Mastitis & PBMT

Finally, Some Good News For Cows !

FINALLY, GOOD NEWS FOR COWS: PBMT AGAINST MASTITIS!

Dairy Vets: Did you know that Laser/PBM therapy attenuates Mastitis and hence beautifully compliments the Global Drive to restore mammary health in Food Production Animals without the use of antibiotics? Previous publications showed that PBMT aided restoration of mammary health without the need to recourse to antibiotic use. PBMT lowered the incidence of subclinical mastitis.

PBMT also aids in preventing an increase in the size of teat hyperkeratosis lesions in cows.

In Lab animals, PBMT reduced polymorphonuclear cells in the mammary alveolus and reduced myeloperoxidase activity, which is a marker for mastitis.

A 2024 paper on Bovine sub-clinical mastitis, reported a decrease in the bacteria count, no changes in the milk composition, and all without generating residues in the milk.

The benefits to the animal are a reduction in pain by an  increase both in blood supply and lymphatic drainage, a reduction in oedema, and an increased milk let-down.

The important benefit of this tool in the management of mastitis for the farmer is that one avoids the bad economics of long withdrawal times and unavoidable culling.

The reduction in the Somatic Cell Count and improved milk quality is of economic benefit to farmers both in an immediate sense regarding sustained high-quality milk sales etc but also on the potential future sale value of the progeny of animals coming from a persistently low SCC herd.

PBMT is also used as an adjunct treatment for hoof ailments and general skin lesions etc

If you are interested in attenuating the pain and loss of production by using a gentle, but powerful treatment, that additionally has Zero withholding times, contact our Vets at Vets1laser to discuss your interest.

Thyroid Blood Testing Timing & PBMT/Laser Sessions

Thyroid Testing & PMBT

When it comes to the harvesting of a Thyroid Blood Screening Test, make sure you are aware of ALL the interfering factors that can give you a non-representative result for that patient. One of those factors may well be the concurrent use of PBMT in the days peri-harvesting the blood screen. 

Photobiomodulation/Class 4 lasers can have impacts on a diseased thyroid gland.  Whilst we have been taught to avoid the actual thyroid gland itself as one of the normal rules of laser/PBM therapy; more recent articles now suggest that PBMT does not cause morphological changes on the healthy thyroid gland. 

However, in the diseased* thyroid gland, PBM therapy can have an actual beneficial effect. In one study in humans, the use of PBMT caused a reduction in the daily dose of thyroid medication. Given that PBMT targets and modulates inflammation and given so many thyroidal diseases are inflammatory or immune-mediated in nature, it makes sense that PBMT would be of benefit, not of detriment, for many of these presentations.

However, the curve ball is that if your patient is on PBM therapy for any reason; be alert that the therapy could alter serum thyroid levels enough that a marginal hypothyroid case might be masked.

If you do run a thyroid screen test, factor in any interference in your serum blood level result.

*Clarification: Never use the laser anywhere near any neoplastic lesion especially if it is a tumour in the thyroid gland i.e. cats.

 

Laser Spotlight on Hot-Spots

Laser Spotlight on Hot-spots/Pyotraumatic /Acute Moist Dermatitis.

Image courtesy of  Dr Amy Schnedeker.

The opinions expressed here below  are solely those of  Vets1laser.com and not attributable to any other individual.

The ever-increasing emphasis on the need to minimize antibiotics use to guard against disturbance of the balance of the skin microbiome-let alone with the global class actions now being brought against manufacturers of certain classes of antimicrobials for humans- means owners are becoming far less likely to comply with administering any antibiotics to their pets. Therefore, we as vets need to do as much as we can initially with these cases in the clinic so as to set the owner and the pet up for success at home.

I am always a big believer in good old-fashioned ‘elbow-grease’: of getting in and shaving and debriding and cleaning up these ‘hot-spot’ areas before starting any pharmacy. Too many dogs present as repeat sufferers that had no prevention nor proper decontamination done on earlier episodes, leaving their owners expecting their pet would go home on some heavy-duty medications for a protracted period. Not surprising, when the previous treatment focus had been solely on pharmacy.

In addition to the gentle debridement, given more and more Companion Pet Clinics now having Class 4 lasers in their treatment rooms, time to consider using this therapy machine on these skin presentations.

