Page 88 - Veterinary Laser Therapy in Small Animal Practice

74 Veterinary Laser Therapy in Small Animal Practice

Immune-mediated perianal fistulae, typical of but
not exclusive to German Shepherds, always require sys-
temic treatment; their etiology is not anal sac impaction
and abscessation, and current standard care involves
a variety of systemic immunomodulating drugs and
topical tacrolimus. Complete healing of the fistulae is
not always achieved, and this disease and the pain that
it involves can heavily impact the quality of life of the
patients – and their owners.
While LT will not cure the disease, it will signifi-
cantly help with the inflammation, pain, and lack of
healing. A clinical study with 20 German Shepherds
that were unresponsive to oral cyclosporin and topical
tacrolimus reported a reduction in pain and dyschezia
in all 20 patients (complete resolution in 18 cases), and
a decrease in lesions in more than half of them when LT
was added to the treatment. Animals were treated every
48 h for the first 3 weeks and then twice a week for 2
more months. A maintenance regime of LT was able to
perpetuate the remission in 15/20 cases. [224] A potential
enhancement of the therapeutic effect of tacrolimus
(oral form, in this case) had previously been described
in an experimental mouse model of atopic dermatitis,
Figure 7.13 Chronic fistula from the left anal sac, 5 cm in 2 [225]
depth, undergoing treatment with antibiotic. using phototherapy with 850 nm light at 25 J/cm .

Figure 7.14 (a, b) Evolution of the fistula with the addition of LT.

REDONDO PRINT (4-COL BLEED).indd 74 08/08/2019 09:47