Therapy laser use in small-animal practice (Proceedings)
In veterinary practice, therapy lasers can be used alone or in combination with other pain management tools to decrease recovery time, help manage pain, and treat other conditions.
Because of the laser's ability to work at the cellular level, laser therapy can be utilized in many conditions especially those that might benefit from the following:
A few examples of how it can be applied include being used post-operatively over incisions, in disc disease, osteoarthritis, over sore muscles and over wounds. It can be used for any type of inflammation including otitis and acute moist dermatitis. Therapy lasers can be used to treat trigger points and stimulate acupuncture points.One of its great benefits is that it is non-invasive and well tolerated with no known side effects. It also offers great promise in some hard to treat disease processes. A study by Kubota (2002) showed enhanced blood flow and perfusion thru skin flaps exposed to low level laser in reconstructive surgery. DeTaboada in 2006 conducted a study of 169 rats where an acute stroke was induced. This was a double blind study where a Ga-As laser was applied with a wavelength of 808 at 0.9 J per square cm, 24 hours post stroke. There was statistical improvement among the treated group. In 2005, Byrnes conducted a study showing that light applied at the site of spinal cord injury is able to penetrate the cord and improve axonal regeneration and restores locomotor function while altering the immune response after injury. A total of 450 joules was applied over a 50 minute session at 150 mW.
Much research is still needed to establish repeatable results that can be agreed upon. For some conditions, data gathered from research studies may be extrapolated to fit the clinical picture of the pet and then applied. The following guidelines are a good starting place for beginning laser users. For wounds, use 1 Joule per square cm directly over wound using a grid pattern or surrounding the wound. Pain can be treated over joints by applying 4-8 joules/cm2. Disc Disease can be treated using. 4-6 joules/cm2 above and below the effected area. Trigger points can be stimulated using 1 joule/cm2.
The contraindications are dependent upon the type and class of laser. For example, some lasers should not be used through hair, over darkly pigmented skin, or over tattoos. Contraindications for all lasers would include not using it during pregnancy and applying it over open fontanels. Caution should be considered when using it over growth plates of immature animals, near eyes, and over malignancies. There is however, some current research where therapy lasers were used in the treatment of esophageal cancer in humans.
The application of laser therapy is an exciting tool to aid in the treatment of a number of medical conditions that warrants its use in general veterinary practice. As the use increases, more standardized treatment protocols will evolve.