Some veterinary professionals regard it as just another ‘alternative treatment’; others swear by its effectivness. Susan Chenery asks some vets to comment on laser therapy
Rodarn the elderly cattle dog had wobbled unsteadily into the surgery, ataxic in his back legs. After laser therapy, he trotted back out, wagging his tail. “Wow,” said his owner to veterinarian Dr Robert William, “you said it wouldn’t work straight away, but that is a marked improvement.”
Dr William is himself so impressed with the Class IV laser, he has bought two: one for each of his Gold Coast vet surgeries. “I was going to have one between the two practices but this was too good not to have one at each practice.” He has been using it for five months on animals with arthritis, joint problems, and for healing after operations. “We have used it on a couple of surgical cases that weren’t healing well. One was a Jack Russell and the other one was a Rottweiler. They both had anal gland removals that were causing them a bit of grief pain-wise. Literally within 48 hours, the improvement was staggering.”
But he adds, “you have got to put this in the scheme of things with non-steroidals and opioids and other sorts of things. It is not the be all and end all. But it is an important extra modality that we use to aid pain relief.”
Class IV laser therapy has become the fastest growing modality in the United States. Because it is non-invasive and stimulates inherent healing mechanisms via a process called photobiomodulation, it is estimated that more than one million animals have been successfully treated using it in the past 10 years.
Australia has been far slower to embrace the technology. “Laser therapy has been on the market for years,” says Dr Laurent Oner, a canine rehabilitation practitioner, whose company Alpha Mobility sells class IV lasers. “The class III was available for 30-40 years and suffered a lot of controversy about being ‘alternative’ medicine and not really efficient. A lot of vets don’t know the difference between a class III and a class IV. The new generation benefits from new technology, higher average power and scientific data collected over the years. Class IV lasers give the therapist the possibility to treat larger areas, faster and deeper in the tissue.”
Dr Oner continues: “It is infrared, painless and stimulates the chromophore. So you are going to have a type of enzyme which is in the mitochondria and by using [laser therapy], you can change the position of the energy in the cell. It is a brilliant tool for the big accidents. If the animal can put more weight down quicker and use their legs earlier than normal, it means that they have less muscle wastage. And overall, you gain a few months recovery just by having better pain management and better control at the beginning.”
“It is not the be all and end all. But it is an important extra modality that we use to aid pain relief.”—Dr Robert William, Gold Coast, QLD
Dr Jane Rickard at Hills District Veterinary Hospital in Dural is a recent convert. “It has been terrific for my practice. There are lasers and there are lasers but a class IV laser puts out more photons or energy and therefore it penetrates tissues more deeply.” Rickard had been watching class III lasers used on greyhounds for “yonks. They were only penetrating into the tissue for the first centimetre. It was fine if you had a muscle tear right up near the skin, the laser would heal that. But with class IV, if you have got a big German shepherd with hip dysplasia and resultant arthritis, you can laser him on the outside and it is going to penetrate and make a difference to those arthritic hips just in those anti-inflammatory and healing effects. The dog is up and walking around without being on anti-inflammatory drugs. So people that don’t want so much medication, or dogs that can’t take much medication because their kidneys are dodgy or they have got other reasons, the laser is really helpful for them.”
Dr Rickard says she has seen the most dramatic improvement in arthritic animals even though it is not understood “super well” how laser therapy works to block pain. “It is supposed to promote release of endorphins and also block C fibre nerve pathways. So it promotes circulation to the area and kind of winds up the metabolism. And there are all sorts of inflammatory mediators that get released to stimulate the body to heal things.”
In the US, she has seen it broadly used. “Lots of other injuries, muscle tears, muscles sprains, wound healing, it stimulates that. I have actually used it for inflammatory things like ear infections. In America, some of the guys who use it would use it for fracture healing, intestinal joins, bowel problems.”
Because it is a big investment—her machine cost $25,000—Dr Rickard did plenty of reading and thinking before committing. “I was confident it was going to work but I didn’t know if anyone was going to come and use it.” But now, she says, she uses it a lot: for torn anterior cruciate ligaments as well as post-surgery and post-injury rehab. But she probably uses it most for arthritis.
Still, Dr Rickard insists, she uses the class IV as part of “a multi-pronged approach to arthritis. We use lots of glycosaminoglycans. That combined with the laser and putting injections into the joint of higher neurontin acid.”
Dr Robert Johnson, president of the Australian Veterinary Association, is more cautious. “There is not enough evidence that laser therapy actually works. I would like to see a lot more evidence in the scientific literature about the benefits of laser before I would say whether it works or not. We need far more information on that before we can give it the imprimatur.
“What does work is lots of physical therapy, applying heat and massage to relieve muscular skeletal pain, and plenty of rest. And time; I don’t think we give enough credit to mother nature and time for healing things. If I see a dog with a sore back I will put it on anti-inflammatories but I will also show the client how to massage the back and apply a heat pack to the middle of the back. That sort of therapy is just as beneficial as anything else.”