Xylitol and Dogs: The Dangers That Dog Owners Must Know

As dog parents, we all want to keep our pets safe in our homes. Some household dangers are more obvious than others. Integrative veterinarian Dr. Julie Buzby warns about xylitol, an artificial sweetener found in everything from a piece of gum to peanut butter, which can be extremely harmful to dogs if ingested.

According to the Pet Poison Helpline, cases of xylitol poisoning in dogs have more than doubled in the last five years. More products are now being produced with xylitol, and many pet parents are unaware of the danger it poses to dogs. Keeping an eye on the ingredients in the products you buy could help keep your dog safe.

What is xylitol?

While xylitol has been around since 1891, it’s a fairly new health concern for dogs. Xylitol is a sugar substitute. It is a sugar alcohol found naturally in various plants and fruits.

Discovered by a German chemist, it was used during World War II because sugar was unavailable. As an alternative, they pulled xylitol out of hardwoods like birch trees to use as a sweetener.

The first xylitol gum (and gum is certainly the most common culprit I see with xylitol poisoning in dogs) was launched in Finland and the United States in 1975. Now a myriad of products for human consumption include xylitol as an ingredient.

A word of caution

Xylitol is sometimes listed on packaging as birch sugar. This can be deceiving and dangerous if you are scanning a label looking for the word “xylitol” and don’t know that “birch sugar” is the same thing.

What products contain xylitol?

If you walk down the grocery store aisle and read the labels, I think you’ll be stunned at how often you see xylitol on the ingredient list. It’s in everything from toothpaste and mouthwash to pudding and peanut butter.

Xylitol in peanut butter: For your dog’s sake, read the label

Since peanut butter is a go-to choice for many dog parents as a way of disguising a pill when medicating a dog that won’t take pills or simply giving a dog a special treat, it’s especially important to read the label on your jar of peanut butter.

Within the last several years, manufacturers have started including xylitol as a sweetener in some peanut butter brands. Unfortunately, this addition led to a number of dogs getting sick after consuming it. The last thing any dog parent wants to do is accidentally hurt their dog when they are trying to keep him or her healthy by unknowingly coating a pill in xylitol-containing peanut butter.

Xylitol can be commonly found in foods labeled “sugar free” and in foods formulated for people with diabetes, since it has a lower glycemic index than sugar.

Here is a short list of human consumables that may include xylitol. One of my colleagues, Dr. Jason Nicholas, whom I interviewed on The Buzby Dog Podcast (listen here: Danger Ahead: Preventing Pain, Suffering, and Death in Pets) has one of the most thorough lists of 700+ xylitol-containing products on his website, Preventivevet.com.

Did you know these products may contain xylitol?

• Toothpaste
• Mouthwash
• Peanut butter
• Chewing gum, candy, mints
• Jellies and jams
• Cereals
• Baked goods
• Puddings and Jell-O®
• Cosmetics
• Lip balm
• Shampoo
• Syrup and honey
• Ketchup and condiments
• Drink powders
• Vitamins
• Medications

Remember that this is not an exhaustive list, and it’s very important to carefully read the ingredients of any human food item or medication you share with your dog.

Prescription medications and pharmaceuticals for your dog may contain xylitol

While your veterinarian would never give your dog a medication that might harm him or her, some prescription medications used for humans contain xylitol. This may be a concern if your vet is prescribing a medication to be filled at a human pharmacy. Your veterinarian should be proactive in watching for medications containing xylitol, but an informed and vigilant pet parent can prevent a tragic mistake if xylitol is inadvertently overlooked. 

Meloxicam human oral suspension is one example. Metacam is the veterinary comparable brand name drug.  Some human generic meloxicam suspensions or syrups contain xylitol.

Another very common medication prescribed for pain is called gabapentin for dogs. The capsules and the tablets don’t contain xylitol, but many gabapentin liquid suspensions do. If you’re getting gabapentin suspension for your dog from a human pharmacy, check with your veterinarian and the pharmacist to make sure the brand being dispensed is safely xylitol-free.

Over-the counter melatonin and xylitol

Also, veterinarians may recommend over-the-counter melatonin for dogs for various reasons. Melatonin in the fruit-flavored, rapid-dissolve tablets and the gummy version are likely to contain xylitol. Just a few of these could be toxic. Please be aware.

Why is xylitol bad for dogs?

Xylitol causes two problems for a dog’s system: hypoglycemia and liver disease in dogs. Let’s take a look at each problem to answer the questions, “what does xylitol do to dogs” and “why is xylitol toxic to dogs.”

Hypoglycemia

Xylitol, a sugar substitute, “tricks” the dog’s body into thinking it has consumed sugar. When the body consumes sugar, the pancreas releases a hormone called insulin.

