The Effects of Tobacco Use on Avian Species

Tobacco products are severely detrimental to birds. They are proven to cause not only respiratory distress and disease, but they are also responsible for illnesses in every other body system.

Second-and third-hand smoke are the most common causes of tobacco-related diseases; however, other forms of tobacco and nicotine products cause damage as well – damage that includes injury to the cardiovascular system, respiratory system, feathers, integument, and gastrointestinal system.

Unless the disease is too advanced, removal of the bird from the toxic environment, along with medical management, will usually result in a resolution of the clinical signs and healing of damaged tissue.

Introduction

Human beings have known of the dangers of smoking for hundreds of years. To deny the health risks posed by tobacco products is absurd.

A century ago, people were giving cigarettes the term, “coffin nails,” and for decades, health care providers have been attempting to warn their clients that they are jeopardizing their own well-being by inhaling or otherwise taking in the harmful by-products of nicotine.

If tobacco products are harmful to humans, with strong hearts and lungs, how much more detrimental are they to birds, which have extremely delicate circulatory, respiratory, pulmonary and integumentary systems?

Chronic illnesses abound: upper respiratory infection, coughing, sneezing, sinusitis, conjunctivitis, just to name a few. Secondary bacterial infections are common, and many of these illnesses can prove fatal.

The more the bird inhales the cigarette, cigar, or pipe smoke, or is handled by a smoker, the more his ability to tolerate the damaging effects of the tobacco products decreases.

However, removing the bird from a second-hand smoking environment, along with proper medical management, can result in the return of the bird to health if caught in time.

The Avian Respiratory System

Birds and other exotic animals have extremely sensitive respiratory systems.

Mammals’ lungs are strong and sturdy and are able to perform all the tasks necessary for breathing. But birds have small, fragile lungs, and their air sacs do most of the respiratory work.

Also, their lungs do not function as ours do; they are attached to the back bones, and so they do not expand and contract in the same way ours do. ²

1.1 Avian Air Sacs

Most birds have 9 air sacs throughout their bodies:

• One interclavicular sac
• Two cervical sacs
• Two anterior thoracic sacs
• Two posterior thoracic sacs
• Two abdominal sacs ²

“Air sacs and axial pneumatization in an extant avian. The body of the bird in left lateral view, showing the cervical (C), interclavicular (I), anterior thoracic (AT), posterior thoracic (PT), and abdominal (AB) air sacs.

The hatched area shows the volume change during exhalation. The cervical and anterior thoracic vertebrae are pneumatized by diverticulae of the cervical air sacs.

The posterior thoracic vertebrae and synsacrum are pneumatized by the abdominal air sacs in most taxa. Diverticulae of the abdominal air sacs usually invade the vertebral column at several points.

Diverticulae often unite when they come into contact, producing a system of continuous vertebral airways extending from the third cervical vertebra to the end of the synsacrum.” ¹⁷

Key Facts About Avian Lungs And Air Sacs

When birds breathe, two inhalations and exhalations are required to completely change

the air in the air sacs. It takes two breaths to complete a single respiration cycle and move air through the entire respiratory system. The second breath pushes the first through to the end of its cycle.

Most birds have 9 air sacs (some have 7) which extend into specific hollow bones. This makes them lightweight and enables flight.

The vertebrae are divided into two sections: The upper section is called the “notarium,” and the lower section is called the “synsacrum.” The bones of each are fused, but each section is able to move independently, thus enabling flight.

Air sacs have very thin walls with few blood vessels, so they do not directly control air exchange; instead, they act as bellows to ventilate the lungs.

The lungs are stationary; they are affixed to the bones of the spine, and they are not lobed like those of mammals.

Birds do not have a diaphragm. Air is drawn in and expelled by the contraction of muscles.

Because there is no diaphragm, and the air sacs extend into the bones, respiratory infections can also extend to the abdominal cavity and the pneumatized bones.

A bird’s respiration rate is slower than that of mammals of similar size, but its pulse rate and body temperature are higher.

The respiratory system of a bird is more efficient than ours in transferring oxygen; it readily extracts harmful gases and particles from inhaled air, increasing a bird’s sensitivity to inspired toxins.

Because of this efficiency, a parrot will succumb to the same level of toxic fumes that would be tolerated by a dog.

Birds cannot withstand inhalation of 100% oxygen for more than 12 hours. This treatment had been used, but was found to be fatal, with death occurring in four to eight days.

Exposed birds appeared stressed and uncomfortable as early as three days post-exposure. ^{2, 22}

2.1 Avian Respiration

Your parrot has a very different respiratory system than humans; birds have lungs, which are not lobed like our own.

They also have air sacs that extend into their bones and are hollow and lightweight; these enable them to fly. Air is drawn in and expelled by the contraction of muscles.

Because there is no diaphragm, and the air sacs extend into the bones, which means respiratory infections also can extend to the abdominal cavity and the bones.

Because the respiratory system of a bird is more efficient than ours in transferring oxygen, toxins inhaled are delivered equally as well. ²⁰

2.2 Movement Of Air Through The Air Sacs And Pneumatic Bones

Birds have nine air sacs and a syrinx (vocal center). Unlike mammals, they have no diaphragm, and there is a unidirectional airflow that requires two full inspiratory and expiratory cycles to complete.

Air enters through the nares, past the larynx and into the trachea (which has completely closed cartilaginous rings), past the syrinx at the bifurcation of the trachea into the bronchi.

Down the bronchi, the air enters the caudal air sacs (2 paired caudal thoracic and 2 paired abdominal air sacs) with a small amount bypassing directly towards the lungs.

At exhalation, the air is expelled from the caudal air sacs into the ventrobronchi and dorsobronchi and down continuously narrowing airways into the lungs where gas exchange takes place.

The exchange occurs in tubular air capillaries rather than saccular alveoli. The lungs are fixed anatomically and therefore do not expand or contract.

At the next inhalation, the air moves into the cranial air sacs (paired cranial thoracic, paired cervical and a single clavicular air sac). At the next exhalation the air is expelled through the trachea once again.

Since birds lack a diaphragm, the inhalation is achieved by expanding the chest, moving the ribs laterally, moving the sternum ventrally and cranially, and expanding the abdominal muscles. ⁷

2.3 Pneumatization

Air sacs are not limited to the individual balloon-like structures as seen in Figure 2; they also extend into the humerus (long) bones of the wings, some vertebrae and ribs, the femur bones, and even the skull.

These bones are then considered “pneumatized.” Only those bones are pneumatized; all others contain marrow. ¹⁷

Pneumatization occurs when “diverticulae,” (smaller sections of the air sacs), extend into the bones. Figure 3 shows a side view of the air sacs and pneumatized bones. The hatched area at the bottom depicts the volume change during exhalation. ²⁶

Pneumatic bones have air spaces in them; they’re structurally more like corrugated cardboard than solid bone. In birds, this system is “open” for air to move through, ²⁶

While most animals have just facial pneumatic bones, birds have them in their skulls and throughout their bodies.

These include their clavicle, humerus, keel, pelvic girdle, lumbar and sacral vertebrae. Attached to a bird’s lungs are eight or nine (up to eleven) air sacs; these are hollow, balloon-like sacs that hold air and act like bellows.

There are usually four or five around the front and underbelly of the bird and four at the back. These air sacs allow air to move one way, which is highly efficient.

Think about our breathing: It’s multi-directional, air goes in and air goes out the same way.

Old air mixes with new air and it’s pretty inefficient. In birds the air is moving around in one direction, and they’re always getting a “fresh breath of air” when they breathe in (no old air moving out past it and mixing). ²⁶

This is an excellent video on movement of respiratory system:

The cervical and anterior thoracic vertebrae are pneumatized by diverticulae of the cervical air sacs, which means that small sections of the air sacs extend into the bones (are diverted) into the upper spinal area. 17

The posterior thoracic vertebrae and synsacrum (the fused bones in the lower vertebrae of the back, see Figure 3) are pneumatized by the abdominal air sacs, meaning that small sections of the air sacs extend into the lower section of the backbones (the synsacrum).

Some diverticulae also enter the rib cage and skull. Diverticulae of the abdominal air sacs extend into the vertebral column at several points.

Diverticulae often unite when they come into contact, producing a system of continuous vertebral airways extending from the third cervical vertebra to the end of the synsacrum. ¹⁷

The function of this connection is thought to be that by having air sacs attached to the bones, their breath/air provides air pressure and strength to the skeleton, helps cool the bird by diffusing heated air, and helps the bird remain light for flight.

