Ozone Therapy for Pets

I’ve recently run across some advertising for the wonders of ozone therapy in pets. This is a treatment that hasn’t caught on much in veterinary medicine (fortunately), but I thought I’d take a look at it before it becomes the next big fad.

What Is It?
According to the Food and Drug Administration (FDA),

Ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy. In order for ozone to be effective as a germicide, it must be present in a concentration far greater than that which can be safely tolerated by man and animals.

According to the Environmental Protection Agency (EPA),

ozone is an air pollutant that is harmful to breathe and it damages crops, trees and other vegetation. It is a main ingredient of urban smog.

Ordinary oxygen gas consists of two oxygen atoms bound together, hence its chemical name O2. Ozone contains three oxygen atoms (O3), and is very reactive, breaking down spontaneously and combining readily with other chemicals. These oxidation reactions are the reason ozone can be used as a disinfectant, killing microorganisms through production of oxidative free radicals.

Proponents of ozone therapy claim that it can be medically beneficial in several ways. Its ability to kill microorganisms and other living cells has been claimed to make it useful for treating infectious diseases and cancer. It is also thought by some to increase the amount of oxygen available to tissues, which may be useful in preventing or treating disease, and to stimulate or modify the immune system in a beneficial way.

Ozone is employed in medical applications in multiple ways, including direct injection into blood, muscle, joints, or body cavities, autohaemotherapy (removing blood from the patient, exposing it to ozone, and then returning the blood to the patient’s body), insufflation of the rectum, vagina, or other body spaces with ozone gas, administration of ozone treated water or saline, and topical application of ozone gas or ozone-treated substances.

Does It Work?
There are pre-clinical, in vitro, studies of ozone applied to infectious organisms and cancer cells and demonstrating it can kill these. As I have often pointed out, however, so can bleach, hydrochloric acid, and many other substances which are not appropriate to give to patients as a form of therapy. A few animal model studies have also suggested a benefit in cancer treatment.

Several reviews have found little controlled clinical research showing beneficial effects in patients treated with ozone therapy. Here are some of the conclusions from these reviews:

Ozone’s use in medicine has been debated for decades, but references to its use were sporadic in the major medical journals. Most of the claims of its efficacy were anecdotal…Current data on the usage of ozone therapy as therapeutic options for various health conditions lacks sufficient safety and therapeutic advantage over available conventional therapeutic modalities…There is insufficient clinical evidence to recommend ozone therapy as a form of alternative treatment….(Health Technology Assessment Report: Ozone Therapy, Ministry of Health, Malaysia, December, 2005)

Given the high risk of bias in the available studies and lack of consistency between different outcome measures, there is no reliable evidence that application of ozone gas to the surface of decayed teeth stops or reverses the decay process. There is a fundamental need for more evidence of appropriate rigour and quality before the use of ozone can be accepted into mainstream primary dental care or can be considered a viable alternative to current methods for the management and treatment of dental caries. (Cochrane Reviews. Ozone therapy for treatment of dental caries. 2004)

Oxygenation therapists proposed that disease is caused by absence of oxygen and loss of cellular ability to use oxygen for “good energy” metabolism, detoxification, and immune system function. Oxygen therapies are proposed in order to restore the body’s ability to produce “good” energy, to “detoxify” metabolic poisons, and to kill invading organisms. However, over the five decades that have passed since this concept was proposed, scientists have shown that:

  1. Anerobic energy metabolism (fermentation) is not the cause of cancer.
  2. Koch’s glyoxylide does not exist.
  3. Ingestion, infusion, or injection of hydrogen peroxide cannot re-oxygenate the tissues of the body.
  4. Ozone-treated blood infused during autohemotherapy does not kill AIDS virus in vivo. (Green, S. Oxygenation therapy: Unproven treatments for cancer and AIDS. Quackwatch.org)

Ozone therapy has been recommended to treat many conditions. There are numerous anecdotes about successful treatment with ozone therapy, although effectiveness and safety have not been proven scientifically. (Ozone Therapy, Intelihealth article, Natural Standard and Harvard Medical School, 2008)

