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Xylitol is a naturally occurring substance that is widely used as a sugar substitute. It is found naturally in berries, plums, corn, oats, mushrooms, lettuce, trees, and some other fruits. It may also be called wood sugar, birch sugar, and birch bark extract. Xylitol is extremely toxic to dogs. Even small amounts of xylitol can cause hypoglycemia (low blood sugar), seizures, liver failure, or even death in dogs.