Brock Boeser scored his second goal for Vancouver with 4:50 left in the third period to tie it 4-4. Ottawa won possession off the opening face-off in overtime and Sanderson was sent in alone in tight by Tim Stutzle, beating Kevin Lankinen five-hole with the game-winner.
Quinn Hughes had a goal and two assists and Lankinen made 15 saves for the Canucks (16-10-7), who are winless in three games (0-1-2).
Giroux put Ottawa ahead 1-0 just 1:45 into the first period by deflecting a Thomas Chabot wrist shot from just inside the blue line down past Lankinen.
Pinto made it 2-0 at 16:22 on a 2-on-1 by finishing off a cross-ice pass from Michael Amadio before Lankinen could push across to his left.
Boeser converted a backdoor pass from Hughes at the bottom of the left circle to make it 2-1 at 18:04, and Hughes tied it 2-2 at 19:42 with a wrist shot past the blocker of a screened Merilainen from the top of the left circle.
Pinto put Ottawa ahead 3-2 at 4:24 of the second period, taking a pass off the rush from Drake Batherson near the top of the circles, chipping it past Tyler Myers and going backhand to forehand and between Lankinen's pads in alone.
Vancouver tied it 3-3 at 13:36 when Merilainen stopped Hughes' one-timer from the point only to have it bounce in off Jake DeBrusk's skate atop the crease.
Josh Norris scored shorthanded at 15:30 to put Ottawa back ahead 4-3, winning a race up the ice and converting a backdoor pass from Giroux.
Boeser tied it 4-4 after passing the puck to Pius Suter in the slot from behind the net, then converting a rebound of Suter's shot from the side of the crease.