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Urgent care is for pets who are unwell, in discomfort, are in urgent situation or are not acting like themselves and should be assessed within 24 hours.
Wellness, routine, or general care is for pets needing vaccines, preventive care, or ongoing monitoring who can safely wait at least 24 hours.
This page focuses on urgent assessment. Routine wellness exams, preventive care, and monitoring of stable conditions are provided through scheduled general wellness appointments.
Dog Ate Xylitol (Sugar-Free Gum or Candy)
Xylitol toxicosis in dogs can range from sudden low blood sugar to acute liver failure, seizures, and death, depending on the dose and timing of exposure.
Dogs may appear normal initially, but severe metabolic or liver injury can develop within hours to days.
Definition
Xylitol toxicosis is a toxin-induced clinical syndrome in dogs, not a diagnosis.
Xylitol is a sugar alcohol widely used in sugar-free gums, candies, baked goods, peanut butter, medications, dental products, and personal care items. In dogs, xylitol is rapidly absorbed from the stomach and triggers an abnormal surge of insulin, causing dangerous drops in blood sugar.
At higher doses, xylitol can also cause acute destruction of liver cells, leading to liver failure and clotting abnormalities.
As xylitol use in “healthy” and sugar-free products has increased, veterinary urgent care teams are seeing a steady rise in severe and unexpected poisonings.
Owners commonly search “dog ate xylitol gum,” “is xylitol toxic to dogs,” “dog ate sugar-free gum,” “xylitol peanut butter dog,” “dog acting weird after gum,” “xylitol poisoning symptoms timeline,” “how much xylitol is toxic to dogs,” or “dog liver failure after xylitol.”
Who This Page Is For
Dogs that may have eaten gum, candy, baked goods, or sugar-free products
Dogs with access to xylitol-containing peanut butter, medications, or dental products
Dogs showing vomiting, weakness, tremors, collapse, or seizures
Dogs that seem normal but had possible exposure within the last 24 hours
Owners unsure whether the amount ingested is dangerous
Who This Page Is Not For
Cats (current evidence shows cats are not at risk for xylitol toxicity)
If you are unsure whether a product contains xylitol, that uncertainty itself warrants veterinary assessment.
Related Urgent Symptoms
Toxin Exposure in Dogs and Cats
Dog Lethargic and Weak
Seizures or Convulsions
Hypoglycemia (Low Blood Sugar) in Dogs and Cats
Vomiting And Diarrhea
Yellow Skin or Gums (Jaundice)
Sudden Collapse (Syncope)
What This Can Look Like at Home
Early signs may appear within 30 minutes to 2 hours, but can be delayed.
Vomiting shortly after ingestion
Sudden weakness or collapse
Tremors or seizures
Acting disoriented or unusually quiet
No signs at all in the first several hours
Dogs can look fine before blood sugar drops or liver injury begins.
Why This Can Be Hard to Judge
Xylitol toxicosis has two dangerous phases.
The first involves rapid insulin release and hypoglycemia, which may come and go. The second involves liver injury, which can develop 24–48 hours later, even in dogs that never became hypoglycemic.
Dogs often hide illness, and outward behavior does not reliably reflect internal metabolic or liver damage.
The Improvement Trap
Temporary improvement does not equal resolution.
Blood sugar may stabilize briefly while liver enzymes are silently rising.
Some dogs develop liver failure without ever showing early neurologic signs, leading owners to falsely assume the danger has passed.
What Is Easy to Miss at Home
Delayed liver injury without early symptoms
Products that do not clearly list xylitol on the front label
Differences between freshly chewed vs previously chewed gum
Hypoglycemia that resolves, then returns
Subtle bruising or yellowing of gums later
These hidden patterns are why testing — not observation — determines severity.
When This Can Be an Emergency
Immediate urgent care is required if:
A dog ingested any amount of xylitol-containing product
Vomiting, tremors, weakness, or seizures occur
A dog collapses or becomes unresponsive
Exposure timing or amount is unknown
Jaundice or bruising develops
The dog seems normal but exposure was recent
How Veterinarians Assess This
Clinical signs alone cannot reliably determine severity.
Xylitol toxicosis can cause life-threatening hypoglycemia and liver failure that are not predictable from appearance alone. Diagnostic testing is how veterinarians determine whether metabolic or hepatic injury is present and whether the risk is escalating.
