The sugar alcohol xylitol is a popular sweetener used in gums, candies, and baked goods. While xylitol has a wide margin of safety in people and most mammalian species, when ingested by dogs it is believed to stimulate excessive insulin secretion leading to severe hypoglycemia, potentially followed by acute hepatic failure and coagulopathies. Additional clinical findings may include thrombocytopenia, hypokalemia, and hyperphosphatemia. The prognosis for recovery in dogs that develop uncomplicated hypoglycemia is generally good with prompt and aggressive veterinary care.