O₃ Yeah! Exploring Ozone Therapy in Veterinary Medicine

A few months back, I worked in a practice that used ozone therapy on EVERY patient! I had never heard of it before, but I was immediately intrigued and fascinated by its potential applications.

What I found out was that Ozone (O₃) therapy is increasingly making its way into integrative and holistic veterinary practices as a tool to support healing, reduce inflammation, and manage chronic conditions in dogs and cats. As an open-minded general practitioner, I’ve seen how clients are seeking complementary treatments that support their pets’ overall wellness—and ozone therapy is one that continues to gain traction. But what exactly is it, and where does it fit in the veterinary toolbox?

What is Ozone Therapy?

Ozone is a molecule composed of three oxygen atoms. In medicine, it’s generated by passing medical-grade oxygen through an ozone generator, creating a reactive form of oxygen. When used properly, ozone therapy has antimicrobial, anti-inflammatory, and immunomodulatory effects. It’s been used in human medicine for decades, and veterinarians practicing integrative medicine are adapting these applications for our patients.

How It Works

Ozone therapy works by leveraging controlled oxidative stress to stimulate biological responses. Ozone (O₃) is highly reactive and, upon contact with body tissues or fluids, rapidly breaks down into oxygen (O₂) and a single reactive oxygen atom. This single oxygen atom reacts with lipids, proteins, and other substrates, generating secondary messengers such as ozonides, lipid oxidation products (LOPs), and reactive oxygen species (ROS), which are central to its therapeutic effect.

These LOPs and ROS serve as signaling molecules that:

• Modulate the immune system: Low doses of ozone can upregulate antioxidant enzyme systems (e.g., superoxide dismutase, catalase, glutathione peroxidase), increasing oxidative resilience and shifting cytokine expression toward an anti-inflammatory profile (Bocci, 2006).
• Improve oxygen metabolism: Ozone enhances glycolysis and the Krebs cycle, improving ATP production. It also increases 2,3-DPG in erythrocytes, facilitating greater oxygen release to tissues.
• Exert antimicrobial effects: Ozone disrupts bacterial cell walls, capsid proteins in viruses, and fungal membranes through oxidation of phospholipids and lipoproteins. It’s broad-spectrum, non-specific, and does not induce resistance (Elvis & Ekta, 2011).
• Support microcirculation: Ozone promotes vasodilation and enhances nitric oxide pathways, improving perfusion in hypoxic or inflamed tissues.
• Activate pain-relief pathways: Through oxidation of nociceptive mediators and modulation of prostaglandins, ozone may contribute to local analgesia, especially when administered intra-articularly or near nerve roots.

Due to its biphasic dose-response (hormesis), ozone must be administered at precise concentrations—typically between 10–40 μg/mL depending on the route and indication—to avoid overt oxidative damage while achieving therapeutic benefit. The key is using ozone as a biological modulator rather than a direct pharmacologic agent.

How Is It Used in Veterinary Medicine?

Ozone therapy can be administered in several ways, including:

• Rectal insufflation – a common route for systemic effects
• Subcutaneous or intramuscular injection – often combined with fluids or other biologics
• Ozonated saline or water – used for flushing wounds or during dental procedures
• Topical ozonated oils – helpful for dermatologic issues and wound healing

Clinical Applications in Dogs and Cats

Holistic and integrative veterinarians are using ozone therapy in a wide range of clinical scenarios:

• Infectious disease support: Ozone has documented bactericidal, antiviral, and antifungal properties. It’s been used adjunctively for chronic otitis, stomatitis, kennel cough, and even parvovirus (Zien, 2021).
• Arthritis and musculoskeletal pain: Its anti-inflammatory and analgesic effects can benefit pets with osteoarthritis or intervertebral disc disease, especially when NSAIDs aren’t tolerated (Tasi et al., 2020).
• Dental procedures: Ozonated saline can reduce oral bacterial load during dental cleanings and extractions.
• Wound care and dermatology: Topical application of ozonated oils or water can accelerate healing and reduce infection risk in chronic or surgical wounds.
• Cancer support: While not curative, ozone therapy may help stimulate immune function and improve quality of life in palliative care settings.

Is It Safe?

