NICOTINE (CIGARETTE) POISONING IN PETS

Everyone knows the Surgeon General’s warning about cigarette smoking but what about cigarette eating?  Nicotine poisoning  is a very real concern anywhere that a pet may find cigarettes, cigarette butts, chewing tobacco, or even nicotine gum or patches.  Dogs, particularly puppies, tend to chew things up first and ask questions later. Cats may find a cigarette butt to be a nicely sized pouncing toy worthy of chewing.

Luckily for pets and small children, tobacco tastes terrible. Even chewing tobacco must have flavorings added to make it something worthy of oral enjoyment. Still, cigarettes have plenty of nicotine and even a small cigarette butt can mean serious illness or even death for a small pet.

The toxic dose for nicotine in pets is 20-100 mg.  A cigarette contains 9-30 mg of nicotine depending on the type of cigarette; while a cigarette butt contains about 25% of the nicotine of the original cigarette despite its deceptively small amount of tobacco. (Smoking seems to concentrate some of the nicotine in the tail end of the cigarette.) Cigars can contain up to 40 mg. Chewing tobacco carries 6-8 mg per gram while the gum is 2-4 mg per piece and patches 8.3-114 mg.  Smoking a cigarette yields only 0.5-2 mg of nicotine but eating one is a different ballgame as all of the nicotine becomes available for absorption into the body.

Some good news is that nicotine is not absorbed directly in the acid environment of the stomach; the nicotine must move past the stomach into the small intestine for absorption. One of the first things nicotine does in the body is stimulate the vomit center of the brain, thus inducing vomiting which may save the patient’s life if there is more cigarette material in the stomach.

SYMPTOMS OF NICOTINE POISONING

Signs begin as quickly as one hour post-ingestion. Symptoms include:

• Tremors
   
• Auditory and Visual Hallucinations
   
• Excitement
   
• Vomiting and Diarrhea
   
• Twitching possibly progressing to Seizures
   
• Racing heart rate but slow heart rate with small doses
   
• High blood pressure but at higher doses there is a circulatory collapse

It is easy to confuse nicotine poisoning with other poisonings such as strychnine, chocolate, organophosphate insecticide, and certain molds. Hopefully, there will be cigarette materials in the vomit to give away the diagnosis.

Treatment

Washing out the stomach to get rid of any remaining cigarette materials is helpful but is likely to require sedation. Since most patients are agitated, this is often a good thing anyway.  Seizures are treated with seizure suppressing drugs.  It is tempting to use antacids to protect the stomach but as it is the stomach acid that is inhibiting the nicotine absorption, it is best to avoid this therapy. If the pet survives the first 4 hours, prognosis is felt to be good. Nicotine is inactivated by a healthy liver and its metabolites are excreted in urine. After 16 hours, the nicotine ingested should be gone.