Photo courtesy Bionet The next evolution in patient care Oxygen therapy has long been the cornerstone of emergency and critical care in veterinary medicine. Whether stabilizing a bulldog in respiratory distress, monitoring a geriatric cat after anesthesia, or supporting a rabbit with pneumonia, the ability to deliver oxygen in a controlled, stress-free environment often determines a patient’s outcome. For many years, general practices have relied on flow-by oxygen methods or makeshift kennels. These improvised solutions served a purpose, but as expectations around safety, recovery, and clinical consistency continue to rise, they are rapidly becoming outdated. Today, purpose-built ICU chambers with integrated ventilation, temperature regulation, and infection control are no longer reserved for specialty or referral hospitals. They are increasingly found in general practices, where they are reshaping both clinical outcomes and business performance.⁵ For hospital owners, medical directors, and veterinary investors, ICU chambers are more than a tool of care. They are a signal of quality, a driver of efficiency, and a tangible return on investment. The clinical imperative: Hypoxemia is widespread Research consistently shows that oxygen desaturation (hypoxemia) is common, even among healthy veterinary patients. A 2024 prospective study published in The Veterinary Journal found 26 to 28 percent of healthy dogs experienced hypoxemia (PaO₂ <80 mmHg) after extubation. The study also identified an SpO₂ below 95 percent as the most reliable indicator of hypoxemia, demonstrating 100 percent sensitivity and 97 percent specificity.1 Several risk factors were noted, including dorsal recumbency, higher body condition scores, lack of positive end-expiratory pressure (PEEP), and the use of high inspired oxygen (FiO₂ = 1). These findings underscore how frequently oxygenation challenges arise—even in routine recoveries. In response to this growing awareness, the American Veterinary Medical Association (AVMA)/ American College of Veterinary Anesthesia and Analgesia (ACVAA) 2025 update calls for continuous monitoring of oxygenation, ventilation, and temperature, supported by appropriate equipment and staff training.4 Today’s ICU units offer consistent oxygen levels that support clinical guidelines while minimizing stress and repeated handling. Artemis and Motown testing out wireless monitoring connectivity inside the ICU system. Photo courtesy Bionet ICU systems: Beyond oxygen delivery Modern ICU systems offer a suite of features that directly address clinical guidelines and patient needs. They deliver consistent oxygen concentrations that remain stable throughout treatment, reducing the need for repeated handling and minimizing stress for both patient and staff. Active carbon dioxide removal prevents dangerous buildup within the enclosure and eliminates the need for soda-lime absorbents. Integrated heating and cooling systems maintain normothermia, a critical factor for anesthetized animals and for patients recovering from heatstroke. Increased humidity helps protect delicate airways from irritation during recovery, while smooth, bacteria-resistant interiors and glove ports enhance infection control by minimizing the risk of cross-contamination. Equally important, these enclosures create a quiet, low-stimulation environment that reduces anxiety for cats, brachycephalic breeds, and exotic species. Together, these capabilities make ICU systems indispensable components of modern veterinary medicine rather than specialized or optional equipment. Versatility across practice types ICU systems bring measurable value to a wide variety of practice models, from single-location clinics to corporate networks. In general practice, they support routine recoveries following procedures such as dentals, spays, and neuters. With up to one in three dogs desaturating after anesthesia, supplemental oxygen is becoming a standard part of safe recovery.1 Senior pets, especially those with undiagnosed cardiopulmonary disease, experience smoother and safer stabilization. Exotics, such as rabbits and birds, recover better in controlled, low-stress environments. In specialty and referral hospitals, ICU systems provide essential support during more complex or high-risk cases. Bulldogs and pugs benefit from pre- and post-intubation stabilization during brachycephalic airway crises, and cats suffering from congestive heart failure can receive oxygen therapy without the need for restraint. For critical trauma patients recovering from smoke inhalation, sepsis, or pulmonary contusions, the precise control of FiO₂ levels and temperature can make a lifesaving difference. For corporate and group practices, ICU adoption supports consistency of care across multiple hospital locations. These systems demonstrate a clear commitment to “human-grade” safety and clinical standards, reinforcing each practice’s reputation for excellence and patient-centered medicine. The veterinary team at the Southern Ocean Animal Hospital in Tuckerton, NJ, usesa Smart ICU setup, which provides stronger oxygen performance to patients. Photo courtesy Bionet The business case: Tangible ROI For veterinary practices, the value of ICU chambers extends beyond improved outcomes. These systems drive hard-dollar returns that impact the bottom line in measurable ways. Retained revenue. When a patient must be transferred elsewhere for oxygen therapy, the practice loses not only income for that case but also often the client’s long-term loyalty. Maintaining in-house ICU capacity allows clinics to keep high-value cases under their own care. In many practices, a single overnight oxygen hospitalization can generate between $1,200 and $1,800 in revenue that would otherwise walk out the door. Improved operating expenses. ICU chambers utilize oxygen more efficiently than flow-by methods.