Pododermatitis

Response to low Level Laser Therapy

Low level laser therapy (LLLT) increases cellular respiration and enhances neovascularization as well as reversing inflammation, hence accelerating healing.  A variety of wavelengths between 600 nm and 1100 nm have beneficial effects on tissue.  The lower end of that spectrum is more useful superficially while the higher end can penetrate deeper tissues as well, with those between 700 nm and 800 nm having less benefit. 

This case involved the use of the patented  ML 830 GaAlAs laser at 830 nm wavelength and 30 mW per diode (three diodes).  This instrument delivers 30 mW x 3 for 33 seconds per cycle.  30mW x 33 sec = 990 mJ (millijoules) of energy per diode, or approximately 3 J (Joules) for all three diodes per cycle.  This is a Class IIIb laser and, as such, must be handled properly, with all the laser safeguards outlined by the American National Standards Institutes in the documents, ANSI 136.1 and ANSI 136.3.  More on safety and training, as well as available publications, may be found at www.laserinstitute.org. 

Cocoa: 

Cocoa, a ten-month-old German Shepherd mix, had a history of Demodicosis which had completely resolved with conventional therapy.  Upon presentation to us he was experiencing much pain and tenderness while walking.  His owners had tried an unspecified over-the-counter ointment but is was too painful to the touch to treat.  The bottoms of all four feet were severely inflamed interdigitally.  The pads were apparently unaffected.

   

He was so painful we chose to treat empirically with antibiotics and antifungals rather than to scrape or biopsy.  We did not do an impression smear either.  The ML 830 laser was employed on all four feet at 6 Joules each in gentle contact mode.  He was rechecked in two weeks

   

Admittedly it would have been ideal to have a definitive diagnosis in this case, as it is uncertain whether it began as a Demodex flare-up or as a contact with some caustic substance in the environment.  Either way, the owners reported that relief was within hours and visible improvement within a couple of days with no topical therapy.  It is the opinion of the author that the laser, along with oral antimicrobials hastened the healing and greatly decreased the pain in this patient.

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