Laser Therapy

for Beginners
Companion Animal Health®

Photobiomodulation Therapy (PBM)

You may have heard the terms “Cold Laser” or “Low-Level Laser Therapy (LLLT)” before. In
general, such terms refer to “treatment using irradiation with light of low power intensity so
that the effects are a response to the light and not due to heat.”1 Many of the terms used to
commonly describe this process do not ideally reflect the mechanisms of action involved.
They also don’t adequately distinguish this type of therapy from the other laser-based thera-
pies that rely on heating tissue to achieve an effect. This lack of clarity has led to significant
confusion and a need for better nomenclature.

In September 2014, the North American Association for Light Therapy (NAALT) and the World
Association for Laser Therapy (WALT) convened to discuss this issue, and as a result of their
efforts, the term “Photobiomodulation Therapy” was added to the MeSH database. This term
more accurately reflects the process and better distinguishes it “from the popular use of light-
based devices for simple heating of tissues…or other applications of light energy that rely on
thermal effects for all or part of their mechanism of action.”2

TABLE OF CONTENTS
Did You Know? PG 1 - 6 How it Works

100 +
That laser therapy is the PG 7 Practical Applications
modality of choice in
professional and collegiate PG 8 - 10 Case Studies
athletics? LightForce Therapy Lasers (the human PG 11-12 Companion
counterpart to Companion) are utilized by over
100 professional and collegiate teams.

1. Ncbi.nlm.nih.gov. Low-Level Light Therapy – MeSH – NCBI. 2016. Available at: http://www.ncbi.nlm.nih.gov/mesh/?term=photobiomodulation. Accessed February 25, 2016.
2. Anders J, Lanzafame R, Arany P. Low-Level Light/Laser Therapy Versus Photobiomodulation Therapy. Photomedicine and Laser Surgery. 2015;33(4):183-184. doi:10.1089/
pho.2015.9848.
PG 1

What is Photobiomodulation drives cellular metabolism. As

light is absorbed, cytochrome

Therapy? c is stimulated, leading to

increased production of ad-
enosine triphosphate (ATP), the
molecule that facilitates energy
Photobiomodulation therapy therapy (LLLT), cold laser, or transfer within the cell. In ad-
is defined as a form of light laser therapy.2 dition to ATP, laser stimulation
therapy that utilizes non-ion- also produces free nitric oxide
izing light sources, including The fundamental principles and reactive oxygen species.
lasers, light emitting diodes, that underpin photobio- Nitric oxide is a powerful vaso-
and/or broadband light, in modulation (PBM) therapy, dilator and an important cellular
the visible (400 – 700 nm) and as currently understood in signaling molecule involved
near-infrared (700 – 1100 nm) the scientific literature, are in many physiological pro-
electromagnetic spectrum. relatively straightforward. cesses. Reactive oxygen spe-
It is a nonthermal process in- There is consensus that the cies have been shown to affect
volving endogenous chromo- application of a therapeutic many important physiological
phores eliciting photophysi- dose of light to impaired or signaling pathways including
cal (i.e., linear and nonlinear) dysfunctional tissue leads to the inflammatory response.
and photochemical events at a cellular response mediated In concert, the production of
various biological scales. This by mitochondrial mecha- these signaling molecules has
process results in beneficial nisms that reduce pain and been shown to induce growth
therapeutic outcomes includ- inflammation and speed factor production, to increase
ing but not limited to the al- healing.3 cell proliferation and motility,
leviation of pain or inflamma- and to promote extracellular
tion, immunomodulation, and The primary target (chro- matrix deposition and pro-
promotion of wound healing mophore) for the process is survival pathways. Outside the
and tissue regeneration.1 the cytochrome c complex cell, nitric oxide signaling drives
The term photobiomodula- which is found in the inner vasodilation which improves
tion (PBM) therapy is now membrane of the cell mi- microcirculation in the damaged
being used by researchers tochondria. Cytochrome c tissue, delivering oxygen, vital
and practitioners instead of is a vital component of the sugars, proteins, and salts while
terms such as low level laser electron transport chain that removing wastes.4

See Photobiomodulation in Action

Watch this short animation to

see how laser therapy targets
damaged areas located deep
within tissue to accelerate
healing on a cellular level.

http://www.LiteCureInfo.com/IntroToPBM

1. Anders JJ, Lanzafame RJ, Arany PR. Low-level light/laser therapy versus photobiomodulation therapy. Photomedicine and Laser Surgery. 2015; 33(4): 183-184.
2. Frydrych. The Evolution of Photobiomodulation link
3. Karu TI. Low power laser therapy. In: Vo-Dinh T, editor. Biomedical Photonics Handbook. Boca Raton (FL) CRC Press; 2003: 48-1-48-25.
4. Hamblin MR, Demidova TN. Mechanisms of low level light therapy. Proc. of SPIE. 2006; 6140: 612001-1-12.

