WHAT IS XYLITOL POISONING?

March 22, 2025
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By Anne Marie Rodgers, reviewed by Renee Calvert, DVM

October 18, 2024, was a crisp autumn day in Centre County, PA. Journey, a gorgeous brindle greyhound, greeted his mom, Kayla ecstatically when she came home from work. Kayla slung her bag up onto the counter, her boy, and fed him. Then she let him out into the fenced yard for a few moments before going out for a bike ride without him. Greyhounds are sprinters that run in short bursts at up to forty-five miles per hour. They usually are not long-distance runners and are generally not a good fit for loping along with a person on a bike. Journey was better suited to a wild sprint around her fenced backyard in a short burst of energy followed by an equally suitable greyhound couch potato nap.

A young and lively dog adopted from a local greyhound rescue a little over a year before, Journey had what his mom calls “an ornery side.” He had once found food in one of her bags and had begun exploring all the boxes and bags he could find in hopes of another windfall. He was also prone to doing himself accidental damage in his exuberant races around the yard.

While Kayla was out for her ride a short time later, Journey’s ornery side appeared in full force. Rather than napping, he did some counter-surfing. He got into his mom’s work tote and found an exciting new treasure: a container of sugar-free chewing gum.

Kayla arrived home from her ride a short while later. When Journey didn’t greet her at the door, she was immediately worried. Rushing inside, she first saw the split-open bag. It appeared Journey had gotten onto the counter, rummaged through her bag and gotten into the large, car-cup-holder-size container of Orbit chewing gum that had fallen to the floor. 

A moment later, she found Journey unconscious on the floor.

Journey had expelled every bodily fluid imaginable, probably from seizure activity before he became comatose. A nurse-practitioner, Kayla immediately realized she might be seeing the signs of some kind of poisoning. Although she had heard that sugar-free gum could be poisonous to dogs, she had no idea how very dangerous it was. Scooping up Journey, she placed him in her vehicle and rushed toward the nearest emergency veterinary hospital, frantically placing calls along the way.

Dr. Renee Calvert, one of Centre Animal Hospital’s veterinarians, is a good friend of Kayla’s. The pair regularly tackles trail runs together. “Renee,” Kayla told her on the phone, “I’m not sure he’s going to make it.”

WHAT IS XYLITOL?

Xylitol is a type of sugar alcohol used as a sweetening substitute. Xylitol occurs naturally in birch trees as well as some fruits and vegetables. While xylitol is used in many human foods and products with no ill effects, it is highly toxic to dogs, causing a rapid drop in blood sugar.

Xylitol poisoning is one of the top ten most common reasons for calls to pet poison helplines each year. Although Kayla did not realize it was a life-threatening hazard until she found Journey, the gum she had in her bag contained the sugar substitute xylitol. 

When blood sugar drops too low in nearly all mammals, they become lethargic and don’t have the energy they need to perform normal activities. This is called hypoglycemia. Dogs’ and other brains rely on glucose (blood sugar) for energy.  As blood sugar drops dangerously lower, they can display weakness and tremors. They may appear confused and be disoriented. They may begin to have seizures and ultimately, they can collapse, lose consciousness, and die.

Many people are unaware of the dangers of xylitol to their beloved canine companions, just as Kayla was. Sharing Journey’s story, Kayla says, “I was surprised when I talked with friends about what had happened to Journey, how many were unaware of the toxicity of gum. So I hope [Journey’s experience] can help others.”

WHAT ARE THE SYMPTOMS OF XYLITOL POISONING?

Xylitol toxicity affects dogs rapidly. Hypoglycemia symptoms occur anywhere from thirty minutes to two hours after the deadly poison is eaten. Some breeds of dogs may be affected more quickly than others. Additionally, xylitol sweetener in gum or candy may be absorbed more quickly than in a less concentrated form. Here are the symptoms of xylitol poisoning:

• Vomiting

• Lethargy 

• Weakness

• Incoordination

• Tremors

• Collapse

• Seizures

• Uncontrolled diarrhea

• Coma

WHAT HAPPENS TO A DOG THAT EATS XYLITOL?

Your dog experiences a rapid loss of electrolytes (essential minerals that are vital to many key functions in the body) and an equally rapid drop in blood sugar. Because of these sudden imbalances, your dog eventually may suffer severe liver damage leading to liver failure and death. According to the FDA, death has occurred in some dogs in as little as one hour.

The more xylitol a dog ingests, the worse the prognosis. Untreated, many dogs will die as their blood sugar continues to drop until they pass away.

HOW IS XYLITOL POISONING DIAGNOSED?