“Hyperoxygenation” therapy–also called “oxymedicine,” “bio-oxidative therapy,” “oxidative therapy,” and “oxidology”–is a method of cancer management based on the erroneous concept that cancer is caused by oxygen deficiency and can be cured by exposing cancer cells to more oxygen than they can tolerate. The most highly touted “hyperoxygenating” agents are hydrogen peroxide, germanium sesquioxide, and ozone. Although these compounds have been the subject of legitimate research, there is little or no evidence that they are effective for the treatment of any serious disease, and each has demonstrated potential for harm. Therefore, the American Cancer Society recommends that individuals with cancer not seek treatment from individuals promoting any form of hyperoxygenation therapy as an “alternative” to proven medical modalities. (Questionable methods of cancer management: Hydrogen peroxide and other “hyperoxygenation” therapies. CA Cancer Journal for Clinicians. 2008;43(1):47-56.)

There is limited research in veterinary species. A lab animal study of rabbits suggested a benefit for cancer. A couple of recent studies in cows from a single research group in Croatia found a possible benefit of ozone in treating retained placentas and urovagina and in improving reproductive efficiency. An uncontrolled case series in dogs reported improvements in signs of intervertebral disk disease after ozone therapy (though often patients with this disease get better with rest or only supportive care anyway).

As is always the case, there are numerous positive anecdotes claiming dramatic success in treating a wide range of diseases, but for well-established reasons, we cannot rely on these stories as a demonstration that this treatment is safe or effective (c.f. here and here). And there are a few clinical studies suggesting a benefit, all with significant limitations. The balance of the evidence, however, does not support the efficacy of ozone therapy for any condition. Given the miraculous results claimed for this treatment, it would not be difficult at all to generate dramatic clinical trial evidence, so the absence of this evidence, despite decades of use, strongly suggest that the anecdotes and testimonials cannot be trusted.

The underlying theories used to justify the treatment are also dubious. As Dr. Green establishes in his article on Quackwatch, it is not plausible that low oxygen levels are responsible for many of the diseases ozone therapy is supposed to treat, and it is not likely that ozone therapy significantly increases the oxygen available to tissues in a patient that is treated with it. And while the hype about the benefits of antioxidants does not appear justified, it is certainly possible that free radicals and oxidative stress could actually cause health problems in patients treated with a potent oxidizing agent like ozone. Which leads to the question…

Is It Safe?
There are anecdotal reports in the media and in the scientific literature of adverse effects and even death following ozone therapy. Patients have died from gas bubbles in their bloodstream following injectable ozone treatment, and patients have suffered injury from the injection of ozone and from the apparatus used to instill ozone rectally, vaginally, and into body cavities. Accidental infection with HIV and hepatitis virus have also been reported from contamination during autohaemotherapy.

According to one scientific review, “The risks of ozone therapy are played down by its proponents. Yet, numerous reports of serious complications, including hepatitis, and at least five fatalities have been reported.”(Ernst E (2001). A primer of complementary and alternative medicine commonly used by cancer patients. Med J Aust, Jun 4; 174(11): 611-2)

The indirect risk of using ozone therapy, if it is ineffective, is that serious disease can progress and the opportunity to treat with truly effective therapies can be lost if one delays conventional therapy in favor of ozone therapy. The FDA referred to this risk, as well as the more direct hazards mentioned above, when reporting its decision in 2009 to seize equipment used for ozone therapy from a company illegally selling these unapproved medical devices. The FDA considers medical use of ozone as an unapproved drug, which makes such use subject to prosecution.

And as mentioned before, ozone has been intensively investigated as a pollutant, and there are many studies reporting harmful effects in humans and veterinary species.

Bottom Line
The theoretical justifications for the medical use of ozone are weak and unproven. There are equally strong theoretical reasons why such use could be harmful.

Actually clinical research in humans is limited, but there is no consistent body of evidence to suggest ozone therapy is effective for any medical condition. There are anecdotal reports of injury, illness, and death caused by ozone therapy in humans.

The research is even more limited in veterinary species, and there is no consistent body of evidence to support the safety or effectiveness of ozone therapy for disease in dogs and cats.

Medical use of ozone is not approved in the U.S., and there have been prosecutions of individuals selling unapproved medical devices for use in ozone therapy.