The Keys To Therapeutic
Success - It’s Not a Class War
• Minimize Light Loss Due to Reflection
• Select the Appropriate Wavelength
• Deliver Sufficient Power
• Minimize Absorption by Molecules not
Involved in Photobiomodulation
What do the laser classifications actually mean?
Class IIIb: IIIb lasers are hazardous to the eye
when viewed directly. For visible and infrared
devices, emission power is limited to 0.5W.
Protective eyewear, key switches, and safety
interlocks are required safety features.
Class IV: Class IV includes all lasers that emit
powers in excess of the IIIB limitation of one
half of one-watt. Eye protection is needed to
limit both direct and diffuse reflected exposure.
Key switches and safety interlocks are also re-
quired safety features. The majority of scientific,
industrial, military, and surgical lasers are in this
category.
Power: Class IIIb lasers are limited to a maxi-
mum power of a 0.5 Watt. Class IV therapy
lasers typically enable the user to select from
powers of a 0.5W up to 15 Watts. Increased
power enables the clinician to treat a larger
area in a shorter period of time, thus allowing
an efficient delivery of a therapeutic dose to
target tissues.
Treatment Strategies: Due to their power dif-
ferences, Class IIIb and Class IV laser treatment
strategies vary. Class IIIb lasers are often used
to treat single points or a group of small points
and are held in one place for the duration of
the treatment time at each point. When treat-
ing with a Class IV therapy laser, the clinician
may treat a much larger area, (ex. 300 cm2 for
the anatomical area of a large dog’s hip); the
PG 2
treatment head is moved throughout the dura-
tion of the treatment to ensure a therapeutic
dose of energy is being delivered evenly to the
entire target area and its associated tissues.
Class IV laser therapy can also be administered
using contact or non-contact treatment heads.
Dosing Strategies: Relative to Class IV lasers,
Class IIIb lasers deliver a smaller dose of Joules
to a smaller area of tissue. Typically treatments
are confined to discrete points. A potential
weakness of this technique is the variability of
clinical results due to the exact placement of
the treatment points. The foundation of Class
IV laser therapy is based on the delivery of a
therapeutic dose of Joules to a large area of
target tissue, reducing variability in outcomes.
For example, on the lumbar spine of a large
dog, to deliver an effective dose for arthritis of
10 Joules/cm2, a Class IV therapy laser set at 10
Watts in continuous wave would deliver 6,000
Joules of energy in a 10 minute treatment ses-
sion. It would take a 0.5 Watt Class IIIb laser 200
minutes to deliver the same dose.
Wavelengths: Different therapeutic lasers of-
ten have different treatment wavelengths rang-
ing from 700 nm to 980 nm. All wavelengths in
this therapeutic window target the same photo-
active chromophores. The main difference
between wavelengths is the absorption of the
light by tissue components such as water and
melanin.
 PG 3

CLINICALCONCERNS
CLINICALCONCERNS
SEOTERRA/ THINKSTOCK

Laser focus
What to know about adding photobiomodulation therapy to your practice.
BY L U I S H . D E TA B O A DA , M S E E , A N D W E N DY S . F RY D RYC H , P H D

