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By Ashley Berke

Anthony Cirado took a break from unpacking to run a quick errand near his new home in Voorhees, NJ. During that 30 minutes, his four-year-old Australian Shepherd mix, Holden, decided to explore the boxes in the bathroom. Unfortunately, the item that appealed most to Holden was a large bottle of Ibuprofen.

After chewing through the cap, Holden ate more than 300 of the 200mg tablets. The ingestion of even one pill can cause significant side effects in dogs, including severe gastrointestinal upset and kidney injury. When Anthony returned home and found Holden vomiting and disoriented, he knew he needed to seek emergency veterinary care immediately.  

A comatose Holden receives treatment at Penn Vet’s Ryan HospitalBy the time Anthony and his wife, Skye, made the 15-minute trip to their primary care vet, Holden’s tongue had turned purple and he was unable to stand. Realizing that he was not equipped to handle the case, the vet told Anthony and Skye that their best chance was to take Holden to Penn Vet’s Ryan Hospital as quickly as possible. Twenty minutes later, as they pulled into the Ryan Hospital parking lot, Skye realized that Holden was unconscious.

As soon as Holden was in the Emergency Room, Penn Vet’s board-certified emergency and critical care vets intubated him and performed gastric lavage, or stomach pumping. But nothing came out when they tried to rid his stomach of its contents. In addition, Holden was completely non-responsive to stimuli.

Anthony and Skye were dismayed to hear that, in his comatose state, Holden’s prognosis was not promising. But they decided to proceed with any treatment that could give him the best chance at survival.

Holden was then transferred to Penn Vet’s renowned nephrology service. Under the guidance of Dr. JD Foster, Director of Hemodialysis, and Dr. Barbara Tauk, Holden underwent charcoal hemoperfusion, during which blood leaves the body through a catheter to be purified. A charcoal filter was used to bind the Ibuprofen and remove it from the blood stream.

Holden lifts his head during hemoperfusion treatment Within three hours of hemoperfusion, Holden started to lift his head. At the end of his six-hour treatment, he was able to sit up on his own and even energetically walk the hallways of the hospital.

Dr. Tauk called Anthony and Skye to provide an update. “We were amazed to hear that he was alert and sitting upright,” Anthony said. As additional proof that Holden was on the road to recovery, Dr. Tauk also sent a video clip of Holden walking. “That video allowed us to sleep peacefully through the night,” Anthony added.

Ryan Hospital is the only veterinary hospital in the area with the equipment and expertise necessary to perform the complex dialysis procedure that ultimately saved Holden’s life.  The power of collaboration at Penn Vet also made Holden’s recovery possible.

“We couldn’t have done this without our incredible emergency room staff, who were able to keep Holden alive long enough for us to start the hemoperfusion treatment,” Dr. Foster said.

Dr. JD Foster, Dr. Barbara Tauk, and student Suzanne Hange with HoldenHolden received a clean bill of health during a recent follow-up appointment at Penn Vet. Despite the risk of neurological damage and stomach ulcers, Holden has not experienced any negative side effects. Thanks to Anthony and Skye’s quick action and dedication, Holden is back to his exuberant self.

“Every single person at Penn Vet was amazing to us, from the security guard in the lobby to the students and clinicians,” Anthony said. “We are so grateful to have Holden in our lives for many years to come.”

Learn more about Penn Vet’s nephrology service.

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