Any use of ozone therapy in dogs and cats must be considered experimental and should only be conducted in the context of properly controlled, monitored, and approved clinical research trials. As with all unproven therapies, those selling ozone therapy will claim benefits and deny the risks. But in the absence of reliable information about the effects of ozone treatment, the chances of harming your pet are at least as good as the chances of helping them.

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20 Responses to Ozone Therapy for Pets

  1. Art says:

    When I was little the neighbor kids dad made a ozone maker in his work shop. I was interested in science when little so the dad showed me how he made it and told me how it made you feel better. It apparently did not make him feel good enough because he killed himself soon after. I do not think he went to a doctor about depression.

    Art Malernee dvm

  2. HEIDI says:

    WE HAVE HAD GREAT SUCCESS WITH THE USE OF OZONE THERAPY WITH CERTAIN CANCERS IN CANINES….AND LYME DISEASE AMONG OTHERS!!!

  3. skeptvet says:

    Oh well, in that case… *sigh*

    Consider reading some possible reasons why this is irrelevant.

    Medical Miracles: Should We Believe?

    Why We are Often Wrong

  4. v.t. says:

    Gosh, Heidi, it must be so successful you had to use all CAPS. Typical.

    Btw, who is “we”?

    I suspect you merely skimmed Skeptvet’s article, or happened upon it via google university, so please, do yourself and those poor canine patients and their owners a favor, read Skeptvet’s article completely, and if you are going to be in denial, provide the proof of your claims.

  5. Anya Lobos says:

    I can certainly understand a reluctance to jump on any band wagon. I consider this reluctance healthy, provided it doesn’t go too far. Heidy (above) enthusiastically described — in capital letters, no less — the good results she witnessed pertaining to ozone therapy and pets. The way I see it, the responses that followed (from skeptvet, and also from v.t.) were not only disrespectful and condescending, they were the exact opposite of open-minded and scientific. Why didn’t someone ask Heidy to describe her experience with ozone therapy?
    Maybe Heidy is a “zealot.” Certainly there are plenty of over-the-top “believers” in the world. But what if Heidy isn’t one of those? Or what if — in spite of excessive zeal — she has stumbled upon something legitimate? When it was first postulated that oranges could bring a halt to scurvy, there were many who thought this suggestion was ridiculous. Certainly I have no idea whether ozone therapy is beneficial or not. I figure that time will tell — that is, if supposedly scientific minds will at least persist in their efforts to be open minded , rather than all too quickly putting on their scientific blinders.

  6. skeptvet says:

    There is nothing open-minded about accepting anecdote as high-value evidence, and nothing closed-minded about asking for better evidence before accepting a claim. If someone writes that magic cured their pet, would it be closed-minded not to ask them to describe their experience with magic? And what the heck are “scientific blinders?” If you mean scientific evidence is considered better than other kinds of evidence, well yes it is. The privileging of science over story telling is what has dramatically improved the length and quality of human life in the last couple of centuries beyond anything accomplished in the millennia before.

  7. v.t. says:

    Anya, I get rather defensive when fly-by posters make grand claims with absolutely no evidence to back them up. Worse, the dubious claims of one therapy capable of helping or “curing” many other serious diseases in pets, particularly cancer. These are the very hallmarks of quacks.

    When the “brave mavericks” can bring forth indisputable evidence, we can all eat crow. Until then, do you think we should all just sit idly by and accept their claims without challenging for evidence? Do you think it is ethical to put pseudoscience into practice concerning animals – you know, those vulnerable ones who cannot voice their concerns, and give informed consent? As stewards of animals and pets and their care, it is incumbent upon us to do right by them by practicing sound, effective, safe and proven medical therapies. To do otherwise is utter failure as stewards.