A
r focus
RE YOU CONFUSED BYfindings initiated research to understand (LEDs) are not included in the term
the effects of light on living cells and
MANUFACTURERS’ CLAIMS ABOUT even though an LED-based device may
the best laser therapy devices? the mechanisms involved. be able to deliver an LLLT response.
Are you skeptical of light therapy as a Hundreds of scientific studies have There was reluctance to adopt the
know about adding photobiomodulation therapy to your practice.
treatment modality? Your confusion CLINICALCONCERNS
is been conducted in vitro to characterize term photobiomodulation because it
understandable—there have been mixed the dosages needed to achieve a cellular was not a MeSH (Medical Subject
E TA B O A DA , M S Eand
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the 2014,
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ligaments. Muscles, Ligaments, Tendons J.
rehabilitation clinicsby
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Mester noticed that which 12 Optical or inhibits
photobiomodulation.
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He is currently
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Benedicenti S, Sorrenti E, Schiavetti
world. 18,19 for researchhttp://www.osa.org/en-
and development at LiteCure.
light to the backs of cell function. Many terms have been
modulation.” term “photobiomodulation therapy”
us/photobiomodulation. Updated Sept. 22,
I, Angiero F. Effect of diode laser in the
treatment of patients with nonspecific chronic
aused their hair to grow LUIS H. DEused
TABOADAto describe
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AccessedWENDYuse4, 2015.
Sept. of was chosen
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back pain: MeSHcontrolled trial.
randomized
13 Conforti M, Fachinetti GP. High power laser
ckly than in mice not has over 20light experience inOne of the more
years’ devices. 3 the clinical studies
therapy treatment compared to simple
database as an indexing
manager at Photomed term. 2014;32(9):490-494.
Laser Surg.
3,5
15 Tumilty S, Baxter D. Effectiveness of class 4
medical laser design, development, LiteCure. Wendy has a BS in
er.1 He also observed frequently used terms has been
segmental physical rehabilitation Photobiomodulation
low- in whiplash therapy
lasers for is definedLasers Surg
Achilles tendinopathy.
and manufacturing. He holds injuries (1° andphysics
2° gradefrom Pennsylvania
of the Quebec TaskState Med. 2015;47(S26):38.
ons appeared to healnumerous patentslevel laser therapy
and has co- (LLLT); however,
University
Force classification) as
and muscles
involving the
a PhD inand therapeutic
materials use of light, absorbed
16 Roberts DB, Kruse RJ, Stoll SF. The
-treated animals. These
authored devices
over 20 publications that
in the fielduse
of light-emitting diodes
ligaments.
science Muscles,
and Ligaments,
engineering
2013;3(2):106-111.
from by chromophoreseffectiveness
Tendons
the J.
University found in the body,
of therapeutic classto
IV (10W)
photobiomodulation. He is currently the VP of Pennsylvania. She can be contacted at laser treatment for epicondylitis. Lasers Surg
14 Vallone F, Benedicenti S, Sorrenti E, Schiavetti
for research and development at LiteCure. wendyf@litecure.com. Med. 2013;45(5):311-317.
I, Angiero F. Effect of diode laser in the 17 Karlekar A, Bharati S, Saxena R, Mehta K.
treatment of patients with nonspecific chronic
References Assessment of feasibility and efficacy of class
M WENDY S. FRYDRYCH , PhD, is lowO back
C T Opain:
B E Ra randomized
2 7, 2 0 1 5 controlled
• R Etrial.
PRINTED FROM CHIROPRACTIC ECONOMICS
1 Mester E, Mester AF, Mester A. The biomedical IV laser therapy for postoperative pain relief in
the clinical studies manager at Photomed Laser Surg. 2014;32(9):490-494.
Lasers off-pump coronary artery bypass surgery
LiteCure. Wendy has a BS in
effectsS,ofBaxter
15 Tumilty laser application.
D. Effectiveness of Surg
class Med.
4 patients: A pilot study. Ann Card Anaesth.
1985;5:31-39.
lasers for Achilles tendinopathy. Lasers Surg
physics from Pennsylvania State 2 Hamblin MR, Demidova TN. Mechanisms of
2015;18(3):317-322.
Med. 2015;47(S26):38.
University and a PhD in materials 16 low level light therapy. Proc. of SPIE.
18 Frostad M, Poulis G, Copeland G. Major
CLINICALCONCERNS

As with any complicated technology, even if you don’t understand exactly PG 4

how it works, you should have a basic grasp of the mechanisms involved.

trigger nonthermal, non-harmful FDA approved the first Class 4 laser evidence is needed.
biological reactions that result in (greater than 0.5 watts) for the relief When the laser is used in gated
beneficial therapeutic outcomes.5 of minor muscle and joint pain. The mode, it is cycling its CW power on
higher powered lasers make it possible and off and consequently delivering a
Protocols for use to not only apply the benefits of lower average output power. In general,
Appropriate dose selection is critical to photobiomodulation superficially, but the use of pulsing decreases light
the safety and effectiveness of photobio- also to treat a greatly expanded range delivered to the target. On the other
modulation therapy. To get clinical of conditions by delivering a clinically hand, in instances where there is a
results, sufficient light must reach effective dose to target areas below the concern about heating tissue, such as
the target tissue. There are various skin (e.g., hamstring muscles), and in a in treatment of the brain, pulsing can
parameters to consider when calculating shorter period of time.9 be used to further control the output
dose, including power density or power of the laser. In a recent paper
irradiance, treatment time, wavelength, Optimal wavelength that looked at human cadaver brain
pulsing, and application technique.6 For light to produce beneficial thera- tissue, there were no differences
The therapeutic dose is measured in peutic outcomes, it must be delivered observed in light penetration between
joules (J) delivered per square inch of at an appropriate wavelength and of pulsed and CW laser light.11
surface area.3 Much of the research sufficient intensity to the target tissue.
conducted in the field has involved cell One range of wavelengths has been Implementation and application
or small animal studies in which low referred to as the “optical window” for As with any complicated technology,
power and small beam size were photobiomodulation therapy, where even if you don’t understand exactly
sufficient to treat the cells or muscles. there is minimal absorption from how it works, you should have a basic
A recent study published by Anders, different substances (e.g., water, grasp of the mechanisms involved. If
et al., reported the successful trans- hemoglobin, and melanin). you are using a laser that has prepro-
lation of in vitro results obtained in the The current understanding is that grammed protocols, understand the
petri dish by using those parameters to light in the visible range (600 to 800 differences between treatments when
treat surgically repaired peripheral nanometers) is absorbed more by your patient’s skin color is light or dark,
nerves in vivo.7 The researchers found hemoglobin and melanin, so these or their body size is small or large. For
an optimal dose for nerve repair in visible wavelengths are better suited for example, if the laser has a mix of 980
vitro to be 97.5 percent less than that superficial areas. To effectively treat and 810 nanometer light for treatment
required when delivered on the surface deeper musculoskeletal conditions, of light skin, it may switch to only 980
of the skin. CLINICALCONCERNS therapy lasers should be in the near- nanometer light to treat dark skin.
infrared range (800 to 1,000 Protocols for larger bodies will deliver
Power and density modulation, andnanometers).light-based devices Morimoto Y, Saito A, Tokuhashi Y. Low level
9 a larger dose compared to treatment of
laser therapy for sports injuries. Laser Ther.
The FDA regulates lasers for medical can be used to address a variety of
2013;22(1):17-20. a patient with a smaller build.
medical issues.12 When a compre-
use. Unlike surgical medical lasers, hensive treatment Understanding
approach is used, pulsed laser
Hashmi JT, Huang YY, Sharma SK, et al. Effect
10

