Xylitol is a sugar-free sweetener that is found naturally in some berries, plums, corn, oats, mushrooms, lettuce, trees, and some other fruits. It is extracted and concentrated to be used as a sugar substitute. Its commercial use has increased in recent years due to its low glycemic index and dental plaque fighting properties. Xylitol has been found to be toxic in dogs. Therefore, the increase in use has led to the increase in toxicity cases seen in veterinary medicine. The amount of xylitol in products can vary widely which means it can vary in severity of toxicity.

Xylitol can be found in:

  • Sugar-free or Sugarless Chewing gum
  • Sugar-free or Sugarless Candy
  • Smoking cessation gum (Nicorette®)
  • Mints or Breath Mints
  • Oral Rinses
  • Tooth Pastes
  • Nasal Sprays
  • OTC Supplements- multivitamins, fish oil, cough drops
  • Foods- pudding, gelatin snacks, peanut butter, etc.
  • Products marked “sugar free”, “sugar less”, “low fat”, “diet”, “light”, etc.

Junk foods with xylitolGums and dental products with xylitol

Common signs of toxicity:

  • Weakness
  • Loss of coordination
  • Lethargy
  • Collapse
  • Vomiting
  • Tremoring
  • Seizures
  • Jaundice (yellowing of the mucous membranes and eyes)
  • Black-tarry stool
  • Coma

How it works:

In most mammals, xylitol has no significant effect on insulin levels, but in dogs, xylitol causes a rapid release of the hormone insulin, causing a sudden decrease in blood glucose or hypoglycemia. Depending on the amount of xylitol, symptoms can be seen in as little as 10-15 minutes. Instances including slow release gums may have a delayed reaction that can occur after 12-18 hours. Larger ingestions can result in liver damage which can lead to liver failure and bleeding complications.


Often the diagnosis is based on the history provided by the client. Diagnostics including blood work and urinalysis are commonly run to evaluate blood sugar levels, cell counts, and to evaluate liver function and/or coagulation (blood clotting) factors. These tests can also rule out other diseases or conditions that may complicate treatment.


Quick action is important for successful treatment. Depending on the amount of ingestion, severity of symptoms, and results of physical exam and diagnostics, your veterinarian can recommend the adequate treatment. Inducing of vomiting should be at the discretion of the veterinarian.

Treatment may include monitoring of blood sugar and liver values, IV fluid therapy, sugar supplementation, and liver protective drugs. Activated charcoal has not been reported to reliably bind xylitol, therefore is not always recommended.

Blood work may need to be repeated 2-3 days after discharge to continue to monitor liver function and coagulation. Bleeding can occur in the stomach, intestines, or abdomen. Signs of bleeding include pale gums, ecchymosis (large dark red splotches on the gums or skin) and petechia (small dark red specks on the gums or skin).


Knowledge is the key to prevention. Check the ingredient list of any household products your dog may come in contact with. Store any products known to contain xylitol in a place inaccessible to dogs.

If you suspect your dog has ingested xylitol, contact us at 218-751-2753. Bemidji Veterinary Hospital has staff on call 24/7 for small animal emergencies.