  8. Donna Marie says:

    First I want to say that I have studied traditional naturopathy and nutrition. I believe in alternative therapies because they work. However, if a therapy doesn’t show results, then I am skeptical. My dog had bladder stones four years ago and needed surgery. I went to a holistic vet. His diet was changed to be Ph balanced and he was given herbs and acupuncture treatments. That was 4 years ago and the bladders stones are gone. However, I don’t believe the acupuncture had anything to do with his healing. I believe it was a waste of my money, stress for my dog, and a money maker for the Vet. He also had chiropractic every few months which I am not sure did anything either. I believe the diet worked because stones are created when the diet is either too alkaline or too acidic.
    Now my dog, who is almost 15 (mini-schnauzer), has tumors on his spleen and liver and is anemic. The holistic vet wants to do ozone therapy, acupuncture, chiropractic, and herbs. Sounds like a big money making deal for the Vet. I let him do one ozone therapy and thought it was a joke. It was done rectally and just looked like he was putting nothing into his rectum. My poor dog was so stressed. He was also given vitamin B-complex with iron. I am giving him herbs to support his liver and health based on my knowledge of nutrition. My dog has much more energy and appetite after just a couple of days. Was it the ozone, B-complex, or the herbs? I believe it was not the ozone but the Vet believes it WAS the ozone. I told him I believed it was the vitamins and herbs. Well, he makes little money on the vitamins. All I know is that my dog is almost 15 and doesn’t have a whole lot of time left. I am not going to subject him to chiropractic, acupuncture, and ozone that I don’t believe is doing anything but stressing him. I will continue giving him the vitamins and herbs and whatever food he wants to eat (which oddly happens to be salmon, seaweed, and a variety of treats). The only good I see coming out of these other procedures is my time, stress for my dog, and money flying out of my bank account. The ozone is $44, acupuncture $44, and office fee $10. If I did this every week, it would cost me $98 a week. I don’t believe in chemo either. Another money making therapy for doctors and Vets.

  9. skeptvet says:

    Everyone is entitled to their own opinion, but not their own facts. There actually are facts, you know, not just opinions. And unfortunately, anecdotes do nothing to help us establish the facts. For thousands of years people decided how to preserve health and treat disease based on exactly thee kinds of anecdotes and experiences. And for thousands of years, we made no improvements in life expectancy, infant mortality, maternal mortality, infectious disease, etc. Thousands of years of failure. Then in the centuries since we began using science, unprecedented success. But sadly, in only a couple of generations people have forgotten all this history and gone back to trusting their own experiences and believing in magic while rejecting science. Truly sad.

    History

    More History

  10. Donna Marie says:

    Your chart doesn’t prove anything. The reason for early death prior to “science” was the high rate of infant mortality and infectious diseases. Granted that science was involved in reducing infant mortality and infectious diseases but that is not the whole story. Your chart doesn’t take into consideration quality of life with people living much older.
    I also didn’t disagree with you on acupuncture and chiropractic if you read my comment all the way through. I only disagreed with you when it came to healing through food and supplements. I would rather take care of my health naturally then rely on drugs or surgery. I got ulcers from taking NSAIDs (very dangerous drugs) to get rid of headaches and almost ended up in the hospital. I now take supplements (magnesium, GABA, L-theanine, 5-HTP, and a few herbs). Not only do I not have headaches or ulcers, my mood has improved. I have seen food and supplements works wonders in family, clients, and my pets. How do you argue results? I don’t need a double blind study. Besides, many supplements have been proven effective through double blind studies.
    That being said, I am grateful for your post on ozone therapy. I do have a question on ozone. If the FDA has not approved ozone therapy, how is it so many alternative practitioners and veterinarians are able to use it? Are they doing this illegally? I don’t get it. When my vet recommended ozone, I thought it was an approved therapy. Please explain.

  11. skeptvet says:

    Your chart doesn’t prove anything. The reason for early death prior to “science” was the high rate of infant mortality and infectious diseases. Granted that science was involved in reducing infant mortality and infectious diseases but that is not the whole story.

    It is not intended as proof but as an illustration. There is an enormous volume of historical data that shows unprecedented improvements in human health associated with the advent of the scientific method. This is also true in modern times when scientific practices in nutrition, sanitation, and healthcare are brought to impoverished countries previously not able to take advantage of them. It is really pretty close to incontrovertible that science has enabled us to achieve an understanding of nature, and an ability to manipulate it, more effective than anything we were able to achieve using pre-scientific methods over the preceding millennia. Science works in a way nothing else does, and there is great danger in relying on anecdote, history, tradition, trial-and-error, “common sense,” and all the myriad of other non-scientific processes of trying to understand health and disease. To say “natural” things (a nearly meaningless term) are safer than surgery or drugs is simply and demonstrably untrue, and this kind of thinking leads to great harm. What, besides science, would you credit with the doubling of average life expectancy, the dramatic decrease in infant and maternal mortality, the dramatic decrease in morbidity and mortality from infectious disease, trauma, acute poisonings, and all the other things science has help us control?

