A Warm Welcome & Congratulations

A Warm Welcome and  Congratulations.

Welcome to our newest Vets1Laser users : Bomaderry Veterinary Hospital & Four Paws Rebab Centre. The dedicated Veterinary and Rehab Centre staff offer an extra-ordinary range of veterinary services for their local area. We were delighted and honoured when their team, already seasoned laser therapists, chose our Vets1laser machines to facilitate their team’s onward journey with all things veterinary laser/pbmt 

Congratulations also to Dr David for celebrating his 2nd anniversary of using our Vets1laser machine at his own practice, by purchasing an additional machine to deal with the increased demand from his successful implementation of Laser/PBM therapy into his veterinary practice

Kudos to waterwalkies for committing to a Laser Safe Work Zone

When it comes to Laser/pbm therapy-All That Glitters is Not Good.

Top marks to the team at waterwalkies and their detailed commitment to creating a Laser Safety Zone for their treatment sessions. It has been a joy to train this team of focused professionals to implement laser/pbm therapy into their treatment sessions. You don’t have to know much about laser safety to see the quantum safety differences in waterwalkies setup compared to so many other laser therapy images posted on various social media. https://lnkd.in/dPUvXcrm

IS THERE AN OPTIMAL TIME TO DO LASER/PBM THERAPY SESSIONS

Yes, there is an Optimal Time: Mornings.

However, that doesn’t mean that Laser/PBM therapy sessions scheduled for other times of the day won’t work. You will get efficacy from PBM applied any time of the day so continue to schedule appointment times as it suits you and the client.

However, if you have the luxury of booking treatment sessions in a Morning slot, then do so in preference for two particular reasons.

                1)Morning sessions are preferred if this is the First time the animal is having laser. This is simply so as to have the full working day to find out if this particular patient gets a strong ergogenic response to the treatment.

If so then that animal will be a bundle of energy and sleep will be the last thing on their mind. This means the pet and the owner might very well have a sleepless night if the pet decides come bedtime, that it is still time to play and play and not sleep. 

Therefore on the occasions that you can’t schedule a morning appointment, be sure to cheerfully alert the client that the pet could be active for longer than normal. Most clients if prewarned are then fine if they are up all night with a super active happy pet. 

This ergogenic effect doesn’t always occur, some animals in fact are the opposite and want to sleep around the clock. Again clients should be pre-warned that this can happen so that they don’t panic after hours at a pet who just wants to stay curled up in bed after a laser treatment.

                2) Mitochondria are ‘Morning’ Workers.

Mitochondria are the main targets for Red-NIR wavelengths so it makes sense to treat when the target is most responsive. Some studies indicate that early morning, or at a minimum within 8 hours of awakening, is the time when mitochondria have spare capacity and are most sensitive to having improvements in the function of cytochrome C complex and ATP production. 

At the start of the day, ATP levels are high which results in a homeostatic reduction in complex activity as demand is low, with mitochondria only needed to top up the system which has not been drained by previous activity. Later when respiration increases, complex activity is elevated as ATP levels declined due to consumption. Mitochondria later in the day have reduced spare capacity to respond as daily activity has increased their workload.

 So where possible-Choose Morning Treatment Times.

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

Eye Safety First, Otherwise: Run, Run Away!

The “I’m Not bothered” attitude about the pet wearing proper 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  for some other brand laser machines can be up to 15 metres, 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.

A Big Thank you to Tammy and Cleo and Waterwalkies  for modelling The correct (and an incorrect way) for our veterinary patients to wear  the safety googles.

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.