Written by Dr. Patty Khuly, contributor to VetMD and the blog Fully Vetted. Reprinted with permission.

FEB 07, 2011

I’ve written about the dog-toxicity of the popular sugar substitute xylitol so often and so fervently that a Google search for “xylitol and dogs” digs up my past posts on the subject among the first several findings. And that’s cool. But it’s not nearly enough. Indeed, the fact that I’m up there tells me precious few people are getting the news. Which is why I keep trying …

Yes, xylitol is still killing dogs … more dogs than ever before. This, despite my efforts and those of like-minded big mouths who seek to inform all U.S. consumers that xylitol is a menace to dogdom.

How menacing? A few sugar-free breath fresheners, a pack of gum, a spilled tin of mints, a sugar-free dessert cup. It takes only a little of this toxin to send a dog into hypoglycemia-induced seizures, and just a little bit more to bring on liver failure.

And what’s worse is not so much its extreme toxicity … but its insidiousness.

Let me explain:

Xylitol is a great product. It’s a natural extract from the birch tree, and it takes only a little bit of this stuff to sweeten a whole lot. It’s therefore less expensive than other sugar substitutes. And it happens to taste better than most of them. Diabetics everywhere can rejoice! The tooth fairy, too.

All of which is why consumer product manufacturers have been slowly and quietly replacing other sweeteners with xylitol … in everything, not just products that are labeled sugar-free.

And that’s the trouble. When I first started writing about xylitol three or four years ago the number of consumer products containing xylitol numbered less than a hundred in the U.S. Moreover, they were largely restricted to the arena of sugar-free gums and foods. Fast-forward to today and the list is way longer and much more diverse. You can find xylitol in everything from Flintstones vitamins to commonly prescribed drugs.

These latter products pose more of a problem for dog owners and veterinarians for a variety of reasons.

These products never used to contain xylitol. In fact, I used to recommend Flintstones vitamins for my patients. Now I have to caution my clients to stick to pet-only brands and to be very diligent about reading labels. But it took months before I became aware of the change in this brand’s ingredients. (So you know, xylitol is included in only a few of the Flintstones formulations, not all.)

What’s worse — and even more stressful for veterinarians — is that it’s not just common consumer products anymore that we have to watch for. The human versions of drugs, especially the children’s elixirs, are now being formulated with xylitol for greater pediatric palatability. Unfortunately, the lower doses in the kids’ meds are exactly what some of our smaller animal patients require.

Got a little dog who needs hycodan syrup for a cough, or the bronchodilator theophylline for breathing? Even if you’ve been getting a drug for months or years as an elixir from the same exact pharmacy, beware. Preparations of these drugs may soon change to reflect the widening market for xylitol as a sweetener.

Case in point: This week I sought to relieve a clients’ small dog of back pain associated with recurrent episodes of intervertebral disc disease. In so doing, I prescribed a dog-only non-steroidal anti-inflammatory drug, and the smallest dosage of gabapentin (used for both seizures and neurogenic pain) currently formulated. But the pharmacy had run out of the 100 mg capsules, which is why I received a call from the pharmacist to see if I would OK the liquid (elixir) version instead.

Now, I’d like to say I’m always up on every single drug and all the new formulations, but I’m not. It’s just too damn much info to consume on a regular basis. I had, however, just read through Plumb’s Veterinary Drug Handbook on this exact point: available formulations of gabapentin. And guess what? Some commercially prepared versions of liquid gabapentin have xylitol in them — and it was one of these very versions my pharmacist was offering.

The same drug I was offering my patient might have killed her had I not known about the change!

Now, I don’t know how much of the elixir it would’ve taken to send her into seizures, but rest assured, this little dog was already getting the high end of the drug’s dose, so I think I’m justified in fearing the worst for other dogs all over the country whose pharmacists don’t make the call (it happens all the time), or whose veterinarians haven’t yet heard of the dangers pediatric elixirs now pose to animals.

Does this shock you?

It should. It terrifies me.

Dr. Patty Khuly

Next: Did you know? 10 things toxic to dogs.

Back to: Sheltie FAQ

6 Responses to “Dog toxic xylitol in gums, mints, desserts … and now drugs”

  1. Rapha's Mom

    Thanks for keeping me informed, because I had no idea. I sometimes give my sheltie Pepto Bismol and I’ll be sure to watch the ingredients, as well as other foods and medicines.

  2. Alissa

    Thanks for the heads up! Both my parents are diabetic so there is lots of sugar free food in their house (my puppy is the family dog and he lives there; I visit on weekends) Mom used to give him some of her yougurt which was sugar free! Fortunatly we don’t feed him “human food” anymore because his stomach is so weak it gets upset VERY easily. Do they uses sweeteners in dimenhydrate? Sandy has to take that for every car ride.

  3. Ruth Shoenthal

    Thank you Dr. Khuly. I use TRUVIA, which is no less problematic. I made hot cocoa (also poisonous) with pure cocoa and Truvia. My Shai got to it and I freaked out. I called my vet and had to rush him to the office to have his stomach pumped. Since I live in Manhattan, I took Shai home after having spent $501.

  4. Lisa

    There is a new sugar substitute out calle “Ideal” and it is just like Splenda only it is a big bag of Xylitol and you use it just like all of the other sweeteners. So if you bake at home and use this instead of sugar do not feed those snacks to your dog.

  5. Francine

    Thank you Dr Khuly for all the advice. We all want the best of health for our four legged friends.

  6. P. Snyder

    Thank you Patty. I have a constant battle with my husband about giving ‘people’ food to the dogs, especially ice cream or frozen yogurt, both of which use artificial sweetners. I also intend to ask our vet about this article. She’s an exceptional vet, but like all doctors, both human & animal, the drug industry is changing so rapidly it couldn’t be possible to keep up with all of it as quickly as needed. You almost have to ask ‘what time is it?’ when asked about recent changes for medication options. I’ll be printing your comments to keep with feeding instructions for the dogs, make sure my husband reads it & to discuss your findings with my vet. Thanks again.


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