Part 2: Patients not accepting the Laser Application.
Be a Veterinarian and adjust your treatment protocols to your patient, just as you would any other treatment or disorder. There are no fixed ‘recipes’ when it comes to Laser in our pets: it must remain a dynamic and individualized treatment per patient that evolves as the patient needs demand.
However, if you are finding your patients are uncomfortable when you yourself use a pre-programmed protocol, (as many different models of Veterinary specific Laser machines have), best before you consider dropping the dose down, to first recheck your patient’s risk factor for allodynia, and check your own technique and that of your technicians.
Protocols provide proven consistency and accuracy so if you alone are having issues, don’t rush to change the therapy delivered.
- Dropping the Dose: This Should Not be Your First Option.
Too low a dose will not be therapeutic; you need to ensure you are getting adequate dose delivery to ensure a therapeutic response.
- First run a self-assessment checklist on the protocol selected and your scanning speed, application pattern, and angle of your actual technique, before you consider changing a pre-set program setting, with which no other therapist has had issues.
A quick revision & checklist of the rules of Laser use during a dummy run could pick up where bad habits have developed in how you hold or use the Laser tool.
- Equally review the program selections you are choosing and check that the program you have selected is actually correct for the lesion or area you are treating.
- Remember that an allodynia patient’s reaction may have nothing to do with the pressure or the power setting, but simply because the brain has taken the heat signal and ‘dressed and expressed’ it as pain.
Turning the power down won’t address the allodynia-in fact it could make it worse.
We know Laser efficacy is directly related to the strength of the Laser. Applying weak ineffective doses because you incorrectly deducted that your chronic lesion patient can’t tolerate the fluence and irradiance you selected could result in poor end results.
- If initially blowing on the skin of these uncooperative patients when the pet is conscious, then triggers an abnormal response: sedate the pet and warn the owner the issue can be worse for 36hrs before improvement is seen. Otherwise, if you start with the Laser beam first and get the allodynia-then the pet and the owner associate the Laser with an adverse response and neither will return to your clinic.
- If you are using on-contact and having issues-just use the head first without turning the machine on. If your patient doesn’t tolerate just the application of the head, the issue is not with the Laser but with the therapist or the patient.
- If the pet tolerates the head, but not the Laser beam, then review all of the above again.
- Once you have checked all the above boxes and found all to be correct, immediately contact your own particular Veterinary Laser machine supplier and directly discuss your findings with them. It may be your machine needs an update, or it may need to be swapped out for a week with another machine to ensure your machine does not have an individual fault
Only after all of the above is completed, should consideration be then given to the use of a much lower dose than the norm.