of pulsing in low-level light therapy. Lasers

Additionally, a significant amount of
which use precisely focused lightlasertotherapy is an Photobiomodulation
effective modality.13- therapy can
Surg Med. 2010;42(6):450-466.
be
Tedford CE, DeLapp S, Jacques S, Anders J.
11
light is lost when you operate in non-
17 Lasers are being used with great
treat or remove tissue, therapy lasers delivered
success in chiropractic, veterinary in either continuous
Quantitative analysis waveof transcranial and contact mode due to reflection from
intraparenchymal light penetration in human
do not focus light and do not harm medicine, professional (CW)sports, or pulsed
and mode.
cadaver Typically
brain tissue. Lasers
2015;47(4):312-322.
there
Surg Med. skin and hair surfaces. Therefore, it is
rehabilitation clinics around the
tissue. Therapy lasers typically have a
world.18,19
are two types of pulsing used
Optical Society 12 of in therapy
America. “Photobio- advantageous to treat on contact, and
modulation.” http://www.osa.org/en-
lower power density or irradiance (i.e., lasers—superpulsedus/photobiomodulation. or gated.10 Updated Sept. 22, it is especially helpful if you are able to
LUIS H. DE TABOADA , MSEE, 2015. Accessed Sept. 4, 2015.
the power is spread out over a larger has over 20Various
CLINICALCONCERNS years’ experience claims
in suggest
Conforti M,the ideal
Fachinetti
13 GP. High power laser compress the tissue (and blood) to
therapy treatment compared to simple
area). The FDA designates these lasersmedicalpulsing laser design,frequencies;
development, however,
segmental physicalthere arein whiplashdeliver even more light to deeper
rehabilitation
and manufacturing. He holds injuries (1° and 2° grade of the Quebec Task
as biostimulation
modulation, and light-based lasers. 8
devices Morimoto Y, Saito9 numerous nopatents
A, Tokuhashipublished
Y. and
Lowhaslevelco-reports onclassification)
Force the advantagesinvolving muscles and tissues.
authored
therapy over 20 publications in the
Ther.field of ligaments. Muscles, Ligaments, Tendons J.
canThe FDA
be used alsoa classifies
to address variety of lasers by
laser for sports
of pulsed
injuries. Laser
light in reducing
2013;3(2):106-111.pain and
2013;22(1):17-20.
photobiomodulation. He is currently the VP
medical issues.12 When a compre-
their output power. Early
hensive treatment approach is used, FDA-approved
Hashmi JT, Huang
for research 10
andYY, inflammation
Sharma SK,atetLiteCure.
development
of pulsing in low-level light therapy. Lasers
al. Effect
in humans.
CLINICALCONCERNS
A
14
review CLINICALCONCERNS
I, Angiero F. Effect of diode laser byin the A bright future
Vallone F, Benedicenti S, Sorrenti E, Schiavetti

treatment of patients with nonspecific chronic

therapy lasers were Class 3b lasers
laser therapy is an effective modality. 13-
WENDY Hashmi,
Surg Med. 2010;42(6):450-466.
S. FRYDRYCH
Tedford CE, DeLapp S, Jacques S, Anders J.
11
et, PhD,
al.,isthat looked
low back pain: ata CWrandomized versus Scientifically sound research is
controlled trial.
17 Lasers are being used with great Photomed Laser Surg. 2014;32(9):490-494.
(maximum 0.5 watts).
success in chiropractic, veterinary
In 2003, the
Quantitative
intraparenchymal LiteCure.
ofpulsed
the clinical
analysis transcranial
Wendy has
light penetration
light
studies manager
and
inahuman
BS in
concluded
at
Tumilty
that
S, Baxter
15 more
D. Effectiveness of class
advancing in the field of photobio-
4
modulation, and light-based devices
lasers for Achilles tendinopathy. Lasers Surg
Morimoto Y, Saito A, Tokuhashi Y. Low level
9

medicine, professional sports, and cadaver brain tissue.