If you think about it, a bird is breathing through its lungs, air sacs, and bones all the time. ²⁶

3. Tobacco Toxicity In Birds

The extremely sensitive respiratory system of birds is affected by any form of air pollution. Second-hand and third-hand smoke are the most damaging.

Pet birds absorb nicotine and other chemicals through their skin and feathers. This can elevate their risk of developing lung cancer and a range of other conditions if they are exposed to second-hand smoke on a regular basis.

Most importantly, birds who live with smokers are prone to developing allergies, pneumonia, and chronic sinus trouble. ¹⁹

3.1 Signs Of Tobacco Toxicity Are:

Dyspnea (labored breathing)	Enlarged cere
Hyperexcitability	Rhinorrhea (sneezing)
Tachypnea (abnormally rapid breathing, panting)	Chronic rhinitis
Collapse, coma and cardiac arrest, eventually leading to rapid death	Chronic or acute coughing
Agitation	Twitching and tremors
Seizures	Drooling
Salivation	Emesis (vomiting)
Muscle weakness	Lethargy
Gastrointestinal upset (e.g., vomiting, diarrhea, or regurgitation)	Unsteadiness  1, 9, 19, 27
Tachycardia (increased heart rate)

“Signs develop quickly in most species, usually within 15 to 45 minutes, and many of the above signs develop. Death from nicotine toxicosis occurs secondary to respiratory paralysis.

A less serious but common response to cigarette smoke deposition on the feathers is feather-destructive behavior. One timneh grey that expired at 21 years of age reportedly had lived its entire life with a heavy smoker.

The histopathologic diagnosis of multiple masses in the lungs was carcinoma, but was not definitely labeled as bronchiogenic, (beginning in the bronchial tubes).” ²¹ Treatment is supportive and based on symptoms. ⁹

3.2 Nicotine Amounts In Tobacco Products

Cigarettes 3-30 mg per 1 whole cigarette	Nicotine gum 2-4 mg per piece
Cigarette butts .75-7.5 mg Cigars 15-40 mg	Transdermal patches 15-114 mg per patch
Moist snuff 4.6-32 mg/g Dry snuff 12.4-15.6 mg/g	Nicotine nasal sprays 10 mg per ml
Chewing tobacco 2.5-8.0 mg/g	Nicotine inhaler rods 10 mg per cartridge 12

3.3 Nicotine Poisoning

Where there are smokers, there are nicotine products. Nicotine poisoning can occur when your bird finds and chews apart a cigarette like a shredder toy.

The butt of a cigarette alone contains 25% of the nicotine of the original cigarette.²⁰ Pets aren’t always picky about what they eat. This appetite can get the better of them if they make a meal of tobacco products.

Just a single cigarette may be enough to cause nicotine toxicity in a bird. Even discarded cigarette butts in ashtrays can poison pets with their small doses of potent nicotine. ¹⁹

3.4 Forms Of Tobacco-induced Toxicity Other Than Inhalation

Inhalation is not the only means of tobacco and nicotine absorption; animals may lick up toxic chemicals.

Nicotine, tar, and carcinogens may land on their fur or feathers after the smoke in the air settles, thus increasing their chances of developing cancer.

In addition, they may eat products containing nicotine, such as cigarettes, cigars, chewing tobacco, nicotine gums, and patches.

Nicotine is often used as an insecticide, so animals must not be allowed access to any such products or walk onto grass and other foliage that has been sprayed. ¹¹

4. Toxicity From Second-hand Smoke

The most common cause of tobacco-induced avian toxicity is second-hand smoke—the smoke that is exhaled from a smoker.

Primary respiratory disease and complications involving other systems of the body are caused by exposure to tobacco smoke.²⁹

Another name for second-hand smoke is “Environmental Tobacco Smoke” (ETS). It contains thousands of different chemicals that fill the air as either gases or particulates.²⁹

Even if the cigarette, pipe or cigar just sits burning in an ash tray, it also releases smoke and toxins from both the lit end and filtered end.

Thirty years of scientific research has proven that people constantly exposed to environmental tobacco smoke are more likely to develop and die from heart disease, lung cancer, and breathing illnesses.

Exposure to marijuana is also deadly for birds. ²⁹

To read more information on marijuana toxicity, see Appendix A, p. 35.

Smoke inhalation is just one source of potential health hazards for pets living with smokers. Dogs, cats, birds, and small pets are continually exposed to second- and third-hand tobacco throughout the day as they groom themselves and interact with their owners.

Birds are persnickety about personal hygiene too. ¹⁹ How much more likely are birds to developing these illnesses than cats and dogs.

4.1 Contents Of Second-hand Smoke

Second-hand smoke contains over 4000 chemicals, including 69 compounds that are known to cause cancer. Anyone who breathes second-hand smoke is breathing in

formaldehyde	vinyl chloride
ammonia,	arsenic
cyanide	carbon monoxide
nicotine	methane
benzene	tar
chromium	carcinogens (cancer-causing agents)
nickel	thousands of other chemicals.

The concentration of these carcinogenic chemicals is actually higher in second-hand smoke than in the fumes directly inhaled by smokers. Their feathers will pick up the odor, and birds will try to rid themselves of it by plucking out the feathers! ²⁰

“Secondhand smoke is classified as a class-A carcinogen, the same classification given to asbestos.” ²⁹

Passive exposure to cigarette/cigar/pipe smoke is responsible for many clinical problems, including conjunctivitis, sinusitis, air sacculitis, rhinitis and dermatitis.

It is very difficult, if not impossible in some cases, to diagnose and treat respiratory diseases resulting from exposure to cigarette smoke; however, in many cases, all respiratory signs appear to cease if the bird is removed from the contaminated environment.

It may take from a few weeks to several months for this to happen, and medications may be necessary to detoxify the bird’s system. 27, 31

4.2 Second-hand Inhalation From Vaping

Even “vaping” (smoking of e-cigarettes) is a cause of illnesses in humans and birds.

“Formaldehyde, a known human carcinogen found in cigarette smoke, is also found in the vaporized liquid of electronic or e-cigarettes.

The exposure to formaldehyde from e-cigarettes, based on similar chronic use of tobacco, could be five to 15 times higher than from smoking cigarettes.

They found that vaping 3 milligrams of e-cigarette liquid at a high voltage can generate 14 milligrams of loosely affiliated or “hidden” formaldehyde.

According to the American Cancer Society, exposure to formaldehyde has been shown to cause cancer in laboratory animals and has also been linked to some cancers in humans.” ¹¹

Though they’re often billed as a safe, smoke-free alternative to the real thing, doctors and veterinarians aren’t so sure that e-cigs solve any of their predecessors’ problems.

The FDA suggests that vaporized tobacco may expose pets to especially high levels of nicotine and other toxic chemicals like formaldehyde. Pets’ sensitive respiratory tracts are vulnerable to absorbing11 these chemicals.

Birds can also re-expose themselves to these “third-hand vape” chemicals throughout the day as they groom, preen, and interact with owners.¹⁹

Among the components of a typical vaporizer is a small cartridge filled with a highly-concentrated solution of liquid nicotine and other chemicals. Pets can become seriously ill if they ingest even a small amount.

Nicotine toxicity from e-cigarette liquid will result in similar symptoms to poisoning from other tobacco products, but they may progress more quickly and prove more severe.

Contact your veterinarian immediately if your pet has ingested liquid nicotine.¹⁹

“Whether vaping is part of a smoking cessation plan or a permanent replacement for leaf tobacco, pet owners are advised to keep electronic cigarette components safely away from pets.” ¹⁹

4.3 Second-hand Smoke’s Effects On The Respiratory System And Air Sacs

For birds, it is suspected that long-term exposure to second-hand smoke in poorly ventilated areas predisposes them to pneumonia and other respiratory ailments, including lung cancer.

Unfortunately, many of the harmful products in smoke are in the form of gas; therefore, environmental tobacco smoke cannot be entirely filtered out through ventilation systems or special fans.

It can take many hours for the smoke of a single cigarette to clear. And the ventilation systems, including furnace and air conditioning ducts and units, are covered with these toxins, so the forced air will continue to put the toxins in the air.

These need to be cleaned often, especially when the indoor smoking terminates. ^{11, 27}

4.3.1 Sinusitis

4.4 Endoscopic Views Of The Air Sacs Of A Bird Exposed To Second And Third-hand Smoke

“Other abnormalities of the air sacs include increased vascularity, thickened walls and granulomas. These changes may be due to infectious processes or to inhalation of respiratory irritants such as tobacco smoke.

In some cases, a definitive diagnosis can be made from visualization, cytology and/or biopsy of air-sac lesions. Removal or debulking of such lesions has been described using laser and radiosurgery via the endoscope.” 12

5. Toxicity From Exposure To Third-hand Smoke

When smokers puff on cigarettes, cigars, pipes, and other combustible tobacco products, they consume smoke “first-hand.”