This is the same process in our own bodies after we eat a meal or a sweet snack. Sugars and carbohydrates in food raise blood sugar levels, and insulin keeps those levels from getting too high. It’s this delicate body balance that the brain maintains.

But herein lies the problem. The dog really hasn’t consumed sugar. There’s not a high blood sugar problem that needs to be counteracted. So, because the insulin drives blood sugar into the cells and out of the bloodstream, the dog ends up with hypoglycemia (i.e. low blood sugar).

If the blood sugar gets too low, seizures in dogs and even death may occur. In some cases, the drop in blood sugar happens fast. It can occur within 10 to 15 minutes after ingestion. In other cases, the symptoms may not appear for up to 12 hours after ingestion.

Liver Damage

Damage to the liver, which can be very extensive and even fatal, is the second problem. Although the exact mechanism isn’t know yet, xylitol causes liver cells to die in some dogs.

Researchers theorize that xylitol may decrease cellular energy (i.e. ATP) stores in the liver cells and/or that it may cause oxidative injury to liver cells. Whatever the exact process is, the end result is acute liver failure.

Slow-release toxin

On top of this, some xylitol-containing products act as a slow-release toxin. Chewing gum containing xylitol is an example. Sitting in the gastrointestinal tract, the gum slowly releases xylitol, which continually drives the dog’s blood sugar down.

If a dog has consumed xylitol-containing gum, his or her blood sugar may continue to drop until the gum is removed from the gastrointestinal tract. Gum doesn’t show up on X-rays, so unless an owner knows their dog got into gum, managing the dropping blood sugar may become a medical mystery for a veterinarian. The gum can sit in the stomach for hours. Unless the vet induces vomiting, the slow-release toxin in the gum may have devastating effects.

Signs of xylitol poisoning in dogs

Here are some of the most common signs and symptoms of xylitol poisoning in dogs:

• Vomiting—often the first sign we notice
• Weakness
• Ataxia (uncoordinated stance or gait) or a wobbly and off balance dog
• Collapse
• Seizures or tremors. These symptoms are caused by the drop in blood sugar that may occur within 15 minutes of ingestion.
• Icterus (jaundice)—yellowing of the gums, eyes, and/or skin. This is a sign of liver damage.
• Blood in stool
• Bruising or bleeding—liver failure can cause problems with clotting
• Neurologic complications due to the liver no longer filtering toxins from the blood

How long does it take for dogs to develop symptoms of xylitol poisoning?

The first signs, vomiting and effects of hypoglycemia, can develop within 10 to15 minutes of ingestion. Typically signs of liver damage may be evident within 9 to12 hours, or can take up to three days to develop.

What should I do if my dog eats a xylitol-containing product?

• Call the animal poison control center immediately. If possible, have the packaging in hand so you can give the most accurate information.
  
  • The ASPCA animal poison control center is run by veterinary toxicologists.  It is a good idea to keep the phone number handy. There is a charge associated with the call, but with xylitol toxicity, time is of the essence. You may be able to help your dog by gaining poison control’s advice before you can get to your veterinarian.

• Contact your veterinarian or your local veterinary emergency animal hospital ASAP for an emergency vet visit .
  
• If you’ve already spoken with a veterinarian at poison control, convey the information to your veterinarian. This may help your vet devise a more effective treatment plan.

How is xylitol toxicity treated?

Treatment for xylitol toxicity in dogs depends on how much xylitol they consumed, and how soon treatment is initiated.

Treatment may include:

• Hospitalization
• Induction of vomiting
• IV fluid therapy
• IV dextrose to increase blood sugar
• Repeated bloodwork

Depending on the severity of your dog’s condition, treatment may be expensive.

Prevention is the best medicine

Xylitol is becoming more and more prevalent in the household products and human foods that we consume daily. Prevention truly is the best medicine. The following tips will help you keep your beloved dog safe:

• Treat products containing xylitol like you would a prescription drug or a harmful substance. Just as you keep prescription drugs safely locked up, keep products containing xylitol out of reach of your dog. Even small amounts of xylitol can be harmful for dogs.
• Read product labels carefully. Educate yourself on what products in your home contain xylitol.
• For more information on xylitol and dogs, please check out my podcast, Xylitol Toxicity in Dogs. Guest speaker Dr. Jessica Taylor recounts the true story of saving Sugar, a Goldendoodle who ingested gum that contained xylitol. You can listen here:

Products containing xylitol and dogs don’t mix. Arm yourself and protect your beloved dog by finding out if you have this poison in your pantry.

What questions do you have about xylitol and dogs? Please comment below.