{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T11:24:58Z","timestamp":1783337098479,"version":"3.54.6"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Vet. Sci."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>There is limited published information on iron toxicosis in dogs, and it is unclear if dogs follow the four stages of progression as in humans. The objective of this retrospective case series was to describe the clinical course and treatment of dogs presenting after iron EDTA ingestion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cases were retrieved through an electronic medical records search at three veterinary teaching hospitals and three private referral hospitals in Australia. Non-parametric descriptive statistics are reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>61 dogs met the inclusion criteria. The most common iron-containing product ingested was iron EDTA molluscicide (60\/61), with only one dog ingesting iron EDTA plant fertilizer. Notably, 20 out of 61 dogs (32.8%) had no clinical signs before presentation. Vomiting without blood was the most common clinical sign (21), followed by lethargy (16), diarrhea without blood (15), ataxia\/weakness (12), and signs consistent with abdominal pain (10). Abdominal pain was the most common physical examination finding (21), followed by dehydration (10). Forty dogs underwent some form of gastrointestinal decontamination. The median pre-chelation serum iron concentration was 61.3\u202f\u03bcmol\/L (Min\u2013Max 9\u2013356, <jats:italic>n<\/jats:italic>\u202f=\u202f40), while the median post-chelation concentration was 14.7\u202f\u03bcmol\/L (5.72\u201344, <jats:italic>n<\/jats:italic>\u202f=\u202f22). Overall, 10 dogs were managed as outpatients, while 51 dogs were treated as inpatients. Inpatient treatments included desferoxamine (43), gastroprotectants (41), antiemetics and\/or prokinetics (36), analgesia (24), and hepatoprotectants (4). The most common protocol for desferoxamine administration was a continuous intravenous infusion at 15\u202fmg\/kg\/h (<jats:italic>n<\/jats:italic>\u202f=\u202f27); other dogs received 40\u202fmg\/kg intramuscularly (<jats:italic>n<\/jats:italic>\u202f=\u202f13). Two dogs had an anaphylactic reaction to an inadvertent bolus of desferoxamine, while two had allergic reactions possibly related to desferoxamine. Two dogs developed neutropenia, and one developed acute respiratory distress syndrome, possibly as a result of desferoxamine treatment. Overall, 91.8% of dogs survived to discharge. One dog died during hospitalization, experiencing cardiac arrhythmias, shock, and cardiac arrest despite treatment. When considering the stage of iron toxicoses, 16\/61 (26.2%) dogs never developed clinical toxicosis, 44 dogs (72.1%) had evidence of Stage 1 clinical signs, 4 dogs (6.6%) also had evidence of Stage 2 clinical signs, and 19 dogs (31.1%) progressed to Stage 3 clinical signs. No dogs had Stage 4 clinical signs (delayed gastrointestinal stricture). A single case was euthanized for acute hepatic failure upon re-presentation after initial survival to discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Iron EDTA toxicosis has a good prognosis in dogs following prompt treatment, but severe organ damage, including hepatic and cardiovascular dysfunction, can occur. Additionally, desferoxamine was well tolerated when administered according to published protocols, but potentially fatal adverse effects can occur.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fvets.2025.1622800","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T04:17:06Z","timestamp":1759292226000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Iron EDTA ingestion and toxicosis in 61 dogs: a multicenter retrospective study of Australian hospital records"],"prefix":"10.3389","volume":"12","author":[{"given":"Elvany","family":"Luswanto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire R.","family":"Sharp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Mooney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah L.","family":"Purcell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/B978-0-12-385926-6.00036-3","article-title":"Iron","volume-title":"Veterinary toxicology: basic and clinical principles","author":"Hooser","year":"2012"},{"key":"ref2","first-page":"939","article-title":"Digestion and absorption of vitamins and minerals","volume-title":"Medical physiology","author":"Binder","year":"2017"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/B978-1-4557-0717-1.00051-X","article-title":"Iron","volume-title":"Small animal toxicology","author":"Hall","year":"2013"},{"key":"ref4","first-page":"240","article-title":"Iron Toxicosis","volume-title":"Current veterinary therapy VIII small animal Pratice","author":"Greentree","year":"1983"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1097\/PEC.0b013e3182302604","article-title":"Iron poisoning: a literature-based review of epidemiology, diagnosis, and management","volume":"27","author":"Chang","year":"2011","journal-title":"Pediatr Emerg Care"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1007\/BF02726009","article-title":"Acute iron ingestion","volume":"69","author":"Sipahi","year":"2002","journal-title":"Indian J Pediatr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1111\/avj.13388","article-title":"Characteristics and outcome of 73 dogs with iron EDTA molluscicide ingestion in Melbourne, Australia (2013-2019)","volume":"103","author":"Lauinger","year":"2025","journal-title":"Aust Vet J"},{"key":"ref8","first-page":"556","article-title":"Elevated serum iron concentrations following hand warmer ingestion in 4 dogs","volume":"49","author":"Brutlag","year":"2011","journal-title":"Clin