As they continue, they also expose themselves and anyone around them to second-hand smoke from their exhalations and the burnt end of their tobacco product.

Regularly inhaling second-hand smoke is especially harmful to infants and children, elevating the risk of ear infections, asthma, and sudden-infant-death syndrome. ¹⁹

5.1 What Is third-hand Smoke?

Both children and pets are especially vulnerable to another type of environmental tobacco: third hand smoke. If you’ve ever walked into a room that reeks of stale cigarettes despite a lack of visible clouds or tobacco products, you’ve experienced third-hand smoke.

Pets and children in smoking households often come into closer and more regular contact with third-hand smoke than adults because of their relative proximity to the floor.

In addition to settling on carpets and spreading through household dust, third hand tobacco particles cling to furniture, walls, curtains, and even the clothes, hair, and skin of smokers.

Nicotine from this lingering tobacco smoke and residue can mix with other chemicals in the air to produce additional cancer-causing compounds that will stick around as well. ¹⁹

Third-hand tobacco is remarkably resilient. A 2011 study published in Tobacco Control found that this residue could remain present in airborne dust and across household surfaces even after intensive cleaning and numerous smoke-free months. ¹⁹

Smokers who light up with pets nearby are forcing them to inhale the dangerous chemicals included in tobacco products. Studies into tobacco’s effect on pets suggest that they suffer many of the same health consequences from repeated exposure as humans do. ¹⁹

5.2 The Danger Of Exposing Birds To Third-hand Smoke.

Pet birds absorb nicotine and other chemicals through their skin and feathers.

This can elevate their risk of developing lung cancer and a range of other conditions if they are exposed to second-and third-hand smoke on a regular basis.

For example, birds who live with smokers are prone to developing allergies, pneumonia, and chronic sinus trouble. ¹⁹

As birds preen their feathers, they may continually ingest chemical particles that have settled on them. The problem is compounded when birds elect to preen their owners’ hair and clothes as well.

Even perching on a surface can prove dangerous, since birds absorb substances (including toxic ones) through their feet.

Standing on the owner’s hands, arms, clothes, furniture, or any surface containing particles of nicotine and tobacco will affect the bird’s feet. Many birds develop pododermatitis (bumblefoot) from these surfaces. ¹⁶

6. Internal Organ Diseases

Birds experience the same high-risk factors as humans. Smoke inhalation exacerbates hemochromatosis (Iron Storage Disease), and nicotine sulfate leads to severe skeletal malformation, reduced body weight, torticollis (aka Wry Neck: twisting of neck to one side), edema, muscular dystrophy, and malformation of the beak, heart, and kidneys. ⁶

6.1 Upper Respiratory Disease

6.1.1 Cataracts, Rhinitis, Sinusitis, And Conjunctivitis

Environmental factors which may precipitate the onset of rhinitis and sinusitis include cigarette smoke, which may damage the mucosa of the upper respiratory tract, allowing pathogens to colonize.

Antibiotics should be used with caution. The eyes, including the nictitating membrane, frequently suffer from exposure to cigarette smoke. The signs include Inflammation, excessive, tearing, redness and infection.

Passive inhalation of cigarette, cigar and pipe smoke can cause chronic ocular, dermatologic and respiratory disease in companion birds.

Birds that live in homes with smokers will often present with clinical signs including coughing, sneezing, sinusitis and conjunctivitis due to continuous irritation of the respiratory system.

The clinical signs may resolve without treatment if no secondary infectious agents are involved, the clients stop smoking, or the bird is placed in a location where there is no smoke. ²⁷

Canaries and finches are particularly susceptible to inhalant toxins because they exchange more air per gram of body weight than do larger birds.

Dangers include carbon monoxide exposure (cages in car garages, leaks from gas heaters), overheated polytetrafluoroethylene (non-stick cookware), carpet freshener, hair spray, glues, paints and smoke.

Birds must be protected from all types of smoke, not just tobacco smoke. Owners must be cautious about exposing birds to smoke from burned food, burned Teflon, and house fires. ²³

To read the photo essay of the author’s rescued cockatiel, who was exposed to years of second-hand smoke, see Appendix B, p. 38.

6.1.2 Oral fungal Infection And Damage To The Beak

“An eight-year-old Umbrella Cockatoo was presented with a nine-month history of progressive sneezing and nasal discharge. The feathers around the beak were moist from a serous nasal discharge.

The rhinotheca (the horn-like covering of the maxilla, or upper beak) had a deep groove that extended from the nostril to the rostral commissure of the upper beak (arrows).

The extent of this defect suggests that the germinative layer of the rhinotheca had been involved in a disease process for over six months. This bird belonged to a heavy smoker.

A mixed population of gram-positive and gram-negative bacteria were cultured from a sinus aspirate. The bird responded to nasal flushing, systemic antibiotics, frequent exposure to fresh air and sunlight, and being removed from a smoke-filled house.” ¹⁴

In another case, a three-month-old Blue and Gold Macaw was presented with a two-week history of serous nasal discharge. There was an accumulation of debris on the feathers of the face.

The nictitating membrane, which moves over the cornea during blinking and in the menace response, was normal. This bird’s rhinitis was caused by exposure to cigarette smoke. ¹⁵

6.2 Lower Respiratory Disease

6.2.1 The Air Sacs And Lungs

The lungs were congested, and also filled with black spots. This is known as anthracosis, and it is the result of accumulation of hydrocarbon particles from cigarette smoke in the respiratory system. (image courtesy Alan K. Jones, Toxic Fumes – The Parrot Society UK).

“A Blue and Gold Macaw was presented with severe dyspnea including a tail bob. He was sneezing and had both ocular and nasal discharges. The only abnormal clinicopathologic finding was WBC=18,000.

Radiographic changes included gaseous distension of the intestines (I) and thickening of the contiguous membrane of the caudal thoracic and abdominal air sac (open arrow).

The client was a heavy smoker, and the lesions resolved over a three-month period when the client quit smoking and the bird received daily exposure to fresh air and sunlight.” (M. McMillan 15

6.2.2 Pulmonary Parenchymatous Abscesses

6.2.3 Subcutaneous Emphysema

6.3 Heart Disease

Smoke intoxication leads to monocytopenia (the deficiency of monocytes, a type of white blood cells) in the blood.

In man, atherosclerosis of the coronary arteries is a major source of morbidityand mortality, and elevated serum lipids (cholesterol, triglycerides, and low-density lipoproteins), hypertension, and exposure to cigarette smoke are important risk factors. The same conditions exist in animals and birds. ¹³

6.3.1 Atherosclerosis

Atherosclerosis is most commonly found in older birds and leads to sudden clinical decline and death.

Risk factors include age, gender, species, increased plasma concentrations of lipids and lipoproteins, high energy diets, physical inactivity, genetics, and coinfection with Chlamydia

Psittaci. Females have a higher incidence of the disease due to the hormone estrogen build up during reproduction. The silent killer: Atherosclerosis in pet birds (Proceedings) (dvm360.com)

6.3.2 Congestive Heart Failure

Another heart condition which is more common in older birds is congestive heart failure. This occurs when the heart no longer acts as an effective pump, and the blood supply to the kidneys is often compromised.

In some cases, there is fluid in the sac around the heart itself, preventing it from pumping optimally. In other cases, the heart may become too muscular or too flabby, with both conditions causing ineffectual pumping.

If the right side ventricle fails (or both ventricles are failing), then usually there is an enlarged liver, fluid found in the body tissues (called edema), and also excessive fluid in the body cavity.

If the left ventricle fails, there is usually excess fluid in the lung tissue. Older birds, overweight birds and perhaps inbred birds are more likely to develop heart disease.

6.4 Damage To The Gastrointestinal Tract

Birds are curious creatures. They will find cigars, cigarettes, or even cigarette butts still containing tobacco on the floor, table, in the ash tray, or on any surface. These all can contain tobacco and poison the bird when ingested.

Common exposure for pocket pets and birds occurs when curious beaks or paws find cigars or cigarettes left within their reach or dropped on the floor. Even the butts of cigarettes can still contain tobacco and result in poisoning when ingested.

There is the risk associated with ingesting tobacco for birds. It can cause significant respiratory irritation (or potentially even cancer) as well.

Ingestion of just a tiny amount of tobacco for birds and pocket pets can result in significant poisoning. Tobacco poisoning can result in the following symptoms: hyperexcitability,

agitation, gastrointestinal (GI) upset (e.g., vomiting, diarrhea, or regurgitation), a racing or rapid heart rate, potential seizures and tremors, and even death.

