As part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, held with the sponsorship of Kito Healthy Pet Food Ecosystem, we have compiled the key takeaways from the session titled “Ozone Therapy in Companion Animals with Veterinarian Batuhan Natur.” We sincerely thank Dr. Natur for his valuable presentation.
During the seminar, Dr. Batuhan Natur covered both the scientific foundations of ozone and how it should be applied in clinical settings in a correct and safe manner. The core message of the session was clearly summarized in two essential statements:
- Ozone therapy is not the same as “room ozonation” or “air disinfection.” Medical application is fundamentally different.
- Dosage is everything. When the dose is correct, it is therapeutic; when incorrect, it can be toxic.
What Is Ozone? Why Is the Term “Medical Ozone” Emphasized?
Ozone (O₃) is a gas composed of three oxygen atoms and has strong oxidative properties. Due to its unstable structure, it rapidly decomposes into O₂ and releases a free oxygen atom. This free oxygen atom is the primary source of ozone’s biological effects.
Key characteristics include:
A distinct sharp odor (often described as the “earthy smell” after a thunderstorm).
Approximately 10 times higher solubility in water compared to oxygen.
A short half-life; at room temperature, it loses activity within 20–30 minutes.
📌 For this reason, ozone is not prepared in advance and stored; it must be generated immediately before administration, next to the patient.
Critical safety note:
The only area where ozone must not be applied is the respiratory system and lungs. Inhalation is toxic.
Brief Historical Overview
1839: Discovery of ozone
1840s: Use in operating room disinfection
World War I: Significant role in the management of gangrene
One of the key pioneers of modern medical ozone therapy: Bocci
A Medical Ozone Generator Is Essential (Industrial Devices Are High-Risk)
One of Dr. Natur’s strongest warnings concerned device safety:
✅ Medical ozone must be generated using certified medical-grade equipment.
❌ Industrial ozone generators or concentrator/air-based devices are not appropriate for medical use.
Why?
When ozone is produced from ambient air, nitrogen oxide derivatives may form, which can cause both respiratory and systemic toxicity.
A proper medical ozone device should:
Operate using a medical oxygen cylinder.
Deliver a controlled and measurable concentration range.
Safe concentration range:
✅ 1–80 gamma (µg/mL)
Key risk point:
Industrial devices often produce ozone in grams, which may reach lethal levels.
📌 Device calibration is also critical:
A deviation of ±1 gamma may be acceptable; anything beyond that is considered unsafe. Therefore, annual servicing and calibration are mandatory.
How Does Ozone Act in the Body?
When ozone is introduced into the bloodstream, two key “messenger” groups are generated:
- ROS (Reactive Oxygen Species)
- LOP (Lipid Oxidation Products)
These substances activate the NRF2 pathway within cells and stimulate antioxidant defense gene expression.
✅ Primary Clinical Effects of Ozone
Induces controlled oxidative stress
→ Activates and strengthens endogenous antioxidant defense mechanisms.
Enhances circulation and oxygenation
Facilitates oxygen release from hemoglobin → improved tissue oxygenation.
Increases nitric oxide release from the endothelium → supports microcirculation.
Modulates immunity (dose-dependent)
Low dose → immune activation and antioxidant reinforcement
High dose → cytokine suppression and immunosuppressive effect
Supports tissue repair
Enhances collagen synthesis → accelerates wound healing
May increase mitochondrial ATP production → supports general recovery and well-being
Dosage Principles (The Most Critical Segment of the Seminar)
Dr. Natur categorized clinical dosing as follows:
- 10–20 gamma: Oxygenation, tissue repair, support in gangrene/ischemia
- 20–30 gamma: General recovery dose, organ damage support, systemic rehabilitation
- 40–50 gamma: Antiviral/antimicrobial effects; autoimmune and allergic conditions
- 60–70 gamma: Severe viral burden + acute rectal bleeding control
- >80 gamma: Cytotoxic → not used therapeutically
📌 Cancer cases:
In his clinical practice, Dr. Natur typically stays at 10 gamma and does not exceed 20 gamma.
Routes of Administration
Ozone can be administered through multiple routes except via the lungs.
