Xylitol toxicosis in dogs

Xylitol is a 5-carbon sugar alcohol. It exists naturally in low concentrations in fruit and vegetables and is a normal intermediary metabolite in glucose metabolism. It is manufactured by extracting a precursor from hardwoods and is most commonly encountered as a sweetener in a wide variety of foods.

Xylitol is found in numerous products (Box 1). It is used as a sweetener and is frequently found in sugar-free chewing gums (Figure 1) and confectionary where it protects against tooth decay. It is also present in some toothpastes. It has multiple effects on oral hygiene including the inability of oral bacteria to use it as an energy source (Nayak et al, 2014). Although, xylitol is found in some drinking water additives for animals at low concentrations to decrease dental plaque and calculus formation by inhibiting growth of oral bacteria (Clarke, 2006), this is generally not a source of poisoning in pets (Murphy and Coleman, 2012). It is also found as an excipient in some human and veterinary medicines. It is often found in chewable medicines including nicotine gums and lozenges for smoking cessation.