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| Links to the top 10: 1. Ant Baits 2. Silica Gel Packets 3. Toilet Water 4. Birth Control Pills 5. Liquid Potpourri 6. Chocolate 7. Cigarettes 8. Pennies 9. Bread Dough 10. Mothballs 11. Moldy Food |
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9. Bread Dough
Raw bread dough made with yeast poses mechanical and biochemical threats to animals ingesting
it. The warm, moist gastric environment stimulates yeast growth, resulting in expansion of the
dough mass, resulting in gastric distention, which if severe, can result in respiratory and
vascular compromise. Perhaps more significant is the release of alcohol from yeast
fermentation, resulting in profound metabolic acidosis, CNS depression and death.
Early clinical signs may include unproductive attempts at emesis, abdominal distention, and
depression. As alcohol intoxication develops, the animal becomes ataxic and
disoriented.
Eventually, profound CNS depression, weakness, recumbency, coma, hypothermia may occur.
Management of exposure includes decontamination and treatment for alcohol toxicosis. Because
emesis is often unsuccessful, gastric lavage is initially recommended. The veterinarian should be
prepared to perform gastrotomy should the lavage fail to remove the bulk of the dough mass due
to the glutinous nature of the dough. Treatment for alcohol intoxication should proceed as
previously described.
10. Mothballs
Mothballs may be composed of either 100% naphthalene or 99% paradichlorobenzene.
Naphthalene-based mothballs are approximately twice as toxic as paradichlorobenzene, and cats
are especially sensitive to naphthalene. Naphthalene causes Heinz bodies, hemolysis, and,
occasionally, methemoglobinemia in dogs with doses of 411 mg/kg or more (one 2.7 g mothball
contains 2700 mg of naphthalene). Paradichlorobenzene primarily affects the liver and CNS,
although methemoglobinemia and hemolysis have been reported in humans.
Signs of ingestion of naphthalene mothballs include emesis (early), weakness, icterus,
lethargy, icterus, brown-colored mucous membranes, and collapse. Rarely, hepatitis has
been reported 3-5 days post-ingestion. Paradichlorobenzene mothballs may cause GI
upset, ataxia, disorientation, and depression. Elevations in liver serum biochemical values
may occur within 72 hours of ingestion.
Treatment of mothball ingestion includes early emesis, activated charcoal, and cathartic.
Treatment for hemolysis or methemoglobinemia (blood replacement therapy, methylene blue, etc)
may be necessary. Intravenous fluid diuresis should be maintained in cases with hemolysis in order
to minimize the risk of hemoglobin-induced renal nephrosis. Evidence of hepatic damage, based on
biochemical values, would indicate that symptomatic therapy for general liver failure (oral
antibiotics, lactulose, dietary management, etc) should be instituted.
11. Moldy Food (Tremorgenic mycotoxins)
Tremorgenic mycotoxins produced by molds on foods are a relatively common, and possibly
under-diagnosed, cause of tremors and seizures in pet animals. Because of their relatively
indiscriminate appetites, dogs tend to be most commonly exposed to tremorgens. These toxins are
produced from a variety of fungi, however tremorgens produced by Penicillium spp. are the most
commonly encountered. These molds grow on practically any food, including dairy products,
grains, nuts, and legumes; compost piles may also provide a source of tremorgens. Tremorgens
have a several different mechanisms of actions: some alter nerve action potentials, some alter
neurotransmitter action, and while others alter neurotransmitter levels. The overall affect is the
development of muscle tremors and seizures.
Clinical signs include fine muscle tremors that may rapidly progress to more severe
tremors and seizures. Death generally occurs in the first 2 to 4 hours and is usually
secondary to respiratory compromise, metabolic acidosis or hyperthermia. Other signs
that may be seen include vomiting (common) hyperactivity, depression, coma, behavior
alterations, tachycardia, and pulmonary edema.
Asymptomatic animals exposed to moldy foods should be decontaminated via emesis or lavage
followed by activated charcoal and cathartic. In symptomatic animals, control of severe tremors or
seizures has priority over decontamination. Seizures may respond to diazepam, however others
have had better success with methocarbamol (RobaxinÒ; 55-220 mg/kg IV to effect), especially in
seizuring animals. Barbiturates may be used in animals that are unresponsive to other
anticonvulsants. Supportive care should include intravenous fluids, thermoregulation, and
correction of electrolyte and acid-base abnormalities. In severe cases, signs may persist for
several days, and residual fine muscle tremors may take a week or more to fully resolve. Testing of
stomach content, suspect foods, or vomitus for tremorgens is available through the Animal Health
Diagnostic Laboratory, Michigan State University (517-355-0281).
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