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Learn tips about Class IV laser therapy and other health related topics on the Companion Therapy Lasers blog!  Check back weekly for updated posts.

Currently, professional human athletes are benefiting from the use of laser (photobiomodulation) therapy delivery platforms. In fact, more and more professional sport franchises and Olympic teams are utilizing this modality to not only treat performance-related injuries, but to enable improved performance while minimizing potential tissue damage.

Laser Therapy for Canine Athletes Bog Post Image 2There is a growing number of performance athletes in the canine world, in multiple disciplines such as agility, fly ball ,and Shutzhund, to name a few popular ones. These canine athletes deserve the same amount of respect and care as their human counterparts. A performance athlete will by definition face a greater risk of event-related tissue injury due to excessive or extended demand of use.

The therapy laser will be beneficial in several stages around an athlete’s performance schedule. In order to set up the tissues for success, it is beneficial to treat the patient prior to a performance event. This preemptive approach is imperative when the individual has a history of specific performance-related injuries, as there will be a predisposition for potential injury. If the event involves demanding activity, such as with agility courses, it is best to do this treatment a day prior to the event. This timeframe will allow for the tissues to fully respond to the cascade of events that happen with photobiomodulation therapy. However, when dealing with a more restrained performance of a slower tempo, such as with dressage, it may be better to do this treatment just prior to the event so that we benefit from the ensuing neural blockade and endorphin release to allow for a cool, calm, collected ability to deliver.

Laser Therapy for Canine Athletes Bog Post Image 1It is wise to provide post-event treatment as well. Even if the individual did not sustain any visible tissue injury, it makes sense to treat these sites since these structures have been worked excessively and been subjected to a higher demand of function. Inevitably, there is always some level of post-event tissue inflammation with such events, so it is important to treat after each event. A single treatment is sufficient to maintain a sound athlete, but a short course of treatments may be needed if there was an actual injury sustained during the performance. If an acute injury happens mid-event, the patient’s injuries should be treated as soon as possible.

Human athletes receiving this modality have shown an ability to perform better, with increased endurance and less injury. The canine performance athlete can benefit in a similar fashion, and should be offered the benefits that photobiomodulation therapy will provide.

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Welcome back to the Companion Animal Health Regenerative Medicine blog series! In today’s blog, we are going to answer three of the most frequently asked questions regarding Platelet Rich Plasma. From protocols to assessing treatment response, we will provide clarity to some of the questions surrounding this ground-breaking therapy.

Question 1: Is there any proof that Platelet Rich Plasma therapy works?

This is a very common question as there are numerous sources of information regarding the efficacy of PRP treatments. A google search will provide different answers to PRP treatments and applications, though many may not be scientifically backed or peer-reviewed (the gold standard of validating a therapy). The number one place to look for efficacy data is the pubmed.gov website. Performing a search on this website will provide the latest peer-reviewed publications which investigate efficacy (or failure) of different treatments. We have provided several of these published papers for your review, which discuss the successful treatments utilizing Platelet Rich Plasma in numerous indications and may be accessed here.

Question 2: How soon after injecting Platelet Rich Plasma do you typically see results?

It is generally accepted both in human and veterinary medicine that positive effects of this therapy will become apparent within 5-10 days post treatment.

Question 3: How do I know if the patient is responding to treatment?

Stance Analyzer_ROM Measurement 3 Cropped 2

There are several considerations that need to be made when trying to decipher if a patient is responding to treatment. It is important to have a method for measuring a baseline of the patient and their response to a treatment. Many practitioners using Platelet Rich Plasma therapy will have patients return to the hospital 2 weeks post-treatment and will utilize on of the following methods to measure response.

  • Canine Brief Pain Survey for Pet Owners – Created by the University of Pennsylvania, this survey asks the pet owner to grade their dog’s pain and general habits which may indicate improvement from the treatment. To access this survey (for free), click here.
  • Pain Assessment/Palpation – Palpation is an extremely valuable tool when assessing a dog’s pain and locating the area of injury. Palpation can not only serve as a useful diagnostic, but can also provide feedback post treatment as to if the pain is still present or has reduced from its original state. Stance Analyzer_Golden Retriever 4 Cropped
  • Stance or Gait Analysis – Having a quantifiable measurement both pre-and post-treatment will provide you the best data for if a dog is improving from a therapy. Stance and Gait analysis provide objective measurements of the dog’s percent weight bearing on each of its limbs, center of gravity and stride length (gait analysis only).
  • The Stance Analyzer is a cost-effective, compact system which can easily be integrated into a hospitals diagnostic program. Requiring a small foot print for floor space (approximately 2’ by 3’), the Stance Analyzer provides accurate readings of percent weight bearing, center of gravity and weight with a minimal time commitment. Once a reading is obtained, results are easy to interpret and can be saved for each patient to track responses to therapies.
  • A gait analysis system typically consists of a 20-foot walkway mat which provides a detailed analysis of stride, locomotion and other advanced objective readouts. This too is a great system for quantifiable readouts, but requires additional space to perform correctly. These systems are more expensive than the Stance Analyzer and are typically utilized by universities performing research and specialty hospitals. Click here to read more about gait analysis systems.
  • Gait videos – If you don’t have a stance analyzer or gait analysis but would like a visual comparison for pre- and post-treatment effects, you can use video to document your patient’s success! With the advancement of technology for smart phones, there are now applications and settings on the camera to take slow motion videos. These videos can enable you to point out changes in gait, stride length and head bobbing. They can also provide you with before and after videos to then market your regenerative treatments to your clients.