Toxicol"},{"key":"ref9","first-page":"240","article-title":"Iron Toxicosis","volume-title":"Kirk\u2019s current veterinary therapy XII small animal practice","author":"Greentree","year":"1995"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.cvsm.2011.12.009","article-title":"An overview of trends in animal poisoning cases in the United States: 2002-2010","volume":"42","author":"McLean","year":"2012","journal-title":"Vet Clin North Am Small Anim Pract"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1002\/9780470699010.ch42","article-title":"Iron and iron salts","volume-title":"Handbook of poisoning in dogs and cats","author":"Campbell","year":"2000"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.2460\/javma.242.9.1244","article-title":"Reports of metaldehyde and iron phosphate exposures in animals and characterization of suspected iron toxicosis in dogs","volume":"242","author":"Buhl","year":"2013","journal-title":"J Am Vet Med Assoc"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1111\/j.1751-0813.2009.00451.x","article-title":"Acute toxicity in five dogs after ingestion of a commercial snail and slug bait containing iron EDTA","volume":"87","author":"Haldane","year":"2009","journal-title":"Aust Vet J"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1007\/s13181-011-0201-3","article-title":"Iron intoxication in a dog consequent to the ingestion of oxygen absorber sachets in pet treat packaging","volume":"8","author":"Brutlag","year":"2012","journal-title":"J Med Toxicol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1067\/mps.2000.104055","article-title":"Iron poisoning","volume":"30","author":"Fine","year":"2000","journal-title":"Curr Probl Pediatr"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1111\/j.1749-6632.1965.tb54077.x","article-title":"The biochemistry of desferrioxamine and its relation to iron metabolism","volume":"119","author":"Keberle","year":"1964","journal-title":"Ann N Y Acad Sci"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"ref19","volume-title":"Multicrop multiguard snail and slug killer safety data sheet","year":"2018"},{"key":"ref20","author":"Fertilizers","year":"2023"},{"key":"ref21","first-page":"987","article-title":"Hypovolemic shock","volume-title":"Textbook of small animal emergency medicine","author":"Boyd","year":"2019"},{"key":"ref22","first-page":"1126","article-title":"Management of dehydration","volume-title":"Textbook of small animal emergency medicine","author":"Allen-Durrance","year":"2019"},{"key":"ref23","first-page":"101","article-title":"Fever","volume-title":"Textbook of small animal emergency medicine","author":"Claus","year":"2019"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1111\/j.1476-4431.2007.00238.x","article-title":"Acute lung injury and acute respiratory distress syndromes in veterinary medicine: consensus definitions: the Dorothy Russell Havemeyer working group on ALI and ARDS in veterinary medicine","volume":"17","author":"Wilkins","year":"2007","journal-title":"J Vet Emerg Crit Care"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1081\/CLT-100108513","article-title":"Hepatotoxicity in acute iron poisoning","volume":"39","author":"Tenenbein","year":"2001","journal-title":"J Toxicol Clin Toxicol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"585","DOI":"10.3109\/15563657108990981","article-title":"Pathophysiology of acute iron poisoning","volume":"4","author":"Whitten","year":"1971","journal-title":"Clin Toxicol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1016\/S0196-0644(85)81034-9","article-title":"Gastrotomy \u2014 a surgical approach to iron overdose","volume":"14","author":"Foxford","year":"1985","journal-title":"Ann Emerg Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/S0022-3468(87)80446-3","article-title":"Emergency gastrotomy: treatment of choice for iron bezoar","volume":"22","author":"Landsman","year":"1987","journal-title":"J Pediatr Surg"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1016\/S0022-3476(82)80584-2","article-title":"Gastrotomy in the management of acute iron poisoning","volume":"100","author":"Venturelli","year":"1982","journal-title":"J Pediatr"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/S0733-8627(20)30435-1","article-title":"Acute iron poisoning","volume":"12","author":"Mills","year":"1994","journal-title":"Emerg Med Clin North Am"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"33","DOI":"10.3928\/0090-4481-19960101-08","article-title":"Acute iron poisoning","volume":"25","author":"McGuigan","year":"1996","journal-title":"Pediatr Ann"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e30711","DOI":"10.1002\/pbc.30711","article-title":"Deferiprone versus deferoxamine for transfusional iron overload in sickle cell disease and other anemias: pediatric subgroup analysis of the randomized, open-label FIRST study","volume":"71","author":"Hamdy","year":"2024","journal-title":"Pediatr Blood Cancer"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"18","DOI":"10.7748\/en1999.09.7.5.18.c1289","article-title":"Acute iron overdose: clinical features and management","volume":"7","author":"McCrea","year":"1999","journal-title":"Emerg Nurse"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/B978-0-12-364931-7.50006-9","article-title":"Iron toxicosis","volume":"31","author":"Aisen","year":"1990","journal-title":"Int Rev Exp Pathol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1191\/0960327105ht564oa","article-title":"Hepatotoxicity in acute iron poisoning","volume":"24","author":"Robertson","year":"2005","journal-title":"Hum Exp Toxicol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1097\/00008480-199406000-00010","article-title":"Iron poisoning