Xylitol Poisoning in Dogs: Products, Labels and What to Do

If your dog has got hold of sugar-free gum, a spoonful of peanut butter you haven't checked, or anything else that might contain xylitol, call a vet straight away, even if they seem perfectly well. If your practice is closed, use its out-of-hours number or an emergency vet. Xylitol is a sweetener that is safe for people but not for dogs, and it's worth knowing where it hides.

Why xylitol is dangerous to dogs

Xylitol is a sugar alcohol used to sweeten sugar-free products. In most mammals it has no notable effect on insulin levels, but in dogs it triggers a rapid release of insulin that can cause profound hypoglycaemia, which means a sharp fall in blood sugar. Dogs are the only domestic species in which xylitol poisoning has been reported, and cats are not at risk of low blood sugar or liver injury from it.

Low blood sugar can cause vomiting, weakness, loss of coordination, lethargy, seizures and coma. Signs can develop within 30 minutes of a dog eating xylitol, or be delayed by up to 12 to 18 hours if the xylitol is in something that slows absorption, such as some gum products.

Some dogs have developed severe liver injury after eating xylitol, and how this happens isn't clear. Signs of liver injury may not appear until at least 24 to 48 hours after xylitol is eaten, and some dogs show no early signs before liver damage develops. That's why a dog who looks well in the first few hours still needs a vet.

Which products can contain xylitol

Xylitol turns up in sugar-free chewing gum, sweets, medications and some nut butters, and in nicotine replacement chewing gums. It's also used in mints, peanut butter and baked goods that are sold as sugar-free.

It isn't limited to food. Xylitol can also be in non-food items, including sunscreens, medications and toothpastes, as well as chewable vitamins and supplements. Sugar-free syrups and elixirs used as medicine bases also frequently contain xylitol, including some liquid gabapentin formulations. If your dog is prescribed a human medicine, it's worth confirming that the product doesn't contain xylitol.

The amount of xylitol in products varies greatly, and even different varieties of the same brand of gum can differ. That makes it very hard to judge at home how much a dog has taken, which is one more reason to ring a vet rather than guess.

Spotting xylitol on a label

If a product says it's sugar-free, the ingredient list should be checked to determine whether xylitol is present. That applies to food, gum, sweets and medicines, and particularly to liquid ones.

Xylitol may be listed as birch sugar in the ingredients list. Another name that can appear is E967. Labels such as natural or sugar-free don't mean a product is safe for dogs.

What to do straight away

Call your vet immediately, or Animal PoisonLine on 01202 509000, and do it before any signs appear. Animal PoisonLine is a UK triage line for suspected pet poisoning, and a fee may apply. Any known ingestion needs immediate veterinary care regardless of how your dog appears.

Keep the packaging, or a photo of what was eaten. Have the product name, roughly how much was eaten, when it happened and your dog's weight ready for the call.

Don't try to make your dog sick unless a vet tells you to. Xylitol poisoning may be accompanied by rapid onset of signs of low blood sugar, and vomiting should ideally be attempted only under veterinary supervision and in dogs that still seem normal. Please don't give any home remedies either, unless your vet has told you to.

At the clinic, a vet may monitor blood glucose and liver enzymes, and give dextrose through a drip as needed. The outlook for uncomplicated low blood sugar is good if prompt treatment is started. If there are signs of liver insufficiency, the outlook is more guarded.

Keeping xylitol away from your dog

Keep handbags and coat pockets, which often contain gum, out of reach. Keep bathroom cabinets closed, because some toothpastes and mouthwashes can contain xylitol. Store medications and vitamins securely too.

Peanut butter is a common surprise, so check the brand before using it to give your dog medication. Check labels on sugar-free treats before sharing anything from your own plate.

Tell visitors about products that contain xylitol, and ask them not to share food with your dog. That matters even more during the holiday season, when house guests are more frequent, and candies more readily available.