Xylitol is a sugar substitute that is commonly used in low carbohydrate products, sugar-free gums and candy, toothpaste, and mouthwashes. Xylitol use has become very popular over the past few years, especially in human diabetic patients and others seeking alternatives to sugar in their diet. There is no "safe dose" or amount of xylitol that can be ingested - dogs can develop problems even if they ingest small amounts of a product containing xylitol.

Xylitol is especially toxic to dogs. Within 30 minutes of ingesting a product containing xylitol, dogs can develop severe hypoglycemia (low blood sugar). The most common signs that owners may see include:

  • Lethargy or depression
  • Vomiting
  • Weakness
  • Wobbly gait (ataxia)
  • Collapse
  • Seizures

If an owner knows or suspects that their pet has ingested xylitol, the pet should be seen by a veterinarian as quickly as possible. Induction of vomiting may be recommended to prevent further absorption, and monitoring of blood glucose and electrolytes should be performed. Dogs with hypoglycemia and other electrolyte abnormalities may require supportive care including intravenous fluids and dextrose supplementation.

One to three days after the initial consumption of xylitol, dogs may go on to develop liver failure. Within twenty-four hours of ingestion, blood tests will reveal any toxic effects on the liver. The degree of liver failure varies between individuals. These patients generally require ongoing supportive care to nurse them through to recovery.


There is no specific antidote for xylitol toxicity.

Treatment is supportive (as described above). Patients that develop liver failure or hepatotoxicity often require continued intravenous fluid therapy and other liver support measures. Supplements including silymarin (Milk Thistle) and SAMe have antioxidant properties and can help in reducing inflammation and scarring in the affected liver. It's important to note that most over-the-counter (OTC) hepato-support products are not generally recommended, as their purity and potency often do not meet the requirements of sick patients. Only products recommended by the veterinarian should be used in patients with liver failure.

Veterinary Professionals learn more about Acute Liver Failure