Patient Information
Patient Name: Dax
Patient Age & Gender: NM D.O.B.–12/18/10
Species and Breed: Canine–Doberman Pinscher
Patient’s Symptoms: Severe infection and granulation tissue proliferation on right hind foot.
Medical History: Dax was the victim of neglect. He was chained in the owner’s yard and the chain strangulated his foot leading to severe infection and amputation of 2 toes. See RESULTS section below for additional history since this area is too small.
Initial Assessments: Painful proliferative granulation tissue where the 3rd and 4th toes were amputated from the right hind foot. Bacterial C&S grew multiple severe antibiotic resistant bacteria including Methicillin Resistant Staph, Pseudomonas aeruginosa, and Morganella morganii. Radiographs suggested possible osteomyelitis.
Treatment Information
Laser Make & Model: Companion Therapy Laser–CTS
Frequency of Treatment: Class IV Laser Therapy treatments were administered every other day for 5 treatments. Family went on vacation for 10 days. When the family came home, we restarted treatments every 5-6 days for 6 treatments.
Protocol Used: Wound setting, 2×3 inches, light skin, medium coat.
Mode: CW for 49 sec, pulse rate 500 for 49 sec, pulse rate 1000 for 49 sec
Power: 2 Watts (W)
Treatment Time: 2:27
Total Energy Delivered: 196 Joules
Areas Treated: Granulation tissue over 3rd and 4th toes of right hind foot
Approximate Size of Area Treated: 10-12 cm2
Other Treatment Details: Small conical treatment head used, 1/4 – 1/2 inch from wound
Any Other Treatments Used: Soaked foot in dilute betadine solution for 10 minutes following treatments, gave appropriate oral/injectable antibiotics to help treat infection, gave oral Rimadyl, bandaged foot between treatments.
Assessment Used: Inspection of right hind foot on treatment days showed lessening of granulation tissue, inflammation, and foul odor. Dax’s pain also subsided in response to therapy.
Results
Dax’s abuse was reported by a neighbor and he was rescued from the yard in which he was chained up at only 8-9 months old. The chain had wrapped tightly around his right hind foot and caused severe infection of the 3rd and 4th toes. The rescue group took him to a veterinarian who amputated the P3 of the 3rd and 4th digits of the right hind foot. Dax was adopted by one of our current clients and presented to us for evaluation when he was 10 months old. On presentation, Dax’s right hind foot had a foul odor with purulent discharge and severe granulation tissue had formed where the 3rd and 4th toes had been. Dax was painful on palpation of the wound and the owner was worried that nothing could be done to save his foot. We took photos of the wound and radiographs of the foot to a local board certified veterinary surgeon for review and consultation. The surgeon advised us that in his career he had seen 2 cases of similar lesions that were almost as severe as Dax’s case, but Dax’s case was the worst. He advised us that in his opinion Dax had less than a 5% chance of keeping his foot. He had to amputate the affected feet of both of his previous patients and he had never heard of a patient with such advanced disease recovering without aggressive surgery. The surgeon was not experienced in the use of Class IV Laser Therapy at the time.
We advised Dax’s new owner of the surgeon’s concerns and explained that we have had excellent success using Class IV Laser Therapy to help treat wounds and inflammation. We designed a treatment protocol and submitted a sample of the purulent material from the wound to the lab for bacterial culture and sensitivity. We started Class IV Laser Therapy on the day of presentation and continued Laser treatments in conjunction with appropriate antibiotics, oral pain relievers, dilute betadine soaks, and bandaging. Dax had been on Clavamox prior to presenting to us. We continued him on Clavamox while the bacterial C&S was pending, not aware that all 3 of the bacteria infecting his foot were resistant to Clavamox. Within 2 days of administering the first treatment of Class IV Laser Therapy, Dax’s foot had markedly improved. The inflammation was subsiding, the granulation tissue was shrinking, and he was less painful on palpation. The foot continued to improve steadily and we added in appropriate antibiotics once the bacterial culture and sensitivity results were in. Over the next 7-8 weeks, the granulation tissue gradually disappeared and healthy skin formed over the site where the toes of the 3rd and 4th digits had been amputated. Please see the attached photos to witness Dax’s steady improvement.
Discussion
Dax’s exceptional recovery was most likely due to a combination of therapies, but since he did not start appropriate antibiotic therapy until 7 days after the beginning of our treatment course and we saw significant improvement only 2 days after the first use of the Class IV Therapy Laser, we suspect that the Companion Laser was primarily responsible for his dramatic response to treatment. Given the antibiotic-resistance of the bacteria grown from Dax’s wound, the laser treatment not only suppressed pain and inflammation, but it also very likely had bactericidal effects as well.
References
Dax’s case demonstrates how effective the Companion Laser can be when utilized in appropriate situations to reduce pain and inflammation, and to speed healing. Many practices are primarily using the laser for osteoarthritis treatment, but we administer Class IV Laser Therapy post-surgically and frequently intra-operatively as well, when we have a cystotomy, enterotomy, or gastrotomy. Patients suffering from cystitis, gastroenteritis, and inflammatory bowel disease have enjoyed much faster pain relief and recovery after we have administered Class IV Laser Therapy. Ruptured anal sac abscesses have completely healed in as little as 3 days following Class IV Laser treatment.