Use the ‘Off-Contact approach’ but don’t just treat the ‘angry’ area. Additionally, treat the peripheral tissue to assist in resolution of inflammation. Treating beyond the lesion boundaries decreases the levels of inflammatory tissue markers swamping the lesion and helps prevent the local nociceptors from firing furiously; which would then have only worsened both  the self-inflected trauma and the overall visual presentation.

I was having this discussion with a very eminent respected Emeritus professor of Dermatology who quite correctly made the additional valid point of needing with Golden Ret breeds (GRB)to ‘remember that the AMD in the golden retriever, particularly on the face/neck/head, may not be pyotraumatic but rather a manifestation of superficial bacterial pyoderma. This is a very valid point about specific breeds and the bacterial aspect as some presentations may or may not need antibiosis. 

However, it is precisely because of the bacterial component of the disease complex that makes me even more determined to encourage vets who have Red/NIR wavelength machines, regardless of the maker or brand, to expand the vet’s mindset to start using their Class 4 laser machines on cases like Hot spots, etc. not just on pain and joint issues.

It’s important to remember that different wavelengths have different effects on bacteria, viruses, etc. Some wavelengths will indiscriminately sterilize the entire treatment area; a result that one doesn’t always desire. Class 4 Red /NIR machines don’t sterilize a site, these wavelengths don’t directly kill bacteria as the main target is mitochondria, which bacteria don’t contain. Therefore, one is less concerned about wiping out the microbiome with these wavelengths, whilst still getting an antibacterial effect due to improved intrinsic signaling.

In applying Laser/PBMT to these presentations, dependance on the client’s home compliance effort is reduced, the treatment will assist with a reduction in pain and self-trauma and hence a speedier recovery for the patient, so a win-win for all.

The more presentations that are highlighted as valid for non-drug treatment options, the more we can move away from blanket destruction of the microbiome by polypharmacy and instead, support the body to recalibrate the issue back to a healthier balance.

PBMT won’t replace antibiotic therapy where it is needed, but it will eliminate a host of cases where antibiotics might have been unnecessarily dispensed.

Keep It Smooth. Glide, Don’t Gouge. Part 2: On-Contact

The on-contact technique does not mean you need to ‘dent’ the patient with the pressure you apply. 

We have personally applied 1000s of laser sessions to pets with the Vets1laser heads shown, all with  tremendous overall success and yet have never ever needed to apply more than the lightest of contact to achieve treatment success.

PBMT is a photochemical process, it is not a physical massage and it is not a physically uncomfortable therapy.

The technique is done at a specific rate: not super fast and not hovering over the one site. If you have not been taught about speed, direction and grid lines, then ask your own laser company to improve their training to you.

If your patients are resenting the laser when you are using it, then most likely it is operator technique i.e You that is at fault.

Too often we see these sad videos of laser headpieces- from a variety of laser companies being applied to the pet’s body with what amounts to brute force.

To apply laser, one is not ploughing through the animal’s muscles making deep furrows.

Aside from the fact the animal is not an equal player in such a process, unable to call stop if the force applied is too great-there is simply no need for such force to be applied through the end of a good laser therapy head.

If you do have to apply such force for your laser machine head, rethink what you are using.

As like most situations in Vet Med; Its Rarely  about Brute Force and Always about Technique

To see an example gentle low stress on contact technique-watch Dr Mark in this video :https://vimeo.com/435250700?share=copy

To see a correct off-contact technique, see Part 1 of our ‘Glide’ Blog Posts

Safety First: Otherwise, Run Away

The “I’m Not bothered” attitude about the pet wearing eye protection in a laser session is simply not acceptable.

This is a Safety Issue: You don’t get to ignore the rules.

There are NO situations where it is acceptable for a laser machine to be in use, yet for the animal (or for that matter, any of the humans around that machine) not to be wearing certified protective eye shields.

Eye safety is not negotiable.

I see far too many social media posts of animals not wearing protective goggles or at least a protective shield.

 If the animal doesn’t accept/fit the laser googles-which is very rare, then you should be using the range of eye protection alternatives that your laser supplier informed you about.

