Examples of Enhancing Treatment & Care with Hyperbaric Oxygen Therapy (HBOT): Adjunctive HBOT in the Management of Chronic Rhinitis

A one-year-old male neutered feline was referred with a history of chronic nasal discharge and sneezing which was noted immediately following adoption from a shelter several months prior to presentation.  Various combinations of antibiotics, antihistamines, NSAIDs, and corticosteroids had been employed without clinical improvement. 

Physical exam was unremarkable except for a bilateral green purulent nasal discharge and episodic sneezing.  MRI

(shown left) revealed diffuse soft tissue density bilaterally in the rostral nasal cavity without turbinate destruction.  Rhinoscopy revealed a normal posterior nasopharynx, with soft tissue swelling and purulent discharge in both nasal passages.  Histopathology of biopsy samples obtained from the nasal mucosa revealed bilateral chronic lymphoplasmacytic follicular rhinitis, with focal areas of neutrophillic infiltrates.  Culture of the nasal mucosa biopsy specimens yielded Pseudomonas.

Based upon culture and sensitivity results, a 10-day course of gentamycin was given concurrently with an anti-inflammatory dosage of prednisolone, and then followed with a 4-week course of doxycycline.  Prednisolone was tapered gradually. Clinical signs of sneezing and nasal discharge persisted according to the frequent follow up telephone reports from the owner. Marbofloxacin was begun, and doxycycline was continued.  Clinical signs did not improve over the next three weeks.

At this point, daily one-hour HBOT sessions were begun at 1.5 ATA for 18 straight days until the nasal discharge and sneezing subsided.  The antibiotics and every-other-day prednisolone were continued, and HBOT session frequency was reduced to once weekly at 1.5 ATA for the next three months.  Antibiotics and prednisolone were discontinued one-month after commencement of HBOT, and were not given again over the course of treatment.  Sessions were eventually reduced to once every two weeks for one year. 

After one year, an attempt then was made to reduce session frequency to once every three weeks, however clinical signs returned.  Sessions were continued at a frequency of once every two weeks for the next year, and then tapered again to once every three weeks with no complaint of nasal discharge, and only occasional sneezing reported by the owner.  At the time of this writing this cat has received 94 HBOT sessions in the management of chronic rhinitis.

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