When administered appropriately by trained professionals, ozone therapy is considered safe with minimal side effects. It’s important to note that direct inhalation of ozone gas is toxic, which is why administration techniques and equipment matter. Veterinarians using ozone undergo specific training to ensure patient safety and effective dosing. Below is a list of places you can go for training.

Final Thoughts

At IndeVets, we support clinical excellence and staying informed on all modalities—conventional and integrative—that can improve patient outcomes. While ozone therapy isn’t part of every GP’s daily practice, it’s becoming a valuable adjunct in clinics offering holistic care. Whether you’re referring a case or expanding your own services, understanding these emerging tools helps us all provide better care.

Several reputable training programs offer ozone therapy certification specifically for veterinarians or integrative practitioners. Here are the most widely recognized options:

• American Academy of Ozonotherapy (AAO) – Veterinary Ozone Certification
  • Course: Veterinary Ozone Therapy Certification Program
  • Format: In-person (with some virtual options for theory)
  • Focus: Teaches ozone physiology, safety, dosing, and administration techniques specific to dogs, cats, and horses. Hands-on modules are included.
  • Website: www.aaot.us
  • Notes: One of the most established and medically rigorous organizations. Led by MDs and DVMs with clinical experience.
• Ozone Without Borders – Veterinary Ozone Therapy Course
  • Course: Ozone Therapy for Veterinarians
  • Format: Online modules + live webinars
  • Content: Covers ozone mechanisms, administration routes, case studies, and protocols for small and large animals.
  • Website: www.ozonewithoutborders.ngo
  • Notes: Global nonprofit organization that promotes ozone education. Their content tends to be more accessible and holistic.
• International Veterinary Ozone Association (IVOA)
  • Course: IVOA Training Series
  • Format: Online learning with options for advanced certification
  • Content: Emphasizes safety, patient selection, clinical protocols, and equipment use.
  • Website: www.ivoa-vet.org
  • Notes: Exclusively veterinary-focused, with growing global membership and clinical library access.
• American College of Integrative Veterinary Therapies (CIVT)
  • Course: Ozone Therapy Introduction and Application for Veterinarians
  • Format: Online, self-paced
  • Website: www.civtedu.org
  • Notes: CIVT is a trusted source for holistic veterinary education. Their ozone course is beginner-friendly and evidence-based.

Equipment Vendors (with training included)

Some medical ozone equipment suppliers, like Longevity Resources Inc. or Promolife, also offer DVM-focused training when purchasing machines. These are helpful for learning machine operation and protocols but don’t always offer comprehensive clinical education.

Sources:

• Zien, J. (2021). Veterinary Applications of Ozone Therapy. International Veterinary Ozone Association.
• Tasi, J., et al. (2020). “The Efficacy of Ozone Therapy in Veterinary Medicine: A Review.” Journal of Veterinary Integrative Sciences, 14(2), 45–53.
• Bocci, V. A. (2006). 
  Scientific and medical aspects of ozone therapy. State of the art.
  Archives of Medical Research, 37(4), 425–435.
  [https://doi.org/10.1016/j.arcmed.2005.08.006]
• Bocci, V. A., Borrelli, E., Travagli, V., & Zanardi, I. (2009). 
  The ozone paradox: Ozone is a strong oxidant as well as a medical drug.
  Medicinal Research Reviews, 29(4), 646–682.
  [https://doi.org/10.1002/med.20150]
• Elvis, A. M., & Ekta, J. S. (2011). 
  Ozone therapy: A clinical review. 
  Journal of Natural Science, Biology and Medicine, 2(1), 66–70.
  [https://doi.org/10.4103/0976-9668.82319]
• Menéndez, S., et al. (2008). 
  Ozone therapy in medicine and dentistry. 
  Journal of Contemporary Dental Practice, 9(4), 75–84.
• Viebahn-Hänsler, R., León Fernández, O. S., & Fahmy, Z. (2012). Ozone in medicine: The low-dose ozone concept—Guidelines and treatment strategies. 
  Ozone: Science & Engineering, 34(6), 408–424.
  [https://doi.org/10.1080/01919512.2012.717847]

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Dr. Andrew Heller
Veterinarian | IndeVet #1 | Cofounder, IndeVets
andrew@indevets.com | www.indevets.com