Treatment includes decontamination (which may include the administration of activated charcoal to bind the tobacco from the intestinal tract), hospitalization for fluid therapy (which will help hydrate the patient), and careful monitoring. ⁹

7. Damage To The Skin And Feathers From Second- And Third-hand Smoke

When toxic particulates and gases in the air assault a bird’s respiratory system, skin, and feathers, feather destruction, plucking and self-mutilation result.

Heat causes the smoke to rise; then, when it cools, gravity brings it back down. The toxins land on the birds, their perches, their cage bars, toys and food. It is also on the smoker’s hands, arms, clothes, and any other exposed skin—even the hair.

If the smoker’s hands are coated with chemicals from holding the cigarette, it is easily transferred to his bird. In one case, an amazon, who turned out to be very sensitive to chemical exposure, began mutilating his feet.

The clinician determined the cause to be his perches which were covered with residue from cigarette smoke. ²⁹

7.1 Feather Discoloration

Of all the tobacco products, nicotine in cigarette smoke poses the greatest danger to birds’ skin and feathers, and second-hand smoke does the most damage, causing both dermatitis and feather damage at presentation.

In addition, the feathers will absorb the odor of the smoke and be discolored by it. Feather-destructive behavior has also been linked to exposure to smoke. ⁵

Some birds who have lived with smokers and are rehomed will continue to carry that odor even after having been bathed. During a bath, the water that rinses off them is often a brownish-yellow color.

Some will even carry the odor until all their feathers have molted out. One group member who rehomed an African grey from a smoker’s house reported that even after a full year, the odor remained on her bird, especially when he was wet.

Other parrots will simply remove the tainted feathers on their own, a practice that may become habit and lead to continued feather-pulling and self-mutilation. ²⁹

Exposure to aerosolized toxins such as cigarette/cigar/pipe smoke will cause these toxins to accumulate on the feathers and skin and cause irritation leading to lesions. S. aureus spp. is

frequently isolated from the lesions, but the birds will usually not respond to antibiotic therapy alone. The lesions may only resolve when the clients stop smoking.

If they continue to smoke, they must do so outdoors and wash their hands and arms and change clothes before handling the birds.

Some cases will only resolve if the bird is removed from the smoke-filled environment, its diet is changed, it is frequently exposed to sunlight, ventilation is improved, a chelator is prescribed, and a topical antimicrobial cream containing steroids is applied.

Topical steroids should be applied with caution to prevent toxicity. ⁴

7.2 Skin Infections

The clinician will look for predisposing factors when attempting to identify a common pathogenesis for the abnormalities he finds on physical examination.

He will be able to identify the true cause of the bird’s ailments when he finds that there is a connection between multiple clinical signs.

When the bird presents with feather abnormalities, respiratory disease, smoke odor on the feathers, systemic fungal infection, poor nutrition, and inadequate exposure to sunlight and fresh air, he will determine that the etiology of the disease is constant exposure to tobacco smoke. ⁵

7.2.1 Staphylococcus Infections

The organism is found in abundant quantities in air and dust. Isolation of the organism can frequently be accomplished from the skin and the mucosa of the respiratory or digestive tract of clinically normal birds.

S. aureus, like other Staphylococcus species, is relatively stable in the environment and can remain infectious for long periods of time outside the host. Given proper conditions, the organism can propagate in an external environment.

Like many bacteria, S. aureus can also develop resistance to disinfectants following continuous exposure, and frequent hanging of disinfectants is required to prevent the development of resistant strains. ⁶

“A five-year-old Amazon parrot was presented with an acute onset of picking at the feet and legs which caused hyperemia and scab formation.

This syndrome, called Amazon foot necrosis, has been reported in Amazona spp., and S. aureus spp. is frequently isolated from the lesions.

However, S. aureus was probably not the primary cause of this problem. This affected Amazon parrot belonged to a client who smoked, and when the owner started washing her hands after

smoking, the foot and leg lesions resolved. The client eventually stopped smoking, and the bird had no further episodes of Amazon foot necrosis.” 8

Case Study

Another bird taken in by the author (Jan. 2022) had a severe Staph infection in his right foot and leg from contact with the owner’s smoke and skin and from his cage and home surfaces.

His foot contained a nidus of infected material on the plantar surface. A nidus is a “nest” of bacteria that settles in one place. If it is disturbed, it will spread along the other skin surfaces. This one had spread to the dorsal foot surface, up the leg, and to several toes.

The leg was inflamed from the foot all the way up to and past the knee joint. One toe was filled with yellow plaque, a sign of Staph infection, and the rest of the toes were red and hot. The bird was in so much pain he held that foot up for months as he was healing.

He could not walk on it without pain. He walked on both his heels of his feet instead. It would be months before the infection resolved sufficiently that he could walk on both feet normally.

The top of the foot had a large, raised section of infection which was spreading across the foot.

This bird was treated aggressively by his avian vet.

He was put on multiple antibiotics until the best one for his condition was found, Robenacoxib at first then celecoxib orally for pain and inflammation, underwent daily soaking, and received topical cream antibiotics.

By the third month, the author began to see an improvement. The redness in the leg and other wound areas resolved. After six months, all but the nidus had healed; it would be another 3 months before

the nidus became flat to the foot. This took a toll on the bird that continues to this day. The bird slept most of the time and had very little energy for quite a while. As time went on, these improved slightly.

The following images describe the infection and healing process (text and images courtesy J. Miesle, Aug. 2022).

7.3 Picking And Self-mutilation Caused By Tobacco Smoke

Many birds self-mutilate. There are numerous possible therapies for the resolution of feather-picking, but before any can be recommended, the underlying medical causes need to be identified and corrected.

When smoking is found to be the underlying cause of the picking, other therapies are required to resolve issues stemming from it.

Treatment of bacterial or fungal folliculitis will need to be initiated, as well as wound management for any other skin or feather diseases and conditions.

Many birds with severe feather-picking issues will resume normal preening behavior when removed from exposure to cigarette smoke.

7.4 Damage To The Feet, Legs, And Face

“The feet and legs should be uniform in texture and color. The feet should have prominent scale patterns on both the dorsal and plantar surfaces.

Changes that result in smoothing of the plantar foot surface can instigate chronic and severe foot and leg diseases.

One of the common etiologies of foot abnormalities is contact with nicotine sulfate from the hands of cigarette smokers. The feet are particularly vulnerable to fungal diseases due to smoking toxicity” ⁶

7.4.1 Pododermatitis

Pododermatitis has been observed in some birds handled by people who smoke routinely. Repeated exposure to the nicotine residues on the hands, arms and clothing of smokers is thought to cause this local irritation.

Macaws and other birds with featherless faces may suffer a similar dermatitis on the bare cheek patches following repeated contact with a smoker’s hands and airborne toxins. ⁶

“An adult Amazon parrot was presented with a ten-day history of progressive picking at the feet with scab formation. The bird was fed a formulated diet supplemented with some fresh vegetables.

The feet were hyperemic (possessing increased blood flow to the tissues), and the feathers were dull and appeared tattered, particularly at the ends. The bird had mild epiphora (excessive secretion of tears) and a serous (watery) nasal discharge.

Both adult clients were heavy smokers. The bird’s ocular, respiratory and foot problems resolved when the clients stopped smoking in the house and washed their hands before handling the bird. ⁶

Smoking-related Diseases

8.1 Aspergillus

Aspergillus is generally found in the respiratory tract, but it can invade any organ and even the skin of the bird. The fungal spores are everywhere, and infections should always be considered to occur secondarily to an immunosuppressive event.

It has been suggested that healthy birds exposed to high concentrations of spores are generally resistant to infections, while immunocompromised hosts exposed to small concentrations of spores are frequently infected.

Factors that influence the susceptibility of a bird to aspergillosis include shipping, overcrowding, malnutrition, poor ventilation, very young or old age, antibiotic therapy (particularly Tetracyclines), corticosteroid administration, respiratory irritants (e.g., disinfectant fumes, cigarette smoke, and ammonia) or concurrent disease (other diseases occurring at the same time). ^{1, 8}

8.2 Pneumoconiosis

“Pneumoconiosis refers to a pathological reaction in the lungs and air sacs due to air pollution. While it commonly involves humans, it has been described in a number of avian species.

It generally involves inhalation, usually of dust and other particulate foreign materials. Chronic exposure to cigarette smoke could result in the accumulation of particulates within the respiratory tract of affected birds” (Bob Dahlhausen, personal communication; used with permission).

8.3 Pneumonia

With pneumonia, the lungs turn a dark pink, and the lung tissue takes on a yellow discoloration. Birds who live in cities, industrial areas, or the homes of smokers generally develop anthracosis, or black spots on the lungs.