    Now, the question of whether people are better off living longer is a separate one. I, for one, and glad to be nearing 50 and to be healthy than most people throughout history could have hoped to be in their twenties, and to have the prospect of several more decades of good quality life. I do think we handle the end of life terribly, in medicine and in our culture as a whole, and I encourage everyone to read Atul Gawande’s latest book Being Mortal which illustrates just how awfully modern medicine deals with dying. But none of that has anything to do with whether or not science has given us greater control over our health and greater understanding of nature that any other method. What we choose to do with that control and understanding is another question.

    To answer your legal question, there are no FDA-licensed medical applications of ozone therapy for humans or animals, and using such therapies is illegal. The FDA has limited resources, but it has, in the past (most recently 2010) sent law enforcement agents to seize ozone generators used for medical purposes in humans. The FDA routinely ignores illegal veterinary activities in general unless they present a significant harm to humans or a lot of people complain about them. So practitioners get away with using these therapies despite the lack of scientific evidence because we simply don’t have the political will in the U.S. to enforce the laws that do exist to protect the public from unproven medical treatments.

  12. Donna Marie says:

    Thanks. I understand where you are coming from in regards to science and health. Science certainly has its place. Surgery, especially, has allowed people to live much longer. Pain medications have allowed people an easier time after surgery and during healing. Depending on medications to live, however, instead of taking care of oneself is a poor way to live. Taking statins and high blood pressure pills instead of exercising and eating right has become the norm.
    Being Mortal sounds like a good book. I just put it on hold at my local library.
    As for ozone therapy being illegal, you’d never know it around here. Many holistic doctors use it. Most people assume it is legal if it is offered as a service because who would take that risk? I’m shocked.
    One more question. My dog started on b-complex with iron to help his anemia one week ago. My vet wants to do another blood test tomorrow to see if the vitamins are working. I know he’s going to try to convince me to do the ozone and acupuncture (which I won’t) but that’s beside the point. I told him my dog’s energy has increased quit a bit. You’d never know he is sick. So I believe his vitamins are working. Isn’t one week a little early to test especially since his energy has picked up? I hardly think after only one week the vet is going to tell me to give him less of the vitamins. I could understand retesting this soon if his energy was the same or less. Then maybe he would recommend a higher dose. Wouldn’t it make more since to wait another week if all seems well?

  13. skeptvet says:

    Vitamins, like any other therapy, need to be used rationally. Anemia can be caused or made worse by deficiency of B vitamins and iron, but these are pretty rare causes in dogs. If the anemia is related to a deficiency, then the vitamins will help, but you’re right they should take weeks to have a significant impact. If there is no deficiency, then the vitamins won’t do anything. B vitamin deficiency is usually related to chronic GI disease, and it is possible to measure B-vitamin levels and determine if supplementation is needed (by injection, since oral supplements won’t work if the reason for a deficiency is a problem with GI absorption). Iron is harder to measure accurately, so it’s harder to know if this is part of the problem. Unlike B vitamins, which are excreted in urine and very hard to overdose, it is possible to give too much iron, so we have to be careful about that as well.

    So whether these therapies are of any use here depends on a number of factors Obviously, I can’t evaluate that for your dog, but these are some of the issues you should be talking about with your vet.

  14. Donna Marie says:

    Thank you soooo much for the response. I do not think he has a deficiency of b vitamins and iron. Just before he was tested (he had a PCV of 23 from a normal of 45-50), he had lots of blood in his feces for a few days. He also has small tumors on his spleen and liver. The Vet believes that the loss of blood was probably due to one of the tumors leaking blood. The bloody diarrhea developed about a month after he had dental surgery. He was on antibiotics after the surgery so I was thinking he developed c. difficile or colitis or some other GI problem as a result. Could a loss of blood over a few days cause anemia? If so, once corrected, could the iron be harming him or would it have to be long term iron intake? I did cancel my appointment for today thinking it was not enough time but the Vet wants to reschedule for Monday. Maybe I should because if it is true anemia or he is slowly losing blood due to a tumor (the Vet’s opinion), then the numbers should decrease or increase only slightly. However, I don’t believe that is the case since his energy and appetite has increased to about 75 to 80 percent of normal. If it was due to some temporary GI problem from the surgery or antibiotics (my guess), could or would his PCV increase more than a few percentage points? What do you think? Sorry, is it OK that I ask you these questions? You obviously know your stuff.

