There has been a big push in the veterinary world in recent years to try and increase dental hygiene in pets. Vets are encouraging owners more and more to make brushing their dog or cat’s teeth, to remove plaque build-up, part of the daily routine, like you would walking or feeding them. Companies have, of course, jumped on this trend, and developed products designed to improve dental hygiene, including pet toothbrushes, toothpaste, and now ‘doggy mouthwash’.
Doggy mouthwash is added to dog and cat water bowls to ‘help fight your pet’s bad breath’. The main ingredients, chlorhexidine and xylitol, are supposed to kill bacteria and reduce plaque, with the advantage being that the liquid can reach where traditional brushing might not. Anecdotal evidence and product reviews indicate these products do help reduce bad breath and keep teeth looking cleaner. However, there’s been a recent hubbub around the inclusion of xylitol in the ingredients.
Xylitol Toxicity:
Xylitol is a sugar-alcohol, commonly used as an artificial sweetener in products such as sugar-free chewing gum, certain toothpastes, and some drugs. Xylitol is, of course, toxic to dogs (there has been no reported evidence of toxicosis in cats), with low doses (75-100mg/kg) causing rapid release of insulin, leading to acute low blood sugar and associated depression, weakness, wobbliness, seizures and coma. Higher doses (>500mg/kg) have led to liver failure, presenting as vomiting, depression, jaundice and death.
It is not uncommon for dogs that have eaten owners’ sugar-free gum, or other food with the sweetener added, to be brought into practices with xylitol poisoning. The best treatment is rapid vomiting before the xylitol is absorbed, though hypoglycaemia (low blood sugar) often does not present for many hours after ingestion, and liver injury can take over a day to present, so by then it can be too late. Further treatment involves stabilisation on fluids to counter the hypoglycaemia, and the prognosis is usually good. Later stage toxicity is unfortunately less well managed, and high levels of liver enzymes usually indicate irreversible liver damage – many of these advanced cases die or are euthanised.
Is Doggy Mouthwash Dangerous?
The very real danger of xylitol has meant that some dog owners have taken issue with the fact that this potentially harmful substance is in a product designed to be swallowed! At face value, this might make sense, but further investigation proves that there is actually little danger when using doggy mouthwash properly (warning: maths incoming!).
The product’s ingredient list states that there is 5mg/ml (0.5%) of xylitol in it. Using the lowest value that can cause hypoglycaemia (75mg/kg), an average 7kg pug would have to ingest over 100ml of doggy mouthwash to induce hypoglycaemia. A somewhat chunky Labrador of 30kg would have to drink around 450ml. Bottles are available in 250ml and 500ml sizes, meaning this Lab would have to ingest at least two smaller bottles, or one larger, to cause hypoglycaemia.
If we are considering the more serious liver failure, which can be caused by xylitol ingestion of over 500mg/kg, our pug would have to drink at least 700ml, and the Lab over 3 litres! Considering this is a huge volume of water to drink for the average pet, the risk of a dog managing this is slim.
Furthermore, this assumes that the dog has gotten hold of the sealed bottle and drunk it all neat! When used correctly, according to product information, 1ml of doggy mouthwash is added to every 100ml of drinking water. Since this increases the volume of water needed to cause poisoning by a factor of 100, the risk of xylitol toxicity from correctly used product is zero – water toxicity would occur long before xylitol toxicity!
Final Thoughts:
So when we look at the figures involved, there is indeed a very small risk of xylitol toxicity if a dog manages to open a bottle of doggy mouthwash and drink a considerable amount, especially if they are a small dog. This risk is very low compared to the risk of chocolate toxicosis, for example, which is much easier to open and consume, than bottles of xylitol-based doggy mouthwash. When the doggy mouthwash is used correctly, there is no danger at all from xylitol toxicity.
The purported benefits of using doggy mouthwash far outweigh the negligible risk of xylitol toxicity, and if the use of such a product increases owner awareness of dental hygiene in pets, then at the very least it should be mentioned in practice when discussing the issue.
Learn more:
https://www.msdvetmanual.com/toxicology/food-hazards/xylitol
Discussion
We have a chiweenie who we have been told needs dental surgery. However she is 9 yrs old and I am scared to allow her to be put under anesthesia.what mouth wash do you suggest?
I’m afraid mouthwash won’t cut it – if she’s got to the point where dental surgery is needed, it’s needed, and any alternative will just delay the inevitable (and potentially leave her in pain for longer). 9 isn’t that old for a smaller breed dog, and modern anaesthetics are very safe – so I would strongly advise you to follow the advice of your veterinary team.
My 14yr old Ruby drinks so much water she actually can puke some of it back up. She is a Rott/Border collie mix. 70lbs. She has been tested for everything because of her excessive water intake and no diabetus etc. She just loves water. I measure the amount each time, she will drink 2 cups of water at a time several times a day. My other two drink very little. Ruby is like me I love water more than any other drink, I guess she seems to also. How much Xylitol could she have?
If she has the dreaded “Psychogenic polydipsia” I’d be inclined not to use a xylitol mouthwash – she’d really have to work at it, but the risks are a little higher if she’s drinking a lot.
My dog doesn’t drink alot of water. She never has. Idk. Can you add the liquid dog breath freshener to food? Will it work the same?
It won’t work properly in food I’m afraid – the antibacterial properties will be overwhelmed by the food material. Tooth brushing is the better option!