physics
2015;47(4):312-322.
Lasers
University
fromSurg
and a
Med.
Pennsylvania
PhD in
State
materials
Med. can be used
2015;47(S26):38. to address a modulation,
variety of laserand
therapy light-based
for sports injuries. Laser
2013;22(1):17-20.
devices
Ther. 9 Morimoto Y
rehabilitation clinics around the Robertsmedical
DB, Kruseissues. WhenThe a compre- laser therap
can be used to address a variety al. of
16 12 SF.
RJ, Stoll
Optical
scienceSociety
12
and of America. “Photobio-
engineering from the University Hashmi JT, Huang
10 YY, Sharma SK, et Effect
world.18,19 modulation.” http://www.osa.org/en- effectiveness
hensive of therapeutic
treatmentclass IV (10W)is used,
approach of pulsing in low-level light therapy. Lasers 2013;22(1):
of Pennsylvania. She can be contacted at
R E P R I N T E D F R O M C H I R O P R A C T I C E C O N Ous/photobiomodulation.
MICS •
wendyf@litecure.com.
2015.
OUpdated
Accessed Sept. 4, 2015.
C T O BSept.E R 22, 2 7, 2 0 1 5 laser treatment for epicondylitis. Lasers Surg
laser therapy is an effective modality.
Med. 2013;45(5):311-317. medical issues. When a compre-. C O M
13- Surg 12
Med. C
2010;42(6):450-466.H I R O E C O
10 Hashmi JT
LUIS H. DE TABOADA , MSEE, Tedford CE, DeLapp S, Jacques S, Anders J.
11
Lasers
Bharatiare being R,used withK. great
hensive treatment approach isand
used,
Karlekar17 A, 17 S, Saxena Mehta
has over 20 years’ experience in Conforti M,
References
Fachinetti
13 GP. High power laser
Assessment of feasibility and efficacyveterinary
of class
Quantitative analysis of transcranial of pulsing
therapy treatment compared to simple success in chiropractic, intraparenchymal light penetration in human
medical laser design, development, segmental
Mester physical
E, Mesterrehabilitation
1 AF, Mester A. in The
whiplash
biomedical medicine, professional sports,laser
IV laser therapy for postoperative pain relief in
and therapy is
cadaver an
brain effective
tissue. Lasers Surgmodality.
Med. 13- Surg Med.
and manufacturing. He holds injuries (1°ofand
effects 2°application.
laser grade of theLasers
Quebec SurgTask
Med. off-pump coronary artery bypass surgery 2015;47(4):312-322. 11 Tedford C
rehabilitation clinics
Cardaround the
numerous patents and has co-
authored over 20 publications in the field of
Force classification) involving muscles and
1985;5:31-39.
ligaments.
Hamblin Muscles, Ligaments,TN.
MR, Demidova
2 Tendons J.
Mechanisms of
patients: A pilot study. Ann
2015;18(3):317-322.
world.18,19
Anaesth. 17
Lasers are being
Optical 12 used
Society of America. with great
“Photobio-
Quantitativ
modulation.” http://www.osa.org/en-
photobiomodulation. He is currently the VP 2013;3(2):106-111.
low level light therapy. Proc. of SPIE.
Vallone F, Benedicenti S, Sorrenti E, Schiavetti
2006;6140(612001):1-12.
14
Frostad M, Poulis G, Copeland G. Major
18

league relief: Laser therapy provides non-

success in chiropractic,
us/photobiomodulation. veterinary
Updated Sept. 22, intraparen
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therapy treatment compared to simple 2015;47(4)
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lowAccessed
back pain:
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a randomized
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lasers for Achilles tendinopathy. Lasers Surg
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physics from Pennsylvania State authored over 20 publications in the field of
University and a PhD in materials
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home.html. Sept.light-based devices
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photobiomodulation. He is currently the VP 2013;3(2):106-111. us/photobi
laser therapy for sports injuries. Laser Ther.
science and engineering from the University
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16 Roberts 3, 2015.
Kruse RJ, Stoll SF.
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PG 5

TOP 10 Biological Effects

of Laser Therapy

Anti-Inflammation
Laser therapy reduces inflammation with vasodilation, activation of the lymphatic drainage system,
and reduction of pro-inflammatory mediators. As a result, inflammation, erythema, bruising, and
edema are reduced.

Analgesic Effect
Laser therapy of diseased and damaged tissue produces a suppression of hypersensitive nociceptors,
normalization of the membrane firing threshold, and an increased release of tissue endorphins. The
result is a decreased patient perception of pain.

Accelerated Tissue Repair and Cell Growth

Photons of light from lasers penetrate deeply into tissue and accelerate cellular reproduction and
growth. Laser light increases the energy available to the cells so that they can take on nutrients and
get rid of waste products more quickly.

Improved Vascular Activity

Laser light significantly increases the formation of new capillaries in damaged tissue. This speeds the
healing process, resulting in more rapid wound closure.

Increased Metabolic Activity

Laser therapy of diseased and damaged tissue produces a suppression of hypersensitive nociceptors,
normalization of the membrane firing threshold, and an increased release of tissue endorphins. The
result is a decreased patient perception of pain.

Trigger Points and Acupuncture Points

Laser therapy stimulates muscle trigger and acupuncture points without mechanical invasion to pro-
vide musculoskeletal pain relief.