The trauma from exposure to these pollutants often causes bleeding within the lungs which can be diagnosed by endoscopic examination. ⁶

8.4 Bacterial Infections

Secondary bacterial invasion of the damaged respiratory epithelium is common and requires therapy; however, therapy for these infections will be of little value if the bird is continuously exposed to smoke. In order to keep pet birds healthy, they should be maintained in well-ventilated, smoke-free environments. ⁶

8.5 Cancer

Smoke-filled environments lead to cancer. Squamous cell carcinomas (skin cancer) are malignant neoplasias that are being reported by clinicians more and more frequently in captive avian species.

These SCCs have been diagnosed in areas such as the beak, eyes, oropharyngeal region, pygostyle (tail base), uropygial gland, and axillary skin.

Although the number of tumors in the captive avian population is unknown, there is increasing evidence that tobacco products from cigar/cigarette smoking contribute to the development of malignant tumors.

The general lifestyle and environment play a vital role in the risk of developing cancer in pets as well as people. ^{11, 18, 30}

“This bird’s beak grew progressively worse until it produced huge amounts of necrotic tissue and the area hemorrhaging excessively.

It was therefore euthanized. Second picture is same bird with material pulled out of the inside of his upper beak.

He spent two years with his beak growing abnormally, getting progressively thicker and more flaky, and finally the inner surface of the upper beak eroded away.

We would periodically put him under anesthesia and clean the impacted food out, but the pulp of the beak was exposed and it would bleed heavily.

At first, I thought it was just an infection and treated it with multiple rounds of antibiotics.

It wasn’t until the pink mass started to appear at the side of the beak that I determined it was neoplasia, and I had to euthanize him within about a week because it grew so fast.” (Julie Burge, personal communication; used with permission).

8.6 Inhalation Toxicosis From Household Sources

Birds are sensitive to inhaled toxins and have historically been used as sentinel animals to detect toxic levels of poisonous gases.

Clients should be educated with respect to the adverse effects that fumes from common household compounds can have on their companion birds.

The clinical changes following inhalation of household fumes may include irritation of mucous membranes, conjunctivitis, rhinitis, dyspnea, or peracute death (peracute: very severe and of very short duration, quickly fatal).⁶

Canaries and finches are particularly susceptible to inhalant toxins because they exchange more air per gram of body weight than do larger birds.

Dangers include carbon monoxide exposure (cages in car garages, leaks from gas heaters), overheated polytetrafluoroethylene (PTFE-non-stick cookware), carpet freshener, hair spray, glues, paints and smoke.

All birds must be protected from all types of smoke, not just tobacco smoke. Owners must be cautious about exposing birds to smoke from burned food, burned Teflon, and house fires. ²³

To print a handout to give to bird owners who smoke, see Appendix C, p. 43

Recommendations:

• Tobacco products can cause significant respiratory irritation or cancer. Ingestion of just a tiny amount of tobacco for birds and pocket pets can result in significant poisoning.
  
  Take the bird to an avian veterinarian immediately if you suspect nicotine toxicity. He will administer chelators such as DMSA (dimercaptosuccinic acid) to decontaminate the bird’s system.
  
  These medications include activated charcoal to bind the tobacco from the intestinal tract. Treatment may also include hospitalization for fluid therapy, which will help hydrate the patient, and careful monitoring.
  
  
• A well-balanced and positive emotional environment helps set the tone for health. Toxic conditions, such as smoke, chemical products, strong aerosolized sprays and odors, should be avoided.
  
  Exposure to cooking in coated cookware or plastics should be minimized. Provide fresh, clean air in a well-ventilated room and natural unfiltered sunlight. Encourage the bird to fly and/or otherwise exercise.
  
  
• Houses are also contaminated by smoking, and this contamination of air, furniture, draperies, etc. lingers for a long time. Those who smoke need to do so outside the house, and visitors should do likewise. Smokers should change their clothing and wash their hands and arms before handling birds.
  
  
• Provide good ventilation. Toxic by-products of tobacco and smoking may take several hours to be eliminated from the air. Hepa® filters on the furnace work best to remove particulates from the air. Providing fresh air is always advisable.
  
  
• Keep all nicotine-containing items, including ashtrays, chewed nicotine gum, and used nicotine patches, out of the reach of pets to prevent accidental consumption.
  
  Birds and other pets may find carelessly discarded cigarettes, cigars, pipes, chewing tobacco, and other tobacco products; these will cause significant poisoning.
  
  
• Watch pets carefully when they are outside since used products and ash still contain residual nicotine. Do not let them pick up cigarette butts, ashes, discarded chewing tobacco, or other tobacco products.
  
  These can attract dogs, as these products are flavored with sugars to hide the naturally bitter taste of tobacco.
  
  Birds in particular should be watched carefully since they may walk on or eat grass that has been treated with garden sprays that may contain nicotine. It is also an ingredient in some natural insecticides.
  
  
• Covered outdoor aviaries for your birds will give them plenty of fresh air and natural light. Covering their cages and play stands while they are outside will help to keep harmful residue from settling on surfaces where they spend their time and prevent wild birds and other animals from defecating on the cages.
  
  Cleaning these aviaries and perches often will help cut down on the possibility of contamination. Frequent bathing is a must for your parrot if you are a smoker. ⁹
  

Conclusion

Today, people know far more about the dangers presented by the use of tobacco products than ever before. If they choose to continue smoking in spite of that, it is at their own risk.

However, they must be aware of the dangers of this habit to their pets. Birds in particular are unable to tolerate second-hand smoke and will become seriously ill when exposed to it.

They require consistent fresh, untainted air to function properly, and it is the owner’s responsibility to provide that for them. Smokers with birds and other pets should seriously consider stopping their tobacco habit for the sake of their pets.

References

1. Bauch L. Mycoses. In: Avian Medicine, Principles and Applications, Ed: Harrison and Lightfoot,. Spix Press, 2006.
   
   
2. Bird Supplies.  Your Parrot’s Respiratory System..
   
   
3. Burroughs D. What is second-hand smoke? Birdtricks.com http://www.birdtricks.com/blog/smoking-around-your-birds/
   
   
4. Cooper J, Harrison G. Dermatology. In: Avian Medicine, Principles and Applications. Ed: Harrison and Lightfoot. Spix Press, 2006.
   
   
5. Doneley B, Harrison G, Lightfoot T. Maximizing Information for the Physical Examination. In: Clinical Avian Medicine. Ed: Harrison and Lightfoot, Spix Press, 2006.
   
   
6. Dumonceaux G, Harrison G. Toxins. In: Avian Medicine, Principles and Applications. Ed: Harrison and Lightfoot. Spix Press, 2006.
   
   
7. Ethos. Veterinary Health, Really Cool Anatomy and Physiology: Avian Respiratory Systems. January 17, 2020
   
   
8. Gerlach H. Bacteria. In: Avian Medicine, Principles and Applications. Ed: Harrison and Lightfoot. Spix Press, 2006.
   
   
9. Guindon S. What’s poisonous to birds and pocket pets? Pet Poison helpline 2011.
   
   
10. Jones M.P. A Case of Squamous Cell Carcinoma of the Beak. In: NAVC Proceedings 2007, North American Veterinary Conference. (Ed). Publisher: NAVC (www.tnavc.org). InternetPublisher: International Veterinary Information Service, Ithaca NY (www.ivis.org) 13-Jan-2007.
    
    
11. Latimer K. Oncology. In: Avian Medicine, Principles and Applications. Ed: Harrison and Lightfoot. Spix Press, 2006.
    
    
12. Lierz M. Diagnostic Value of Endoscopy and Biopsy. In: Clinical Avian Medicine. Ed: Harrison and Lightfoot. Spix Press, 2006.
    
    
13. Lumeij JT, Ritchie B.. Cardiology. In: Avian Medicine, Principles and Applications. Ed: Harrison and Lightfoot. Spix Press, 2006. P. 719
    
    
14. Lumeij JT. Gastroenterology. In: Avian Medicine, Principles and Applications. Ed: Harrison and Lightfoot. Spix Press, 2006″
    
    
15. McMillan. Imaging Techniques. In: Avian Medicine, Principles and Applications. Ed: Harrison and Lightfoot. Spix Press, 2006.P. 317
    
    
16. Miesle. Pododermatitis (Bumblefoot): Diagnosis, Treatment, and Resolution. In: Reviews in Veterinary Medicine,. Ed. Revah I, Publ: International Veterinary Information Service (IVIS).March 8, 2021.
    https://www.ivis.org/library/reviews-veterinary-medicine
    
    
17. Naish D. Publishing with a Hidden Agenda: Why birds simply cannot be dinosaurs. From: Science Blogs: Tetrapod Zoology, 2009.
    
