Xylitol is a common and widely used sugar substitute. Coupled with its popularity in the human health and wellness space, accidental poisonings in pets (especially dogs) do occur as they are attracted to its sweet flavor. Xylitol is highly toxic to dogs and even very small amounts can lead to life-threatening illness. Cats are less likely to ingest sweets, so confirmed cases are rare — but the potential for toxicity exists, and caution should still be taken.

Xylitol can appear in a variety of low carbohydrate, sugar-free products including:

• Sugar-free gum and breath mints
• “Keto” or low-carb baked goods
• Sugar-free candies and chocolates
• Peanut and nut butters
• Protein bars and drink mixes
• Toothpaste and mouthwash
• Nasal sprays
• Chewable vitamins
• Over-the-counter medications
• Bulk xylitol sold in 1–5 lb bags for home baking

After ingesting a product containing xylitol, pets may experience:

1. Rapid, Severe Drop in Blood Sugar (Hypoglycemia)

Within 30–60 minutes after ingestion, xylitol triggers a massive release of insulin in dogs. This causes their blood sugar to rapidly plummet and the effects can last up to 12 hours. This stage is a true emergency — blood sugar can drop to dangerously low levels.

Common signs of hypoglycemia include:

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

2. Delayed, Potentially Fatal Liver Failure

One to three days after ingestion, some dogs go on to develop acute liver failure. This can occur even if hypoglycemia was mild or went unnoticed.

Severe hepatic toxicity can develop at doses as low as 0.5 g/kg, meaning even a small amount of baked goods, gum, or peanut butter containing xylitol can be deadly.

Blood tests within the first 24 hours usually reveal early liver changes. The severity of liver injury varies greatly between dogs but can progress quickly without proper care.

Known or suspected xylitol ingestion by a dog or cat should be regarded as an emergency. Even if the pet seems normal, a veterinarian or an emergency animal hospital should be contacted immediately. Early intervention and care can dramatically improve the outcome.

Veterinary care may include:

• Inducing vomiting (pet owners should NOT attempt this unless directed by a veterinarian)
• Checking blood glucose and electrolytes
• Starting IV fluids
• Providing dextrose supplementation if hypoglycemia is present
• Monitoring liver values and clotting function for 24–72 hours
  
  

There is no specific antidote for xylitol, so supportive care is the mainstay of treatment.

While supplements like silymarin (milk thistle) and SAMe can support liver healing, many over-the-counter (OTC) products are not appropriate for treating xylitol-induced liver injury.

OTC supplements often have:

• Poor purity
• Low or inconsistent potency
• Unreliable bioavailability (often only 10–20% absorbed)
  
  

For a critically ill dog, this simply isn’t sufficient. Only veterinary-prescribed formulations should be used.

Xylitol toxicity is one of the most common and most dangerous household poisonings seen in dogs. Because the sweetener appears in so many modern products — and because even small amounts can cause seizures, collapse, or fatal liver failure — all pet owners should be aware of this hidden danger. Simple steps that can minimize the chance of toxic exposures include:

• Reading labels on all sugar-free or “diet” products. If they contain xylitol, keep these away from pets.
• Keeping bulk xylitol and xylitol-containing products secured in high cabinets, not on counters or in purses.
• Choosing peanut butters and treats that specifically state “xylitol-free.”
• Warning guests who may bring sugar-free gum or snacks to gatherings.
• Teaching children not to share foods with pets.