  15. v.t. says:

    Donna Marie,

    The CBC accompanied by the option of an ultrasound should help your vet determine what the anemia is from – (it could be the spleen) – either way, I’d strongly suggest seeing another vet (not holistic) so that such vet can focus strictly on the blood problem and hope to correct/manage it properly. When you’re dealing with tumors on vital organs and whenever the spleen is compromised, you really have to take this seriously, with serious action (not supplements, herbs, ozone therapy, acupuncture etc).

  16. skeptvet says:

    If he is losing blood in the GI tract, that certainly can cause anemia, and potentially iron deficiency if enough blood is lost and depending on appetite and iron intake. Supplementation is usually most useful with chronic anemia, though large volume blood loss can cause a deficiency of iron over a shorter time. A PCV of 23 is pretty low, so that suggests either a lot of blood loss or some other underlying problem. It should be possible to determine if GI loss of blood is the cause of the anemia, if the anemia is regenerative (the body is making new red blood cells to replace those lost) with appropriate testing. Short-term supplementation of reasonable amounts of iron shouldn’t be harmful, but I agree with V.T. that a thorough workup and consistent management, along with good communication, is what your pet needs. Your vet may be able to provide all of these, but the recommendations of things like ozone is a red flag.

  17. Donna Marie says:

    No, I already paid for one ozone treatment and thought it was a joke. This was before I searched online for studies and information like your website. I wish I had come across your website 4 years ago before I went to go see a holistic vet. I would have saved a lot of money and time. He did help with my dog’s bladder stones but like I said before, a change in diet and monitoring of his urine Ph was all I needed. But I spent about $1,000 on acupuncture and chiropractic treatments. A vet who does not perform surgery is not going to make as much money just by telling people to change their dog’s diet and see them for annual check ups. So for $45, the vet spends two minutes putting needles in your dog, setting a timer and walking out of the room for 20 minutes. With four rooms, he can literally make almost $400 an hour. That does not include the office fee and whatever herbs you are prescribed at a significant mark up. Actually this Vet told me he makes much more money as a holistic vet then he ever did when he practiced conventionally. Plus there’s less stress because he doesn’t perform surgeries or euthanize. He had me convinced about the acupuncture when I met the owner of a dog that he helped walk again that was paralyzed. The dog didn’t walk very well but he did walk. According to the owner, the dog had acupuncture every week for years. That is about $200 a month. Yes, I am done with acupuncture and chiropractic for any dogs I may be blessed to have in my life. I’ve never even had an acupuncture treatment myself so I am not sure why I allowed a vet to use it on my dogs. I have used chiropractic with mixed results. I believe the days it seemed to work was when the chiropractor was using a roller that loosened the muscles along the side of my spine and legs. It was more like massage. So maybe the next time my back or neck hurts, I should get a massage instead. If anything, a massage lasts longer, is relaxing, and is more enjoyable. Thanks again. 🙂

  18. john butrico says:

    My min pin 8 yr was diagnosed with spinal degenerative disorder (9 locations).
    He was given anti inflajmatories, acupuncture for slghtly weakened rear legs. He did well, but then suddenly lost function of front legs. He did not have deep pain loss. MRI showed cyst in cervical spine. It invaded the spinal cord, surgery was done 3 wks agol. He now receives PY, but he still cannot stand or walk. All we are told is he may getback function over time. What are his chances? And what therapies may we try?

  19. skeptvet says:

    I’m afraid this is a big question, and I can’t really offer specific advice for individual pets. Your first source of information should, of course, be the veterinarians caring for your pet. If you have questions about the evidence regarding specific therapies, I can sometimes comment on that if there is any literature available.

    Good luck!

  20. Ryder says:

    I think your chart actually points at the use of fossil fuels as the turning point in mortality rates.

    And this is something we still see today… when a group adopts fossil fuel usage on a large scale…. mortality rates improve drastically… very much “post science”.

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