It looks like something out of a science fiction movie, sounds like a child’s video game system, and just might save your horse in the event of a serious injury.
Hyperbaric Oxygen Therapy (HBOT) is a treatment modality that is quickly gaining acceptance in various veterinary facilities across the country. What it does is deliver 100% oxygen under high atmospheric pressure to the animal in a chamber, increasing the ability of tissues to heal as well as accelerating the healing process itself.
Hyperbaric chambers have been used for over 70 years to treat deep sea divers for the ‘bends’ or decompression sickness. When a diver is breathing tank air underwater, nitrogen is being absorbed by the tissues. If the diver rises to the surface too rapidly, the nitrogen forms bubbles in the blood, causing serious complications. The diver must be placed in an environment under pressure and allowed to equilibrate to the sea level pressure slowly so that the nitrogen can gradually dissipate. Therefore, hyperbaric chambers were designed to allow the application of atmospheric pressure to the person inside and could be regulated as needed. Once scientists could put something (like humans) under pressure, they started to look at how other things worked on them under pressure. Like oxygen.
Living above the surface of the sea we are breathing air that is about 21% oxygen. Those of us at higher elevations (I live at 7,500 ft.), slightly less. Hemoglobin, the molecules that carry oxygen to the tissues are approximately 97% saturated with oxygen at normal atmospheric pressure. If you could increase the rate at which you inhaled oxygen, it still wouldn’t increase the amount of oxygen in your bloodstream. Breathing in 100% oxygen at normal atmospheric pressure would also not increase significantly the amount of oxygen that can be delivered to your tissues. However, if you breathe 100% oxygen under higher atmospheric pressure, it drastically increases the amount of oxygen available to be delivered to tissues, by as much as five times that at normal atmospheric pressure.
Why is this important?
When an injury occurs to the body, the initial response is inflammation; damage to the tissues causing blood vessels to become torn and leaky, losing their contents into the tissue, which swells. If the injury is a long way away from vessels bringing in oxygen, it may delay the delivery of oxygen to damaged tissues. Blood clots may form at the site of the injury resulting in a loss of blood flow to the tissue and the tissue, deprived of oxygen, may begin to die.
In certain types of wounds, however, blood clots actually are helpful. The clot may cover the defect and the body will then begin to lay down a framework of new tissue to fill in the wound. New blood vessels begin to form and new skin begins to spread out over the wound. This is a long process as it takes time for the new blood vessels to infiltrate the area, bringing nutrients and oxygen to the repairing wound.
One of the main effects of hyperoxygenation is a reduction of swelling and the perfusion of oxygen into tissues – even those that might not have great blood flow, thus enhancing healing at a more rapid rate.
According to many of the clinics that currently use it, HBOT has proven useful in the following treatments:
• Colic: Restoring blood flow to tissues after colic surgery. It reduces swelling in intestinal tissues and improves oxygenation in the resected intestine. Colic cases respond better to surgery when treated before and after surgery with HBOT.
• Infections: HBOT increases blood flow to the infection site, increasing antibiotic delivery. It may increase the effectiveness of the antibiotic due to the increased oxygenation. Hyperoxygenation stimulates faster cell turnover and more rapid healing. Many harmful bacteria are anaerobic (live without oxygen). Therefore increased oxygenation acts as an antibiotic, killing anaerobic bacteria. It increases white blood cell activity, and enhances the action of some antibiotics that don’t work well in low oxygen environment.
• Wounds: HBOT effective for many types of wounds including large de-gloving injuries to lower leg, large surface wounds from trauma, injection reactions, spider bites, pressure sores. Decreases swelling, salvages tissue. Assists epithelium covering wound. Stimulates fibroblast production, collagen production.
• Abscesses: Internal abscesses often form thick walls around themselves that make them difficult to treat. HBOT increases ability of antibiotic to get to abscess and may enhance activity of the antibiotic.
• Laminitis and Navicular Syndrome: Currently being studied. Controlled studies at University of Tennessee started. Much anecdotal evidence from practitioners report improvement in many cases.
• Septicemia and Joint Ill in Foals: In one study, foals who did not respond to conventional therapy and were going to be euthanized were put into a group that combined conventional therapy and HBOT. Sixty percent of the foals recovered. Would be useful in instances with anaerobic bacteria. Increased oxygen delivery and enhanced antibiotic activity may increase treatment effects.
• Soft Tissue injuries: Studies show that soft tissue injuries treated with HBOT recover in half the time. Swelling is reduced and new blood vessels form more quickly, resulting in improved blood supply to injured areas. Oxygen delivered to areas with restricted circulation, improving healing rates.
• Injured tendons and ligaments: Increases blood flow to injured areas, increased healing and oxygenation to surgical repairs. Decreases swelling, less damage to tissues. Assists growth of new skin. Stimulates collagen production. Anecdotal cases where career-ending injuries treated with HBOT were back in training in six weeks.
• Reproductive problems: Anecdotal reports of increased fertility in aged stallions. Increased pregnancy rates in previously barren mares. Potential benefits: increased blood flow and oxygenation. May kill anaerobic bacteria that might be causing infertility.
• Bone infections: HBOT increases oxygen to the blood vessels. Stimulates collagen activity to build new bone. Improves blood flow by reducing swelling. Enhances leukocyte ability to kill bacteria. Enhances activity of antibiotics.
• Neurological Injuries: HBOT will decrease swelling, improving blood supply and circulation. Improves oxygenation. Salvages healthy tissue.
• Dummy foals: HBOT reduces edema. Oxygen under pressure has ability to penetrate cerebrospinal fluid. Increases blood supply. Increases oxygenation.
How are treatments administered?
The hyperbaric chamber is like a big, lozenge-shaped stall. The horse is led into the chamber, which may contain a set of stocks or stall configuration. The chamber is sealed and the horse is taken slowly to whatever atmosphere is required by the treatment. Concurrently, 100% oxygen is pumped into the chamber at a rate determined by the condition and treatment. Many clinicians have reported that horses handle the confined space and treatment well. Horses that are claustrophobic, poor trailer loaders or nervous may require mild sedation.
The number and duration of treatments needed are on a case by case basis, depending on the type and severity of the condition.
Although the initial cost is around $200,000 per chamber, more veterinary clinics are now making the investment and charge around US$400 per session. Horses may require multiple sessions in the chamber depending on the condition requiring treatment. However, for a horse that may face euthanasia due to an uncontrollable infection, for example, it would appear to be money well spent.
Like any treatment, results appear to vary, depending on the situation. HBOT is not meant to replace conventional treatments, but may enhance the effect of some treatments when they are used together. As medical advances blaze new ground in the horse world, HBOT looks like a therapy that will continue to have a positive impact on horse's lives for a variety of ailments.
Equineox Technologies Limited was responsible for creating the first hyperbaric oxygen chamber for the equine market. www.equineox.com
Copyright © 2008 The NW Horse Source, LLC
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