Reduced Fibrous Tissue Formation

Laser therapy reduces the formation of scar tissue.

Improved Nerve Function

Slow recovery of nerve functions in damaged tissue may result in numbness and impaired limbs. La-
ser therapy accelerates nerve cell regeneration.

Immunoregulation
Therapy laser photons have an effect on the immune system’s status through stimulation of immuno-
globins, neutrophils, and lymphocytes.

Faster Wound Healing

Laser light stimulates fibroblast development. Fibroblasts produce collagen, which is predominant in
wound healing in damaged tissue. Collagen is the essential protein required to replace old tissue or
to repair tissue injuries. As a result, laser therapy is effective on open wounds and burns.
 PG 6

What Role Does Power Play in Dosing?

There are many different types veterinary la-
ser therapy devices. Class IV, Class IIIB, Class
III, and even Class II lasers may be used for
therapy. One parameter that separates these
lasers from one another is its available power.
What role does power play in achieving clinical
results for pet pain?
Power impacts the functional depth of pen-
etration of the laser light. The combination
of treatment time and power determines the
therapeutic dose of energy that is received
by tissues at depth. If a therapy laser has low
power, the total number of Joules it can deliver
to relevant depths for treating most musculo-
skeletal conditions in a realistic treatment time
is very low.
For example, to treat the lumbar spine for
arthritis on a large dog with a treatment area
of 300 cm2, since it is a deep condition, an ef-
fective target dose of 10 Joules/cm2 is 3,000
Joules (300cm2 x 10 J/cm2 = 3,000 J). Below is
an example of how long it would take to deliver
3,000 J of therapeutic energy with 4 different
lasers of varying power capabilities:
• 5mW Laser = 10,000 minutes (166.7 hours)
• 500mW Laser = 100 minutes (1 hour 40 min.)
• 3W Laser = 16.7 minutes
• 10W Laser = 5 minutes
Therefore, treating with a low-powered laser
will deliver less than the identified therapeutic
dose of 3,000 Joules simply because the treat-
ment time is unrealistic. Companion Therapy
lasers enable you to deliver power from 500mW
up to 15 Watts giving you the flexibility you
need to give every condition the appropriate
therapeutic dose. Understand the difference
between class IV laser therapy and other thera-
py devices before you invest.

What is Your Time Worth?

Your time is valuable – and providing your patients with the best care in
the most efficient amount of time is a priority. Class IV therapy lasers are a
great resource to maximize your staff’s efficiency in treating your patients.

Class IV laser therapy enables you to deliver a therapeutic dose of Joules

(J) to a larger area of target tissue in a shorter period of time: ultimately
resulting in positive, consistent, clinical results. Higher power and the op-
tion to deliver treatment in continuous wave give the clinician the flexibil-
ity to deliver the therapeutic dose of energy in less time than with other
lower-powered devices. This technology is very effective at reducing pet
pain and speed healing.

Class IV laser therapy is often able to provide pain relief to pets suffering
from a variety of conditions such as arthritis and otitis. Flexibility of treat-
ment delivery gives the clinician the power to deliver therapy in either
contact or non-contact mode to maximize results based on the presenting
condition.

Provide your patients with a quick, medication-free solution to their pain

while maximizing staff efficiency in the clinic with a Companion therapy
laser.
PG 7

What Can Laser

Therapy Treat?

Laser Therapy: A Powerful Adjunct

Due to the drug-free, non-invasive nature of laser therapy it is often used as a powerful adjunct to
existing treatment protocols. It can be used before, during, or after surgical procedures, alongside
pharmacological management of certain conditions, and in conjunction with rehabilitation programs.
Since laser therapy has a broad spectrum of physiological effects, mainly surrounding the reduction
of pain and inflammation and increasing the speed of healing, it is a versatile tool as part of a multi-
modal approach to treating MANY common conditions in veterinary medicine.

Common Acute Conditons That Benefit from Laser Therapy

• Abscesses • Otitis
• Acral Lick Dermatitis • Post Surgical Pain Relief
• Acute Nephritis • Post-Operative Healing
• Acute Pain • Pyotraumatic Dermatitis
• Bacterial Infections • Skin Grafts
• Burns • Snake Bites
• Edema • Soft Tissue Trauma
• Fractures • Sprains & Strains
• Fungal Infections • And More...
• Mastitis

Common Chronic Conditons That Benefit from Laser Therapy

• Arthritis • Neurological Disorders

• Bursitis • Orthopedic Disorders
• Chronic Pain • Otitis
• Degenerative Joint Disease • Pyoderma
• Feline Asthma • Respiratory Disorders
• Geriatric Disorders • Stomatitis
• Gout • Urinary Tract Disorders
• IVDD • And More...
 PG 8

Baring Boulevard Veterinary Hospital, Severe Demodicosis,

American Staffordshire Terrier
Author: Baring Boulevard Veteinary Hospital, Reno, NV

Signalment: 2 year old, M/N, American Staffordshire Terrier, “Bosley”

