Xylitol Poisoning in Dogs
Written by Small Door's medical experts
Xylitol, a common sugar substitute found in many foods and non-food products, can cause a life-threatening toxicity in dogs, affecting their blood sugar and liver enzyme levels. You can first help your canine by making sure they avoid consuming products that contain xylitol, but if they do, assessment and treatment are necessary right away. Learn here what products to avoid and when to seek immediate treatment from your veterinarian.
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Xylitol is a sugar alcohol made from birch sugar. It is commonly used as a sugar substitute in sugar-free or low-calorie human foods, but it can also be found within a variety of non-food personal hygiene products as well.
Where is xylitol found?
Xylitol can be found in many food and non-food items, such as:
Nut butters (peanut, almond)
Toothpaste and dental hygiene products
Candy, mints, and chocolates
Chewable vitamins and supplements
Hair care products
Medications (especially liquid formulations, such as liquid gabapentin)
Is xylitol bad for humans?
Xylitol is safe for humans. As a sugar substitute, it provides sweetness to foods and contains 40% fewer calories than normal cane sugar, potentially aiding in weight management. It contains antibacterial properties and is therefore often used in oral health products, like mouthwash, to help reduce periodontal disease. It may have other benefits as well.
Is xylitol bad for dogs? Why?
Xylitol is extremely toxic to dogs. Unlike in humans, it’s absorbed into the bloodstream very quickly in dogs. This causes your canine’s body to rapidly release insulin to handle all the sugar, which then leads to hypoglycemia and liver failure.
The U.S. Food and Drug Administration (FDA) has received several reports over the past few years of dogs consuming sugar-free gum and ice cream containing xylitol, leading to severe illness or death.
Xylitol has two toxic effects on dogs:
Hypoglycemia: In dogs, xylitol causes a rapid release of three to seven times the normal amount of insulin, which then causes extreme hypoglycemia (low blood sugar). This can happen very quickly – within 30 minutes to an hour.
Hepatic necrosis: Xylitol can also destroy your dog’s liver tissue within eight to 12 hours after ingestion of a xylitol-containing product. This destruction of tissue can result in the development of liver failure.
How much xylitol is toxic to dogs?
A toxic dose of xylitol to dogs is approximately 0.03 to 0.045 grams per pound of body weight.
For example, one piece of Orbit sugarless chewing gum can have between 0.009 grams to more than 0.3 grams of xylitol, depending on the flavor of the gum. If your dog is small, just one stick of gum is enough to be toxic, yet it all depends on the size of your dog and the product consumed.
How quickly does xylitol affect dogs?
As the Merck Veterinary Manual states, signs and symptoms of xylitol toxicity can occur in as little as 30 minutes after ingestion. Similarly, the FDA notes that effects can happen in 10 to 60 minutes after ingestion.
Most often, symptoms of hypoglycemia will be the first to develop. However, if the substance ingested is slow to be absorbed by the body, such as some sugarless gums, clinical signs may not be observed for 12 to 18 hours after ingestion. Onset of clinical symptoms can also depend on the size of your dog (for instance, a smaller-sized dog will likely be affected much more quickly than a large breed dog).
Signs and symptoms of xylitol poisoning in dogs includes:
Loss of coordination (ataxia)
Yellowing of the skin, gums, and eyes (also known as icterus or jaundice)
Blood tests that will show elevated liver enzymes and liver failure
Xylitol poisoning is diagnosed by your veterinarian with a physical exam and taking a clinical history. Additionally, bloodwork to check your dog’s blood glucose levels and liver enzymes will be performed. As the onset of signs and symptoms of elevated liver enzymes can take hours to develop, your veterinarian may run repeat lab work every 24 hours for 3 days to monitor for any abnormal developments. Glucose lab work will be monitored for approximately every 1 to 2 hours over a 12-hour period.
Some specific testing your veterinarian may perform includes:
Blood chemistry: A blood chemistry test will check the function of your dog’s organs. Your veterinarian will specifically be looking for abnormalities within your dog’s liver enzymes, such as alanine aminotransferase (ALT) and alkaline phosphatase (ALP), as well as other enzymes that can also indicate a liver issue, such as albumin, bilirubin, blood urea nitrogen (BUN), creatinine, glucose, and cholesterol.
Blood glucose: Either done as part of a chemistry panel or using a glucometer, this will allow your veterinarian to monitor your dog’s blood sugar levels and treat for any development of hypoglycemia.
CBC: A complete blood count (CBC) will measure your dog’s red and white blood cells and platelets.
Coagulation profile: Prothrombin time (PT) and activated partial thromboplastin time (APTT) will show your dog’s ability to form blood clots and detect bleeding risk.
If your dog eats xylitol, we recommend you notify your veterinarian immediately. Your veterinarian may also recommend that before you come in, you call either:
Pet Poison Hotline (800-213-6680)
ASPCA Animal Poison Control Center (888-426-4435)
These poison control centers offer phone consults for a fee, where they can rapidly assess the estimated amount of toxin ingested and then immediately provide specific treatment information to your veterinarian. We do not recommend you induce vomiting at home in an attempt to get rid of the xylitol, as the onset of hypoglycemia can be rapid, and your dog will likely need care nonetheless.
Also, try to bring the packaging label with you so that your veterinarian can confirm the amount of xylitol ingested.
Xylitol poisoning in dogs most often requires hospitalization and supportive care, including:
Intravenous (IV) fluids
Dextrose boluses or constant rate infusions (CRIs) administered through an IV to help counteract the hypoglycemia
Management of elevated liver enzymes using liver supportive medications and supplements such as N-acetylcysteine, silymarin, and S-adenosylmethionine
Is there an antidote for xylitol poisoning?
No, there is no antidote for xylitol poisoning in dogs.
If your dog receives immediate treatment for xylitol toxicity, it is likely they should fully recover. If your dog experiences a severe increase in their liver enzymes, or sustains severe liver damage, they can have a poorer prognosis.
You can prevent xylitol toxicity with your dog by keeping all potentially xylitol-containing products away from your dog. Do not leave items such as sugarless gum or candies in areas that are within reach of your dog. If you are eating foods that contain xylitol, such as sugar-free ice cream, keep them out of reach of your dog.
Be sure to check all food labels, even peanut butter, or treats prior to feeding them to your dog to ensure they do not contain xylitol. Also, make sure that you are using dog-specific toothpaste when brushing your dog’s teeth, as human toothpaste often contains xylitol (and sometimes other ingredients not safe for dogs).
Currently, it is unknown whether xylitol is toxic to cats, but it appears they do not have the same problem, according to the FDA. There are no known reports of xylitol toxicity in cats, according to the ASPCA Animal Poison Control Center. However, the FDA says that ferrets are at risk and caution is warranted.
While xylitol poisoning in dogs can be fatal, if treated quickly and appropriately, your dog can make a full recovery. Call your veterinarian and a poison control center immediately if you know your dog has consumed xylitol. To take preventive action, always keep xylitol-containing products out of your dog's reach.