Saturday, February 22, 2014

E-cigarette linked to dog death in the UK

Ivy's legacy: image courtesy of Dogs Trust UK.
SAT readers may be aware that in the UK a staffordshire terrier died following ingestion of a nicotine capsule for an electronic cigarette. E-cigarettes are marketed as a safer alternative to cigarettes, even being used to thwart non-smoking bans, but many critics have raised doubts. 

Nicotine is found in tobacco products like cigarettes, cigars, chewing tobacco, nicotine gum and skin patches, but refills of e-cigarettes are unique in that they contain liquid nicotine.

At low doses, nicotine acts much like a neurotransmitter with stimulant effects on the nervous system and muscle. At higher doses it leads to constant stimulation of receptors in these systems, as well as stimulating the vomiting centre.

It is readily absorbed via mucous membranes, so animals don't even need to swallow (or inhale) to experience toxic effects. Onset of clinical signs may be delayed up to one hour, but in Ivy's case the owner noted salivation and vomiting within 30 seconds of ingestion according to reports. Other clinical signs include bradycardia (slow heart rate), tachycardia (rapid heart rate), tachypnoea (rapid breathing), excitement, agitation, restlessness, muscle fasiculations, seizures, depression, paralysis and death. Affected animals often defecate.

According to reports, Ivy was admitted to a vet within thirty minutes of ingestion, but could not be saved.

In terms of treatment, administration of activated charcoal may be bind toxins in the gastrointestinal tract but is contraindicated in patients that are vomiting. Treatment is supportive and involves intravenous fluids, blood pressure monitoring, sedation, supplemental oxygen and in severe cases mechanical ventilation.

You can access information on nicotine exposure from the British Veterinary Association and Veterinary Poisons Information Service here

E-cigarettes and their contents should be treated with the same precautions as household chemicals, being kept well away from children and animals.

It should be pointed out that there is a huge amount of conflict between various reports about many factors that would impact on the severity, management and outcome of this case, ranging from the age of the dogs (in reports she is stated to be anywhere from 12 weeks old to 14 months), the amount of fluid ingested (anything from one drop to an entire vial), timing of arrival at the vet (ten minutes to the following day) and veterinary treatment (activated charcoal and supportive care to steroids). In any case of toxicity, any or all of these factors 

Creating public awareness is of course important in reducing risk to other dogs, but this is a good reminder for veterinarians to report cases of toxicity (in the UK veterinarians are very fortunate to have the Veterinary Poisons Information Service, in the US the ASPCA provides this service) and publish these in the veterinary literature as soon as possible.

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