Written by Companion | Mar 12, 2023 10:30:00 AM
Case and Photos courtesy of Dr. Jeffrey W. Foltz, Dover Veterinary Clinic in Dover, OH.
Species and Breed
8 year old, M/N Canine, Labrador Retriever
Presentation
Owner noted partial weight bearing lameness and severe swelling in the left front leg. The patient had a history of chasing the family cat 3 days prior when 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
Treatment Details
307.5 total joules administered to superficial component and 690 total joules delivered to deep component at 3.5W; Frequency of two treatments, two consecutive days. Appropriate topical therapy was used as well. Otitis resolved with ear much less swollen and pruritic after treatment.
72 Hours Post
Re-presented to DVM; now febrile with evidence of a wound with severe tissue devitalization and avascular necrosis. There was additional swelling also noted in the ventrolateral neck area
Additional History
Another family member recalled seeing the cat bite the dog and also that this same cat had bitten another family member in the household previously, resulting in hospitalization for treatment of “a rare bacteria.”
Treatment Plan
The rapid progression and worsening of the patient’s symptoms along this unusual history provided to DVM prompted a modification of the original treatment plan. Intensive case management with appropriate medical therapies (antibiotics, analgesics, and wound care) as well as laser were instituted.
Laser Therapy
Initially beginning with a dose of 2,520 total joules to the entire affected area (target energy density of 4-5 J/cm2) and decreasing the dose as the wound area became smaller.
Treatment Frequency
21 laser treatments total over a period of 7 weeks
Other Comments
Staff noted minimal drainage from the wound, and a lack of any putrid odor during bandage changes.
- Edema within the leg and neck resolved within days of starting treatment and the patient remained comfortable, never bothering or chewing the bandage.
- The patient’s wounds healed rapidly and completely with very minimal scarring since the laser helped accelerate tissue repair and reduce fibrous scar tissue formation, there were no other skin grafts or surgeries required after initial debridement.
Presentation
Pre-surgical debridement
After surgical debridement
Post-six treatments from debridement
Post-13 treatments from debridement