Vet News Xylitol toxicity in dogs (Oh, Starbucks, Flintstones! Where did you go wrong?)

Some of you may know that I used to recommend Flintstones chewable vitamins for pets. You may also know that I enjoy my daily Starbucks. And Virbac is a pet product manufacturer I’ve profiled on Dolittler for its excellent concepts…

…and yet I’ve recently learned that all of them have let us down when it comes to heeding warnings on the use of Xylitol (a sugar substitute) in their products.

In case you missed my first couple of rants on the subject of Xylitol, here’s another one:

Nothing much has changed. Xylitol is still alarmingly toxic to dogs. Even tiny quantities can cause a severe drop in blood sugar, triggering seizures and trailing a failing liver in its wake. What IS new is that the number of products employing Xylitol is steadily growing, despite the veterinary outcry against its indiscriminate use without appropriate warning labels.

Xylitol is a sugar substitute with excellent sweetening qualities. As a less expensive alternative to the aspartames and saccharines of this world, this ingredient is making headway in the realm of mints, toothpaste, gum, kids’ vitamins and even cupcakes.

It’s a godsend, say some diabetics and nutritionists. Xylitol is, after all, a naturally occurring molecule with none of the calories or blood glucose elevating effects of traditional table sugar. Above all, say consumer product manufacturers, it’s less expensive.

The problem is that most dog owners haven’t yet heard of Xylitol. Even if they have, they don’t always know to look at their labels. And then there’s the issue of all the products now adding Xylitol to their ingredient list—Flintstones vitamins, for example.

I used to recommend Flintstones vitamins for dogs…until yesterday. That’s when I received an updated list of products containing Xylitol. Flintstones vitamins are a new addition.

When I first heard of Xylitol a couple of years back, I’d checked the labels of Flintstones vitamins to be sure I wasn’t recommending a toxic product. But the product’s manufacturer since decided Xylitol was a great ingredient for its “Flintstone’s Complete” vitamins.

So much for my past posts in support of the product. Though I don’t specifically recommend this version of Flintstones, it’s an easy enough mistake for any pet owner to make. That’s why I spent the afternoon drafting an advisory for the waiting room. Then I removed Flintstones from my online “recommended” lists.

Guess what other products made the list? Starbucks mints and gums. Another email fired off to big-time corporate managers who will most likely never take my concerns seriously.

Oh, and one more: Virbac, a company I respect for its excellent cache of product offerings. Their C.E.T. water additive (for reducing oral bacterial populations to help treat periodontal disease) contains Xylitol. Sure, it’s only present in minute quantities. But its very presence there is unwelcome—especially without the toxicity warning Virbac’s veterinarian customers are clamoring for.

Toxins in pet foods are bad. They kill pets. I’m gratified to see all the attention paid to this problem. But where’s the public outcry over Xylitol? How many dogs have already died? The numbers are inestimable simply because death from low blood sugar doesn’t exactly manifest in ways consistent with toxins most veterinarians are aware of.

So you know, I still find vets who don’t know about Xylitol. Though I almost always ask the owners of newly seizuring pets and those with acute liver failure whether they might have been exposed to Xylitol, I know for a fact that one of my local emergency hospitals doesn’t always ask.

When one of my clients’ dogs arrived almost dead after presumably encountering a toad, his owner elected to euthanize rather than treat, assuming a hopeless scenario. Though that may well have been the case, the query’s omission speaks to the insidious nature of Xylitol toxicity.

If humans don’t know that a few mints can kill their dogs why should they be careful when handling them. Would they buy them if they knew?

I find it hard to believe that consumer product manufacturers don’t know of their products’ dangers to dogs. It’s not hard—or expensive—to add warning labels to their products. What keeps them from doing so is simply the fear of losing their market share and the ability to use this profitable ingredient should knowledge of its effects become widely known.

Long post. Long rant. But I vow to keep ranting as long as I still encounter pet owners and veterinarians unaware of this toxic ingredient…and consumer product manufacturers willing to risk our dogs’ lives by sweetening their products with it.

September 16th, 2008

Add Comment116 Comments

It is amazing to think that in more than 2 years, more veterinarians are not aware of the dangers of this ingredient. And, if veterinarians don't know, often legions of pet owners won't know as well. To help spread the word, the Veterinary News Network created a news insert video 2 years ago about the dangers of Xylitol. It can be seen here: http://www.myvnn.com/page.asp?id=39&media_type... or, as with most videos any more, just search for it on YouTube!!