CASE CONTEST: SEVERE DEMODICOSIS
RUNNER UP CASE
CONTEST WINNER!
Presentation: Presented after being taken in by Animal Control, received single dose of Ivermec-
Baring Boulevard Veterinary Hospital, Reno, Nevada
tin SC injection and had received Prednisone 20mg PO SID for unknown duration. DVM diagnosed
severe Demodicosis and discontinued steroids, started Cephalexin and benzoyl peroxide bathing/
Species daily
shampoo, and Breed
Ivermectin PO and 2laser therapy.
year old, M/N, American Staffordshire Terrier, “Bosley”

Presentation Presented on
after1/29.
being taken in by Animal Control,
Treatment Details: Started laser therapy Approximately 85%received singleskin
of total dose surface
of Ivermectin SC
treated for
injection and 2had received2Prednisone 20mg PO SID for unknown duration. DVM
total dose of 16,200 J at 6W over ~3,200 cmsteroids,
discontinued (5 J/cm ). Cephalexin and benzoyl peroxide bathing/shampoo, daily
started
Ivermectin PO and laser therapy.
Every other day treatment for 5 treatments, then weekly through 3/1 when all lesions resolved.
Started laser therapy on 1/29. Approximately 85% of total skin surface treated for total
Treatment Details
dose of 16,200 J at 6W CW over ~3,200 cm2 (5J/cm2).
Treatment Results: “Patient’s skin Every
lesions/disease
other day treatmentshowed rapid then
for 5 treatments, reduction in erythema,
weekly through 3/1 when all crusting, and
pruritis leading to marked improvement in patient’s comfort level while managing/treating general-
lesions resolved.
ized demodicosis/pyoderma.
Treatment Results Overall healing
“Patient’s process was
skin lesions/disease showed dramatically accelerated
rapid reduction in by laser
erythema, crusting, therapies
and pruritis
leading to marked improvement in patient’s comfort level while managing/treating
and most importantly comfort was generalized
makedlydemodicosis/pyoderma.
improved throughout laser therapy period.” – Dr. Sara
Overall healing progression was dramatically
Hogel accelerated by laser therapies and most importantly comfort was markedly improved
throughout laser therapy period.”—Dr. Sara Hogel

Photos courtesy of Baring Boulevard Veterinary Hospital, Reno, Nevada

1/21 1/21 1/29

1/29 1/31 (Post 2nd Treatment) 2/4 (Post 4th Treatment)

2/22 (Post 7th Treatment) 3/1 (Post 9th Treatment) 5/7

“The Companion Laser is the best investment I have ever made.

And Companion is the best company I have ever worked with.”

Gary E. Stevens, DVM

Care Hospital for Animals
Oshkosh, Wisconsin
PG 9

Best Friends Forever Veterinary Care, Chronic Wounds

& Stomatitis, Feline

Author: BFF Veterinary Care, Minneapolis, MN

Signalment: 5 year old, M/N, DSH Feline, “Stewie”

Presentation: Presented in 2009 with mild stomatitis. Treated over the next four years with a combi-
nation of steroids, diet change, antibiotics, homeopathy and multiple pharmacologic analgesics as
well as partial dental extraction. Patient also experienced feline hyperesthesia, constantly biting and
chewing his skin, and was treated with amitriptyline as well.

Secondary to the long term use of steroids for his stomatitis, Stewie’s skin was very thin and tore eas-
ily, resulting in four episodes of skin tears/ wounds created by normal grooming

Complications from suturing these wounds and the placement of Penrose drains in his thinned skin
resulted in further skin tearing. Despite extensive workup and therapies, Stewie’s stomatitis contin-
ued to worsen and by April 2013, he was anorexic and had experienced weight loss secondary to this.
Additionally, he was withdrawn and painful and the owners were considering euthanasia due to his
poor quality of life.

Dr. Smith outlined each problem and complication, adding that each new issue and its treatment
seemed to complicate or exacerbate his other problems. “For instance, each skin tear seemed to
increase the hyperesthesia, and Stewie’s attempts to deal with the hyperesthesia created more skin
tearing. It was difficult to orally medicate him because his mouth was so painful. Weight loss also
reduced his immune resistance. Stewie, who had been a lively, friendly cat, refused to get out of bed,
eat or interact with the owners or the other cat.”

Treatment Details: Stomatitis – Open Mouth = 186 Total Joules (at 3W), Closed Mouth = 360 Total
Joules (at 4W); Wound – 2×3 = 196 Total Joules to 45 cm2 area (4.35 J/cm2) at 2W

Stewie was initially treated 2 to 3 times weekly, decreasing treatment frequency as his condition im-
proved.

Treatment Results: By improving the quality of his skin and decreasing his somatic pain, his owners
felt his improved quality of life justified further [dental] extractions. …Laser treatment following his
oral procedures allowed the gingival, tonsillar and lingual lesions to heal.

