Raw bread dough made with yeast poses mechanical and biochemical hazards when ingested, including via resultant gastric distention, metabolic acidosis, and CNS depression. Although any species is susceptible, dogs are most commonly affected because of their indiscriminate eating habits.
Pathogenesis of Bread Dough Toxicosis in Animals
Bread dough toxicosis occurs when the warm, moist environment of a stomach serves as an efficient incubator for replication of yeast within ingested raw dough. The expanding dough mass causes the stomach to distend, resulting in vascular compromise to the gastric wall, similar to that seen in gastric dilatation/volvulus Gastric Dilation and Volvulus in Small Animals Gastric dilation and volvulus (GDV) is an enlargement of the stomach associated with rotation on the mesenteric axis. GDV is an acute, life-threatening condition that primarily affects large-... read more . With sufficient gastric distention, respiratory compromise occurs. Yeast fermentation products include ethanol, which is absorbed into the bloodstream, resulting in inebriation and metabolic acidosis.
Clinical Findings of Bread Dough Toxicosis in Animals
Early clinical signs of bread dough toxicosis may include unproductive attempts at emesis as well as abdominal distention and depression. As ethanol Alcohols intoxication develops, the animal becomes ataxic and disoriented. Eventually, profound CNS depression, weakness, recumbency, coma, hypothermia, or seizures may be seen. Death is usually due to metabolic effects of alcohol rather than from gastric distention; however, the potential for dough to trigger gastric dilatation/volvulus Gastric Dilation and Volvulus in Small Animals Gastric dilation and volvulus (GDV) is an enlargement of the stomach associated with rotation on the mesenteric axis. GDV is an acute, life-threatening condition that primarily affects large-... read more in susceptible dog breeds should not be overlooked.
Diagnosis of Bread Dough Toxicosis in Animals
Blood alcohol concentrations
A presumptive diagnosis of bread dough toxicosis can be based on history of exposure and clinical signs. Blood ethanol concentrations are consistently elevated. Differential diagnoses include gastric dilatation/volvulus Gastric Dilation and Volvulus in Small Animals Gastric dilation and volvulus (GDV) is an enlargement of the stomach associated with rotation on the mesenteric axis. GDV is an acute, life-threatening condition that primarily affects large-... read more , foreign body obstruction Gastrointestinal Obstruction in Small Animals GI obstruction is an emergency condition and has a range of causes. Pain, vomiting, and diarrhea are typical signs. Diagnosis is based on signs, clinical pathology, radiographs, ultrasonography... read more , ethylene glycol toxicosis Ethylene Glycol Toxicosis in Animals Ethylene glycol toxicosis is often fatal and primarily affects dogs and cats, though all species are susceptible. Most commonly found in vehicle radiator antifreeze, it is also available in... read more , and ingestion of other CNS depressants (eg, benzodiazepines).
Treatment for Bread Dough Toxicosis in Animals
Symptomatic and supportive care
In cases of recent ingestion in asymptomatic animals, emesis may be attempted as a treatment for bread dough toxicosis, although the glutinous nature of dough may make removal via emesis difficult. In patients in which emesis (whether induced or spontaneous) has been unsuccessful, gastric lavage may be attempted. Cold water introduced into the stomach may slow the rate of yeast fermentation and aid in dough removal. In rare cases, surgical removal of the dough mass may be required. Patients presenting with signs of alcohol toxicosis should be stabilized, with any life-threatening conditions corrected before attempts are made to remove the dough. Alcohol toxicosis is managed via correction of acid-base abnormalities, management of cardiac arrhythmias as needed, and maintenance of normal body temperature. Providing fluid diuresis to enhance alcohol elimination may be helpful. Anecdotally, yohimbine (0.1 mg/kg, IV) has been used in severely comatose dogs with alcohol toxicosis.
Ingestion of raw yeast bread dough can result in mechanical obstruction and ethanol toxicosis.
Efforts to remove the dough mass from the stomach may include induced emesis (asymptomatic patients) or, rarely, surgery.
Cold-water gastric lavage may slow the rate of yeast fermentation.