Examples of Enhancing Treatment & Care with HBOT: Adjuvant HBOT In The Treatment Of Injuries From A Sandhill Crane Attack

 An 11-year-old chihuahua was presented as an emergency transfer referral case. He had sustained acute severe puncture wounds about the face, head, and neck as the result of an attack by a Sandhill Crane.  It was later revealed that the crane likely acted in protection of her recent hatchlings. The referring veterinarian had treated for shock and head trauma with IV dexamethasone, famotidine, mannitiol, and furosemide. Image #1 shows the soft tissue trauma and wounds at presentation.

Left to right: image 1, 2, 3, 4.

There was mild ataxia and anisocoria on initial exam, with dull mentation. Radiographs of the chest showed no evidence for pulmonary lesions, and survey skull radiographs did NOT reveal depressed skull fractures.  On rounds, it was debated as to whether anesthesia for MRI would carry a favorable benefit/risk ratio.  It was decided to withhold this diagnostic procedure unless progression of clinical signs occurred.

The patient was treated with IV fluids, enrofloxacin, amoxicillin/clavulinic acid, buprenorphine, and BID HBOT sessions at 1.5 ATA.  Each session was approximately one hour in duration, with 40 minutes “at pressure”.  Image #2 shows the patient less than 24 hours after presentation, and after two HBOT sessions.

Clinical recovery was rapid, anisocoria resolved within 2 days, and the treatment schedule was unchanged until the patient was discharged less than 48 hours after admission.  Antibiotics, Tramadol, and famotidine were dispensed.  Images #3 and #4 show the patient in the chamber during a treatment session, and at recheck 6 days after the attack.

Studies have shown that HBOT upregulates the expression of TNF-alpha, MMP-9, and TMP-1, which are beneficial modulators in the wound healing process (Reference, Sander AL, et al, In Vivo Effect of Hyperbaric Oxygen on Wound Healing and Angiogenesis, Wound Repair Regen, 2009 Mar-Apr; 17[2]:179-84).  In addition, HBOT reduces the acute inflammatory response to help dampen the secondary brain damage caused by traumatic brain injury (Reference, Vlodazsky E, et al, Hyperbaric Oxygen Therapy Reduces Neuroinflammation and Expression of Matrix Metalloproteinase-9 in the Rat Model of Traumatic Brain Injury).

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