    
18. Ness R. Integrative Therapies. In: Clinical Avian Medicine. Ed: Harrison and Lightfoot. Spix Press, 2006.
    
    
19. Pet Place. Second-Hand Smoke and Pets.
    
    
20. Pine Mountain Vet. Second-hand Smoke and Birds.
    
    
21. Richardson J. Implications of Toxic Substances. In: Clinical Avian Medicine. Ed: Harrison and Lightfoot. Spix Press, 2006.
    
    
22. Samour J. Diagnostic Value of Hematology. In: Clinical Avian Medicine. Ed: Harrison and Lightfoot. Spix Press, 2006.
    
    
23. Sandmeier P, Coutteel P. Management of Canaries, Finches, and Mynahs. In: Clinical Avian Medicine. Ed: Harrison and Lightfoot. Spix Press, 2006. P.908
    
    
24. Seger M. Before you vape: High levels of formaldehyde hidden in E-cigs. In: Health. Jan 21, 2015
    
    
25. Smith, Travis: Does Marijuana have Nicotine?
    
    
26. The Infinite Spider. Blog, Pneumatic Bones: Birds and you.
    
    
27. Tully T, Harrison G. Pulmonology. In: Avian Medicine, Principles and Applications. Ed: Harrison and Lightfoot. Spix Press, 2006. P. 576
    
    
28. What is Marijuana? Drug facts: National Institute on Drug Abuse: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.
    
    
29. What is second hand smoke? Bird Tricks. http://www.birdtricks.com/blog/smoking-around-your-birds/ 2009

30. Williams D. Ophthalmology. In: Avian Medicine, Principles and Applications. Ed: Harrison and Lightfoot. Spix Press, 2006.

31. Wissman M. The Top Ten Bird Killers.  Exotic Pet Vet, www.Exoticpetvet.net  2006.

Appendices

Appendix A: Selected Excerpts from Papers Discussing Marijuana’s Effect on Birds

Excerpt 1: Marijuana Toxicity by Travis Smith (text used with permission).

What Is Marijuana?

Marijuana is a drug that affects the entire nervous system of the bird. Birds and other animals are affected by the toxins produced by smoking or consuming marijuana products and byproducts, just as humans do.

In fact, it affects birds more seriously since they have more sensitive respiratory systems, and it would require far less for them to suffer from toxicity. In birds, exposure to marijuana causes severe depression and regurgitation and should be strictly avoided.

Marijuana contains a number of hazardous chemicals. When combustion occurs in smoking materials, the combustion process does not completely reduce the burned material to ash.

The partial combustion of these materials results in large quantities of hundreds of different chemical compounds, such as carbon monoxide, soot, and other particulate matter being given off.

Smokers tend to “hold in” the smoke longer, particularly when smoking marijuana. This allows greater THC uptake (delta-9-tetrahydrocannabinol), which is the reason it is smoked; in addition, sustained “holding in” allows for greater uptake of all the other byproducts in the smoke.

The other particulate matter in the byproducts, such as tiny particles of soot, have more time to get absorbed by the lungs and not be exhaled. There are a number of organic compounds that are known carcinogens in marijuana smoke.

Even though there is no nicotine, some of the other cancer-causing chemicals in tobacco are present in cannabis smoke – and at twice the levels they are in smoke from tobacco. Any type of smoking will damage the lungs; it maybe a quick way to maximize uptake of THC, but it comes at a price. ²⁸

Excerpt 2. High Crimes & Parrot Health: Implications Of Loosening Marijuana Restrictions

An increasing number of cities and states have moved ahead with legislation to legalize or decriminalize marijuana for medical or recreational use. Medical marijuana is now legal in 23 states and Washington, D.C. In November, Alaska, Oregon and Washington, D.C. joined Colorado and Washington State when ballot measures passed to allow the sale and use of recreational marijuana.

The increase in availability of legal marijuana has legal, health, and medical implications for pet birds and their owners.

Although there is not yet extensive research available on the specific effects of marijuana smoke on pet birds, veterinarian Cassee Terry of Redmond, Oregon cautions that the effects could be severe.

“Birds are much more sensitive to smoke inhalation toxicity than other animals,” she explained. “Generally,” Terry observed, “Lung toxicities are more severe in birds.”

There are several reasons for this. Birds have very efficient respiratory systems, which means that with each breath, birds extract many more air particulates than humans.

In addition, birds breathe at an increased rate compared to humans, so airborne toxins such as smoke will have an increased impact on birds. Bird anatomy also plays a role.

In addition to their lungs, “Birds have a system of air sacs,” explained Megan Jones, a researcher in bird behavior at Florida State University, “so when they inhale, the air goes first into the posterior air sacs, then into the lungs when they exhale.”

But that breath remains in the bird, Jones explained, for yet another breath. The air travels “then through the lungs to the anterior air sacs on the second inhale, and is exhaled out of the body on the second exhale.”

Exposure to second-hand smoke of any kind, even from kitchens, can have negative health consequences for pet birds. Repeated exposure can cause skin and eye irritation and infection, respiratory infections, and chronic respiratory disease.

Birds can develop symptoms such as coughing, sneezing, and sinus and eye infections, and these may lead to secondary bacterial infections which may even be fatal.

How Marijuana Can Affect Pet Birds

Peer-reviewed studies have not yet been published on the effects of so-called “edibles,” or edible products infused with THC oil, on birds.

Because all species of animals process different chemicals differently, don’t assume that you can accurately determine how much of a cannabis-edible product a bird could safely ingest based merely on its weight as compared to your own.

In addition, effects such as distortions of balance and the senses, which humans might experience as a pleasurable “buzz,” can be uncomfortable, disorienting and even frightening for animals.

Terry cautioned that in general, “The effects last longer when ingested than smoked in birds and other species.” Therefore, even if a small amount of edible marijuana did not prove fatal or cause illness, a bird could experience any unsettling effects for longer if exposed to an edible product.

Some ingestion of marijuana by pets occurs by accident, through exposure to second-hand smoke, or when a pet raids its owner’s unattended stash of marijuana or edible products.

The Legal Ramifications For Exposing Your Pet Bird To Marijuana

Although there are some reports of pet owners attempting to treat their pet’s diseases with marijuana, many anecdotal reports of bird exposure to marijuana appear to result from the owner’s own use when their diminished judgment leads them, or their friends, to feed marijuana or its by-products (such as bong-water) to pets or blow smoke in their faces to see their response.

Before intentionally administering marijuana to your bird, either medicinally or in fun, you should be aware that there could be legal consequences for you. Intentionally subjecting your pet to the effects of marijuana could be viewed as animal abuse or cruelty in some states.

Twenty-nine states have laws either requiring or permitting veterinarians to report animal neglect, cruelty, or abuse to authorities.

Although there are numerous examples on social media of people intentionally getting their birds high, some people who intentionally expose their pets to this drug are prosecuted.

You should make yourself aware of criminal drug laws and animal abuse and cruelty laws in your state.

As you could be held legally responsible for actions that are seen by authorities as animal cruelty or abuse, you should make it clear to your friends that any acts which might be illegal or harmful to your bird’s health are unacceptable.

To reduce the temptation for your friends to do something irresponsible, you should keep your bird in a separate room, away from potentially toxic fumes, in an area not connected by shared ventilation systems.

If your bird does inhale smoke or consume marijuana products and becomes ill, taking prompt action to save her, like bringing her to a vet, could still be seen as a mitigating factor in your favor.

Even in states where medical marijuana is approved for human use, veterinarians are not permitted to prescribe it for animals.

According to an article on the American Veterinary Medical Association website, which explores the medical marijuana debate in veterinary circles, “Physicians in states where medical marijuana is sanctioned are exempt from prosecution by the state for recommending the Schedule I drug to patients.

Such protections do not apply to veterinarians, for whom it is illegal in every state to prescribe or recommend marijuana to treat a patient.”

Some people are nonetheless using marijuana, usually in edible form, to treat chronic pain and illness in their pets.

However, due to the lack of available medical research, dosage and administration is often a matter of guesswork.

For bird owners, in addition to moral and ethical considerations, there may be criminal consequences for administering marijuana to your bird.

Appendix B: A Photo Essay—Pedro’s Case Study by J. Miesle

Pedro was an older cockatiel of indeterminate age that was surrendered to Sugarcreek Bird Farm in Bellbrook, Ohio on Saturday, Dec. 12, 2015. I picked him up the following day.