⁵ With active carbon dioxide removal systems, the need for soda-lime absorbents is eliminated altogether, cutting recurring supply costs. Staff efficiency. Stable enclosures allow a single technician to monitor multiple patients safely, minimizing hands-on intervention and freeing up valuable nursing time. Especially in a labor-constrained environment, this operational flexibility becomes a force multiplier. Just as important is the effect on client trust and treatment acceptance. Pet owners are increasingly informed about what recovery should look like. Offering a highly visible standard of care that mimics human medicine, builds confidence, and strengthens loyalty. It also differentiates the hospital in a competitive landscape, making it easier to market a brand known for medical excellence and patient-first design. Why invest now Several converging forces make the case for ICU adoption more urgent than ever. The ongoing “brachycephalic boom” has introduced a surge of patients that are especially prone to airway emergencies. With French bulldogs now topping the charts as the most popular breed in the U.S., veterinary teams are encountering more heatstroke cases, post-operative respiratory events, and airway crises than ever before. ICU systems offer the controlled environments these patients require, pre- and post-intubation. At the same time, the number of households owning exotic pets—rabbits, guinea pigs, birds—is climbing steadily. These animals are notoriously fragile under anesthesia and benefit greatly from low-stimulation recovery conditions with precise thermal and oxygen control. Client behavior is changing, too. Today’s pet owners are increasingly aligned with the standards of human healthcare. They expect visible investments in patient safety and comfort. For a growing number of clients, the presence of ICU systems in a hospital is not just reassuring, it is expected. Larger groups and consolidators are also seizing this moment. For these organizations, ICU systems are not only a tool for care but a strategic business decision. Their installation across a network signals a commitment to consistency, quality, and innovation. In every case, the message is clear: the longer a practice waits to adopt ICU technology, the more ground it cedes—to competitors, to rising client expectations, and to changing medical standards. Overcoming barriers to adoption Despite the compelling clinical and business case, many practices hesitate to implement ICU systems due to three primary concerns: cost, training, and space. However, in today’s veterinary landscape, each of these hurdles is more manageable than ever. Upfront cost remains the most cited concern. Yes, ICU chambers require capital investment, but their daily use makes the return on that investment both rapid and substantial. By reducing patient transfers, cutting down on oxygen waste, and eliminating the need for certain consumables, practices begin to see value from day one. When amortized over even a few years of usage, the cost becomes less of a burden and more of a budget-friendly infrastructure upgrade. Staff training is another challenge, particularly in practices where ICU use is still viewed as “specialty medicine.” However, with the right onboarding, teams can quickly normalize ICU systems as part of routine post-operative recovery, rather than just emergency care. Most vendors provide on-site or virtual training, and because the technology is designed to be intuitive, integration into daily workflow is fast and frictionless. Space limitations are no longer a barrier. Modern ICU designs are modular and compact, allowing even small clinics to incorporate a single system into their floor plan. For larger hospitals and corporate groups, scalable systems can be installed to manage high patient volumes efficiently without consuming excessive space. The key is not to wait until a crisis forces the investment. It is to build it into standard care now—before clients, patients, or competition demand it. ICU systems offer crucial support for high-risk patients like pugs during brachycephalic airway crises. Photo courtesy Bionet Conclusion: From specialty to standard Controlled oxygen environments have been standard in human neonatal and pediatric care for decades. Veterinary medicine is approaching a similar turning point, one defined by higher expectations, stronger evidence, and smarter infrastructure. ICU chambers are more than a medical tool. They are a reflection of a practice’s continued commitment to safety, innovation, and excellence. By improving outcomes, streamlining workflow, and reinforcing brand trust, they serve the needs of patients, clients, and business owners alike. The decision to adopt this technology is not about luxury, it is about leadership. The practices acting now are setting the standard others will follow. They are retaining more patients, generating more revenue, and cultivating deeper client loyalty in the process. For those serious about modernizing care and growing sustainably, the message is clear. ICU chambers are not optional—they are essential. Blue Pearl Veterinary's Smart ICU system installation at their Monterey, Calif. location. Photo courtesy Bionet Jacqueline Lopez, CVT, has more than 20 years of hands-on experience in small-animal and exotic medicine. She specializes in bridging clinical practice with medical technology, working closely with veterinary teams, corporate groups, and universities to elevate standards of care across monitoring, ICU, anesthesia, and diagnostic workflows. Known for her deep industry expertise in anesthesia, recovery, and cardiopulmonary monitoring, Lopez regularly collaborates with hospitals nationwide to implement modern, evidence-based recovery systems that improve outcomes for both patients and staff. References Piemontese, C., Stabile, M., Di Bella, C., Scardia, A., Vicenti, C., Acquafredda, C., Crovace, A., Lacitignola, L., & Staffieri, F. (2024). The incidence of hypoxemia in dogs recovering from general anesthesia detected with pulse-oximetry and related risk factors. The Veterinary Journal, 305, 106135. https://doi.org/10.1016/j.tvjl.2024.106135 Martin-Flores, M., Cannarozzo, C. J., Tseng, C. T., Lorenzutti, A. M., Araos, J. D., Harvey, H. J., Gleed, R. D., & Campoy, L. (2020). Postoperative oxygenation in healthy dogs following mechanical ventilation with fractions of inspired oxygen of 0.4 or >0.9. Veterinary Anaesthesia and Analgesia, 47(3), 295–300. https://doi.org/10.1016/j.vaa.2020.01.002 Duffee, L., Stewart, S., Banerjee, T., & Khanna, C. (2023). Retrospective evaluation of the impact of hypoxemia during thoracic surgery in dogs on outcome: A multicenter analysis of 94 cases. Veterinary Anaesthesia and Analgesia, 50(4), 341–348. https://doi.org/10.1016/j.vaa.2023.05.001 American Animal Hospital Association. Anesthesia & Monitoring Guidelines for Dogs and Cats. 2020. VETgirl Veterinary Continuing Education. (n.d.). From “Oh no” to high-flow oxygen therapy in veterinary practice [Blog post]. Retrieved from https://vetgirlontherun.com/from-oh-no-to-high-flow-oxygen-therapy-in-veterinary-practice-vetgirl-veterinary-continuing-education-blog/ AVMA/ACVAA. Updated Anesthesia & Monitoring Guidelines. 2025