Wondering if Petlab dental formula for dogs is safe for cats if they drink from the dogs’ water bowl
I’m not familiar with it – your best bet would be to call the manufacturer and ask. However, xylitol itself isn’t particularly toxic to cats – see this study.
I’ve been using Petlab Dental Wash for a few months now. Since you say there is no published data on its safety is there a brand(s) you would recommend that is sold in the States. Thank you
I’m afraid we’re UK based and I have no idea what products are available in the US! Over here, I’d usually advise Aquadent, but I have no idea if the formulation is the same in different regions.
My mini doxie, has a distended stomach and drinks water non stop,and can’t hold his pee. He has had a few urinary infections, non lately. How can I help him.do you think the doggy mouthwash does this.
I totally agree with Mr. Harris’s reply to you. Your focus sounds like it is displaying exactly the same symptoms 2 of my mini dishes did and both were diagnosed with Cushings. Cushings is fatal but can be control!ed with regular testing and dai!y medication. My male baby, Riot, did not respond to treatment and I was left no choice but to spare him the suffering of being suffocated to death from the bloat caused by Cushings by having him put to sleep at home in my arms by his vet. He was only 6 years old and I miss him more every day for the last 29 years. My female, Rainey, who was Riot’s true love and bonded partner in life, was diagnosed with Cushings when she was 9 yrs old and responded very well to treatment. She lived to be one week shy of her 16th birthday before she went into full renal failure and had to sing her to sleep in my arms for the last time as her vets helped her go with tears streaming down her cheeks. Please, get your baby checked out immediately! If we had caught Riot’s Cushings earlier he might have made it..now it’s too late and I have to live knowing it didn’t have to be that way for him.
It’s unlikely; from what you’ve said, I suspect an endocrine disorder like Cushing’s or Diabetes is more likely. Get him checked by your vet as soon as you can.
My dog’s mouthwash (that is used in his drinking water for keeping teeth clean) contains hydrogenated caster oil! Hydrogenated vegetable oil which is oils cooked at high temperatures like for chips, according to top heart specialist, goes rock hard in the arteries leading to the heart… in humans. Therefore I imagine it would be the same for dogs! Is this ingredient dangerous for my dog’s heart?
Interestingly not – carnivores do not develop atherosclerosis in the same way that humans (and , rarely, some herbivores) do. their metabolism handles fats quite differently, so coronary heart disease is incredibly rare! The calorific content is probably more of a concern, as obesity is still a problem though…
Help dental rinse
I’ve ben considering using the rinse in water form but know I’m not sure, I♡Dogs have Dental Rinse key ingredients is probiotics (dried bacillus Licheniformis Fermentation product) Aloe juice ,& peppermint oil.. Is it healthy or not for my little dog & ole cat?
If it contains peppermint oil I’d strongly advise against it – if ingested it can be really toxic especially in cats.
My dog was fine on 1/3 by 1/4 he was less energetic, by 1/5 he had gone into DKA and now dead after two hospital admissions. I gave him mouth wash on the evening of 1/3, stay away from this.
I to would like to know the brand. My dog is 13 and I’m concerned about him being put to sleep for a much needed cleaning. I am considering trying a dog mouthwash.
I am so sorry for your loss. I was wondering if you could share the brand of mouth wash used. Was it Pet Labs? Thank you
I have been buying pet labs dental formula for my dog, is this the dangerous one. Can he have it on biscuits instead of water
Putting it on biscuits would miss the point and be counterproductive… Xylitol wouldn’t trigger DKA, so there must be something else going on heee.
What brand or type of mouthwash was it, and how much did he have? Because I’ve never seen a reaction like that to any of the products available on the UK market!
You say Xylitol can cause Hypoglycemia in dogs due to a rapid increase in insulin.
Would the DKA asked about above not be a hyperglycemia event. Not the same effect seen from Xylitol?
I agree, which is why I asked for more information.
What about the new PetLabs Mouthwash to add to their water. No xylitol in their ingredient list BUT are other ingredients in it safe for daily ingesting??
This isn’t a product that’s widely available in the UK, and it’s not one that I’m familiar with. The active ingredients are reported to be Sodium Benzoate, Potassium Sorbate and Sodium Bicarbonate. I cannot find any published data on any of these being used in an oral form for dental treatment, and certainly all three seem to be of low acute toxicity in dogs, but unfortunately, there isn’t enough data on whether there are long-term health issues, I’m afraid! If you know of any studies or toxicity reports, please do post them here, because there doesn’t seem to be much in the literature on these compounds for dental treatment (except Sodium Bicarobonate which has been reported safe for use as a paste for dental polishing).
It contains chlorine and a surface bacterial disinfectant. These are toxic. Read reviews.on Amazon. Why would you want to poison your pet?
Reviews on Amazon aren’t necessarily a good indicator. Also, the ingredients list is meaningless without the concentrations – with poisons, its the dose that’s key.
It also depends WHICH mouthwash you’re talking about – the ones I’m familiar with from practice certainly aren’t, and my colleague Joe is talking about these, rather than potentially dodgy over the counter products.
Dog mouthwash is a great formula for dogs and it is safe to ingest. Is Listerine or something like that a safe product ?
No, we really wouldn’t recommend human mouthwashes. They contain much higher levels of xylitol than the dog ones, plus the mint flavouring can apparently hurt a dog’s mouth.