Xylitol is a sugar substitute that appears in candy, chewing gum, toothpaste and baked goods. It's a popular choice for diabetics and people on low-carb diets because it causes little insulin release in people. Unfortunately, it's terribly toxic to dogs and even at small doses of less than 0.1 grams of Xylitol per kilogram of a dog's body weight requires emergency treatment.
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Poisoning
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Symptoms of Xylitol poisoning include difficulties standing or walking, vomiting, seizures and lethargy. The onset of symptoms can occur as quickly as 30 minutes after ingestion. Treatment for Xylitol poisoning requires immediate hospitalization. Because it is so fast acting, a peer-reviewed article in Veterinary Medicine does not recommend inducing vomiting and giving activated charcoal since activated charcoal does not absorb Xylitol well.
Hypoglycemia
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Unlike humans, dogs absorb Xylitol well and at 30 minutes, the Xylitol reaches peak plasma concentration levels. This causes a flood of insulin in the dog's bloodstream and the dog goes into hypoglycemia. Excessive bleeding and gastrointestinal hemorrhages appear after about 72 hours, if the dog is still alive. If untreated, the hypoglycemia may kill the dog. Even if treatment is administered, given Xylitol's rapid effect, the hypoglycemia may be fatal.
Liver Failure
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Another effect of Xylitol is severe liver damage leading to liver failure. Although the precise reason for why Xylitol destroys a dog's liver is unknown, it's guessed that Xylinol depletes a crucial compound in the liver that is necessary for the liver to function. Dogs who manage to survive hypoglycemia may die from liver failure, especially if not treated quickly. The emergency veterinarian needs to monitor liver enzymes and should give liver protectants and antioxidants for poisonings at 0.5 mg/kg. Blood and plasma transfusions may also be needed. Regardless of whether the dog shows signs of hypoglycemia, the veterinarian should treat for that as well to prevent liver failure.
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