We understand how heartbreaking it is when your dog is diagnosed with arthritis. Your formerly happy, exuberant pup may be increasingly grumpy, hesitant to play or walk, or have trouble finding a comfortable sleeping position.
If your best friend is suffering with the pain of arthritis, you may want to speak with your vet about laser therapy treatment, orphotobiomodulation therapy (PBMT). When successful, you’ll see results almost immediately. With regular maintenance, you may be able to decrease your dog’s pain meds—or even discontinue them completely. And best of all, laser treatment is totally safe and has no side effects at all!
To give our readers more information on this popular therapy, Big Barker’s consulting veterinarian Dr. Sarah Wooten interviewed Ronald J. Riegel, DVM, a pioneer in PBMT and co-founder of the American Institute of Medical Laser Applications (AIMLA). AIMLA provides education on medical lasers in both the veterinary world and the human healthcare profession. He is a well-recognized champion for medical laser education and has an extensive background in laser technology for humans and animals. Here is what he had to say.
Dr. Sarah Wooten: How long has PBMT been available in veterinary medicine for animals with chronic pain?
Dr. Ronald Riegel: I bought my first therapy laser in 1979. That said, if I had to estimate the time when it was being adopted for the treatment of chronic osteoarthritis pain in veterinary medicine, I would say it was around 2007. This coincided with advancements in cold laser technology that allowed penetration of deeper structures, such as the hip joint.
SW: How does it work?
RR: The mechanism of action is something called photobiomodulation. It works on the cellular level within the mitochondria of cells. The laser increases the metabolic rate of the cell through a biochemical cascade of events, increasing, among other things, production of ATP and nitric oxide. Physiologically there is a reduction in pain, increased control of inflammation, and an increase in micro-circulation (capillaries that carry blood to sites of injury) resulting in an accelerated healing process.
SW: How long does it take to see the benefits?
RR: Pain control effects are usually seen almost immediately after the therapy session. All of the benefits are usually seen within a few treatments. My standard recommendation is “If not better in four, treat them no more,” because one of two things is happening: the therapeutic dose of laser therapy is not reaching the target tissues, or we are administering in the wrong anatomical location.
SW: What questions should a dog owner ask their veterinarian in regards to PBMT if it is recommended as adjunct therapy for osteoarthritis?
RR: “Would the administration of therapeutic laser treatments help to relieve pain, slow down the progression of arthritis, and allow my animal a higher quality of life?”
SW: In my practice, I start arthritis patients out at 3 times per week for 2 weeks, then 2 times per week for 2 weeks, then once per week for 2 weeks, then 2 to 3 times per month for maintenance of chronic pain with PBMT. What is the typical treatment regimen that you would recommend for a dog with arthritis, as far as how often to receive treatments?
RR: You are spot on. Most chronic arthritis cases are managed quite well utilizing this frequency of therapy sessions. There hasn’t been clinical proof that chronic cases benefit more from initial daily treatments than they do from every other day, by the way. Maintenance will be unique to each patient—some dogs are managed on twice a month treatments; others need more or less often.
SW: Which joints tend to benefit the most from PBMT?
RR: All joints within the body benefit from PBMT. With the ability to penetrate deep within the tissues, with the correct technique and dosage, hip arthritis seems to be responding better than in the past, especially with the large breeds.
SW: I’ve heard some differing opinions on whether PBMT benefits patients with back pain due to acute and chronic intervertebral disc disease (IVDD). What is your opinion?
RR: Utilizing PBMT to treat IVDD is very efficacious in both acute and chronic cases. I started using PBMT to treat IVDD about 19 years ago. Around 2006 when the dosages were increased, I saw a big difference in the efficacy of PBMT in treatment of IVDD. [Editor’s note: PBMT is not a cure for IVDD, but it does seem to reduce pain and inflammation when used as an adjunct therapy to other recommended treatments such as cage rest, anti-inflammatories, and/or surgery.]
SW: Can you think of one osteoarthritis patient’s story to share who received benefits from PBMT?
RR: Meggie is an 8-year-old female spayed Golden Retriever with no [prior] health problems at all during her lifetime. However, she seemed to not want to play as often or for very long, appeared uncomfortable at times, and restless. She was X-rayed and digitally thermal imaged, and diagnosed with arthritic changes in her hips, knees, and hocks (the equivalent to our ankles). She was treated with PBMT, and twenty-four hours post-therapy Meggie was very active. In fact, she was so active that the clients said, “Doc, could you take some of that energy back out?”
There was an objective reduction within the thermal gradients of at least a 30% in all contralateral [same on both sides] joints but two when measured with digital thermal imaging. Therapy was continued and monitored with digital thermal imaging for a total of eight sessions over three weeks’ time. Meggie has been on maintenance therapy for over 8 months now: once every 4 weeks in the winter and once every two or three weeks in the summer and is doing well! Best part – she does not require any pain medication.
SW: Anything else our readers should know?
RR: The nomenclature for laser therapy has been consistent up until about three years ago when the AMA adopted photobiomodulation therapy (PBMT) as the term to use in medical records. Other nomenclature such as phototherapy, light therapy, LLLT, cold laser, and hot laser are slowly being phased out, so if your veterinarian recommends one of them, they’re referring to PMBT!
|Dr. Sarah Wooten is Big Barker’s consulting veterinarian. Dr. Wooten is a small animal veterinarian with more than 15 years of clinical experience. She is an expert contributor to sites such as vetstreet.com, DVM360.com, and The Bark Magazine.|
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