At first glance, he didn’t look bad. From a distance, there just seemed to be a few feathers missing on his shoulders, but there was so much more. He had led a very hard life.

He’d been neglected, fed a terrible, cheap seed diet, subjected to years of toxic cigarette smoke by several adults, and confined to a filthy, small cage his entire life. He couldn’t even spread his wings—his muscles had atrophied. His feathers hid a much more serious condition.

His skin was dry, pruritic, infected, and damaged. Open wounds covered some of his skin, particularly on the tops of the wings and the underwing areas.

His feathers were substandard and blunted; it was obvious he had not grown in new feathers in a very long time.

His feet were very dry, flaking, and had lesions on the dorsal and planter surfaces of the feet and up the legs.

His head was missing feathers, and the skin on the crown was bare and infected. His feathers were barbered from being confined in such a small cage. He couldn’t even stretch them without scraping the sides of the cage. His beak showed signs of beginning hyperkeratinization on the tip and at the tomia, or cutting edges of the beak.

His body position was abnormal; he would perch on both feet and lean forward, as if unable to balance otherwise.

His back was rounded and his tail curved down. The tail bobbed as he breathed, a sign of respiratory distress. He kept his head down most of the time, and his crest was low, indicating depression and fatigue.

His body has been ravaged by pruritis–dry, red, sore, inflamed, infected, pus-filled skin. His feathers, thin and dystrophic, would fall out with little provocation. His nares were filled with debris.

His dry feet had sores on them, and he was missing nails on two of his toes, one on each foot. His uropygial gland was beginning to atrophy, although the feather tuft was still there.

I suspected he was suffering from severe Vitamin A deficiency as evidenced in the blunted choanal papillae in the roof of his mouth and the pruritic, inflamed condition of his skin.

The tissue on his wing was extremely thin and completely unfeathered, making the patagia (wing web) transparent. He was underweight, only 79 grams, and his keel protruded. The muscle mass in his breast was soft and thin. A pitiful little creature, indeed.

Dec. 12

First, I cleaned out his nares. They were full of debris, but fortunately there was no concretion yet, and so no rhinoliths had formed. I trimmed his overly long nails and took my time examining him more thoroughly this time.

He was very dirty, and his feathers reeked of cigarette smoke. I bathed him so that I could get a really good look at his entire body, especially his feathers and skin, and also to remove as much of the nicotine residue and odor as possible.

I was surprised to see how much of his skin was pruritic and featherless. I couldn’t see this from a distance because the wings hid the unfeathered areas under them, and the breast feathers hid the bare skin on the axial areas and area around the vent.

Everything I did was painful; he did not want to be touched. There was poor feathering on his entire body, and the feathers that were there were dystrophic and matted, even after the bath.

There were sores at the shoulder and elbow joints, on the patagium, and on the bones of the wings. There were no feathers under his wings or on the sides of his body.

His bare thighs also indicated an allergic reaction to the smoke. The vent seemed unusually small and tight, as though his droppings had been abnormal.

Dec. 13-30

We had a 9:30 appointment with my avian veterinarian, Bob Dahlhausen, that day. He examinined him and took choanal and fecal samples for Gram’s stains and skin impressions of the pruritic areas.

He didn’t think he was very old, possibly in his late teens. Since cockatiels can live as long as 30 years, that’s not very old at all. But longevity is determined also by living conditions.

The Gram’s stains were normal—and I was quite surprised by this. The fecal grams showed normal flora in the intestinal tract, and the oral stains showed only a small amount of debris. No infection.

The skin was pruritic from the heavy smoking environment and his picking. His feet were dry and had small sores on them from poor perches and contact with smoke on perches or hands.

He confirmed that the uropygial gland had begun to atrophy, but we might be able to stop it from continuing since it still had the little feather tuft, and he was able to express a small amount of sebum.

Pedro was suffering from severe Vitamin A deficiency as evidenced by the lack of papillae surrounding the choanal slit and his skin and feather condition.

Pedro was given the chelator, DMSA, to clear the lungs and air sacs of the poison inflicted by years of exposure to smoke.

Dr. Bob also gave him an injection of doxycycline and Robenacoxib to begin the healing of the skin infection; they would reduce the pain and inflammation he was experiencing.

At home, I was to give him Optomega (now Vetomega), Emeraid with additional vitamins, Celecoxib after a week had passed, and apply topical Aloe Vera liquid gel.

At the office, his weight had dropped to 73 grams. I attributed that to the stress of the day–the trip to and from the office, lack of food during that time, the handling, and the newness of everything.

He did not do well on Wednesday. He had very little energy and slept most of the time.

He sat hunched over, and he ate very little all day. I think he was exhausted from his visit—the drive to and from, the exam, the injections, tests—it was all too much for him.

His weight plummeted to 69 grams by evening. I was giving him Emeraid all day, hoping to stimulate his appetite, but it wasn’t doing the job. I considered that the DMSA, nasty concoction that it is, had upset his crop, and that could be why he wasn’t eating.

So I decided to hold off on giving this to him for a while until he had gained some weight and was more stable. He hadn’t had the medication since the morning, and by later in the evening he had begun to eat.

I kept him up later than the rest of the flock so I could get more Emeraid and food into him and spend some quality time with him. This would be our evenings for a long time.

2016

Jan 4-20

He was able to keep down half dosage of DMSA, and his weight had stabilized at around 78 g. His skin condition was improving slightly.

He was no longer pruritic. It would be a long time, though, before we saw any feather growth. To encourage molting and feather regrowth, I was told to begin oral Thyrosyn.

We were finishing up the second week of DMSA and I was to wait two weeks and do another round. I had begun giving him Celebrex (celecoxib) the week before to aid in decreasing the discomfort from the skin irritation.

Today, I had him in to see the Dr. Bob again. He determined that the skin was vastly improved, and he recommended continuing the medications—Emeraid, vitamins, Vetomega, and celecoxib—and to finish out the DMSA.

At this point, any redness on the skin was due to his picking, not infection. The celecoxib had made a huge improvement in his skin irritation, and he rarely picked at his wings anymore.

Jan. 14

March 1-17

I felt he had done well with his appetite, skin improvement, and general health, although he still was sitting slumped a lot. We had finished up the DMSA and I was giving him all the meds.

By this time I had begun giving him Silymarin, or Milk Thistle, since I felt there was probably some degree of liver damage. I based this assumption on the dark, greasy appearance of his feathers and some slight hyperkeratinization of his beak.

I dremmeled it a little in the beginning from time to time, but by this time it had ceased to overgrow.

I took him back to see Dr. Bob. I had noticed that the top, round bones on his elbow joints were becoming quite enlarged. The left was larger than the right, but it too was beginning to grow.

It was fixed and immovable, so I doubted it were a neoplasm. Still, it was abnormal and I wanted him to take a look at it. He manipulated it, noted that it articulated well, and the movement wasn’t painful to him. I was to let it alone and just keep an eye on it. He removed an ingrowing feather.

March 17

Pedro only lived with us for four months before he passed away. We have no idea how many years this poor bird was forced to live with cigarette-smoke toxicity. I don’t know what condition his lungs and air sacs were in.

His body had been enduring so much pain, and his life had been so miserable.

I can only hope the readers understand the dangers of imposing their smoking habits onto their birds and that they are motivated to stop smoking—for their sakes as well as their birds’.

His was by far the worst case of nicotine toxicosis the author had ever seen, and one of the worse Dr. Bob had ever seen.

Appendix C. Handout for Bird Owners Who Smoke.

You may print pages 44-47 and give it to people you know who smoke and have pet birds.

Smoking And The Damage To Your Bird’s Health

Birds and other exotic animals have extremely sensitive respiratory systems. They have small, fragile lungs, and their air sacs do most of the respiratory work.

It takes very little to negatively impact the lungs and air sacs of birds. The respiratory system of birds is adversely affected by any form of air pollution.

Signs Of Tobacco Toxicity Are:

Dyspnea (labored breathing)	Gastrointestinal upset (e.g., vomiting,
Hyperexcitability	diarrhea, or regurgitation)
Tachypnea (abnormally rapid breathing, panting)
Enlarged cere
Twitching and tremors	Rhinorrhea (sneezing)
Agitation	Chronic rhinitis
Seizures	Chronic or acute coughing
Salivation	Collapse, coma and cardiac arrest, eventually leading to rapid death
Muscle weakness	Tachycardia (increased heart rate)

Tobacco Products Contain Varying Amounts Of Nicotine: 

Cigarettes 3-30 mg per 1 whole cigarette	Cigarette butts .75-7.5 mg
Cigars 15-40 mg	Moist snuff 4.6-32 mg/g
Moist snuff 4.6-32 mg/g	Dry snuff 12.4-15.6 mg/g
Chewing tobacco 2.5-8.0 mg/g	Transdermal patches 15-114 mg per  patch
Nicotine gum 2-4 mg per piece	Nicotine inhaler rods 10 mg per cartridge
Nicotine nasal sprays 10 mg per ml

Animals may lick up toxic chemicals. Nicotine, tar and carcinogens may land on their feathers after the smoke in the air settles, thus increasing their chances of developing cancer.