When a dog is brought to a veterinarian with symptoms or information that lead the vet to suspect xylitol may have been tasted or eaten, often the first line of defense is to call a pet poison helpline. This is because the amount of xylitol in any given product is often not clearly listed. Pet poison hotlines keep published information on hand for some of the more common products that contain xylitol, and manufacturers are sometimes able to help if they are contacted.

If a dog is not showing symptoms, the vet may ask to do baseline bloodwork to ensure there is no evidence of poisoning.

If a dog is showing any symptoms from the list above, the vet will suggest doing a urinalysis as well as the physical exam and bloodwork. A dog who develops low blood sugar or shows elements of liver damage will be given further treatment.

VETERINARY STAFF FOUGHT TO SAVE JOURNEY

Journey was comatose and completely non-responsive when Kayla arrived at the ER vet.  The vet later said he looked worse than most of the poisoning cases they see.

Kayla mentioned the gum she had found, leading the vet to suspect xylitol poisoning. To the untrained eye, he had few other abnormal signs except for panting. But the veterinary staff knew what was occurring inside Journey’s body. They quickly began emergency treatment and called poison control.

The vet advisedKayla to return home and check to see if he may have chewed up anything else to ensure they did not miss anything. She called them immediately when she found the chewed and bitten gum. Other common possibilities she discovered included a bottle of Advil from her bag and some pet-safe rat bait she had placed. The bottle, she reported, was untouched, as was the rat bait.

As that first evening progressed, Journey’s blood sugar dropped dangerously low. His liver enzymes rose, indicating his liver was struggling to process the potential damage from the xylitol. There is no antidote for xylitol poisoning, so he was placed on oxygen and intravenous fluids and given other supportive measures and appropriate treatments. 

DO MOST DOGS RECOVER FROM XYLITOL POISONING?

Yes! Most dogs recover after a bout of xylitol poisoning. If a dog is treated by a veterinarian immediately after xylitol is eaten, he has a good chance of making a full recovery. Most dogs develop “uncomplicated hypoglycemia,” which takes time and veterinary care to overcome, but offers a good outcome.

Unfortunately, a small number develop liver damage or liver failure. If the liver is damaged, the mortality rate is at least 70%. 

The key is immediately getting the affected dog to a veterinarian who can begin treatment. Never wait if you suspect your dog has gotten into something containing xylitol. They may appear all right initially, but veterinary evaluation and intervention as necessary is critical.

WHAT PRODUCTS MAY HAVE XYLITOL IN THEM?

Xylitol, or birch sugar, may be found in a surprising number of foods and other products. Here is a partial list, although we encourage you to carefully check ingredients:

• toothpaste 

• peanut butter

• sugar-free gum

• Breath mints

• Vitamins, both children’s and adults’

• Mouthwash

• Over-the-counter medications

• Cough syrup

• Baked goods

• Sugar-free “skinny” ice cream

• Sugar-free desserts such as those used for baking for persons with diabetes

• Dietary supplements

• Sunscreen

• Cosmetics

• Skin and hair care products

WHAT OTHER NAMES DOES XYLITOL GO BY?

Xylitol is also marketed as birch sugar, birch bark extract, and wood sugar. If you are shopping for pet-safe products, it is critical that you read the label to be sure none of these ingredients are listed. Peanut butter, a common way many people give pills to dogs, may contain some form of xylitol. The best peanut butter is one that contains only unsalted peanuts and  salt, and contains no added sugar, no artificial sweeteners like xylitol, or any other additives like hydrogenated oils of any kind. You may want to consider purchasing a peanut butter made specifically for dogs.

JOURNEY’S HAPPY ENDING

Journey was one of the lucky ones. After spending three nights at the vet for his xylitol poisoning, Journey was released. Kayla rested him, fed him a bland diet for several days, and gave him a prescribed liver supplement for four weeks. The following day, she brought him to Centre Animal Hospital for a recommended follow-up appointment with her friend Dr. Calvert.

CAN CATS OR FERRETS DIE FROM XYLITOL POISONING?

Cats do not appear to metabolize xylitol in the same way that dogs do. While cats generally appear not to have an extreme reaction to xylitol like dogs do, we still encourage you to call your veterinarian if you suspect your cat has ingested a product containing xylitol.

Ferrets, like dogs,  should never consume any product with xylitol. Although there is not a great deal of research, a ferret’s reaction to xylitol is much more like a dog’s. Ferrets develop low blood sugar after eating xylitol, and suffer vomiting and other symptoms.

HOW TO PREVENT XYLITOL POISONING

• Never use human toothpaste for dogs. Use only toothpastes made for dogs.

• Do not give dogs table food or share any of your food with them. 

• Read product labels. Look for xylitol, but also double-check for birch sugar, wood sugar, and birch bark extract. All of these are other names for xylitol.

• If you have sweetener or any other product containing xylitol in your home, store it in a closed bag high out of reach of curious dogs.