Examples of Enhancing Treatment & Care with HBOT: Necrotic Rear Limb Foot Wounds

A one-year-old female spayed canine was referred by a veterinary anesthesiologist/rehabilitation specialist and flown in from out of state for treatment of necrotic rear limb foot wounds in which the toes and foot pads appeared to be sloughing.

The wounds (above left) developed as the result of a caudal aortic thrombus, which occurred immediately after an anesthesia-associated cardiopulmonary arrest and successful resuscitation by the pet’s primary care veterinarian. The thrombus was recognized quickly, and the patient was placed on oxycodone, niacinamide, pentoxifylline, Previcox®, Clavamox®, famotidine, enoxaparin, and managed with wet to dry bandages prior to referral. Class IV laser therapy and therapeutic ultrasound was also employed by the referring veterinarian.

After presentation and initial assessment, the patient was switched to enrofloxacin (based on the culture/sensitivity results and the potentiation of this antibiotic by HBOT). Oxycodone, niacinamide, pentoxifylline, and enoxaparin were tapered and discontinued. Low-dose aspirin was begun as an anti-platelet and anti-inflammatory. The wounds were managed topically with an Elizabethan collar, dilute chlorhexidine soaks, and hydrotherapy (without bandages).

No surgical debridement or grafts/flaps were performed.

The AFTER picture (above right) represents the wound healing progress after 14 days of HBOT given BID daily at one hour per session [2 ATA]. Most of the vital foot pad surface has been preserved, and the patient is ready for referral back to the original attending veterinarian. It should be noted that HBOT sessions should be discontinued for at least 72 hours prior to flying, so as not to predispose the patient toward decompression sickness [Workman, WT, Hyperbaric Facility Safety, Best publishing, 1999, page 643].

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