TREATMENTS :: HYPERBARIC OXYGEN THERAPY
Hyperbaric Oxygen Therapy is a procedure that delivers increased amounts of oxygen to diseased or injured tissues. It is currently one of the most powerful tools available as an adjunctive form of therapy, and in some cases it works well as the primary therapy for horses. Oxygen is delivered to the patient under pressure, the procedure concentrates the oxygen available in the air breathed by the horse, which allows more oxygen to be dissolved into the blood plasma and delivered to the injured or diseased tissues.
Acute and Chronic conditions commonly treated with HBOT:
• Post Surgical and Slow Healing Wounds
• Tendon and Ligament Injuries
• EIPH (Exercise Induced Pulmonary Hemorrhage)
• Infections - aerobic and anaerobic - including infections not responding to antibiotic therapy
• Colic (post surgical)
• Laminitis and Navicular Syndrome
• Pneumonia and Internal Abcesses
• Tying Up
• Thermal Burns and Smoke Inhalation
• Tissue Necrosis
• Pre and post stem cell surgery patients
• Reproductive Problems in Stallions including low libido, sperm count and morphology
• Reproductive Problems in Mares-including uterine infections, fluid pooling and increased oxygen
• Dummy Foals and Dystocias with fetal asphyxia
• Joint Ill in foals
• Joint infections in foals / adults
• Enhancement of healing in selected problem wounds
Prevention of infection in "dirty" wounds
• Higher quality granulation tissue in wounds over joints and other areas of increased mobility
• Wounds not responding to conventional antibiotic therapies alone
• Selected Aerobic and Anaerobic soft tissue infections
• Staph infections
• Obstetrical infections
• Crush injuries
• Post-Colic Surgery
• Prevention of ischemia reperfusion injury post colon torsion
• Septicemia in adults and foals
• Post-surgical complications
• Compromised Immune Systems
• Breeding difficulties in mares and stallions
• Low sperm count / low libido
• Carbon monoxide poisoning
• Management of Fungal Diseases
• Neonatal maladjustment syndrome
• Dummy foals
• Dystocia foalings involving fetal asphyxia
• Wound Healing
• Infections (aerobic & anaerobic)
• Soft Tissue Edema
• Respiratory Conditions
• Necrotizing Infections
• Osteomyelitis (bone infections)
• Desmitis and tendonitis (injury to ligaments and tendons)
• Post-surgical wounds and wounds that were slow to heal
• Thermal burns and smoke inhalation
• Rhabdomyolisis (tying-up)
• Head trauma, peripheral nerve trauma
• Intestinal surgeries (normalizes function post-surgery)
• Tissue necrosis due to rattlesnake and spider bites
• Enhanced recovery from athletic performance
How Does HBOT Work:
Normal atmospheric pressure that we live under every day exerts approximately 14.7 pounds per square inch on our skin and on the air we breathe. Air is approximately 79% nitrogen and 21% oxygen, which results in an oxygen pressure of about 160 mmHg. HBOT is talked about in terms of Atmospheres absolute (ATA), normal atmospheric pressure at sea level is equal to 1 ATA. Each 33 feet of seawater provides an increase of 1 ATA of pressure.
Normal circulation of oxygen delivery in the body depends on these factors: Proportion of oxygen in the air that we breathe, lung function, the amount of hemoglobin in the blood, the body’s normal blood pressure. The amount of oxygen that red blood cells can carry is limited with normal atmospheric pressure, meaning that only a small amount of oxygen is dissolved back into the plasma. As the pressure of the oxygen is increased in the hyperbaric chamber, the amount of oxygen being inhaled increases by 10 to 12 times. The hemoglobin in the red blood cells quickly becomes 100% saturated with oxygen, and the excess oxygen is dissolved into the blood plasma, this allows the oxygen to be diffused into the tissue at a much higher level.
In the case of bone and soft tissue wounds and infections, resulting in inflammation and swelling, the increased oxygen levels help salvage bone and tissue by increasing blood flow and stimulating faster cell turnover, which in turn speeds up the healing process. New blood vessels form more quickly, improving blood supply to injured areas resulting in a swift reduction in edema (swelling). Studies have shown that soft tissue injuries treated with HBOT recover in half the time. The increased oxygen also increases the effectiveness of antibiotics, and aids in killing many anaerobic bacteria, (bacteria which doesn’t survive well in high oxygen environments). At pressure, with oxygen at a higher level, it is also detrimental to aerobic bacteria. Extra oxygen also helps white blood cells function better to kill infectious organisms.
