Laser therapy is a relatively new therapy used to reduce pain and inflammation. Although this service is fairly new to the veterinary world, it is not completely new to the market. Different types of laser therapy have been common in the human medical world for many years. For example, for hair removal and eye surgery. However, many companies are now offering laser therapy in dogs (and even cats) for a wide range of conditions, including wound healing, arthritis, and even skin disease. Laser and related techniques, such as the Klox system, can be grouped together as photobiomodulation, and are increasingly popular. However – does it work? Can it be used in dogs? And if so, where can you get it?
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What is laser therapy in dogs supposed to do?
It is most commonly used for one of three issues:
1) Pain management
Most owners want their pets as comfortable and pain free as possible, for as long as possible! Laser therapy, it is claimed, can help with this goal. Many conditions can cause pain for your pet, but most painkillers have a maximum safe dose, and potentially may cause side effects – meaning that laser therapy is generally very popular.
Pain can be chronic (long term), but it can also be acute (sudden and intense). Laser therapy is supposed to help both types of pain, with the treatment protocol tailored to your pet and their medical needs, meaning the frequency, duration and intensity of treatment may vary.
The idea is that the laser treatment reduces inflammation (helping with acute pain) and helps damaged nerves to “reset” (helping chronic pain). It’s very popular for use in arthritis, for example, because of this combination.
2) To accelerate wound healing
There is research suggesting that laser treatment can dramatically accelerate wound healing, by increasing cell efficiency. Certainly, studies (such as this one and this one) support the use of the technology for this use, especially in skin wounds.
3) To help manage skin disease
Recently, other forms of light therapy (including polychromatic treatments) have been gaining popularity for managing some skin diseases. Supportive studies (like this one, this one, and this one) have led to some really exciting developments in veterinary dermatology. Although this isn’t strictly a “laser system”, it has the benefit of having a solid evidence base in dogs!
How does laser therapy work?
Laser therapy uses controlled light energy at a specific wavelength and frequency to alter the physiology of the cells. The light energy affects the cytochrome C molecules in the cells – part of the system that generates ATP (adenosine triphosphate). ATP is the main energy carrying molecule of aerobically respiring cells; by allowing cells to manufacture ATP more easily, they can (at least theoretically) repair, grow, and heal faster than they otherwise would. There’s a great paper on this here.
The process stimulates blood flow to the damaged tissue, so the body’s natural healing cells and inflammatory mediators which are carried in the blood are driven to the needed area much quicker and can therefore have a more optimum effect.
Laser treatment increases collagen formation which is very useful in aiding the healing of ligaments and tendons. Collagen is the scaffolding that holds your body together, so having strong collagen is vital for preventing further injury – and there are studies, like this one, supporting this.
By altering the cells’ energy, increasing the rate of collagen formation and increasing blood flow to the area, we can increase the rate of healing in our dogs.
Where can I get it?
Not every veterinary practice will offer laser therapy for dogs as it is a specialist service requiring specific, expensive equipment. If your vet believes laser therapy could benefit your dog, you could seek referral to another veterinary practice in order to receive this treatment. Some insurance companies will cover the cost for laser therapy as part of a holistic treatment protocol but be sure to check the terms and conditions of your policy and contact your insurance company to make sure before starting the treatment.
OK, but does it work?
That’s the problem – the evidence for most of the effects of laser therapy in real-world situations is fairly poor. Recent review papers have been rather dubious, and at least one study has found that laser therapy was ineffective in speeding up wound healing in dogs.
By comparison, the use of a polychromatic light system (Klox/Phovia) to improve skin disease is fairly well supported by evidence.
There are a couple of issues to contend with.
Firstly, tissue penetration
Red and near-infrared light penetrate skin to a predictable depth of 6-10mm. So expecting a laser to have a significant impact on organs and tissues deeper than this (or hidden behind bone, for example) seems quite a stretch. So it might be that we are focussing on the wrong things.
Not enough data
The other big problem is that hardly anyone is actually conducting studies into the use of lasers on dogs! Vets who use them often say they see good results (which is great), but as we’ve discussed before, it’s easy for us to fool ourselves (especially, to be cynical, when we’re making money from it). But so far, they aren’t being written up and subjected to peer review.
Problems with laser therapy
Laser therapy can in fact make some conditions worse. The light from some laser systems can, rarely, cause burn wounds which would then need treatment using topical creams, dressing and potentially oral medication should the wound become infected. More commonly, blindness can occur if the laser shines into an eye (which is why operator and patient must wear special goggles).
If tumours are present, there is some suggestion that the light energy can stimulate growth making these tumours larger and more difficult to cure. Prior to any laser therapy starting, your veterinary professional would always perform a thorough clinical exam and try to identify any tumours or neoplastic activity in order to prevent this from happening, but it is not always possible to find tumours initially due to their small size and variable location within the body.
So is it worth it?
The answer is – we don’t know yet! Many of our more sceptical colleagues believe it is a fad treatment that will fade away as soon as we learn it doesn’t work. Others believe that it could be a revolutionary therapy, we’re just not using it to its best effect yet.
Reality is probably somewhere in between. So we’re definitely not going to say don’t use it – it might work well for your dog! However, make sure that your pet is getting other appropriate therapies as well, such as medication or physiotherapy. Laser as part of a multimodal treatment plan is a great idea, laser on its own is pretty high risk.
And above all, try to persuade your vet to write it up for a journal, whether or not it works – because that’s how we move forward as a profession!
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