Is your Halloween candy dish actually a potential threat to your dog’s health? While most dog owners recognize that chocolate is a sinister sweet for dogs, fewer are familiar with xylitol—a popular sugar substitute that causes serious, sometimes life-threatening, side effects when consumed by our canine companions.

Learn everything you need to know about xylitol in this Creature Comforts Veterinary Service guide to xylitol toxicosis in dogs.

Xylitol toxicosis in dogs

Xylitol is a naturally occuring sugar alcohol used as a sugar substitute in many processed foods. Initially prized for its sweetness and low glycemic index, its moisture-retaining and antibacterial properties have made xylitol a common ingredient in an ever-increasing array of non-food items, as well.

Dogs are especially sensitive to xylitol, which can cause severe low blood sugar (i.e., hypoglycemia), abnormal bleeding, and changes in liver function following ingestion. When eaten in significant quantities, xylitol toxicity can lead to irreversible liver damage and failure. 

Creature Comforts Veterinary Service recommends that dog owners familiarize themselves with common xylitol-containing products, learn to recognize xylitol toxicosis signs, and stay vigilant about this popular but deadly ingredient.

X marks the spot—keep these xylitol-containing products away from dogs

Protecting your dog starts with recognizing potential hazards. Check all food and product labels for xylitol, which may listed under other names, including:

  • Birch sugar
  • Wood sugar
  • Birch bark extract

The most commonly recognized xylitol-containing foods and products include:

  • Sugar-free foods — Candy, mints, gum, baked goods, pudding, jelly, jam, and nut butter—including some peanut butter
  • Dental health products — Mouthwash, toothpaste, and oral rinses
  • Personal hygiene products — Deodorant, shampoo, lip balm, makeup, and sunscreen
  • Medication and supplements — Flavored preparations, including liquids and gummy formulas

Because clinical signs and prognosis (i.e., outcome) are not necessarily correlated with the ingested dose (i.e., some pets may experience serious signs despite consuming only a small amount), all xylitol ingestions should be treated as a veterinary emergency.

Xylitol toxicosis signs in dogs

After xylitol ingestion, the pancreas releases a large amount of insulin that causes significant hypoglycemia (i.e., low blood sugar). This can occur as quickly as 30 minutes after ingestion or take as long as 12 hours. Hypoglycemic dogs will show visible signs, including:

  • Weakness
  • Fatigue or lethargy
  • Vomiting
  • Tremors
  • Dullness or unresponsiveness
  • Seizures

If you know or suspect your dog has consumed a xylitol-containing product, immediately contact Creature Comforts Veterinary Service or the ASPCA Animal Poison Control Center for emergency triage. Do not wait for visible signs or attempt to induce vomiting without veterinary guidance.

Xylitol toxicosis diagnosis in dogs

If you suspect your dog has xylitol toxicity, your veterinarian will need to know what was ingested (e.g., product, brand, flavor), the approximate amount, your pet’s weight, and the time the ingestion occurred. Bring any packaging to your veterinary appointment. If the label is no longer legible, your veterinarian can find the necessary information online. 

Diagnosis is generally based on the pet’s physical examination and their recent history. Blood work is often recommended to assess your pet’s blood glucose level and check for liver enzyme elevation, although these changes may not be immediately apparent.

Xylitol toxicosis treatment in dogs

If your pet is not showing visible illness signs, your veterinarian may prescribe decontamination (i.e., induced vomiting, activated charcoal administration) to prevent xylitol absorption and hypoglycemia. They may also recommend hospitalized supervision to ensure your dog has no delayed effects.

Clinically ill patients are hospitalized to correct severe hypoglycemia, monitor blood glucose, and identify any liver function changes. If the liver is damaged, liver protectant medication and supportive therapies may be initiated to manage liver insufficiency. 

Xylitol toxicosis prognosis in dogs

Asymptomatic dogs who receive rapid veterinary treatment generally recover from xylitol ingestion without complications. Hypoglycemic dogs without liver injury also experience good outcomes when they receive hospitalized care. Because the liver is a regenerative organ, mild liver changes tend to resolve in a few days with supportive care. Unfortunately, severe liver damage is irreversible and unresponsive to treatment, and owners usually elect humane euthanasia for these pets.

Protecting your dog from xylitol toxicosis

Safeguarding your dog against xylitol ingestion requires awareness of this ingredient’s increasing presence in food and non-food products, reading ingredient labels carefully, and securely storing xylitol-containing items to prevent pet access. Some general pet protection tips include:

  • Emptying pockets before placing laundry in a basket or hamper
  • Hanging purses, backpacks, and lunchboxes on wall hooks—never place them on the floor or a low table
  • Instructing house guests to keep luggage and toiletry bags off the floor
  • Purchasing xylitol-free gum and mints 
  • Storing medication in lockable boxes or medication organizers
  • Prohibiting children from keeping holiday candy in their bedroom that they leave unattended or forget

Xylitol may be a superstar ingredient for large food and hygiene product manufacturers, but it’s public enemy number one at veterinary hospitals—including Creature Comforts Veterinary Service. Contact us for additional xylitol toxicosis information or for care for a pet known or suspected to have ingested the substance.