Thanks Dr. Patty!!

Tomcat1765 September 16th, 2008 09:53:00 AM

It's funny that you should bring this up today. Just yesterday I was looking through the cabinets at work (I'm a vet assistant) and noticed the CET water additive contained Xylitol. I mentioned it to to the doc and he told me that the amount in the CET product was not enough to cause any problems. I just thought it was very odd that a product formulated specifically for dogs contains something that can potentially harm them, but you see it all the time in other dog products that contain garlic, too.

Heifzilla September 16th, 2008 10:23:00 AM

The -tols are confusing. My boyfriend gave my dog a tiny bite of a piece of gum he was going to eat...for whatever reason and I freaked, turns out that particular gum is sweetened with Malitol not Xylitol.
I'm not a chemist or a scientist, I don't get what the difference is. From my understanding malitol is not toxic to dogs not that I was able to ever find much out about it.

Don't even get me started on garlic, so much conflicting information on it. It's fine ... it's terrible. Blah.

Esmee September 16th, 2008 11:07:00 AM

Garlic - oh the bane of cat lovers everywhere. I went out looking for a "premium" canned food for my cats, and was shocked at the number of "premium" brands that contained garlic. I wrote to one of the companies asking why they would include a product that was known to be toxic to cats, and they wrote back saying "oh we don't put enough in to be toxic, and besides, it makes the food taste better"

*rolls eyes*

xylitol in a product specifically made for dogs, those people need to be taken out to the shed and flogged!

Connie September 16th, 2008 11:37:00 AM

Unfortunately, I don't think there will ever be warnings about toxicity to dogs on products containing Xylitol because the word "toxic" is not a good look on a food label and the manufacturers (probably rightly) fear that people will assume (wrongly in this case) that what is toxic for a dog is also toxic for them and their kids. I think the warning is going to have to come with the dog as it were - in so far as that is possible.

There is a similar problem with non-stick pans and birds. Warnings have never been put on these pans regarding the deadly effect of the fumes from an overheated non-stick pan on birds. In fact vested interests have done their best to deny and downplay the danger. In this case I can't help thinking what kills a bird also can't be too good for humans either - the canary/coal mine thing - and obviously they really don't want that info out there. I also believe that non-stick pans are also not exactly environmentally friendly either. Yet they are still sold hand over fist and in fact it can be hard to find a pan that *isn't* non-stick at times.

And stuff sticks to them just as it does to anything else!

Alison September 16th, 2008 08:51:00 PM

Dr. K, do you happen to know of any websites that would contain a list of certain foods that contain xylitol?

ashleigh September 17th, 2008 07:35:00 PM

Dr., a little off topic, but if you could do a blog post on nothing but GARLIC for pets, I would really appreciate it. Some lists cite it as being toxic but I know people who actually supplement with garlic products as a bug repellant. Thoughts?

Cat September 18th, 2008 12:21:00 AM

Dr.,
I came across your site this evening trying to learn more about Xylitol. My dog (which rarely gets into anything) had found a pack of gum in my daughter's pocketbook while we were gone for a couple of hours. At first, I thought that she would eventually pass it through her system, but I had a strong feeling to call my friend who happens to be a vet. She ask me immediately if it had xylitol in it and it did. She told me to give her 1/2 ounce of hydrogen peroxide, wait 10 minutes and repeat if she had not thrown up. Luckily, it worked great and she got most of it out of her system. We figured she had eaten 4 1/2 pieces and she only weighs 20 lbs. We are very thankful that we still have her today!!! If my family was aware that this ingredient was fatal to dogs, then that pack of gum would have not been available to my children's dog, Sadie. Not to mention that my daughter would have felt as though it was her fault for killing her dog! So, today I went shopping for some new sugarless gum without xylitol!!! People definitely need to be aware that xylitol is toxic to their dogs because everyone that i had talked to today did not have a clue. All had gum in their cars or homes and some of our dogs like to go for rides. Go figure!

Andrea September 18th, 2008 02:16:00 AM

I'm really glad you posted about this because I'd never heard of this.. I will spread the word.

