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My dog is about 73 pounds and I had 2 used hand warmers in…

My dog is about...

My dog is about 73 pounds and I had 2 used hand warmers in the trash. He got them out and apparently chewed and crumbled, ate and vomited at least 4 times so far

Veterinarian's Assistant: I'll do all I can to help. The Expert will know if your dog will be able to digest that. What is the dog's name?

Jackson, he is a Labradoodle

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Jackson?

HotHands was the brand. Ingredients iron powder, water, salt, activated charcoal, and vermiciculite.

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Customer reply replied 1 month ago
Jackson seems ok, just had 4 episodes of vomiting and it's been black
Answered in 36 minutes by:
3/25/2018
Dr. Kara
Dr. Kara, Dog Veterinarian
Category: Dog
Satisfied Customers: 18,172
Experience: Over 20 years of experience as a veterinarian
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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Most of these hand warmer packets do contain reduced iron and if enough if that is ingested it can be toxic, but in most cases the iron isn't enough to cause true severe toxicity, rather it irritates the stomach lining and that leads to vomiting.

The black color of his vomit could be due to the reduced iron, or it could be that the iron caused enough irritation and led to some bleeding of the stomach lining.

The good news is that he seems fine at this point after vomiting several times.

Ingestions of less than 9 mg per pound of body weight of elemental iron typically result in mild clinical signs but are not likely to result in significant toxicity. 9 - 27.27 mg/pound of body weight of elemental iron can cause mild to moderate signs of toxicity, and eating more than 27.27mgs per pound of body weight can lead to serious poisoning or death. Eating between 45mgs and 113mgs per pound is potentially lethal.

Toxicity can cause direct damage to the lining of his gastrointestinal tract, (leading to vomiting, diarrhea, abdominal pain, lethargy, and gastrointestinal bleeding, sometimes severe), damage to the cells in his body leading to liver damage and difficulty clotting (the liver produces clotting factors) shock, and death. Very rarely we can see strictures forming in the stomach which cause an obstruction 2-8 weeks after eating the iron.

At this point because it appears he has stopped vomiting, seems normal and that he may have vomited most of the contents that were ingested I would recommend that you give an acid reducing medication to protect his gastrointestinal tract as a just in case measure. This will reduce the amount of remaining iron that he will be able to absorb. You can give either:

1) Pepcid ac (famotidine) at a dose of one 10mg tablet per 20 to 40 pounds of body weight every 12 hours (two 10mg tabs every 12 hours for him)

OR

2) Prilosec (omeprazole) at a dose of one quarter 20mg tablet per 40 to 80 pounds of body weight every 24 hours

Either one should be given for at least the next 2 weeks. If you don't notice any other symptoms you can then discontinue the acid reducer after that.

If you notice diarrhea that is bloody, he should be seen by a veterinarian. If he has a tense painful abdomen, refuses to eat, or seems very lethargic he should see a veterinarian.

If the whites of his eyes appear yellow or his gums appear yellow, or his urine is very dark yellow in color he should see his veterinarian to check his liver function.

I also recommend that you feed him small meals of a bland diet for the next couple of days to dilute out the effects. A homemade bland diet consists of 1/3 boiled minced white skinless chicken and 2/3 boiled white rice. Feed this for several days and if all seems well then slowly start mixing in his regular diet, a little more at each meal. It should take about a week to convert him back once you start.

It has been my pleasure to help you today, and I hope that I have earned my 5 star rating. Please remember to rate my service by selecting the 5 stars at the top of the screen (rating me now does not close your question). You are welcome to ask follow up questions about my response here until you are satisfied, simply use the reply box and let me know. Thank you!

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Customer reply replied 1 month ago
Thank u so much!!

You are very welcome, my best to your pup.

Dr. Kara
Dr. Kara, Dog Veterinarian
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Satisfied Customers: 18,172
Experience: Over 20 years of experience as a veterinarian
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