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Midwest Equine

Feature Article

LASER THERAPY

by Jody Hallstrom, DVM

Article Archives LinkK-Laser Therapy

K-Laser Therapy

Einstein first envisioned the possibility of a LASER (Light Amplification by the Stimulated Emission of Radiation) device over a hundred years ago. The technology did not exist to build a laser until about 1960. From that very first inception, the enormous potential for wide-spread applications was immediately recognized and enthusiastically researched and developed. Lasers, laser light, and LED’s are an integral part of our daily life; from communications and entertainment to medical, industrial, and military applications. Laser therapy is joining the ranks of these main stream applications. A Kantar Media study done for Veterinary Economics in 2015 found that nearly 40% of veterinary practices now offer laser therapy as part of their armamentarium.

Laser therapy works by a wavelengthspecific form of photobiomodulation. A series of physiologic effects along with a broad cascade of secondary and tertiary effects are directly stimulated or enhanced. The primary responses are photochemical reactions which occur when photons in the near infrared range are absorbed by chromophores within the mitochondria and on the cell membranes. This energy is then converted to a chemical kinetic energy within the cell. The result is an improved efficiency of the respiratory chain within the mitochondria of the cell due to changes in membrane permeability, nitric oxide formation and production of reactive oxygen species which increases oxidative metabolism to produce more adenosine triphosphate (ATP) and improve cell signaling.

The downstream effects of secondary and tertiary reactions lead to amplification of the primary photochemical reactions. These cellular reactions result in three major clinical benefits for the patient: pain reduction; inflammation reduction; and accelerated and improved tissue healing. These events are happening simultaneously and naturally complement each other.

The following cases illustrate the healing and anti-inflammatory properties of laser therapy.

CASE #1 is a 19 yo Quarter Horse mare used for Junior Rodeo. She had chronic mild lameness issues and a noticeable fetlock drop in both front legs for some time. In October of her rodeo season, she presented with an acute exacerbation of lameness after being shod with heel wedges in a misguided attempt to correct the fetlock drop. Ultrasound exam at this time revealed bilateral acuteon- chronic desmitis of her suspensory ligament bodies and medial and lateral branches, osteoarthritis of both fetlock joints, and desmitis of the LF medial and lateral distal oblique sesamoidean ligaments. The owner was just hoping to finish this last season before retiring her. Her shoeing was changed to an extended heel shoe for more fetlock support and she received a 5-day course of Phenylbutazone and rest before running in her next rodeo. Laser therapy of the affected structures was then started. Laser therapy was performed twice weekly initially, and then decreased to once weekly for the remainder of the season. Her intensity of training was reduced between rodeos, but she was never taken completely out of work for a proper rehabilitation. She continued to compete every 4-6 weeks for the rest of the season. While the goal was to maintain her and avoid worsening of the ligament damage, follow-up ultrasound exams in January revealed actual improvement in both the acute and chronic lesions in spite of continued competition. She qualified for State Finals in the spring and finished her season comfortably.

K-Laser Therapy - Case Study 1 - Image 1 K-Laser Therapy - Case Study 1 - Image 2

K-Laser Therapy - Case Study 2 - Image 1

CASE #2 is a 4 month old Thoroughbred filly intended for racing. The presenting complaint was a nonweight- bearing lameness of the left hind leg with a large swelling over the lateral thigh. The filly was also thin and unthrifty. A needle aspirate of the swelling produced 150ml of purulent discharge. Culture of the discharge revealed Rhodococcus equi. An ultrasound of the limb was performed to determine the extent of the infection. A large area of osteomyelitis was found in the left femur at the level of the third trochanter measuring 8.16cm proximal to distal x 2.33cm wide x 2.55cm deep. There was a large loculated abscess associated with the bone defect and extending distally along the femur. Extrapulmonary R.equi infections are historically frustrating to treat. There was a high risk of a pathologic fracture occurring in this case. The filly’s owner declined surgical curettage of the osteomyelitis but agreed to try conservative management. The abscess was lanced with standing sedation and lavaged thoroughly with dilute betadine. Antimicrobial therapy was initiated with Azithromycin 10 mg/kg orally once daily for five days, and then decreased to 10 mg/kg orally every other day, as well as Rifampin 5 mg/kg orally twice daily. Laser therapy was used every 4-5 days for two weeks over the infected area to improve healing. The filly’s activity was restricted with stall confinement. At her first recheck exam two weeks later, she was fully weight-bearing on the LH leg, ambulating comfortably in the stall, and gaining weight. A recheck ultrasound exam performed five weeks later revealed significant improvement in the appearance of the femur. Antibiotics were continued for a total of 12 weeks. Ultrasound exam of the femur one month after antimicrobial therapy was discontinued revealed only a very small residual cortical defect. The filly is now a yearling turned out in a large pasture with her cohorts. She shows no sign of lameness and is expected to have no training or performance issues related to the femur.

These cases demonstrate how laser therapy, as an adjunct to traditional medications and therapies, can achieve a better than expected outcome. Our goal is not to just make the patient comfortable again. We want to get the patient back to their normal activity; restore range of motion; improve muscle strength and function. Laser therapy helps us accomplish these goals much more frequently and efficiently. It is not just a non-drug pain reliever or antiinflammatory. It directly stimulates tissue repair, regeneration, and remodeling. It allows us to improve and resolve conditions that have traditionally been less responsive as well as enhancing the clinical response of the broad variety of conditions we treat every day. Laser therapy allows performance animals to recover more quickly and more fully to regain their competitive edge. It allows pets to remain active members of the family. It can extend the productive and functional life of all patients; veterinary and human. This is why there is so much interest. This potential is the primary force behind the growth and enthusiasm in laser therapy.

Jody Hallstrom, DVM received her doctorate of veterinary medicine from the University of California – Davis in 2000. She worked in private practice as an ambulatory equine veterinarian for 12 years before joining the team at Pioneer Equine Hospital, a large referral center, in Oakdale, CA. She is a general practitioner, but has a special interest in dentistry, reproduction, and foal care.

About K-Laser USA

ABOUT K-LASER USA

K-Laser USA is relentlessly focused on developing the most advanced therapeutic lasers that provide a non-surgical option for veterinarians to treat pain, reduce inflammation, and aid healing. Our product development is guided by veterinarians to ensure we deliver the most effective, powerful, durable and easy to use laser technology. Additionally, we are committed to your practice’s success through bestin- class clinical support, education, training, and marketing launch plan. For more information, visit us at www.k-laser.com.