Low-level laser therapy offers dogs a noninvasive complement to surgery and medication.

Dogs rehabilitating from injury or trauma, healing from wounds, or simply aging may benefit from low-level laser therapy, a high-tech treatment that reduces pain and inflammation, and stimulates healing. Today, LLLT is not commonly used in the veterinary world in the United States. It’s better known as a therapy treatment for horses in the United Kingdom and Europe.

“Although it’s still in its infancy here, laser therapy will be a driving force of medical treatment in the future for treating companion animals,” says Ronald E. Hirschberg, D.V.M., medical director at Brockton Animal Hospital in Brockton, Mass., who has been using LLLT for several years.

LLLT is a sterile, painless, surgery-free and drug-free treatment for a variety of conditions. It speeds up healing in muscles, tendons, skin and other soft tissues by stimulating the body from within. It can also reduce the amount of bacteria in an affected area.

Sometimes referred to as cold-laser therapy, LLLT is not a heat treatment. Wherever the laser beam is applied, non-thermal photons of light penetrate the tissue and accelerate cellular growth. The laser light stimulates the cells, which causes them to respond with a higher rate of metabolism. This results in increased circulation, relief from pain and an acceleration of the healing process.

Although formal studies using lasers for treating dogs are limited, significant research exists in the human world. The U.S. military, NASA and major medical facilities worldwide have published successful clinical studies on the use of lasers for treating soft-tissue injuries, pain syndromes and wound healing.

Doctors and physical therapists have also been using LLLT for decades to help people quit smoking and to mitigate some withdrawal symptoms of drug dependencies. In these situations, laser therapy operates on the same principles as acupuncture. Stimulating specific acupuncture points on the body creates an endorphin release, which is intended to help alleviate drug or smoking withdrawal symptoms. The endorphin release causes patients to relax as they detoxify from the addictive substance. Once the person overcomes the physical withdrawals, it becomes easier to cope with the psychological aspects of beating the addiction.

Even though the treatment is FDA approved for both people and animals, neither standards nor protocols have been established regarding the laser dose, number of treatments or the length of a session when treating dogs.

“There are different classes of lasers available,” Hirschberg says. “It’s not about how intense the laser is. What’s much more important is the frequency of the wavelength.”

Pain management
LLLT can be used in a generalized way for treating chronic pain or as an alternative to needles in acupuncture. Lisa Moses, V.M.D., Dipl. ACVIM, CVMA (Certified in Veterinary Medical Acupuncture), director of pain medicine services at MSPCA-Angell Animal Medical Center in Boston, has been practicing laser therapy for more than two years. “Mine is a pain-management practice,” she says. “Most of my patients come to see me for chronic pain. I get better results when I combine different kinds of therapies at once.”

For dogs with arthritis, Moses might use laser acupuncture or general laser treatments to reduce their pain enough so she can perform traditional acupuncture with needles.

In noninvasive laser acupuncture, the light beam stimulates muscle trigger points and acupuncture points, causing the release of chemicals known as endogenous opioids, or endorphins. The same chemicals are released by the human nervous system, causing the phenomenon known as runner’s high (a feeling of euphoria experienced by some individuals engaged in strenuous exercise). These narcotic-like chemicals cause people and animals to become relaxed or sleepy during acupuncture. “Endorphins are natural body chemicals that trigger a sense of well-being,” Hirschberg says.

LLLT is also used to treat degenerative joint disease in dogs. Conventional treatment for canine joint pain is usually based around nonsteroidal anti-inflammatory drugs. NSAIDs reduce swelling and inflammation in the joints, and relieve pain quickly. However, long-term use of NSAIDs can cause liver damage and gastrointestinal problems. An alternative to NSAIDs, LLLT is effective in treating acute joint injuries, such as ligament sprains or strains. It can also treat long-term joint problems, such as chronic osteoarthritis. LLLT won’t cure arthritis, but it reduces pain and swelling, and increases a dog’s range of motion.

When treating dogs that exhibit typical orthopedic problems, Hirschberg believes LLLT should be considered part of a triad treatment. In addition to the laser therapy, he often suggests a change in diet (if the dog is overweight) and prescribes nutraceuticals. “I’m a big supporter of glucosomine and chondroitin,” he says.

Other uses
“My favorite application for laser is treating skin issues,” Moses says. “A lot of my patients are senior dogs that are very disabled and often get pressure sores or bed sores. In the future, I think we’ll see more dermatologic applications and more applications for acute soft-tissue injury rather than treating chronic problems. In my practice, laser has been more effective for those kinds of ailments than it has been for chronic pain.”

LLLT is also successful in treating herniated or bulging disks, a common problem in small-breed dogs. Short of surgery, treatment options are generally limited to muscle relaxants, steroids and NSAIDs. These medications can take several days to work while the dog remains uncomfortable.

“With laser therapy we can get a rapid response for this type of problem because spinal-cord tissue and spinal-nerve tissue tend to be very sensitive to trauma and inflammation,” Hirschberg says. “If a disk is bulging or putting pressure on a nerve, the nerve tends to inflame quickly. Laser therapy can usually penetrate the area that is causing the problem and minimize the pain.”

