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Analgesic effect 25
Figure 4.3 Chronic elbow pain needs 6–12 J/cm .
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behavior (activities or postures), and subjective judge- are arguably a gold standard (Table 4.2). Some of them
ments such as visual scales. To achieve a proper and have been validated more than others, but it is always
more systematic assessment of the potential pain and better to use a non-optimal pain scale than none at all,
its associated behaviors, the species, breed, and individ- or many cases will go undiagnosed, especially in cats.
ual are taken into account, as well as the clinical history By no means is this to underestimate the importance of
and examination. Sometimes changes in gait, posture, validation, but rather to focus on integrating proactive
or facial expression can be quite obvious, but a cat with pain assessment into your work routine.
chronic pain may only be hiding a bit more than usual Visual analogue scales (VAS) and numerical rating
or no longer being found on the kitchen counter. scales (NRS) represent the possible range of pain, from
Routine pain assessment is recommended. There no pain at all to the worst imaginable kind or a very
are many available scales for this purpose and these severe pain, in a way that depends on the particular
Table 4.1 Recommended parameters for pain management.
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Example Dose (J/cm ) Power (W) Power density (W/cm )
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Acute superficial Dog bite, acute tendinitis 2–5 1–4 0.2–1
Acute deep Closed fracture 4–8 3–8 0.5–1.5
Non-healing ulcer, chronic
Chronic superficial 4–15 2–5 0.5–1
tendinitis
Chronic deep Spondylosis, hip dysplasia 8–20 6–15 1.5–3
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