Study finds no recovery benefit from HBOT after IVDD surgery

Version 2 — Full analysis

A new American Journal of Veterinary Research study reports that hyperbaric oxygen therapy did not improve recovery of deep pain perception in dogs after hemilaminectomy for thoracolumbar intervertebral disk disease when those dogs presented without deep pain perception in the pelvic limbs. The study retrospectively reviewed cases from January 2014 through December 2024, comparing dogs that received adjunctive HBOT after surgery with dogs that did not. For a therapy that’s often discussed as a way to reduce secondary spinal cord injury, the result is notable because it suggests no measurable benefit on one of the most consequential neurologic endpoints in a very high-risk IVDD population. (public-pages-files-2025.frontiersin.org)

That context matters. Dogs that lose deep pain perception represent one of the most severe thoracolumbar IVDD presentations, and prognosis changes sharply once that milestone is crossed. The American College of Veterinary Surgeons says dogs that still retain pain perception have about a 90% chance of regaining limb use with surgery, while dogs with complete loss of pain perception have a lower surgical recovery range of about 50% to 60%. (acvs.org)

Interest in HBOT has persisted because the physiologic rationale is appealing: higher dissolved oxygen delivery, possible reduction in edema, and theoretical mitigation of secondary injury cascades. But the broader literature has been cautious. A 2020 review in Frontiers in Veterinary Science grouped HBOT among emerging or adjunctive therapies for spinal cord injury after acute canine disc herniation and emphasized that many such treatments remain supported by limited or inconsistent clinical data, especially compared with surgery itself. (public-pages-files-2025.frontiersin.org)

That same review highlights a broader pattern in severe IVDD care: some adjunctive strategies have shown mixed or conflicting results, and even better-studied additions such as durotomy remain debated. In other words, the field is still sorting out which extras truly move outcomes and which mainly add complexity. This new AJVR report appears to push HBOT closer to the latter category, at least for recovery of deep pain perception after hemilaminectomy in deep pain-negative dogs. That interpretation is an inference based on the study summary and the surrounding literature, not a direct quote from the authors. (public-pages-files-2025.frontiersin.org)

If that holds in the full paper, the practical implications are significant. HBOT requires specialized equipment, trained staff, careful case selection, and added handling of neurologically fragile patients. For referral centers, the study may prompt a closer look at whether HBOT is being positioned as a routine postoperative adjunct for IVDD or reserved for narrower indications where evidence is stronger. For general practitioners and neurologists counseling pet parents, the takeaway is simpler: adjunctive HBOT should not be framed as a proven way to restore deep pain perception after decompressive surgery in these cases based on current evidence. (public-pages-files-2025.frontiersin.org)

There’s also a communication issue here. Pet parents facing an emergency IVDD surgery are often searching for anything that might improve odds, and adjunctive therapies can sound compelling in that moment. Studies like this help clinicians separate biologic plausibility from demonstrated benefit, which is especially important when cost, transfer decisions, and postoperative expectations are on the line. In a population where baseline prognosis is already guarded, avoiding overstatement matters as much as identifying new options. (acvs.org)

Why it matters: For veterinary professionals, this study reinforces an evidence-first approach to postoperative IVDD care. Hemilaminectomy remains the central intervention for eligible dogs with severe thoracolumbar disc extrusion, while adjuncts should be judged on outcome data, not just mechanism or anecdotal enthusiasm. A negative finding is still clinically useful if it helps hospitals refine protocols, focus spending, and give pet parents more accurate guidance. (acvs.org)

What to watch: The next step is the full publication details, especially sample size, timing and dosing of HBOT, adjusted analyses, adverse events, and whether any subgroups appeared to benefit despite the overall negative result; absent that, prospective controlled trials would be the clearest way to determine whether HBOT has any role in selected IVDD cases. (public-pages-files-2025.frontiersin.org)