All humans in the optical hazard zone must wear eye protection as well. Again, there are too many social media laser posts showing humans either not wearing eye protection or the glasses sitting halfway down their face.

The glasses must be a snug fit and remain so throughout the session.

Given that the optical hazard zone can be up to 15 metres for some machines, the potential for something to go wrong and cause significant optical injury to your co-workers is such that the number of people in the treatment zone is strictly limited to the number of safety glasses you can provide.

Laser emissions in the 810/980nm range are NOT visible to the human eye so be aware of that risk. That is why the red guide emission light is usually at 650nm, which is visible. Light entering the eye from a collimated beam in the retinal hazard zone area is concentrated by a factor of 100,000 times when it strikes the retina so even a low-power beam is a concern. If the eye is not focused at a distance or if the laser light has been reflected off diffuse surfaces, this hazard is greatly diminished, but can still be very dangerous especially as we don’t blink fast enough to stop the damage from Laser. 

The eye will focus a 400-1400 wavelength beam to a very small spot. 

A 1mw beam gives a retinal irradiance on the spot of 1200w/cm2.

Looking at the Sun only gives 10/w/cm2.

Laser machines can be demonstrated in the Off-Mode or Safety Mode: which is how Laser companies can display at conferences etc. This means a knowledgeable salesperson can allow you to handle the machine and try out various steps on the many preset programs without harm before you buy. If a Laser Rep doesn’t know how to allow you to do this, be concerned.   A Laser salesperson can demonstrate a machine running in full operation mode in your clinic so as to perform a treatment session on one of your patients.

A knowledgeable salesperson will never start nor run any treatment session until everyone in the room, including the pet, is wearing wavelength-specific glasses or eye shields. If the salesperson does not insist on this safety approach, be so very concerned to the point of cancelling your demo.

Rest assured none of the above appalling dangerous behaviour is ever something that we would allow to occur in a Vets1laser demonstration.

However, If any of the above had happened with your laser demo from another company that has left you unsure about Laser therapy etc., then please do, as some of our newest most wonderful clients have done, and contact Dr. Aine Seavers or Dr. Mark Weingarth. Our Vets1laser Veterinarians will be more than happy to safely and expertly walk you through all the steps of understanding and implementing laser therapy for your particular practice set-up.

 

Laser Heads 3

Keep It Smooth. Glide, Don’t Gouge. Part 1:Off-Contact

Whilst Laser therapy per se doesn’t cause damage or worsen an injury, a human operator with poor technique will do damage.
Tissue damage is an operator technique problem. The correct treatment motion is one of scanning the treatment head across an area, not using the head to repeatedly fire on a specific spot.
Exacerbation of a joint or disc problem may well be from a heavy-handed operator. We have seen videos of operators looking like they are using the treatment head to plough through the poor pet’s frame. The aim is to Glide, not Gough the treatment head along the treatment area.
The primary aim of laser therapy is Not massage and certainly never at the intensity level of a Deep Tissue or even a  Swedish massage. Yet, we see cases where the therapist seems to have used the laser tool to apply an unneeded and potentially damaging physical level of tissue compression and manipulation during the laser sessions.
Summary:Keep it Smooth.
                    Scan, Don’t Loiter
                   Glide, Don’t Gouge. 
Check out the short snippet below on the correct off-contact  technique.
 
  
TinyTake19-09-2023-04-06-42

Why I First Purchased A Veterinary Laser Therapy Machine

Over many years, Dr Aine wrote and published well over 100 clinical articles for Sydney University’s Centre for Veterinary Education quarterly publication: Control and Therapy. One of the most popular of these articles was an article documenting Dr Aine’s initial decision to investigate and then implement photobiomodulation/laser therapy into her own veterinary practice. Many vets wrote back of their appreciation of being able to access such knowledge that then, in turn, helped them start on their own veterinary laser therapy journey. We have republished the article in full here now and hope all our new Vets1laser readers now get to benefit from the knowledge shared. 

Enjoy!

If any vet or therapist would like some more spin-free, weasel word-free, fake claim-free re the origin of the machines, information about Veterinary laser therapy then the experienced veterinary team at Vets1laser is more than happy to discuss the therapy with you.

Clothing and Laser

Ditch the Dress-ups

Ditch the Dress-ups-no matter how cute the patient might look.