Stay tuned for our next blog where we will answer additional questions focused on Platelet Rich Plasma. If you have a question you would like answered, please contact Companion Animal Health at info@companiontherapies.com.

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Previously, we have looked at a general treatment approach, as well as treatment frequency for acute conditions in particular. Here, we will look further into treating chronic conditions. As opposed to acute conditions where our goal is resolution, the goal in treating chronic conditions is essentially to prevent an active decline with an incurable condition.

A complete recent physical examination is crucial when addressing a chronic condition, as it is likely that there have been compensatory changes in secondary or even tertiary biomechanically associated sites. For example, lumbar spine degeneration and iliopsoas muscle strain are often seen with the primary issue being degenerative joint disease of the pelvic limb (like with CCL rupture). Thus, a recent physical exam is a must as the progression of chronic disease can be quite dynamic and multifaceted. Not addressing all of the patient’s areas of pain or discomfort may lead to unsatisfactory results and difficulties managing client expectations. The natural progression of arthritis can be better assessed and addressed by reading and understanding the subtle symptoms that the patient develops as their condition continues to deteriorate.

It is just as important for the laser operator to have a thorough knowledge base in anatomy. Using the iliopsoas as an example, the operator must be able to visualize the target structure, from its origin at the lumbar spine to its insertion point at the lesser trochanter of the femur. The same principle applies to skeletal structure and neural pathways.

Elderly Dog Arthritis Treatment_SmallThe third important aspect of treating chronic conditions lies in setting realistic goals and expectations prior to initiating a treatment regimen. Age is not a disease, but it is a consideration. Each case will have individual factors, which will be taken into account when establishing these goals. The adept operator will keep in mind that geriatric patients have a slower rate of response to therapy, partly due to a slower metabolic rate, but also potentially due to concomitant disease.

Primarily, promoting quality of life via a sustained palliative response is always the primary goal. Secondly, it is our long-term expectation to be able to prevent an active decline by slowing the progression of the disease. Lastly, we may also be able to taper pharmaceuticals or even discontinue them. There are so many unique factors that each case must be handled as a separate entity.

Once these three factors have been addressed, we can proceed with a complete picture and a common goal for the case. Typically, a chronic condition will need an extended induction (or initial) phase of treatments. This induction phase is usually around 6 treatments, but with these cases, it may extend up to 9 or 12 treatments before an effective and sustained clinical response is seen.

Unless the patient is in established pain, an every other day frequency is typically applied when starting laser therapy for these cases. Once significant clinical improvement is seen, the operator should consider tapering the treatment frequency so as to promote a continued response. In this fashion, the patient is expected to undergo several treatment phases, from frequent “induction”, to less frequent “transition”, and then long term “maintenance” phase treatments.

Elderly Dog Arthritis Treatment 2_SmallSometimes, a client will report the patient seemed a little stiff after the first few treatments. Although this may seem unsettling, this is actually an encouraging sign of active tissue remodeling taking place. Remember, part of the cascade of events that happens with photobiomodulation is vasodilation and angiogenesis. It can be easily explained to the client by making the analogy of blood flow returning to a foot after it went numb from kneeling for too long. This is similar to the “pins & needles” feeling we get with reperfusion of tissues after an ischemic event. When noted, it should be transient and low grade, and is usually seen early after initiating the modality. If it is not seen, that does not mean that the patient is not responding effectively, it just means each patient is an individual and not a statistic.

As the patient progresses through treatment phases, we are able to maintain a clinical response while periodically tapering on the frequency of treatments. It is important for the client to be aware that regardless of the current treatment schedule, they are to return as soon as possible if there are any setbacks or sudden decline. Photobiomodulation offers the operator a certain flexibility in order to enable not only a long-term response, but be able to address acute to chronic events as well.

Many patients will benefit from long-term photobiomodulation therapy. Our patient base will also continually grow as we enable longer life spans via the advancements in the medical field. The savvy laser operator will also be dedicated to keeping an eye out for patients predisposed to arthritic changes, such as working dogs/athletes, chronic NSAID/opioid users, breed predisposed for DJD, patients with surgical implants or a history of traumatic injuries, etc.

 

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