(10/2021) Xylitol is an artificial sugar substitute found in many products. Some of these are not even edible. It is a sugar alcohol also known as birch sugar or wood sugar. Ingestion by dogs, can put them in grave danger. The problem is that there are benefits to humans making it present in many different products. It provides sweetness with 40% less calories than sugar. It helps keep the mouth clean with its antibacterial properties and it reduces periodontal disease. It also may help with osteoporosis, preventing ear and throat infections, and may reduce the risk of uterine fibroids, endometriosis, and breast cancer. People can handle this compound, but dogs do not.

Check for xylitol in: many sugar-free gums such as Trident, Orbit, and Ice Breakers, some Peanut butters and nut butters, sugar-free candies, baked goods such as muffins, pies, and cakes, sugar-free desserts such as "skinny" ice cream, children’s and Adult chewable vitamins such as Gummies, toothpaste, mouthwash and breath mints, cough syrup and over the counter medications, diet supplements, hair care products, & baby wipes

Xylitol has been found to be useful in preventing dental plaque on teeth. That is why sugar-free gum is recommended by dentists. Also there are mouthwashes and oral rinses containing this compound for human use. There are even veterinary oral care products with low levels of xylitol to prevent intoxication.

Lower levels of poisoning cause hypoglycemia (low blood sugar) which affects the brain and nervous system. A dog’s pancreas over-reacts to xylitol and releases an excessive amount of insulin (3-7 times more) versus the response to regular sugar. The insulin transports sugar out of the blood stream into cells and the blood sugar level drops drastically. This leads to weakness, disorientation, tremors and possibly seizures.

Higher levels of xylitol poisoning lead to liver cell damage even liver cell death which is called hepatic necrosis. The mechanism of how this happens is unknown. Signs take longer to appear. They may be temporary, but complete, acute liver failure can result leading to death. Liver failure can lead to internal bleeding with an inability to clot blood.

A small dog can be poisoned by a single stick of gum. Symptoms can appear within 30 min. and can last for more than 12 hours. However, xylitol may be slowly absorbed, so that any symptoms may not show for 12 hours. Typically, vomiting occurs first, then incoordination, collapse and seizures.

If there is only hypoglycemia and rapid treatment, the prognosis is good. If hepatic necrosis develops, the prognosis is guarded.

Prompt action is necessary for the best chance of recovery. Vomiting needs to be induced to get as much of the xylitol out of the body as fast as possible. IV fluids are recommended along with glucose (sugar) supplementation. The liver needs to be monitored with blood tests for 2-3 days.

Interestingly, there have not been reports of xylitol toxicity in cats. Toxicity in cats is unknown. They don’t generally have a sweet tooth unlike dogs, so they don’t usually seek out and ingest the products listed above like dogs do. However, ferrets are susceptible to toxicity. They can get a low blood sugar which leads to seizures.

Preventive Measures

To ensure your pets are not exposed to xylitol:

• Check for xylitol listed in labels on products labelled sugar-free or low sugar
• If a product has xylitol, keep it where your pet can’t get to it. Check your purse, pockets, countertops and prevent easy access.
• Only use pet toothpast for your pets and never human toothpaste.
• If you use a nut butter as a treat or to hide medication, check the label to avoid xylitol.

Because of the oral health benefits of xylitol, there are pet mouthwashes and oral rinses that have low levels of the compound. As long as recommended dosages are followed, there should not be a problem. These products get mixed in the drinking water. If there are multiple dogs in the house, the dosing should be done for the smallest dog present.

Always seek veterinary attention for a suspected xylitol oral intoxication and call one of the poison control centers. ASPCA Animal Poison Control Center 888-426-4435 provides a 24 hour service. The cost is $65, but if your pet has any type of microchip registered with HomeAgain (1-888-HomeAgain), there is no charge.