When it comes to laser therapy, it’s all about ditching the patient’s drapes, the dressings, and the dress-ups for the duration of the therapy session.

The Grothuss-Draper Principle states that only light which is absorbed by a system can bring about a photochemical reaction. Energy directed at the patient’s body through the material will be wasted as there are no photoreceptors in the material for a biological effect to be caused by the light. The material may neutralise the light but equally, if the material is metallic or shiny, it could dangerously reflect the laser light. Either way, energy will be lost and treatment outcomes will be suboptimal.

Please remove clothing, bandages, and casts before attempting to apply PBM therapy to that area.

boxerwith3legs

Acute Pain is a Vital life-saving Signal: Chronic Pain is a Vindictive life-damaging Signal

Acute Pain is a Vital life-saving Signal: Chronic Pain is a Vindictive life-damaging Signal

As a profession, we must be as exacting as possible to prevent sustained or chronic pain.

The  Philosophy of recognising the issues of Neuropathic and/or Chronic pain and working to prevent or re-calibrate the response to prevent chronic pain can be as life-changing and often as life-saving as other therapeutic interventions. We must therefore be proactive and pre-emptive in our application of pain relief.

Pain is a multi-step process so Pain relief, therefore, must be multi-modal: but multi-modal must not mean only multi-drug therapy. If, as a profession, we are going to have multimodal pain management within a  ‘Standard of Care,’ then that care must include non-pharmaceutical interventions. PBM may not be a primary chemical or a pharmaceutical drug, but for many PBMT is regarded 1,2 as a ‘Drug-Therapy Equivalent.’

PBM is a scientifically, down to the micro-cellular levels, proven analgesia modality and hence is a powerful tool to arrest and suppress pain and to ward off chronic pain. 

PBMT elicits the same end effects as a mainstream drug therapy by impacting the inflammatory cascade at similar points i.e., decrease in COX2 and Bradykinin levels etc., but achieves that result cua improved intrinsic anti-inflammatory signalling that is generated by better cell metabolism and improved microcirculation at the level of the injured tissue.

PBMT is easily woven into existing pain protocols and should be an absolute ‘Requirement of Care,’ not considered an alternative only when a case fails to respond to previous standards of care.

Neuropathic pain.

We have not paid enough attention to Neuropathic pain/Allodynia in our vet patients. Pain is not just about the pain you feel, but also about how that pain makes you feel…” The brain ‘dresses’ and then ‘expresses’ that pain uniquely in each individual.

As a survivor of chronic pain, I am keen to prevent as many veterinary patients from progressing into a chronic or neuropathic pain scenario. The freedom I get, when PBM releases me from the cage of chronic pain is a freedom that we as Vets should be offering to our patients. The Joy I see PBM therapy bring my veterinary patients- now freed from the virtual cage of pain that is life with unresolved pain-has converted me from a sceptic to an avid proponent of this pain management therapy tool.
We have excused our neglect of considering neuropathic pain in our vet patients as neuropathic pain being a self-reporting condition, so then animals can’t self-report. I disagree. Animals do report back to us that they have neuropathic pain. All it requires is to have an observing and informed mind and suddenly the ‘clinically silent’ presenting case is actually screaming from the roof-tops that it is registering pain, especially allodynia. The animal that: is no longer lame, but still withdraws from contact or inexplicably guards one part of its body, a sweet animal becoming aggressive, a confident animal suddenly fleeing from the lightest touch, an animal who verbalises when a wind blows on its skin or if a blanket is placed on an external body part, these animals are flagging their allodynia

PBM induces normalisation of the microcirculation and interrupts the vicious cycle that originates develops, winds up and maintains pain. Normal physiological conditions of the tissue are then restored which means we have given the patient a head-start in reducing the risk of chronic or neuropathic pain.

As clinicians, to be serious about pain relief, we must expand our therapeutic tools; We have to move beyond the drug cupboard if we are serious about pain relief.

PBM treatment modality is a powerful ally in the drive to suppress pain and ward off chronic pain. If you are uncompromising about pain relief, it the time to add PBM therapy to your therapeutic armoury.

At Vets1Laser, we are passionate about putting Veterinarians at the forefront of Laser /PBM therapy.

