASPCA Animal Poison Control Center at (888) 426-4435.

Preventive Vet has an extensive list of common household items and edibles containing Xylitol, including such name brands as ACT® mouthwash and rinse products, Biotene®, Aquafresh®, and Sugar-Free Jell-O. Products that list xylitol as the first ingredient often are the most hazardous. However, it is hard to determine the exact content levels as manufacturers tend to keep those numbers secret.