“By removing most of the remaining problem teeth and following up with laser treatment for post-
extraction healing, Stewie’s appetite returned, he began to eat normally and put on weight. We were
able to significantly reduce pain medication and completely eliminate antibiotics and steroids.” – Dr.
Smith
 PG 10

Photos and case courtesy of Dr. Jerri Smith and Christine Garbow, CVT, from BFF Veterinary Care in Minneapolis, Minnesota.

Stewie Stomatitis 5/15 Skin tears 5/15

Skin Tears 5/15 Improved skin 6/28

Webinar: Case Highlight

Photobiomodulation Benefits for Very Difficult Cases

In this 60-minute webinar, presented by Ronald J. Riegel, DVM learn

about laser therapy for hard-to-treat conditions.

Watch it now at: http://www.litecureinfo.com/PhotobiomodulationForDifficultCases

PG 11
5 Things to Ask Before
You Buy a Therapy Laser
If you are thinking of adding
Class IV laser therapy to your
practice there are a few ques-
tions you should ask before
you make a purchase. You
should be purchasing more
than a laser for pet pain –
but a total solution for your
practice. Here are 5 ques-
tions you should ask a your
sales representative before
you buy:
1 Implementation: Many
companies say they
provide implementation solu-
tions for your practice, but
take the time to dig deeper
to understand the details of
the support materials they
provide. Does the implemen-
tation program help educate
the staff and clients alike?
What components are really
included in the program?
Some companies offer com-
prehensive marketing toolkits
that include both staff and
patient education tools. The
more comprehensive toolkits
should include client educa-
tion videos, presentations,
ads, banners, training videos,
promotional materials for
the office, website resources
and marketing tips. Also
ask if they have a marketing
consultant too – this added
service can be a huge asset
to your practice.
2 Downtime: When add-
ing any type of capital
equipment to your practice
there is always the possibil-
ity that the unit will require
repair or maintenance. Ask
your sales representative
what happens if your laser
therapy equipment experi-
ences a failure. Will they
send you a loaner unit? How
long will it take to repair
your unit? The answer you
should get is that the com-
pany will deliver a loaner
system to you overnight to
ensure you don’t go a day
without your therapy laser.
3 On-Going Laser Ther-
apy Education: Ask
about what kind of edu-
cational opportunities are
available after you purchase
your laser therapy equip-
Did You Know?
ment. Some companies offer
on-going seminars, webinars,
users’ conferences, and spe-
cial CE events. Also ask if the
company you plan to work with
is engaged in scientific studies
– is the company continuing to
educate itself too? The strong
companies are constantly striv-
ing to learn and teach.
4 Clinical Support: If a pa-
tient comes in and you are
not sure how to approach their
condition is there someone at
the laser therapy company you
can talk to? Clinical support is
a must-have. Ask about who
the clinical experts are on staff
that will answer your questions –
what are their credentials?
5 Customer Care: Is there a
dedicated customer care
department? How long does
it take for them to get back
to you? When you are having
a problem the last thing you
want to do is wait. Go with a
company who prides itself on
outstanding customer care after
the sale.
Class IV laser therapy can have a
real impact on your patients and
your practice. Be sure you are
selecting a company who will
be your laser therapy partner for
the long-term.
Companion Therapy
Lasers are manufactured
in the USA?

Why Choose Companion®?
Your Innovation Partner
The Company
Innovation
Whether you are considering adding laser
therapy, regenerative medicine, or another
Companion rehabilitation product - Companion
allows you to practice reliable, innovative medi-
cine.
You can elevate your standard of care with con-
fidence. Keep a finger on the pulse of the most
innovative therapeutic solutions with Compan-
ion.
Partnership
You don’t just purchase a product with Com-
panion - you gain a clinical and business part-
ner. Leverage the Companion CORE business
consulting program to realize success with any
Companion Product.
Education
Never be left behind - Companion provides you
with the most current research and applications
through a multi-channel education program.
Versatility
Effectively treat a wide variety of clinical condi-
tions with a Companion product.
Synergy
Realize synergy by leveraging multiple Com-
panion products to achieve the best clinical
outcomes for every patient. Every time.
PG 12
The Therapy Lasers
Outcomes
Backed by scientific evidence and on-going
research you can achieve the best results with a
Companion Therapy Laser. On-going software
updates ensure you are always practicing the
most current medicine.
Achieve results on acute and chronic conditions
alike. Treat with ease with the most species-
specific protocols available on any therapy laser
on the market.
Clinical Support
Veterinarians are on staff and available to an-
swer your clinical questions. Receive on-going
clinical training with monthly webinars and
other Companion University educational op-
portunities.
ROI
Realize ROI with the Companion CORE imple-
mentation program. The program includes
one-on-one consulting.
Education
Attend live events or monthly webinars for the
latest applications.
Customer Support
Never spend a day without your most versatile
tool. Customer support and a loaner program
ensures you are always up-and-running.
Ebook Provided Courtesy of

For more information about how a

therapy laser can transform your clinic
call 877-627-3858 to set up your in-office
demonstration.

CompanionAnimalHealth.com
302-709-0408