Laser Therapy for a Necrotic Wound - A Success Story
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Published: IVC Journal, Winter 2023
Author(s): "Lisa Miller, DVM, CCRT, CVA"
An eight-year-old Labrador retriever was presented to Dover Veterinary Clinic after the owner noted partial weight bearing lameness and severe swelling in the left front leg. The patient had been chasing the family cat three days prior, and the owner assumed the dog had slipped on the floor.
Initial examination and radiographs revealed only soft tissue swelling and pain on flexion and extension of the left elbow. A sprain/strain was suspected at this time. However, 72 hours after this initial presentation, the patient represented, now febrile with increased swelling and pitting edema extending from elbow to carpus. The patient was also now non-weight bearing and had evidence of a wound with severe tissue devitalization and avascular necrosis. Additional swelling was noted in the ventrolateral neck area. At this time, another family member recalled seeing the cat bite the dog and added that the cat had previously bitten another family member, resulting in hospitalization for treatment of “a rare bacteria”.
The rapid progression and worsening of the dog’s symptoms along with this unusual history prompted a modification of the original treatment plan. Intensive case management with appropriate medical treatments (antibiotics, analgesics and wound care) as well as laser therapy was responsible for the patient’s ultimate recovery.
The dog responded positively to the effects of laser therapy. Staff noted minimal drainage from the wound, and a lack of any putrid odor during bandage changes. Additionally, edema within the leg and neck resolved within days of starting treatment, and the patient remained comfortable, never bothering or chewing the bandage. The wounds healed rapidly and completely with very minimal scarring, and since the laser helped accelerate tissue repair and reduce fibrous scar tissue formation, no other skin grafts or surgeries were required after initial debridement.
The patient received 21 laser treatments over a period of seven weeks, initially beginning with a dose of 2,520 total joules to the entire affected area (target energy density of 4 to 5 J/cm2) and decreasing the dose as the wound area became smaller.
“When [the patient] came to our clinic, we had only been using laser therapy for seven months,” says Dr. Foltz. “The dramatic improvements my staff and I witnessed [in this patient] as a result of laser therapy made us true believers in its ability to improve patient comfort and healing...[this] success story has caused me to re-evaluate how I practice veterinary medicine after 23 years. This case has challenged and encouraged
me to look for ways to use the laser for many other conditions, as I want all my patients to benefit. With each case I find myself asking, ‘Could laser therapy help in this situation?’”