![]() The owner did not return the dog for recheck of liver enzymes. Three months later a recheck examination and labs revealed a normal physical examination, an elevated ALT (217 U/l), mildly elevated BUN (31 mg/dl), and normal CBC and urinalysis. During a follow-up telephone call the week after ingestion, the pet owner reported that the dog remained asymptomatic following discharge. Twenty-six hours after the initial exam, the dog was discharged on oral sucralfate, oral metronidazole, and a bland diet. Twenty hours after the initial presentation ALT was reduced to 136 U/l and all other values were within reference ranges. The dog’s lethargy resolved approximately 8 h following the initial exam, and melena was last noted 14 h following the initial exam. Three hours following presentation the dog vomited again maropitant (1.5 mg/kg, SQ, 104 once) was administered maropitant (1.5 mg/kg, SQ, once) and the vomiting resolved. ![]() The dog’s urine was a gold color 3 h after instituting deferoxamine and a dark amber color 6 h later. Chelation therapy was instituted with a constant rate infusion of deferoxamine (15 mg/kg/h IV for 21 h) and supportive care including IV fluids (Normosol-R at 3.86 ml/kg/h) and oral metronidazole (10 mg/kg PO q 12 h). Two hours after admission one 60-ml warm water enema was administered, and the dog defecated dark tarry feces, black granular material believed to be the contents of the oxygen absorber sachets, and white liquid resembling milk of magnesia. Treatment for iron intoxication commenced with milk of magnesia (5 ml PO once), sucralfate (100 mg/kg slurry PO q 8 h), and famotidine (1 mg/kg IM or IV q 12 h). Results of a limited serum biochemical analysis were within reference ranges with the exceptions of mildly elevated ALT (ALT = 175 U/l reference 10–100 U/l) and mildly elevated BUN (BUN = 31 mg/dl reference 7–27 mg/dl). The fecal flotation exam was normal except for the presence of black stool with mucous. Complete blood count (CBC) and activated clotting time (ACT) results were within reference ranges. The serum iron concentration was 436 μg/dl (reference 94–220 μg/dl). Abdominal radiographs revealed granular, radiopaque material within the distal colon consistent with granular iron. The physical exam revealed lethargy, melena, and a tense abdomen with the remainder being unremarkable. There was no known exposure to other toxins or foreign material, and the dog had no known health problems. One of the oxygen absorber packets was completely emptied, and the other was punctured and spilled. In the 8–12 h preceding examination, the dog had chewed into an unopened package of rawhide pet treats as well as the two oxygen absorber sachets that were included in the rawhide packaging. Human and veterinary medical personnel need to be aware of this effect and monitor serum iron concentrations as chelation may be necessary.Ī 7-month-old female intact Jack Russell terrier weighing 5.18 kg presented to a veterinary clinic for evaluation of vomiting of 3 h duration. This case demonstrates that iron intoxication can occur following the ingestion of such products. Results indicate the contents contained 50–70% total iron. The lack of ingredient information on the packaging prompted analysis of contents of oxygen absorber sachets. To our knowledge, no cases of iron intoxication following the ingestion of oxygen absorbers have been reported. The ingestion of reduced iron in humans has been reported to cause mild elevation of serum iron concentration with minimal clinical effects. Clinical signs resolved 14 h following treatment, but the ALT remained elevated at the 3-month recheck. The dog was treated with deferoxamine and supportive care. Serum iron concentration and ALT were elevated. A 7-month-old female Jack Russell terrier presented for evaluation of vomiting and melena 8–12 h after ingesting 1–2 oxygen absorber sachets from a package of dog treats. We present a case of canine ingestion of an oxygen absorber from a bag of dog treats that resulted in iron intoxication necessitating chelation therapy. Although reduced iron typically has minimal oral bioavailability, such products are potential sources of iron poisoning in companion animals and children. They usually contain reduced iron as the active ingredient although this is rarely stated on the external packaging. Oxygen absorbers are commonly used in packages of dried or dehydrated foods (e.g., beef jerky, dried fruit) to prolong shelf life and protect food from discoloration and decomposition.
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