Page 95 - Veterinary Laser Therapy in Small Animal Practice

Pointing light at soft tissue: clinical applications 81

Table 7.9 Recommended parameters for transthoracic treatments.
Dose (J/cm ) Power (W) Power density (W/cm )
2
2
Cat/small dog 4–10 3–6 1–2
Large dog 6–12 4–10 1–2

2
occasionally pass over it when treating the larynx, but needed. Maintain a power density of 1–2 W/cm (Table
that will not be a problem. 7.9).
The list of intrathoracic respiratory conditions With asthma, the clinical goal is to decrease the
for which LT could be a helpful adjunctive therapy duration and frequency of episodes; in case of a marked
includes: seasonal component, treatments can be spread further
apart when the season is over, but others will need
• asthma high maintenance, such as weekly or biweekly sessions,
• pleurisy for a sustained improvement. In the case of pulmo-
• pneumonia nary fibrosis, which is a progressive and fatal disease,
• idiopathic pulmonary fibrosis our goal with LT is to slow down the progression and
• bronchitis improve quality of life by relieving the symptoms.
• SIRS syndrome. Concomitant pulmonary arterial hypertension (PAH)
may develop; make sure this is treated and monitored
Probably the most common respiratory disorders as needed. Since LT may act on vascular tone (smooth
in which LT is used in small animal practice are feline muscle relaxation) via nitric oxide, and the treatment of
asthma and canine pulmonary fibrosis. Studies in PAH involves this precise mechanism, with drugs like
asthma and pleurisy models show regulation of hyper- sildenafil, there could be a potential benefit for this sec-
responsiveness of bronchial and tracheal smooth ondary condition, but this has not been investigated. A
muscle; decrease in inflammatory cells and mediators, minimum frequency of three times per week is needed
such as circulating histamine, ICAM expression, and for 2–3 weeks, then twice a week for the same period,
Th2-type cytokines; and a reduction in exudate volume. followed by treatments once a week and a maintenance
[44, 46, 56, 69] regime of at least one treatment every 2–3 weeks.
Although there are no published clinical studies in Nevertheless, some patients with asthma or pulmonary
small animal airway conditions and LT, some have been fibrosis will require a continued higher frequency of
published on the human side. In pneumonia patients, treatment, such as twice a week, in order to maintain
LT improved peripheral microcirculation, decreased the clinical improvement.
pain and coughing, and helped to resolve clinical
parameters and leukocytosis [263, 264] ; mean duration of
hospital stay was reduced from 19 to 15 days in a study Summary from a
using LT for acute pneumonia, [265] and from 28 to 23 different perspective
days in another study of elderly patients with pneumo-
nia. [263] This was also described in patients with pleurisy
and tuberculosis, who after laser treatment showed a Soft tissue injuries are some of the most popular
decrease in total amount of exudate and earlier resolu- candidates for laser therapy, mostly because being
tion of hyperthermia, in the study by Tiukhin et al. [266] predominantly superficial, it is relatively easy to
For transthoracic treatments, use 3–10 W and cal- deliver a high enough dose to the affected tissue.
2
culate 4–12 J/cm to be applied over each hemithorax But as you’ve read, there are many subdermal
(intercostal spaces may help you) and also over the tho- issues that can benefit from laser. And for many
racic inlet area – include this area in your treatment of these, the other therapeutic options are
area calculations! You can start on the lower end of the pharmaceutical and come with highly undesirable
power and dose ranges: start with 3–4 W and 4–6 J/ (and unfortunately probable) side effects. If you
2
cm for a smaller patient, and progressively increase if don’t suspect cancer, laser.

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