Mischie’s story
Sharyn Katz of South Easton, Mass., credits laser therapy with saving the life of Mischie, her 17-year-old Toy Poodle. When the dog jumped off the bed one day, Katz heard something snap. “From that point on, Mischie stopped moving and eating.”

Hirschberg, who is Mischie’s veterinarian, tried numerous treatments and medications, but nothing seemed to improve the dog’s condition. “I was getting more and more desperate,” Katz says. “Mischie couldn’t walk up and down the stairs, and she was losing her ability to get around. There were so many things she couldn’t do anymore. She was obviously in a lot of pain.”

Hirschberg determined that Mischie’s problem stemmed from cartilage injury sustained in her hind legs. He suggested LLLT.

“We started Mischie on laser treatments once a week,” Katz says. “It took several sessions before we saw the smallest, incremental changes begin to happen. Although Mischie never got back to the point where she could jump up on the bed again, she is now able to maneuver the stairs. She started acting like an old dog as opposed to a dog in pain.”

A year after starting the laser therapy, Mischie continues to receive laser treatments every three weeks to maintain her condition.

Shine a little light
One of the big advantages of using LLLT is that it has no known side effects. Dogs don’t require sedation or fur clipping prior to the treatment. “We believe that the laser energy of the wavelengths in the machines in use today do not have any effect on normal tissue, which is what makes this treatment very attractive,” Moses says. “In contrast to surgical lasers or lasers that cut or burn tissue, these lasers are not in the wavelength where heat is produced. The animal doesn’t feel anything other than the laser wand touching its skin.”

LLLT also has a favorable effect on nerve cells that transmit pain. Hirschberg adds that sometimes an area can be over-treated, but that can also be beneficial. “If you over-radiate an area, you get what’s known as cellular inhibition, which means the cells go to sleep for a bit,” he says. “By withdrawing the laser therapy, it’s very reversible. We use the knowledge that we can over-treat an area to promote pain relief by inhibiting cells that transmit the pain impulses.”

Hirschberg achieves this by applying LLLT to both the specific problem area and to the spinal cord, which houses certain fibers that transmit pain messages throughout the body.

Hirschberg often uses LLLT before a scheduled surgery. “If one of my patients is going to have orthopedic surgery, I will pretreat the animal two or three times before surgery and about three times after surgery,” he says. “The dog’s recovery is smoothed considerably and it will begin to use its limb much earlier than if I don’t treat the animal.”

Hirschberg cites recent cases in which three dogs had been diagnosed by other vets with ACL tears and were brought to him for laser therapy. “I told each of the owners that we could treat their dog with LLLT and get some relief for them, but we were probably not going to get 100-percent resolution without surgery.” All three dogs were started on laser treatments prior to surgery, which was performed by Hirschberg.

“Most of the time I tell my patients that a dog should be toe touching or toeing down in about 10 to 14 days after surgery,” Hirschberg says. “The animal might not necessarily put its full weight on the leg, but it should be touching its toe to the ground. Amazingly, every one of these dogs was toe touching within two to three days after surgery.”

Hirschberg is quick to point out that these examples don’t constitute a clinical trial. “But the interesting thing is that one of the patients was a really large dog, the second was an 11-year-old dog and the third dog was a 7-year-old that weighed 110 pounds,” he says. “Each dog had a much quicker recovery to the point that it was a little difficult to make sure that they weren’t trying to do too much too early.”

What to expect
Results from LLLT vary depending on what the laser is being used for and how chronic the problem is. Treatments generally last 10 to 30 minutes. Improvement is usually seen in the patient within the first three to six treatments. Initially, a veterinarian will most likely perform multiple treatments in the first few weeks. Once there is visible improvement, the sessions will taper off until the condition is cured.

“LLLT allows veterinarians to monitor a dog’s condition more closely,” Hirschberg says. “It also gives us greater contact with the patient, which results in better care. This is especially true with geriatrics, which is a unique area of medicine. Although LLLT may be more cumbersome than just giving the dog a pill, we don’t have to worry about the dog’s liver and can keep close tabs on the animal at all times.”

LLLT has garnered a lot of attention from dog lovers and veterinarians. Although it’s becoming a more common therapy treatment in veterinary medicine, veterinarians must purchase specialized equipment to treat their patients. For the dog owner, the expense of LLLT is minimal. “The cost of NSAIDs and blood tests about equals the cost of laser treatments, which won’t require ongoing blood tests, unless it’s the occasional geriatric screening,” Hirschberg says.

Many clinics recognize the value of offering LLLT as an alternative, especially when dog owners claim that their dog is acting like a puppy again after just a few sessions.

LLLT Treatment
Low-level laser therapy can provide healing and pain relief for a variety of canine conditions, including:

• Arthritis
• Muscle, tendon and ligament injuries
• Back pain
• Trauma to the skin, muscles and bone
• Open wounds and burns
• Pain or discomfort in dogs that compete in performance events
• Surgery
• Inflammatory conditions, including ear problems, anal-gland inflammation, gingivitis, bladder inflammation and nasal problems