Sian September 18th, 2008 06:54:00 AM

Here's the most complete list of Xylitol-containing products I've found:

http://74.125.45.104/search?q=cache:kpGyewRz3-wJ:w...

Dr. Patty Khuly September 18th, 2008 08:43:00 AM

Garlic is one I've never found a good answer for... I've done some literature searches and never managed to find a studying implicating garlic as a cause of Heinz body anemia in dogs or cats. Every paper that I read extrapolated from data about onions, which are known to cause Heinz body anemia. I don't quite buy that just because onions and garlic are both in the same genus (Allium) that they both have the same toxicity.

I'm in toxicology right now, so am hoping for an answer soon...

Megan September 18th, 2008 09:29:00 AM

I should also add, there is no data that garlic has any efficacy against parasites.

Megan September 18th, 2008 09:33:00 AM

If you're looking for an alternative to the C.E.T. products try Oxyfresh http://www.oxyfresh.com/pet/
They have excellent water additive and toothpaste products - without any xylitol. We've used them for years and had excellent results with them. It really is good stuff, and we're not affiliated with them, so this is an relatively unbiased opinion.

Janeen September 18th, 2008 08:06:00 PM

Again, as a Finn where Xylitol has been used extensively for the last 30 or so years, I find the outcry against Xylitol somewhat amusing.

Naturally, as a substance toxic to dogs, it shouldn't be used in animal products but some sense should be applied to warning people of a substance that in humans has clinically proven health benefits (see http://en.wikipedia.org/wiki/Xylitol for an overview). The fact that it is beneficial to human health means that it's use will spread.

And honestly, does anyone really think that warning labels on products are read by most consumers? Of course pet owners need to be educated on toxic substances (cocoa anyone ?), but does every product need a warning label for all of the various possibilities?

And coming from a country that has used Xylitol for ages (hey, it's been on the market longer than I've been around ;) the cases of pets dying from Xylitol poisoning are quite rare. I've heard more stories about dogs getting into chewing-gum stashes and eating lots without any problems than of poisonings.

I honestly wonder why common sense and education aren't valued more than warning labels...

ramin September 20th, 2008 07:28:00 AM

ramin: I would agree with you were it not for the slow adoption of a common knowledge understanding of this product's high degree of toxicity--at least in the US. When one sugar-free cupcake (do you have Sara Lee brand sugar-free products in Finland?) can kill a medium-sized dog, I'm not amused.

Sure, humans must be careful. But that assumes they have knowledge of what goes into their over-processed diets--another topic altogether.

Considering, also, that many Xylitol -containing products in the US are simply labeled as containing "sugar alcohols," it makes it tough for me to buy the "common sense trumps all" contention.

On the health benefits of Xylitol versus other similar sweeteners: None. I respectfully submit that perhaps your Finnish heritage ( in which Xylitol is used to sweeten almost all gums and where the industry of Xylitol extraction from your birch trees is a robust one) has colored your view on this.

Dr. Patty Khuly September 21st, 2008 01:56:00 PM

I used xylitol for months before I knew it was toxic to dogs. Special labeling is definitely in order, especially when it only shows up on the ingredient list of a prepared food. It's easy for people to get it into their heads that chocolate kills dogs, because they can tell at a glance what has chocolate in it. Avoiding xylitol is like avoiding an allergen -- you'd HAVE to check ingredients. There should be a nice, visible, "contains xylitol" note, at the least. Xylitol is a godsend, compared to sucralose and aspartame, for diabetics -- merchants should be proud to advertise its presence in their foods anyway. The garden shop in my neighborhood specially labeled all the cocoa fiber products as unsafe for canines; it's the right thing to do.

sarah September 21st, 2008 09:41:00 PM

Dr. Khuly, I really appreciate your rants. They are welcome, believe me!

I'm stunned by the ignorance (often willful) so many in our society display regarding pets and other animals. It's always nice to hear a voice speaking up for the animals.

I don't have any dogs now, but I will certainly remember this, and I will pass the info on to my mom, who is considering getting another dog.

Thanks much!
Jen M.

