by John Gilpatrick
Dog owners know the dangers that foods like chocolate, garlic, onions, and grapes pose to their canine companions’ health; foods that are harmless to most people.
Another common substance that’s harmless to most humans but potentially life-threatening if consumed by dogs is xylitol—a sugar alcohol that is used as a sugar substitute in many human foods.
But for dogs, xylitol poisoning is a major problem, according to Ahna Brutlag, DVM, associate director of veterinary services at Pet Poison Helpline. Brutlag says ingesting xylitol causes a rapid and massive insulin release in dogs, which will manifest itself outwardly to a pet owner as acute weakness, staggering, and vomiting. “Within 15 to 20 minutes, they might even be comatose,” she adds, and depending on the amount consumed, a dog can also experience liver failure from ingesting xylitol.
According to the Poison Pet Helpline, cases involving xylitol ingestion are increasing rapidly. In 2009, they were consulted on approximately 300 cases, while in 2015, that number increased to 2,800. Read on for more about what foods xylitol is found in to learn why these cases are multiplying and what you can do to respond appropriately if it happens to your dog.
Xylitol in Gum
If a gum is labeled as sugar-free, that should be a warning sign for xylitol, though various gums can have vastly different amounts of xylitol. “One or two pieces of certain gums can cause serious problems, while ingesting ten pieces of another gum can be fine for your dog,” Brutlag says. “It all depends on the xylitol dosage.”
Some gums—like Spry—plainly advertise themselves as containing xylitol because it’s good for your teeth and for diabetics. Meghan Harmon, DVM, is a clinical instructor for emergency and critical care at the University of Missouri College of Veterinary Medicine. She co-authored a 2015 study in the Journal of Veterinary and Emergency Care that retroactively evaluated cases of xylitol ingestion in nearly 200 canines. She lists Stride, Trident, and Orbitz as other gums containing differing amounts of xylitol and echoes Brutlag, saying it’s critically important to know what kind of gum was ingested, how much your pet has ingested, and how long it’s been since he or she ingested it in order to appropriately treat the problem.
“Most dogs we looked at were hospitalized, usually for about 18 hours,” she says. Dextrose is typically administered as quickly as possible in order to bring the canine’s blood sugar up. Harmon says that as long as liver health appears normal, once they regain the ability to regulate their blood sugar levels by themselves, dogs are weaned off the dextrose and eventually released.
Xylitol in Mouthwash and Toothpaste
While not usually containing the same levels of xylitol as gum, dental health products tend to use this sugar substitute because of its appealing, sweet taste and its teeth-strengthening, plaque-fighting properties.
The Pet Poison Helpline cites gum as the source of nearly 80% of cases involving xylitol. While gum manufacturers have the options of using other sugar substitutes, like erythritol and Stevia, xylitol is the only one experts know of that causes such adverse reactions in canines, according to both Brutlag and Harmon. Manufacturers of dental health products aren’t facing the same scrutiny as the food industry, meaning their share of xylitol cases may increase in the coming years.
Next: Xylitol in Baked Goods and Groceries
Xylitol in Baked Goods
Because packaged xylitol can be bought in bulk at many food stores, baked foods are becoming a more common source of canine health emergencies. “It’s a good option for diabetics who like to bake,” she says. Similarly, you might find some already-made baked goods containing xylitol at bakeries and specialty stores. And because cupcakes and cookies have a lot more sweetener in them than mouthwash, a pet that consumes a baked good packed with xylitol is in danger of facing a life-threatening situation.
“You need to call your vet or the Pet Poison Helpline immediately,” Brutlag says. “Give them as much information as you can. Depending on the severity, they may suggest feeding [the dog] syrup or honey—something sweet to help keep their blood sugar up temporarily while you drive to seek emergency help.”
Xylitol in Sugar-free Groceries
Xylitol is found in trace amounts in many fruits and vegetables, but because it’s occurring naturally and in such small amounts in these cases, it’s hardly ever a problem for pets, Brutlag says.
On the other hand, many grocery stores have started carrying sugar-free foods like ketchup, peanut butter, protein bars, pudding, and more that contain xylitol as one of their primary ingredients. Harmon even says there is a brand called Zapp! that manufactures condiments, sauces, and other groceries that are marketed primarily on their being made with xylitol. “In this case, it’s very clearly labeled,” she says, “but in most other instances, you’ll need to check the ingredients list on the label to know if something sugar-free is made with xylitol or some other substitute.” And in some cases, products that are not labeled as sugar-free still contain xylitol. It is important to always carefully read the entire ingredient list of any food before giving it to your dog.
Next: Xylitol in Medications and Body Care Products
Xylitol in Medications
Brutlag says most medications that contain xylitol are of the “meltaway” variety. These accounted for 12 percent of xylitol cases referred to a veterinary emergency facility, according to the Pet Poison Helpline—the second most behind gum.
You also might see xylitol in some medications containing melatonin, liquid prescription products, and gummy vitamins.
Xylitol in Lotions, Gels, and Deodorants
You’re probably thinking, “Wait, why does my deodorant contain an artificial sweetener?” Fair question.
“Xylitol has humectant properties,” Brutlag explains. “This means it can help a product retain moisture, which makes it perfect for products like this.”
Brutlag says this is a relatively new development, meaning even many veterinarians aren’t aware of the dangers of dogs digesting deodorants—at least when it comes to xylitol. As with everything on this list, it’s best to keep such products in a cabinet or on a high shelf—completely out of reach of your four-legged friends.
This article was verified and edited for accuracy by Dr. Jennifer Coates, DVM
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