Birch sugar, also known as xylitol, is a chemical commonly used in human foods for “sugar-free” sweetening purposes. It contains fewer calories than regular sugar and doesn’t cause blood sugar spikes, so it can be helpful for people with diabetes and those who are monitoring their sugar intake.

However, xylitol is extremely toxic to dogs. In fact, in 2020, xylitol poisoning was the second most common reason pet parents contacted the Pet Poison Hotline.

In this article, we’ll cover what birch sugar is, why it’s toxic — and potentially life-threatening — to dogs, and symptoms of xylitol poisoning.

Birch sugar is a natural sugar alcohol found in many plants, including birch trees (it’s extracted from the sap in birch bark). It’s popular as a sugar substitute in human foods like sugarless gum, candies, and desserts because it has a very low glycemic index and doesn’t cause insulin spikes.

Additionally, birch sugar doesn’t have the same negative impact on human dental health that real sugar does, so it’s less risky from a tooth-decay perspective.

Birch sugar/xylitol is a common ingredient in nearly any household. You can find it in sugar-free foods and even toiletries like:

• Peanut butter

• Jams, jellies, and syrups

• Ice cream

• Baked goods

• Gummy vitamins and dietary supplements

• Cough syrup

• Mints, candies, and chewing gum

• Lip balms

• Toothpaste and mouthwash

• Baby wipes

• Sunscreens

When thinking of human-safe foods that are toxic to dogs, many pet owners may immediately think of chocolate. However, some may not realize that xylitol is actually even more dangerous.

Even though birch sugar is naturally derived and safe for humans, dogs metabolize it differently. In short, a dog’s body recognizes the chemical as sugar, while human bodies don’t. It triggers a rapid release of insulin in dogs (3–7 times higher than real sugar), leading to hypoglycemia — also known as low blood sugar — which can be fatal.

There are both immediate symptoms and more progressive symptoms of birch sugar poisoning in dogs. Here are some signs your pet has suffered a toxic exposure to xylitol:

Immediate Symptoms

• Vomiting: Gastric distress and vomiting can occur as soon as 10 minutes after ingesting birch sugar and up to 12 hours after ingestion.

• Weakness, lethargy, and decreased activity: These symptoms may appear soon after ingestion, but they can also show up hours or days later.

• Staggering and incoordination: Staggering or acting “drunk” is often a clear sign of toxicity in dogs.

• Tremors: Tremors can happen within an hour after xylitol ingestion and warrant an immediate trip to the emergency vet.

Progressive Symptoms

• Liver toxicity: Blood clots or excessive bleeding may occur after the first day.

• Acute liver failure: This can begin on day three after ingestion (even if no other symptoms are present).

• Hypoglycemia: Though hypoglycemia may start as soon as 30 minutes after ingestion, it can take up to 12 hours for symptoms to begin.

• Coma: Though extreme, if left untreated, xylitol toxicity could lead to a coma.

If you believe your dog has ingested birch sugar, call your vet right away and let them know how much the dog ingested and any symptoms you observe. Doses greater than 0.1 grams per kilogram can cause hypoglycemia, while doses greater than 0.5 grams per kilogram can cause acute liver failure.

Be sure to monitor your pup, and if the symptoms increase (regardless of suspected dosage), call the Animal Poison Control Center and go to the emergency vet. The hotline call is important because it can help jumpstart the process before arriving at the vet.

Going to the emergency vet may feel scary and cause anxiety on top of already worrying about your pup. But it’s important to go as soon as you start to notice symptoms. Here’s what you can expect when you go.

First, the vet will likely perform blood tests to assess blood sugar levels and liver function. If the veterinarian determines that the dose of xylitol the dog ate is high enough, they’ll likely start an IV with sugar supplementation right away.

From there, the vet will use the initial blood test as a baseline value and check the dog’s blood sugar every two hours. If levels seem to be stabilizing, they may start spreading the tests out 12 hours, then 24 hours, and finally, 72 hours.

Finally, the vet may give liver protectants while they have your dog to protect their liver from damage. These protectants could include vitamin E, antacids, or milk thistle.

The course of action determined by the emergency vet will depend on the dosage of xylitol your dog ingested. So, if the dose is lower, some of these steps may not be necessary.

In a perfect world, your dog would never encounter birch sugar, and there would be no risk of poisoning. But since the chemical is found in so many products dog owners have around, it’s up to you to protect your pup from accidental ingestion by:

• Keeping products that contain xylitol out of your pets’ reach (child-proof locks can be helpful here)

• Securing all trash

• Educating everyone in your household about the dangers of xylitol

• Getting in the habit of checking the labels of food and household products for xylitol/birch sugar

• Making sure your pup can’t get into guests’ purses or bags, which may have breath mints or gum that contain xylitol

• Avoiding feeding your dog any human food unless you’re certain it’s safe

• Opting for personal care and cosmetic brands specifically labeled as safe for pets

The best way to protect your dog from xylitol poisoning is to eliminate their access to products containing it. However, if the worst happens, contact your vet immediately, monitor your pup for any signs of xylitol poisoning, and get them to an emergency vet right away.

In addition, choose a pet food brand that you can trust to keep all toxic ingredients out of your dog’s food. The Honest Kitchen offers human grade dog food, treats, and supplements made from delicious whole food ingredients.

For better safety and more peace of mind, shop The Honest Kitchen’s dog food collection today.