Xylitol toxicity in dogs

31st Aug, 2017

Written by Dr Kathryn Knipe of Bryanston Veterinary Hospital

With low-carbohydrate and Banting diets gaining popularity, xylitol has become popular as a sugar substitute. This has resulted in an increase in the incidence of cases of xylitol toxicity in dogs.

Xylitol is a sugar alcohol that is often used as a sugar substitute in chewing gum, sweets and baked goods.

Although safe for humans, xylitol is highly toxic in dogs and ingestion may even be fatal.

Why is xylitol dangerous for dogs?

In dogs, ingestion of xylitol leads to a rapid release of insulin in the body, which, in turn, leads to a severe drop in blood glucose levels (hypoglycaemia). This can lead to clinical signs such as weakness, disorientation, seizures and vomiting. These signs can occur within 30 minutes to 12 hours after ingestion.

Xylitol can also damage the liver, causing acute liver failure, which can result in a bleeding tendency as the liver is responsible for producing many of the components of the body’s blood clotting factors.

Clinical signs such as bleeding in the mucosal membranes and skin (known as petechiae and ecchymoses), bleeding into the intestinal tract characterised by bloody or black, tarry stools or excessive bleeding from wounds such as sites where blood is collected. These signs can manifest within 12 to 48 hours after ingestion.

Both of these conditions are potentially fatal and need to be promptly treated by your veterinarian if you suspect your dog has ingested xylitol.

What should be done if my dog has eaten xylitol?

Your veterinarian will most likely induce vomiting to try to get rid of the xylitol in the digestive tract in order to limit the amount absorbed; they may even also choose to flush your dog’s stomach under general anaesthesia.

If you are unable to reach a veterinarian within the first six hours of your dog ingesting the xylitol, you should try to induce vomiting in your dog, provided he/she is not too weak or collapsed. Be careful – if your dog is very weak and you make them vomit they may inhale their vomit, leading to them choking or developing aspiration pneumonia.

If they are, however, still strong, and have not vomited themselves, a diluted hydrogen peroxide solution (3%), washing powder (as a paste), or liquid dishwashing soap can be effective in inducing vomiting.

Regardless of whether or not your dog has vomited, it is vital that you take him/her to a veterinarian as soon as possible. Your veterinarian will monitor your dog’s blood glucose levels at regular intervals, as well as monitoring for signs of acute liver failure, while providing your pet with supportive care such as intravenous fluids and anti-nausea drugs.

Can my dog be successfully treated?

The key to success in treatment of dogs that have ingested xylitol is rapid veterinary intervention. If you suspect your dog of having eaten a xylitol-containing product, do not hesitate to take them to your nearest vet or after-hours emergency centre for treatment.

Patients that show clinical signs of low blood glucose have a good prognosis for recovery with prompt treatment, whereas the prognosis becomes more guarded if they progress to signs of liver failure.

As always, prevention is better than cure. Always ensure that all xylitol-containing products and baked goods are carefully stored in such a way that your dog cannot access them. Check labels of sweetened foods as many, including peanut butter and yoghurt, contain xylitol too.  

To date, xylitol toxicity has not been reported in cats.

Testimonial story


Written by Lindi Schwella and photography by Heather Edwards

On the lead-up to my son’s third birthday, my mother-in-law was experimenting with sugar-free vegan cake recipes and made one with xylitol for us to try. She brought it to our house and, without thinking, left it on our kitchen counter while I was at a funeral. When I returned home I found that our big black Labrador, Wilfred, had eaten the entire cake!

The greedy Labrador

This is not the first time that Wilfred has helped himself to something in the kitchen and, since it was a sugar free-vegan cake, I didn’t think to even worry about it… But Wilfred became more and more lethargic and, a couple of hours later, he began to vomit. Still thinking that he must just be feeling ill because he’d eaten the whole cake, I didn’t worry much about it, but the vomiting continued and he was looking more and more sorry for himself.

Finally, dinnertime arrived; I served up Wilfred’s pellets but he was not interested at all, which is very strange for our greedy Labby!

Wilfred’s nose was dripping blood

I phoned my mother-in-law to find out exactly what she’d used in the cake and the only unusual thing she mentioned was xylitol. I’ve never been a fan of artificial or replacement products so I didn’t know much about xylitol either, even though the packaging warning label read: “DO NOT FEED TO DOGS. May have a laxative effect”.

I decide to Google it… I was utterly horrified as article after article popped up saying that it’s highly toxic to dogs (and a few other animals). My heart in my throat, we rushed Wilfred (and the entire family – toddler and baby too) to the 24-hour vet clinic in Kenilworth. By this time Wilfred’s nose was dripping blood!

For the next eight days, our darling Wilfred was kept in intensive care; he had liver failure, blood clotting issues, organs leaking fluid (I can’t remember all the medical terminology), etc. On numerous occasions we thought he wasn’t going to make it…

Our last hope was a feeding tube

After a full week of getting blood plasma transfusions, taking in handfuls of medication, losing a lot of protein from not eating and looking very sorry for himself, the amazing staff suggested that our last hope was putting in a feeding tube and sending Wilfred home where, hopefully, the warm loving care we could give him would help him turn around.

Day after day, my husband and I took 30-minute turns syringing food into his feeding tube six times a day as well as constantly cleaning the entry wound for the pipe. After 15 days Wilfred’s toxicity levels were still nowhere near normal but things were starting to turn around slowly. He was starting to look happy again.

A warning to pet owners

It’s been over a month now and our poor boy is finally looking like himself, although he still has a long path ahead of him before his liver is functioning normally again, and we must constantly remind ourselves to be extra careful to keep him safe because he remains vulnerable.

I was completely unaware of the dangers of xylitol and it seems so many other people are too, so I would like to inform as many pet owners as possible how extremely toxic it can be.

This ordeal has most likely shaved a couple of years off Wilfred’s life, but I’m so relieved that he has pulled through and that saying goodbye to my best friend isn’t something I’ve had to do just yet.