HBOT helps restore blood flow to tissues after colic surgery. It also reduces obstructive swelling in the intestinal tissue and improves oxygenation of the resection (after abdominal surgery to correct colon torsion, small intestine strangulation, etc.) It’s been found that many colic cases respond much better to surgery when treated with HBOT before and after surgery.
HBOT can arrest laminitis in the early stages. If you can treat the horse before the structures in the foot collapse (before there is crushing of the blood vessels), it is very effective.
Effects of oxygen therapy on problems like navicular syndrome and laminitis are now being studied. Researchers at the University of Tennessee are starting controlled studies on laminitis to get the data needed to document the effects of HBOT.
HBOT increases blood flow to the infection site, which increases the amount of antibiotic delivery. The extra oxygen also increases the effectiveness of the antibiotic, magnifying the way it works against bacteria. High-dose oxygen tends to potentiate the effect of some antibiotics, such as sulfamethoxazole (SMZ). You are also getting 15 times the amount of oxygen to a tissue that was lacking oxygen due to infection of poor circulation. Oxygen also stimulates faster cell turnover and thus faster healing.
Oxygen acts to kill bacteria. Most bacteria causing serious infection are anaerobic—working best in an environment without oxygen. At pressure, with oxygen at a higher level, it is also detrimental to aerobic bacteria. Extra oxygen also helps white blood cells function better to kill the organisms.
Certain antibiotics such as gentocin and amikacin don’t work well in low-oxygen environments. Oxygen therapy enhances their function and gives a whole combination of benefits. HBOT is an adjunctive therapy; you still use antibiotics and anti-inflammatory drugs and other treatments. It’s a component process in which everything is working together.
Internal abscesses (such as in the lungs or the abdomen) are sometimes not diagnosed early. By the time they are diagnosed, there is a thick-walled capsule of connective tissue around them that keeps antibiotics from reaching the site. This results in prolonged antibiotic treatment (often with no resolution of the abscess) at high cost to the owner, and potentially fatal consequences for the horse. HBOT helps the antibiotic get to the site and enhances its ability to fight the infection.
Septicemia and Joint Ill in Foals:
Major clinics have evaluated HBOT for treating foals with septic joints. In 2002, all the foals which came into the clinic with septic joints went through a standard protocol using systemic antibiotics, lavage to flush the joints with antibiotics, etc. After 30 to 90 days of treatments, they took the foals which were hopeless (which would ordinarily be euthanized) and moved them to a test group. They continued to use their standard treatments, but combined them with HBOT. They had a 60% recovery rate in foals which were going to be put down.
Soft Tissue Injuries:
Many injuries result in inflammation and swelling. Studies have shown that soft tissue injuries treated with HBOT recover in half the time. New blood vessels form more quickly, improving blood supply to injured areas, and there is swift reduction in edema (swelling). Since oxygen is normally carried by red blood cells, any tissues with a compromised blood supply suffer from poor healing. But with HBOT, oxygen is forced into all body fluids and delivered to areas with restricted circulation.
Injured tendons and ligaments respond well to treatment:
HBOT can be useful in dealing with bowed tendons, surgical repair of tendon or ligament injuries, etc. Surgical traumas (incisions) also heal faster with HBOT, as do large surface wounds and pressure sores. It decreases tissue swelling and helps salvage damaged tissues in traumatic injury. In chronic wounds, it assists growth of new skin and stimulates collagen production.
A prominent DVM wrote an article three years ago and described how he’d treated some older stallions for laminitis and noticed an increase in fertility. After reading that, a Thoroughbred farm sent their stallion to a clinic in the US to treat their stallion in the HBOT chamber, and there was a very dramatic change. The stallion’s covers in the breeding shed had declined, but after HBOT treatments his libido increased (along with his sperm count), and the morphology (cell structure) of his semen was much improved.
A rehab clinic in the US has also treated mares that were unable to conceive. One mare went to the breeding shed 16 times in two years without becoming pregnant. After two treatments in the HBOT chamber, she was bred, and had a live, healthy foal.
Dummy Foals and Other Neurological Problems:
Used on dummy foals, it reduces edema. The oxygen in a pressure chamber has the ability to penetrate the cerebrospinal fluid. Head and spinal trauma often create neurological damage, thought to result from swelling of these tissues within a confined space, loss of blood and oxygen supply, and the sequential effects of these factors on nervous tissue. HBOT reduces the swelling and increases the blood supply.
HBOT is one of the most powerful tools available as an adjunctive form of therapy, and in some cases it works well as the primary therapy in horses.