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As electronic cigarettes (e-cigarettes) are becoming more popular, exposures to animals are increasing as the types of exposures have changed.
E-cigarettes were first marketed in 2007 and have been gaining market share ever since. At the ASPCA Animal Poison Control Center in 2012, e-cigarettes made up 4.6 percent of nicotine exposures in a category that included traditional cigarettes, nicotine gums and patches. In 2013, e-cigarette calls increased to 13.6 percent of all nicotine cases. In addition, the numbers of exposures reported increased during that time period from 240 animals affected in 2011 to 305 in 2013.
This is of concern, because nicotine is a dangerous poison for pets, and e-cigarettes and their associated paraphernalia often contain it in more concentrated levels than in traditional tobacco products.
People use e-cigarettes to try to cut back on tobacco, but it is important to realize that these products are filled with liquid nicotine and still remain a hazard for pets. Electronic cigarettes contain a rechargeable battery (that can cause oral burns if ingested), a cartridge that contains liquid nicotine and an atomizer that vaporizes the liquid for inhalation by the user. The liquids inside can vary from those not containing any nicotine to those containing up to 16 milligrams of nicotine per milliliter of liquid (80 milligrams per teaspoon). In comparison, most tobacco cigarettes contain only eight to 40 milligrams of nicotine total. People who use e-cigarettes also often buy refill containers. This more concentrated refill liquid nicotine may contain up to 100 milligrams per milliliter (500 milligrams per teaspoon), which is diluted by the user to a lower concentration when refilling e-cigarette cartridges. It is the more concentrated liquid cartridges and larger-volume containers of nicotine liquid that pose the greatest risk for poisoning in pets, as well as people. In addition to the nicotine, many of the liquids contain flavoring agents. These flavorings are not a poisoning concern for animals but may possibly make the e-cigarette even more enticing to pets.
The most common clinical sign in dogs and cats (canines make up most of our reported cases, but felines have been involved as well) with nicotine ingestion is vomiting. As nicotine receptors throughout the central nervous system and the body are stimulated, drooling, diarrhea, agitation and high heart rates can occur. With higher doses of nicotine, the receptors become blocked, and tremors and seizures can be seen, along with lethargy, muscular weakness and death from respiratory muscle weakness and heart arrhythmias.
The most dangerous thing about nicotine in liquid form is that it can be absorbed through the skin or mucous membranes of the mouth in dogs, cats and humans. Normally with oral doses (e.g., eating a tobacco cigarette), the liver removes much of the nicotine before it reaches the bloodstream, but transmucosal routes avoid the liver. This means more nicotine will be active when compared to the same amount of ingested tobacco in a traditional cigarette.
Suspected nicotine ingestion is a true emergency. Because of the rapid absorption, most animals will become symptomatic very quickly. Vomiting usually develops within 30 minutes to an hour. If you think your pet has ingested nicotine (e-cigarettes, patches, gum or tobacco) and your pet is vomiting, agitated or lethargic, call your veterinarian immediately or the ASPCA Animal Poison Control Center at 1-888-426-4435.
To help prevent nicotine poisonings, remember to always keep e-cigarettes, refill containers and any nicotine-containing products, such as nicotine patches and traditional tobacco products, out of the reach of pets and children.
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