Xylitol is a sugar-free sweetener used in chewing gum, baked goods, and many other products created for human consumption. It is commonly used by people with Diabetes Mellitus due to its low glycemic index and low-calorie content.

Xylitol can be highly toxic to dogs, causing low blood sugar and liver failure.  The hypoglycemia is caused by insulin release stimulated by xylitol.  This effect generally lasts 12-24 hours but can be delayed.  The liver failure is idiosyncratic and the mechanism is poorly understood but is thought to be due to reactive oxygen species formation and damage to the liver thereafter.  Xylitol toxicity in cats has not been documented.

The most common source of xylitol toxicity in dogs has been sugar-free chewing gum, however, this may change with the many new sources of xylitol. Our Emergency Room doctors continue to see patients coming in who have ingested gum with an additional candy coating that increases the xylitol content to dangerous levels.

Xylitol has gained great popularity in the human market because if its various properties. Xylitol is a sugar alcohol nearly as sweet as sugar but with fewer calories which promotes its addition to various flavored, sugar-free or low-calorie products. Xylitol has humectant properties, which means it can help retain moisture, which encourages its use in many skin and hair care products. It also has antibacterial properties which can diminish skin problems and dental plaque promoting its use in various skin care and dental products. These features have led to the development of xylitol-containing products including ice cream, breath mints, chewing gum, cough drops, gummy vitamins, dental care products, shampoos, moisturizers, deodorants and much more.

Scientists are researching even more possible uses of xylitol including its potential to increase skin collagen production which may be important in anti-aging, its role in wound healing, and as an antibiotic.

Possible Sources of Xylitol

Human toiletry products that may contain xylitol:

  • Facial care products including tinted moisturizers and foundations, facial cleansers and scrubs, facial creams including moisturizers, illuminators, skin pigment reducers, facial toner, make up remover, body butter
  • Oral care products including toothpaste, mouthwash, dental rinse, breath sprays, throat lozenges
  • Flavored lip balm
  • Shampoos
  • Essential oil products
  • Deodorant
  • Hand creams

Human foods that may contain xylitol:

  • Cookies
  • Pudding snacks
  • Ice cream
  • Pie filling
  • Peanut butter
  • Sugar-free cake mixes
  • Non-fat Greek yogurt
  • Chocolate
  • Sugar-free chewing gum
  • Chewing gum (sticks, wads or car cups)
  • Low calorie baked goods
  • Sugar-free honeys
  • Various sweeteners
  • Sugar-free jam preserves
  • Sugar-free syrup
  • Various condiments including sugar-free ketchup and BBQ sauce
  • Flavored water and electrolyte drink mixes
  • Protein powder and protein bar
  • Meal replacement mixes

Medications and supplements that may contain xylitol:

  • Oral liquid prescription products (for example Children’s Allegra Oral Suspension®)
  • Oral disintegrating medications (commonly referred to as “Meltaway”) such as alprazolam.
  • Cough drops
  • Chewable and gummy multivitamins, chewable and gummy supplements
  • Antacids
  • Stool softeners
  • Enemas
  • Nasal sprays
  • Other medications and supplements include clonazepam, mirtazapine, toviaz, melatonin gabapentin and many more

The concentration of xylitol can change and varies greatly between products and companies often do not share the exact amount of the artificial sweetener with consumers. Generally, xylitol will be listed in the ingredient label under “Other ingredients”, “Inactive ingredients” or “Supplement facts”. Some companies list xylitol as an ingredient while others list “sugar alcohols” which may include xylitol. This makes it very difficult to determine the amount of xylitol a dog may have ingested.

Pet Poison Helpline has the most up to date information on these products. We recommend that all pets that eat xylitol seek consultation with their family veterinarian, emergency clinic and/or the Pet Poison Helpline or the ASPCA Animal Poison Control Center (APCC).

Prior to making the call, it is important to know the weight of the dog, the exact product, amount, and time the xylitol product was ingested. If the ingestion is considered toxic, the client should immediately come to your clinic or closest emergency clinic. If the client has contacted a poison control center, be sure they bring the case number so you can follow up for further treatment recommendations. There is a fee to contact the Helplines.

Given that we are seeing xylitol in so many products, we recommend that dog owners read package ingredient labels before giving any product to their dog and carefully reviewing package labels after accidental ingestion of any product.

Here is a comprehensive list of sources of xylitol that may be useful:
http://www.preventivevet.com/xylitol-products-toxic-for-dogs

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