Contact Dr Aine at [email protected] to share and discuss any thoughts or knowledge on all things Laser.

Kyra

Comment on Canine Degenerative Myelopathy Paper

Hi Everyone.

I have had a few people ask me my opinion on the Dr Lisa Miller’s paper on PBM for Canine Degenerative Myelopathy.

The paper, one of many reviewed by Drs Millis & Bergh, was given this accurate if rather terse summary:

‘A study of laser use in treating degenerative myelopathy did not have a control group (comparison to a historical control group was used), had other confounding factors that may have influenced the results, and the laser dose used to compare Class III and Class IV lasers was not the same. The risk of bias for the study came in as high.

In fairness to the paper, despite it being from a competitor company-I don’t think we should dismiss Dr Miller’s findings based on the above reasons.

To put the comments into context: Drs Millis & Bergh had undertaken a systematic literature review in general for PBMT and found gaps in the scientific documentation. Conflicting study results and unclear application for clinical use are explained by the wide variety of treatment parameters used in the analysed studies, such as wavelength, laser class, dose, and effect, as well as the frequency and duration of treatment. Some beneficial effects have been reported during treatment with light therapy; however, the published studies also have limited scientific quality regarding these therapies, with a high or moderate risk of bias. Although some beneficial effects were reported for light therapy, the studies also had limited scientific quality regarding these therapies, with a high or moderate risk of bias.

In general, I would have to agree with Dr Millis and  Dr Bergh’s findings on most of the clinical papers out there in the PBMT field. The standard of publishing for PBMT is nothing like the ring mill the AVJ or EJFM etc puts you through to get a veterinary paper published with them.

Pure Science Research PBM papers focused at the cellular level, however, do tend to hit a higher standard.

So where does that leave us with Dr Miller’s paper?

1)Tacit Knowledge: What you know from being in the field, not from a textbook.

Our own knowledge of using our PBM machine on German Shepherd Myelopathy is that the therapy does work. The therapy should be added as an adjunct therapy-it doesn’t replace Megaderm, Denosyl, NSAIDS, Rehab, etc but PBMT alone, delivers about 70% of the total successful response.

2)Scientific Knowledge.

We know CDM disease is a mitochondrial-based disease with superoxide dismutase1 mutation being the fault line.

We know PBMT targets mitochondria very efficiently.

We know muscles and nerves have a high mitochondrial load.

Therefore PBM therapy has a natural scientific ‘in’ or ‘back door’ to this disease.

Conclusion. The findings of Dr Miller’s paper are worthy of application in general practice.

Reading list.

  1. Miller, L.A.; Torraca, D.G.; De Taboada, L. Retrospective observational study and analysis of two different photobiomodulation therapy protocols combined with rehabilitation therapy as therapeutic interventions for canine degenerative myelopathy. Photobiomodul. Photomed. Laser Surg. 2020, 38, 195–205. (Attached above)
  2. Canine degenerative myelopathy: a model of human amyotrophic lateral sclerosis Raffaele Nardone

et al . PMID: 26432396 DOI: 10.1016/j.zool.2015.09.003

  1. Mitochondrial dysfunction and amyotrophic lateral sclerosis

Isabel Hervias et al . Muscle Nerve 2006 May;33(5):598-608. PMID: 16372325 DOI: 10.1002/mus.20489

  1. Pre-exercise low-level laser therapy improves performance and levels of oxidative stress markers in mdx mice subjected to muscle fatigue by high-intensity exercise. Paulo De Tarso et al. Lasers in Medical Science30(6) 1007/s10103-015-1777-7
  2. Evaluation of inflammatory biomarkers associated with oxidative stress and histological assessment of low-level laser therapy in experimental myopathy

Natalia Servetto et al lhttps://doi.org/10.1002/lsm.20910

  1. Low-level laser therapy (LLLT) prevents oxidative stress and reduces fibrosis in rat-traumatized Achilles tendon Fillipin L. et al. https://doi.org/10.1002/lsm.20225.
  2. Millis D, Bergh A. Systematic Review A Systematic Literature Review of Complementary and Alternative Veterinary Medicine: Laser Therapy. Animals 2023. 14;13(4):667.doi:10.3390/ani13040667