Diagnostic testing may include:
Blood glucose testing to detect hypoglycemia
Serum chemistry profile to evaluate liver enzymes and bilirubin
Electrolyte testing to identify potassium or phosphorus shifts
Coagulation testing (PT/PTT) to assess bleeding risk
Complete blood count (CBC) to evaluate platelets and anemia
Serial monitoring to detect delayed liver injury
Additional disease-specific testing (such as repeated liver enzyme trends or clotting studies) may be considered based on the overall clinical picture.
Veterinary Differentials - Serious / Must-Rule-Out First
Xylitol toxicosis. Rapid insulin release and possible liver cell injury after ingestion of xylitol-containing products in dogs.
Tests may include blood glucose testing, serum chemistry profile, coagulation testing, electrolyte testing.
Insulin overdose or oral hypoglycemic drug ingestion. Excess insulin activity can cause sudden hypoglycemia and neurologic signs.
Tests may include blood glucose testing, serum chemistry profile.
Insulinoma. A pancreatic tumor that can cause recurrent or severe hypoglycemia.
Tests may include blood glucose testing, serum insulin testing, abdominal imaging.
Sepsis. Systemic infection can disrupt glucose regulation and liver function.
Tests may include blood glucose testing, CBC, serum chemistry profile, blood cultures.
Addison’s disease. Hormonal imbalance may cause weakness, hypoglycemia, and electrolyte changes.
Tests may include serum chemistry profile, electrolyte testing, endocrine testing.
Acute hepatic necrosis from other toxins. Several toxicants can cause rapid liver failure.
Tests may include serum chemistry profile, bile acids testing, coagulation profile.
Veterinary Differentials - Common / More Typical
Dietary indiscretion. Ingestion of inappropriate food items may cause vomiting and lethargy without hypoglycemia.
Tests may include serum chemistry profile, blood glucose testing.
Medication-related adverse effects. Certain drugs may affect glucose or liver enzymes.
Tests may include serum chemistry profile, blood glucose testing.
Dehydration with prerenal azotemia. Reduced fluid intake may alter lab values and mentation.
Tests may include serum chemistry profile, urinalysis.
Ethanol ingestion. Alcohol exposure can cause neurologic depression and hypoglycemia.
Tests may include blood glucose testing, serum chemistry profile.
Bread dough ingestion. Fermentation can cause hypoglycemia and GI distress.
Tests may include blood glucose testing, abdominal imaging.
Stress-induced hypoglycemia in small dogs. Rare but possible in toy breeds.
Tests may include blood glucose testing, serum chemistry profile.
Safety, Psychology, & Peace of Mind
Xylitol toxicosis is dangerous because it can change rapidly and unpredictably.
A dog may look normal while blood sugar is dropping or liver injury is beginning.
Veterinary assessment replaces uncertainty with measurable information about glucose, liver function, and clotting ability.
Testing allows clinicians to identify delayed complications before outward signs appear.
Owners often feel relief after evaluation because they know whether the risk window has passed or remains active.
Prompt urgent care significantly improves outcomes and reduces long-term complications.
Frequently Asked Questions
Is xylitol toxicosis an emergency for dogs?
Xylitol toxicosis in dogs can range from mild vomiting to rapid hypoglycemia, seizures, or acute liver failure, depending on the amount and timing of exposure. Because outward appearance does not reliably indicate severity, any xylitol exposure is treated as urgent. Same-day urgent care is recommended even if the dog seems normal or exposure was brief.
My dog seems normal now — can this still be serious?
Yes. Dogs often hide illness, and xylitol toxicosis may not cause immediate symptoms. Apparent normal behavior does not reliably reflect internal blood sugar or liver stability, which is why veterinary assessment is appropriate even when a dog appears fine shortly after exposure.
What if my dog only had a small amount or it happened once?
Even a single ingestion of xylitol can be clinically meaningful in dogs. Temporary improvement does not equal resolution, and waiting can allow delayed hypoglycemia or liver injury to develop hours to days later. Early assessment helps determine whether the risk window has passed or is still evolving.
Why are tests needed if I already know my dog ate xylitol?
Clinical signs alone cannot determine severity or predict which dogs will develop liver failure. Diagnostic testing is how veterinarians evaluate blood glucose trends, liver enzyme changes, electrolyte shifts, and clotting status that cannot be assessed at home. Testing replaces guesswork with clarity and guides appropriate care.
What should I do right now?
Do not rely on watchful waiting. Any suspected xylitol exposure in dogs warrants veterinary assessment, particularly when the timing, product type, or amount is uncertain. Same-day urgent care helps reduce risk and determine the safest next steps.