In addition, they may eat products containing nicotine, such as cigarettes, cigars and chewing tobacco, nicotine gums and patches.

Nicotine is often used as an insecticide, so birds must not be allowed access to any such products or be permitted to walk onto grass and other foliage that has been sprayed.

Marijuana

The toxins produced by smoking marijuana are dangerous to birds because of their sensitive respiratory systems; they require far less to suffer from toxicity. In birds, exposure to marijuana causes severe depression and regurgitation and should be strictly avoided.

Marijuana may be smoked, eaten, drunk, or inhaled. Although it does not contain nicotine, it is often rolled up with tobacco or inside cigar leaves, so nicotine will be included in the smoke.

Combustion produces large quantities of hundreds of hazardous chemical compounds, such as carbon monoxide, soot, and other particulates.

Holding in the smoke allows for more time for THC and other bi-products to be absorbed by the lungs and not be exhaled.

Cancer-causing chemicals in tobacco are present in cannabis smoke – and at twice the levels they are in smoke from tobacco.

The Marijuana Smoker And His Pets Will Encounter:

Lung disease	Mental illness
Increased heart rate and heart attack	Physical and mental damaging effects

Toxicity From Second-hand Smoke

Exposure to tobacco smoke causes respiratory disease and diseases involving other systems of the body. A lit cigarette, pipe or cigar releases smoke and toxins, from both the lit end and filtered end.

People and animals constantly exposed to tobacco smoke are more likely to develop and die from heart disease, lung cancer, and breathing illnesses.

Tobacco smoke contains over 4,000 thousand different chemicals that fill the air as either gases or particulates, including 69 compounds that are known to cause cancer.

These include formaldehyde, ammonia, cyanide, nicotine, benzene, chromium, nickel, vinyl chloride, arsenic, carbon monoxide, methane, tar, carcinogens (cancer-causing agents).

The concentration of these carcinogenic chemicals is actually higher in secondhand smoke than in the fumes directly inhaled by smokers.

Second-hand smoke is classified as a class-A carcinogen, the same classification given to asbestos.

Passive exposure to tobacco smoke is responsible for many clinical illnesses, including conjunctivitis, sinusitis, air sacculitis, rhinitis and dermatitis.

In many cases, respiratory signs will cease if the bird is removed from the contaminated environment.

It may take from a few weeks to several months for this to happen, and medications, such as chelators, may be necessary to detoxify the bird’s system.

Vaping

Vaporized tobacco may expose pets to especially high levels of nicotine and other toxic chemicals like formaldehyde.

Birds’ sensitive respiratory tracts are vulnerable to absorbing these chemicals. Birds can also re-expose themselves to these “third hand vape” chemicals throughout the day as they groom, preen, and interact with owners.

The cartridge is filled with a highly-concentrated solution of liquid nicotine. Birds can become seriously ill if they ingest even a small amount.

Nicotine toxicity from e-cigarette liquid will result in similar symptoms to poisoning from other tobacco products, but they may progress more quickly and prove more severe.

Formaldehyde, a known carcinogen, is present in the vaporized liquid of e-cigarettes, and it could be 25 times higher than that found in cigarettes.

Contact your veterinarian immediately if your pet has ingested liquid nicotine. Keep electronic cigarette components safely away from birds

Smoking’s Effects On The Bird’s Respiratory System

Second-hand smoke predisposes birds to pneumonia and other respiratory ailments, including lung cancer.

It cannot be entirely filtered out through ventilation systems or fans. It can take many hours for the smoke of a single cigarette to clear.

And the furnace and air conditioning ducts and units are covered with these toxins, so the forced-air furnace will continue to put the toxins in the air.

Furnaces, vents, and ducts need to be cleaned often, especially when the indoor smoking terminates.

Endoscopic Views Of The Air Sacs Of A Bird Who Lives With A Smoker

Upper Respiratory Disease In Birds. Rhinitis and sinusitis from cigarette smoke damage the mucosa of the upper respiratory tract, allowing pathogens to colonize.

The eyes, including the nictitating membrane, frequently suffer inflammation, excessive tearing, redness and infection.

Smoking Toxicity’s Effects on Other Systems and Parts of the Body. Smoke inhalation exacerbates Iron Storage Disease, and nicotine sulfate leads to severe skeletal malformation, reduced body weight, torticollis (twisting of neck to one side), edema, muscular dystrophy, and malformation of the beak, heart, and kidneys.

Effects on the Circulatory System and the Heart. Smoke intoxication leads to poor white blood cell development, hypertension, atherosclerosis, congestive heart failure, and heart attack in animals and birds.

Effects on the Skin and Feathers Nicotine in cigarette smoke poses the greatest danger to birds’ skin and feathers, and second-hand smoke does the most damage, causing both dermatitis and feather damage.

The feathers will absorb the odor of the smoke and be discolored by it. Feather-destructive behavior has also been linked to exposure to smoke.

Smoke toxins accumulate on the feathers and skin and cause irritation leading to lesions. Staphylococcus ssp.is frequently isolated from the lesions, and antibiotic therapy is needed.

Many birdshave bacterial infections or fungal folliculitis from smoke exposure and require wound management.

Smoke lands on the birds, their perches, cage bars, toys, and food. It is also on the smoker’s hands, arms, clothes, skin, and hair.

Smoker’s hands transfer toxic chemicals to the bird. Birds will mutilating their legs and feet because their perches were covered with smoke residue.

Some rehomed birds carry that odor even after having been bathed and will carry it until all their feathers have molted out.

Some resort to feather picking to remove the tainted feathers. Many birds will resume normal preening behavior when removed from exposure to cigarette smoke.

Effects On The Feet, Legs And Face

The feet are particularly vulnerable to fungal diseases as a result of smoking toxicity. The feet and legs should have prominent scale patterns both top and bottom of the foot.

Smoothing of the bottom of the foot’s scale pattern can lead to severe foot and leg diseases.

Nicotine contact is a common cause of foot abnormalities. Foot infections are due to handling by smokers since nicotine residue on the hands causes irritation.

Macaws suffer dermatitis on the bare cheek patches following repeated contact with a smoker’s hands.

Smoking-related Diseases

Aspergillus. Aspergillus is generally found in the bird’s respiratory tract, but it can invade any organ and even the skin. The fungal spores are everywhere, and birds exposed to smoke have immune systems that are weak, so they are unable to fight off the disease.

Pneumonia. With pneumonia, the lungs turn a dark pink, and the lung tissue takes on a yellow discoloration.

Birds exposed to cigarette smoker generally develop black spots on the lungs. The trauma from exposure to these pollutants often causes bleeding within the lungs.

Bacterial infections. Secondary bacterial infections are common and require medical therapy. Staphylococcus,. Staph is found in abundant quantities in air and dust.

S. aureus can remain infectious for long periods of time outside the host. It can also develop resistance to disinfectants following continuous exposure, and frequent changing of disinfectants is required.

Cancer. Exposure to cigarette smoke leads to cancer. Skin cancer is being reported by clinicians more and more frequently in pet birds.

It has been diagnosed in areas such as the beak, eyes, mouth, tail base, preen gland, and skin on the body.

Recommendations: take the bird to an avian veterinarian immediately if you suspect nicotine toxicity. Treatment may include medications, hospitalization for fluid therapy, and careful monitoring.

Houses are also contaminated by smoking, and this contamination of air, furniture, draperies, etc. lingers for a long time.

These must be cleaned often. Smoking must be done outside, and smokers should change their clothing and wash their hands and arms before handling birds.

Provide good ventilation. Toxic by-products of smoking may take several hours to be eliminated from the air. Hepa® filters on the furnace work best to remove particulates from the air.

Provide fresh air. Keep all nicotine-containing items, including ashtrays, chewed nicotine gum, and used nicotine patches out of the reach of pets to prevent accidental consumption.

Birds and other pets may find carelessly discarded cigarettes, cigars, pipes, chewing tobacco, and other tobacco products; these will cause significant poisoning.

Clean cages and perches daily. Frequent bathing is a must for your parrot if you are a smoker. Other pets suffer significantly too. It takes very little tobacco or nicotine to be toxic to a dog or cat.