Major Autohemotherapy (Ozonation of Blood)
- 50–250 mL of blood is drawn
- Mixed with an equal volume of ozone gas
- Immediately reinfused intravenously
- Requires 8–15 sessions (2–3 times per week)
Clinical applications: infections, circulatory disorders, oncology support, autoimmune diseases, organ insufficiencies, diabetes.
Important materials note:
Ozone-resistant tubing and syringes must be used (glass/teflon/siliconized).
Standard plastic syringes and infusion sets may pose a microplastic release risk.
Rectal Insufflation (Systemic and Practical)
One of the most practical systemic approaches in small animals. More sessions may be required compared to major autohemotherapy.
Recommended volumes:
- Cats: 20–30 mL
- Small dogs: 30–60 mL
- Medium–large dogs: 60–150 mL
📌 Rapid administration or excessive volume may increase the risk of colon distension or rupture.
Minor Autohemotherapy (“Ozone Vaccine”)
- 2–10 mL of blood is drawn
- Mixed with an equal volume of ozone
- Administered SC/IM
This may be considered a nonspecific immune-supportive approach and may be preferred for allergic, viral, and dermatologic autoimmune conditions.
Bag/Cup Ozonation (Local Application)
Commonly used for chronic or infected wounds.
The wound and the interior of the bag are moistened (ozone is ineffective on dry surfaces).
The bag is vacuum-sealed.
Ozone is introduced for 15–20 minutes.
Dosage strategy:
- Infected phase: 70–80 gamma
- Healing phase: 20–30 gamma
Local Injections
May be administered intramuscularly, perilesionally, paravertebrally, or at acupuncture points. Typically 10–20 gamma in small volumes (0.1–0.3 mL).
Intra-articular applications:
Used for OA, arthritis, meniscal conditions, etc. For acute cases, ozone is recommended first, followed by PRP.
Dr. Natur noted that combining PRP with ozone may enhance PRP efficacy.
Intradiscal / Foraminal Ozone (Notable in Neurology)
This was one of the most striking sections of the seminar.
Within the intervertebral disc, ozone may:
- reduce inflammation
- decrease disc volume by facilitating dehydration
- reduce pain
Dr. Natur shared cases where paraplegic dogs regained the ability to walk within weeks, including a chronic paraplegic case of six months’ duration that stood again within 45 days.
Protocol approach:
First-line: paravertebral/foraminal ozone (less invasive)
If no response within 3–5 days → intradiscal ozone (general anesthesia + fluoroscopic guidance)
Where Can Ozone Therapy Be Effective?
Ozone therapy has a wide range of clinical applications in veterinary practice, including:
- Viral diseases (e.g., parvovirus, distemper)
- Dermatology (atopic dermatitis, chronic otitis, wound management)
- Orthopedics (OA, tendon and meniscal disorders)
- Neurology (disc herniation, epilepsy support)
- Diabetic wounds and gangrene
- Supportive care in kidney/liver insufficiency
- Autoimmune and rheumatic diseases
- Gynecological infections such as mastitis and endometritis (supported in the literature)
Critical Warning Regarding “Ozonated Serum”
At the end of the session, Dr. Natur emphasized an important caution:
❌ Ozonating isotonic solutions/serum is not true ozone therapy.
When ozone reacts with isotonic fluids, sodium hypochlorite may form, shifting the procedure toward a chemical effect (similar to bleach-like reactions) rather than biological ozone therapy.
Conclusion: Ozone Is Not “Alternative”—It Is a Powerful Clinical Tool When Used Correctly
The clinical impact of ozone therapy can be substantial when applied under appropriate conditions:
✅ With the right device, correct dose, and proper materials, ozone may:
- help control infections
- support circulation
- accelerate regeneration
- reduce pain
- modulate immune function
❌ With an incorrect device or uncontrolled dosing, it may:
- become toxic
- cause more harm than benefit
The clinical summary of the seminar was captured in the following statement:
“Ozone is not a cure-all, but with the right protocol it can provide significant support in many conditions.”
We will continue sharing key takeaways from VetSummit 2025 sessions under the sponsorship of Kito Healthy Pet Food Ecosystem. We look forward to meeting you again in upcoming content designed to support your clinical practice.
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