in children","volume":"6","author":"Anderson","year":"1994","journal-title":"Curr Opin Pediatr"},{"key":"ref37","first-page":"239","article-title":"A review on iron chelators in treatment of iron overload syndromes","volume":"10","author":"Mobarra","year":"2016","journal-title":"Int J Hematol Oncol Stem Cell Res"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1111\/vec.13028","article-title":"Suspected hepatotoxicity secondary to trazodone therapy in a dog","volume":"31","author":"Arnold","year":"2021","journal-title":"J Vet Emerg Crit Care (San Antonio)"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"5705","DOI":"10.1021\/bi300752r","article-title":"Mechanisms of mammalian iron homeostasis","volume":"51","author":"Pantopoulos","year":"2012","journal-title":"Biochemistry"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"311","DOI":"10.4103\/0972-5229.120326","article-title":"Fatal overdose of iron tablets in adults","volume":"17","author":"Abhilash","year":"2013","journal-title":"Indian J Crit Care Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1097\/01.SMJ.0000152546.05519.FE","article-title":"Acute liver failure due to iron overdose in an adult","volume":"98","author":"Daram","year":"2005","journal-title":"South Med J"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1542\/peds.36.3.322","article-title":"Studies in acute iron poisoning I: Desferrioxamine in the treatment of acute iron poisoning: clinical observations, experimental studies, and theoretical considerations","volume":"36","author":"Whitten","year":"1965","journal-title":"Pediatrics (Evanston)"},{"key":"ref43","first-page":"198","article-title":"The effect of chelating agents on acute iron toxicity in the dog","volume":"10","author":"Figueroa","year":"1962","journal-title":"Clin Res"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1097\/00006565-199110000-00006","article-title":"Gastrotomy and whole bowel irrigation in iron poisoning","volume":"7","author":"Tenenbein","year":"1991","journal-title":"Pediatr Emerg Care"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1016\/S0196-0644(80)80385-4","article-title":"Emergency gastrotomy for acute iron poisoning","volume":"9","author":"Peterson","year":"1980","journal-title":"Ann Emerg Med"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1081\/CLT-200026974","article-title":"Iron bezoar retained in colon despite 3 days of whole bowel irrigation","volume":"42","author":"Velez","year":"2004","journal-title":"J Toxicol Clin Toxicol"},{"key":"ref47","first-page":"534","article-title":"Acute iron poisoning: management guidelines","volume":"40","author":"Baranwal","year":"2003","journal-title":"Indian Pediatr"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1177\/000992286600500907","article-title":"Deferoxamine in the treatment of acute iron poisoning. Clinical experiences with 172 children","volume":"5","author":"Westlin","year":"1966","journal-title":"Clin Pediatr (Phila)"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1177\/000992289002900604","article-title":"Assessment of management guidelines:acute iron ingestion","volume":"29","author":"Klein-Schwartz","year":"1990","journal-title":"Clin Pediatr"},{"key":"ref50","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1177\/000992289002900604","article-title":"Assessment of management guidelines. Acute iron ingestion","volume":"29","author":"Klein-Schwartz","year":"1990","journal-title":"Clin Pediatr (Phila)"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1542\/peds.38.1.102","article-title":"Studies in acute iron poisoning II: further observations on desferrioxamine in the treatment of acute experimental iron poisoning","volume":"38","author":"Whitten","year":"1966","journal-title":"Pediatrics"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1002\/ajh.10348","article-title":"Iron chelators for the treatment of iron overload disease: relationship between structure, redox activity, and toxicity","volume":"73","author":"Chaston","year":"2003","journal-title":"Am J Hematol"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1016\/0140-6736(92)90598-W","article-title":"Pulmonary toxic effects of continuous desferrioxamine administration in acute iron poisoning","volume":"339","author":"Tenenbein","year":"1992","journal-title":"Lancet"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1007\/s004310050042","article-title":"Acute respiratory distress syndrome in children with acute iron poisoning: the role of intravenous desferrioxamine","volume":"159","author":"Ioannides","year":"2000","journal-title":"Eur J Pediatr"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1515\/CCLM.2006.054","article-title":"Influence of hemolysis on routine clinical chemistry testing","volume":"44","author":"Lippi","year":"2006","journal-title":"Clin Chem Lab Med"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"1823","DOI":"10.1111\/jvim.15337","article-title":"ACVIM consensus statement: support for rational administration of gastrointestinal protectants to dogs and cats","volume":"32","author":"Marks","year":"2018","journal-title":"J Vet Intern Med"}],"container-title":["Frontiers in Veterinary Science"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fvets.2025.1622800\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T04:17:09Z","timestamp":1759292229000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fvets.2025.1622800\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":56,"alternative-id":["10.3389\/fvets.2025.1622800"],"URL":"https:\/\/doi.org\/10.3389\/fvets.2025.1622800","relation":{},"ISSN":["2297-1769"],"issn-type":[{"value":"2297-1769","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,1]]},"article-number":"1622800"}}