Nelly resting in the ICU. Photo courtesy DoveLewis Nelly, a seven-year-old dog, was brought to DoveLewis Veterinary Emergency & Specialty Hospital in Portland, Oreg., after reportedly ingesting large amounts of lamotrigine, mirtazapine, dextromethorphan, and bupropion—doses associated with seizures, arrhythmias, and sudden death in dogs. Shortly after presentation, she experienced cardiopulmonary arrest. The emergency team initiated CPR following RECOVER guidelines. Nelly developed ventricular fibrillation requiring defibrillation, and return of spontaneous circulation was achieved after 17 minutes of continuous resuscitation. She remained critically ill, with a guarded prognosis. Post-resuscitation care included lipid emulsion therapy, antiarrhythmic treatment with lidocaine, neuroprotective measures, and supportive monitoring. Liver enzyme elevations were managed medically, and her neurologic status remained intact. Nelly’s recovery was made "a little easier," thanks to toys an ICU technician bought for the patient. Photo courtesy DoveLewis “Nelly’s case was both medically complex and emotionally intense,” says DoveLewis veterinarian Julia Supino, VMD. “Seventeen minutes of CPR is a long time, and the fact that she came back from that is nothing short of remarkable.” The patient reportedly recovered over 48 hours and was discharged home with her family.
