Examples of Enhancing Treatment & Carewith Hyperbaric Oxygen Therapy (HBOT): Delayed Carbon Monoxide Toxicity

Pre HBOT (at Admission)

A two-year-old male neutered Chihuahua was found unresponsive on the floor of a burning residence by firemen. They gave oxygen by mask, and the dog quickly recovered, appearing neurologically normal within 48 hours after the incident (despite a persistent cough).

Four days after the fire, neurologic dysfunction commenced and progressed rapidly to blindness, non-ambulatory tetraparesis, and demented behavior.

The attending veterinary neurologist made a diagnosis of delayed carbon monoxide (CO) toxicity, and referred the patient for hyperbaric oxygen therapy.  Upon presentation the dog was flailing beyond control, non-ambulatory, apparently blind, and coughing frequently.  A sedative dosage of Dexdomitor® was given (image above), an IV catheter was placed, and BID one hour sessions of hyperbaric oxygen therapy at 1.5 ATA were begun along with adjunctive IV fluid therapy.  Admitting blood tests were normal with the exception of elevated plasma lactate.

After the first HBOT session the dog became ambulatory (image above left).  The cough resolved within 48 hours of admission, and the patient began to eat and drink normally.  IV fluids were discontinued. 

After seven days (14 HBOT Sessions) the dog regained vision.  On day 14 (28 HBOT sessions) the dog was discharged home to the owner, with improved mentation and  strong, coordinated gait (image above right).

Acute CO toxicity is actually the major cause of death in house fires.  Prompt administration of HBOT dramatically increases the clearance of CO from exposed individuals, and is a “coded” and accepted treatment for CO toxicity in the United States. Unfortunately, delayed CO toxicity is a common sequela in humans with CO exposure.  Blindness, neurologic dysfunction, and neuropsychiatric signs predominate in humans.  A 2010 article demonstrated that clinical signs in a group of human patients with delayed CO toxicity improved with HBOT (Chang, DC et al, Hyperbaric Oxygen Ameliorates Delayed Neuropsychiatric Syndrome of Carbon Monoxide Poisoning, UHMJ, 2010, Jan-Feb; 37 (1):23-33).

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