Page 91 - Veterinary Laser Therapy in Small Animal Practice

Pointing light at soft tissue: clinical applications 77

Figure 7.17 Lip retraction to expose the gingiva. Figure 7.18 If the patient does not tolerate doggles, the
assistant can help protect the eyes and the therapist will
retract the lips.
7.18), but caudal stomatitis may benefit from sedating
the patient to better reach those surfaces. Of course
this is not always an option, especially if the patient is in – of course, you may combine LT with other medical
a very poor clinical condition, as often happens in cats approaches. Once the condition improves, treat every
with severe oral pain, unable to properly eat for quite other day for a week and then try to decrease to twice a
some time and with concomitant systemic disease. For week, and so on. Chronic cases will, of course, require
these cases, though, LT with a closed or partially open maintenance treatment, for which the frequency is very
mouth can help provide analgesia and improve oral dependent on the case.
feeding, with an awake patient and no side effects, until The best technique for cats is to place them with the
the general condition allows sedation if necessary for head over the edge of a table, and have an assistant/
better exposure. owner holding them from the back, protecting the eyes.
The dose and power used depend on whether the Most cats like being surrounded or embraced even
treatment is directly over the mucosa, with the mouth if they don’t enjoy other manipulations. The person
open, or with the mouth closed, from the outside. For holding the laser can then access the mouth from both
a direct treatment, the starting dose is 2–4 J/cm , with sides and from under the cat, to reach into the inter-
2
1–3 W of power and a low power density, 0.2–0.8 W/ mandibular space. Very often, you will notice that after
2
cm . If our aim is to treat from the outside, then these 1–2 minutes the cat seems more relaxed and moves the
parameters increase 2–3 times: 6–10 J/cm and 4–6 tongue a bit, feeling more comfortable.
2
W, and we also need a higher power density, about
2
1 W/cm , unless we are dealing with a very sensitive 7.9 Abdominal organs
patient (Table 7.7). For your treatment area calcula-
tions, include the intermandibular space. I tend to treat Abdominal organs also suffer from inflammatory and
at least half the mouth, even for localized problems, painful conditions, and therefore they may also be
rather than using the laser for a few seconds over a a target for LT. As with any treatment, how we treat
small spot. intra-abdominal organs depends on how we reach
In cases of severe pain, start treating on several them and what amount of energy and delivery mode we
consecutive days until you achieve good analgesia want to use. They can be reached during a laparotomy

Table 7.7 Recommended parameters for oral treatments.
2
Dose (J/cm ) Power (W) Power density (W/cm )
2
Direct treatment 2–4 1–3 0.2–0.8
Through skin 6–10 4–6 0.6–1

REDONDO PRINT (4-COL BLEED).indd 77 08/08/2019 09:47