This anxiety puppy was inspired by our real bernese mountain dog, Our beloved Mama Bear - she was loved by all dogs and puppies and was always a great comfort to all she encountered. The heartbeat simulator requires (2) AAA batteries (not included) and will mimic your dog or puppy sleeping with their sibling or best friend and will help calm them and allow them to sleep or just settle down when anxious. The heat pack is reusable. Just put it in boiling water until you can see through it. Be sure to use tongs when putting it in the boiling water and when removing it from the boiling water. Dry off the heat pack and click the metal piece inside the heat pack before putting the heat pack into the puppy. USE CAUTION - it could be a burn hazard while preparing the heat pack. The heat pack simulates your pet sleeping next to their sibling or best friend and allows them to stay nice and warm for hours. Our anti-anxiety puppy is a nice way to remember our Mama Bear and allow her memory to live on in homes and for her loving nature to continue to help puppies and dogs all around the world! Once your puppy no longer has anxiety, you can use the plush toy as a regular, every day toy!