Jen M. September 23rd, 2008 09:16:00 AM

I can understand your concern about Xylitol in pet products, but the products that I saw you talking about were NOT intended for pets. I too am a pet owner and would never consider giving my pets HUMAN products that contain Xylitol. I don't give them any human products other than organic, home prepared food. Anyhow, I am also a Registered Dental Hygienist and I do highly recommend Xylitol to my HUMAN patients because of its HIGHLY anti-cariogenic properties. For anyone who needs to suck on mints or chew gum, it is much better for them to choose one with Xylitol.

Leslie Melody, RDH October 18th, 2008 02:45:00 PM

Rescue Remedy has a candy with xylitol in it! Be ware and tell everyone!

http://mainepets.mainetoday.com/blogentry.html?id=9116

nancy freedman-smith November 18th, 2008 10:58:11 AM

FYI, tic tac Chill mints contain Xylitol.

Just got off the phone with my vet letting me know that it looks like Spirit, my 8 mo. - old chocolate beagle, who ingested who knows how many tic tacs with Xylitol yesterday morning is going to be one of the lucky ones. I didn't think much of it yesterday when I caught him with the near empty container of tic tacs until he started vomiting all over the place a little while later. As he continued vomiting, I remembered reading that Xylitol was toxic to dogs a long time ago when I was researching it as a sugar substitute. I checked the tic tac package, but xylitol was not mentioned. I then went to the tic tac web site and found that this particular sugar free tic tac was sweetened with xylitol and immediately called my vet. Thank goodness I knew it was toxic because the girl I spoke with did not seem that concerned. The vet, however, was aware of Xylitol's toxicity, but was not sure how toxic until he did a little research and then immediately took action. Spirit was put on fluids to maintain his sugar levels, which luckily had not dropped, and some liver support therapy and antibiotics. His liver enzymes were elevated yesterday so they kept him on the fluids overnight to flush out his system. Today his glucose is good and his liver enzymes have returned to normal.

No matter how hard we try, our dogs are always getting into things they shouldn't. Having the knowledge of what's toxic to our pets and the ingredients of what they ingest is crucial. The makers of tic tac (Ferrero) do have a comment on the Q&A section of their web site stating that Xylitol may not be safe for animals, but how many people go there? I wasted precious time by having to go to the web site to find out if Xylitol was even in this particular type of tic tac. (The ingredient may have been listed on the clear plastic wrapper, but once opened there was no mention of the ingredient.)

We should all help spread the word to dog owners out there who may not know how toxic Xylitol is.

Kim Keenan November 19th, 2008 12:20:25 PM

Please don't belittle your research and compassion. This was no rant, it was intelligent and greatly helpful. Good for you.

anotherhappydogowner January 30th, 2009 11:56:06 PM

Your list of xylitol products is the most complete I've seen. I'm doing research on this for an article intended for dental professionals and it really helps. I did not know about the Starbucks gum/mints or the sugar-free Tic Tacs another poster reported on. Thank-you! FYI and all others who are curious - xylitol is also in Jell-O Sugar Free Pudding Snack Cups, so don't let your dogs lick the container clean!

Julie Seager, RDH, BS March 8th, 2009 05:31:33 PM

My 10 pound Maltese dog, Prince, ate 15 pieces of Trident Citrus Twist gum today. He is now at the vet's home overnight, because they need to check his blood sugar every few hours. The past few hours have been really difficult. We have pets in our lives for the enrichment that they provide. Prince is a member of my family and the fact that a seemingly innocent article as chewing gum could cost us his life is really appalling to me. I never had any idea that Xylitol was toxic to him. When I realized he had eaten the gum and exactly how much, my daughter said we better call the vet just in case. It escalated from there and our little guy was quickly placed on IV fluids. After spending the evening on the internet researching the subject, I realize just how strange the American culture really is. I understand that the product is helpful to diabetics who cannot ingest sugar. But why is it in GUM? GUM is not essential to human beings and for some reason it is attractive to my dog, but IT IS TOXIC TO HIM! I guess right now I am just very upset, but I will not let this go. Everyone I know will hear about this and hopefully word will spread. This is just SO WRONG.

cory2992 March 11th, 2009 04:50:48 PM

Avoiding xylitol is like avoiding an allergen -- you'd HAVE to check ingredients. There should be a nice, visible, "contains xylitol" note, at the least. Xylitol is a godsend, compared to sucralose and aspartame, for diabetics -- merchants should be proud to advertise its presence in their foods anyway Mission Travel

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