Integrating A Class IV Laser Into The Practice

Bringing a Class IV laser into a practice is a strong way to increase efficiency in therapy.

Technicians administer laser therapy to this dog's pyotraumatic dermatitis.

Veterinarians say Class IV therapeutic laser therapy is an important component in pain treatment, often decreasing or eliminating the need for steroids and pain medication, while adding a therapeutic approach that can be performed largely by technical staff.

“Technicians perform about 98 percent of the laser treatments in our practice,” says Charles Eager, a seven-year veterinary assistant at Vulcan Park Animal Care in Birmingham, Ala. “We’ve used the procedure on more than 200 animals, and it’s been well received by our clients."

Veterinarians say the laser is an excellent addition to any practice because of its diverse uses. The laser can be used alone to treat a multitude of disorders or as an adjunct to routine procedures or surgeries.

Spreading the word that a practice offers laser treatment therapy can be as simple as including the modality on an online listing of services and adding a poster in waiting and exam rooms.

“I list the therapeutic laser as a treatment option on my clinic’s website,” says Dennis Woodruff, DVM, of Avondale Veterinary Healthcare Complex in Des Moines, Iowa. “Many people inquire about the treatment when looking for a modality other than anti-inflammatory drugs.”

Pricing is an individual preference. When contemplating a fair way of charging clients, veterinarians already using the equipment can provide some advice.

“I began packaging the laser treatment into usual procedures,” Dr. Woodruff says. “With cruciate ligament repair, the laser therapy is included in the fee. For animals with arthritis that need a series of treatments, I charge $250 for seven treatments. Post-surgical applications add $10 to $25 depending on the procedure.”

Laser therapy has provided a new niche for veterinarians serving a large orthopedic patient population or in a rehabilitation setting.

“I see a lot of orthopedic cases, which are catalogued in a database,” says Bob Cohn, DVM, of North Laurel Animal Hospital in Laurel, Md.

“My staff started calling these clients to see if they’d be interested in trying laser therapy, which could eliminate or reduce their pets’ need for pain medication and anti-inflammatory drugs. I decided to incorporate the cost of laser therapy in certain procedures such as dentals, spays, cruciates, acute trauma and bite wounds. I charge between $25 and $35 a session for other procedures.”

The laser’s portability is a bonus, too, practitioners say, allowing it to be moved around the clinic with ease, or even outside of the practice.

Laser therapy has provided a new niche for veterinarians serving a large orthopedic patient population or in a rehabilitation setting.

Some practitioners say their interest in laser therapy treatments was sparked by wanting to get away from dependence on pain medication and steroids.

“I got tired of watching steroids destroy dogs’ livers and kidneys,” says Joshua Halper, DVM, of Hillview Veterinary Clinic / Bed & Biscuit in Reynoldsburg, Ohio. “Laser therapy helps reduce the need for these drugs.”

The equipment can be incorporated into many procedures. This allows a veterinarian to determine the product’s payoff time by multiplying the number of procedures performed by the additional fee charged.

“I’ve used the Companion Therapy laser on about 60 patients in two months’ time,” Dr. Cohn says. "The unit I have cost approximately $18,000. I recouped $5,000 in the first six weeks.”

John Godbold, DVM, of Stonehaven Park Veterinary Hospital in Jackson, Tenn., a 30-year practitioner, says he has incorporated therapeutic laser treatments into his practice’s pain control protocol.

Technicians’ Roles

Technicians can take charge of the laser therapy program, freeing veterinarians to see other patients.

“Technicians have always played an integral role in our practice, but their value increases further once therapeutic lasers are introduced,” Woodruff says.

Veterinary staffs’ enthusiasm about laser procedures creates client interest and compliance, Eager says.

“I’ve seen dogs that have had trouble getting around for years and after about five treatments, they’re getting around better than they have in years,” Eager adds. “Clients feel comfortable talking to technicians and may be more inclined to ask questions about their pets, whereas with the veterinarian, they may feel like they’re monopolizing too much of the doctor’s time.”

Aging Pets

The procedure has not only improved quality of life, but saved lives in some cases.

“I’ve treated several cases where owners were contemplating euthanasia, then changed decision after agreeing to laser treatments,” Cohn says. “A client owning a German shepherd was contemplating euthanasia after his dog was diagnosed at another practice with hip dysplasia.

“After I examined the dog, I found it suffered from bilateral ruptured interior cruciate ligaments and laser therapy vastly reduced the dog’s pain and improved mobility."

The laser can be used with almost any post-surgical case. According to guidelines, the only cases to steer clear of are ophthalmic cases and malignancies, Cohn adds.

Skin Conditions

“A hit-by-car golden retriever presented with a bilateral degloving injury on its legs and did not have enough skin remaining to cover the wound,” Woodruff recalls.

“The skin that was over the wound was dry, brown and didn’t appear to have adequate blood supply. I used my Companion Therapy Laser over wounds and covered with a wet-to-dry bandage. On the following day, the edges of the tissue were pink. After two months, the wounds were almost undetectable.

“I wouldn’t have believed that type of improvement possible if I hadn’t seen it with my own eyes.”

Treating Cats

Cats are known to have a low tolerance for restraint and foreign environments, and have been shown to benefit from laser therapy, practitioners say. Little touching of the animal is necessary, which reduces its stress.

“Our first major breakthrough with laser therapy came during the treatment of a feline with severe stomatitis,” says Dynasty Briscoe, a veterinary technician at Animal Care Center in Prattville, Ala.

A less painful outcome following a declaw procedure is seen when implementing post-surgical laser therapy, its users say.

“I use surgical lasers for feline declaw procedures, then use therapeutic lasers post-op for pain control,” Godbold says.

How Class IV Evolved

Class IV lasers are  about 50 times more powerful than class IIIa or IIIb lasers which were first to enter the market, according to Godbold.

“The class III can be used on the same procedures, but takes much more time to perform treatments and may not reach the same tissue depth as the class IV laser,” Godbold says.

The important parameters for successful laser therapy are wavelength and output power, according to experts. 

“Higher power lasers–Class IV, with optimal wavelength for penetration, allows for an optimal treatment dosage in a reasonable treatment time,” says Brian Pryor, PhD, President of LiteCure manufacturer of the Companion Therapy Laser.

“A therapy laser using 5 or 6 watts of output power can perform effective treatments for companion animal disorders in 5 to 10 minutes. The Class III therapeutic laser technology can reach deeper tissue, but the length of time to reach desirable results can be prohibitive in a clinical environment. By having a large spot size and a larger amount of power the user doesn’t have to be as anatomically precise and can treat a broader area increasing the rate of success. Unlike class IV surgical lasers, class IV therapeutic lasers use a large laser spot size, 15 mm in diameter, which spreads out the energy, allowing for safe and effective treatments.”

Veterinarians who have been using class IV lasers say there aren’t drawbacks to the product, citing ease of use, minimal time to operate and low stress for patients.

“I’ve had a class IV laser in the practice for about a year, and I’m learning a new way to use it every week,” Woodruff says. “We are at the beginning of something that will be very big. I predict half of all veterinary practices will have therapeutic lasers within the next five years.”


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