Exposure to electronic cigarettes and e-liquids is a growing concern in small animal practice, particularly given the known risks of nicotine toxicity. A new study from the UK’s Veterinary Poisons Information Service (VPS), published in the Journal of Small Animal Practice, provides reassuring data on outcomes following canine exposure — while also highlighting the importance of individual case assessment.
The study reviewed 321 canine cases reported to the VPS involving exposure to e-liquids or electronic cigarettes. Most exposures were oral, typically involving chewing or ingesting bottles, cartridges or devices.
Overall, outcomes were favourable. More than half of dogs (53%) remained asymptomatic, and a further 41% developed only mild clinical signs. Where signs were seen, the most common were vomiting, hypersalivation and tachycardia, consistent with mild nicotine toxicosis. Less typical signs such as tremors, ataxia or tachypnoea occurred in fewer than 7% of cases.
Clinical signs were generally short-lived, resolving within hours in most dogs. The median recovery time was three hours, although recovery ranged from as little as ten minutes to several days in a small number of cases.
Management varied depending on presentation. Around 28% of dogs required no treatment or observation only, while 45% underwent some form of gastrointestinal decontamination, most commonly activated charcoal or oral lavage. Two dogs required surgical or endoscopic removal of a foreign body — an e-cigarette device and a refill bottle — highlighting that mechanical risks can be just as important as toxic ones.
More serious outcomes were uncommon but did occur. Six percent of cases were classed as moderate, severe or fatal, and two dogs died. One death followed ingestion of e-liquid with progressive cardiorespiratory compromise; the other dog was euthanised due to financial constraints rather than clinical deterioration.
Interestingly, the study found no clear relationship between reported dose and severity of clinical signs, and the authors note that it remains unclear why some dogs tolerate apparently large exposures without developing severe nicotine toxicosis.
For vets and nurses in practice, this study offers helpful context for risk assessment and client communication. While e-liquid exposure should never be dismissed, the findings suggest that most cases can be managed conservatively with symptomatic and supportive care, provided dogs are assessed carefully. As the authors emphasise, each case should still be evaluated individually, taking into account clinical signs, formulation, potential foreign body ingestion and owner circumstances.
Overall, this large case series provides reassuring evidence to support measured, evidence-based management of e-liquid exposures — while reinforcing the value of poison advice services in guiding treatment decisions.
Nicola Bates, lead author of the study, said: “Although severe effects following exposure to e-cigarettes or e-liquid is uncommon in dogs, each case should be assessed on a case-by-case basis to determine if any decontamination or treatment is required”.
Read the full article here: https://onlinelibrary.wiley.com/doi/10.1111/jsap.70014