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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.

Physical Exam

ROM Testing 2Performing a systematic physical examination and visual observation of the patient’s mobility will provide an initial assessment on where the potential issue(s) may exist. A thorough orthopedic exam allows for palpation of the limbs and joints while moving them through their range of motion to draw attention to changes within the tissue and help assess if the patient seems painful. Additionally, it is important to complete a neurologic evaluation and consider running additional diagnostic tests to look for any underlying disease processes that could affect treatment options.

Pain Evaluation

According to the Summary of 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats, the most accurate method for evaluating pain is through observing any changes in the pet’s behavior. A pain score is considered the fourth vital sign after temperature, pulse and respiration.1 A patient’s pain should be evaluated in the clinic and by the pet owner to paint a full picture of how the pet is acting.

Pet Owner

Feedback from the owner is vital in understanding where, the length of time and severity of how the pet has been affected to determine the next steps for evaluating if arthritis is present. He or she should be asked a series of questions about any changes in behavior and given a pain scale form to fill out based on whether it is an acute or chronic problem. This will provide valuable insight into the pet’s everyday activities and how they vary.

Standing Evaluation

Stance Analyzer Golden Retriever SmallGathering data on how a patient is bearing weight while standing can provide objective numbers to determine which limb or limbs are effected. It has been shown that bathroom scales can be used as a reliable way to measure static weight bearing in canines2; therefore, a free-standing platform with built-in sensors, such as the Stance Analyzer, can visually show where a potential lameness exists. This sort of tool takes up minimal floor space and can be a cost-effective option in helping obtain a diagnosis, as well as measuring patient outcomes. Recording this sort of information can help guide treatment plans and provide owners with a better understanding of the source of their pets’ complications.

Gait Analysis

Objectively measuring a patient’s gait can be performed via force plate or a commercially available portable walkway. Force plate is considered the gold standard for evaluating gait by calculating the ground reactive forces of a cat or dog while standing, walking or jogging over the plate. The portable walkway is a mat that allows a pet to stand, walk or jog providing information on gait symmetry, stride length and the amount of pressure placed on each paw. These types of devices are expensive and take up a lot of floor space, thus they are not as common of an option for general practice.

Imaging

It is very important to obtain a picture of the joints suspected of having osteoarthritis. Radiographs are most commonly taken to assess the bony changes associated with OA. MRI and CT offer additional diagnostic capabilities, though less commonly used to assess OA, with MRI showing how the soft tissues are involved, while CT can offer better detail for the bony changes in more complex joints.

Arthrocentesis

Collecting a sample of the fluid in a swollen joint or joints suspected of having arthritis can help rule out what is causing the swelling or pain, especially in younger patients, or in those with a more complicated clinical history. The color, consistency and cellular make-up of the synovial fluid can provide clues as to what changes are occurring within the joint and why.3

 

References

1. Epstein, M. et. al. (2015). 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats. JAAHA, 51(2), 67-84. doi: http://dx.doi.org/10.5326/JAAHA-MS-7331.
2. Hyytiäinen, H.K. et. al. (2012). Use of bathroom scales in measuring asymmetry of hindlimb static weight bearing in dogs with osteoarthritis. Veterinary and Comparative Orthopaedics and Traumatology, 25(5), 390-396. doi: https://doi.org/10.3415/VCOT-11-09-0135.
3. Degner, D. (2014, August). Arthrocentesis in Dogs. Clinician’s Brief. Retrieved from https://www.cliniciansbrief.com/article/arthrocentesis-dogs.

 

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Welcome back to the Companion Animal Health Regenerative Medicine blog series! In case you missed Part 1, you can read it here. In today’s blog, we are going to answer two more of the most frequently asked questions surrounding Platelet Rich Plasma.

Question 1: What is a joint flare? How often are they seen post injection?

A joint flare is an inflammatory response in the joint due to a change in the synovial environment. Also referred to as Reactive Synovitis, joint flares can be seen after the injection or withdrawal of fluid into or from the joint. The most common characteristics are: swelling of the injected joint(s), heat emittance from the area and mild to moderate lameness. Typically lasting between 24-28 hours post injection, joint flares can be managed utilizing pain medication (excluding NSAIDs).

ROM Testing 1

Joint flares are reported to occur between 15-20% of patients, but have not been reported to have a negative effect on the treatment outcome. If symptoms are lasting more than 72 hours, synovial fluid analysis is recommended in case there is an unlikely event of an immune moderated disease or septic joint.

Question 2: How long should I wait to laser the area after injecting Platelet Rich Plasma?

Laser Therapy Treatment_Lab_Hip_CroppedCurrently there is limited data surrounding the interaction of photobiomodulation and PRP. However, preliminary research is beginning to show promise for the immediate use of laser post-injection. In one recent study, researchers investigated the use of photobiomodulation, platelet rich plasma and the combination of both in the healing of an Achilles tendon. The results of this study showed compounding therapeutic effects, shortening the healing time and returning the tissue closer to “normal” tissue structure.

While this study shows promise, further research and validation in canine patients will provide more accurate recommendations for post injection settings and protocols. Currently it is recommended to wait 3-4 days post injection to begin treating the area with photobiomodulation.

 

If you would like to learn more about Platelet Rich Plasma and Stem Cell therapies or if you have questions that were not answered in this blog, please contact Companion Animal Health at info@companiontherapies.com.

Stay tuned for our next blog which will explore the benefits of treating with Platelet Rich Plasma!

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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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