Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.
Issue link: http://todaysveterinarypractice.epubxp.com/i/321264
May/June 2014 Today's Veterinary Practice 65 Laser Therapy in Companion Animals REVOVERY & REHAB | tvpjournal.com ATP = adenosine triphosphate; COX-2 = cyclooxygenase-2; laser = light amplification by stimulated emission of radiation; LLLT = low-level laser therapy; nm = nanometer; OA = osteoar- thritis; PGE2 = prostaglandin E2 References 1. Millis dL, Saunders dG. Laser therapy in canine rehabilitation. in Millis dL, Levine d (eds): Canine Rehabilitation and Physical Therapy, 2nd ed. Philadelphia: elsevier, 2014, pp 359-380. 2. djavid Ge, Mortazavi SMJ, Basirnia A, et al. Low level laser therapy in musculoskeletal pain syndromes: Pain relief and disability reduction. Lasers Surg Med 2003; 152:43. 3. Stelian J, Gil i, Habot B, et al. Laser therapy is effective for degenerative OA. improvement of pain and disability in elderly patients with degenerative OA of the knee treated with narrow-band light therapy. J Am Geriatr Soc 1992; 40:23-26. 4. Chow rT, Heller GZ, Barnsley L. The effect of 300 mw, 830 nm laser on chronic neck pain: A double-blind, randomized, placebo-controlled study. Pain 2006; 124:201-210. 5. Belanger AY. Laser: Evidence Based Guide to Therapeutic Physical Agents. Philadelphia: Lippincott williams and wilkins, 2002. 6. Bjordal JM, Lopes-Martins rA, Joensen J, et al. A systematic review with procedural assessments and meta- analysis of low level laser therapy in lateral elbow tendinopathy (tennis elbow). BMC Musculoskelet Disord 2008; 9:75. 7. Hasmi JT, Huang YY, Sharma SK, et al. effect of pulsing in low-level light therapy. Lasers Surg Med 2010; 42(6):450-466. 8. Karu T. Mitochondrial mechanisms of photobiomodulation in context of new data about multiple roles of ATP. Photomed Laser Surg 2010; 28(2):159- 160. 9. Medrado Ar, Pugliese LS, reis Sr, Andrade ZA. influence of low level laser therapy on wound healing and its biological action upon myofibroblasts. Lasers Surg Med 2003; 32(3):239-244. 10. rubio Cr, Cremonezzi e, Moya M, et al. Helium-neon laser reduces inflammatory process of arthritis. Photomed Laser Surg 2010; 28(1):125-129. 11. de Morais NCr, Barbosa AM, vale ML, et al. Anti-inflammatory effect of low- level laser and light-emitting diode in zymosan-induced arthritis. Photomed Laser Surg 2010; 28(2):227-232. 12. Hegedus B, viharos L, Gervain M, et al. The effect of low-level laser in knee OA: A double-blind randomized placebo- controlled trial. Lasers Surg Med 2003; 33:330-338. 13. Oliveria FS, Pinfildi Ce, Parizoto NA, et al. effect of low-level laser therapy (830 nm) with different therapy regimes on the process of tissue repair in partial lesion calcaneous tendon. Lasers Surg Med 2009; 41(4):271-276. 14. Fung dT, Ng GY, Leung MC, Tay dK. Therapeutic low energy laser improves the mechanical strength of repairing medial collateral ligament. Lasers Surg Med 2002; 31(2):91-96. David Dycus, DVM, MS, Diplomate ACVS (Small Animal), is a staff surgeon at Regional Institute for Veterinary Emergencies and Referrals (RIVER) in Chattanooga, Tennessee. His interests include osteoarthritis, wound care, surgical oncology, fracture repair, bio- mechanics, and physical rehabilitation. Dr. Dycus received his DVM from Mississippi State University. After graduation, he pursued a rotating intern- ship at Auburn University; then completed a MS degree and small animal surgical residency at Mississippi State University. CAUTION: Federal (US) law restricts this drug to use by or on the order of a licensed veterinarian. BRIEF SUMMARY: Please consult package insert for complete product information. Indications: For use in dogs to prevent canine heartworm disease by eliminating the tissue stage of heartworm larvae (Diroflaria immitis) for a month (30 days) after infection and for the treatment and control of roundworms (Toxocara canis, Toxascaris leonina), hookworms (Ancylostoma caninum, Uncinaria stenocephala, Ancylostoma braziliense), and tapeworms (Dipylidium caninum, Taenia pisiformis). WARNINGS: For use in dogs only. Keep this and all drugs out of reach of children. In safety studies, testicular hypoplasia was observed in some dogs receiving 3 and 5 times the maximum recommended dose monthly for 6 months (see Animal Safety). In case of ingestion by humans, clients should be advised to contact a physician immediately. Physicians may contact a Poison Control Center for advice concerning cases of ingestion by humans. PRECAUTIONS: Use with caution in sick, debilitated, or underweight animals and dogs weighing less than 10 lbs. The safe use of this drug has not been evaluated in pregnant or lactating bitches. All dogs should be tested for existing heartworm infection before starting treatment with IVERHART MAX Chewable Tablets, which are not effective against adult D. immitis. Infected dogs should be treated to remove adult heartworms and microflariae before initiating a heartworm prevention program. While some microflariae may be killed by the ivermectin in IVERHART MAX Chewable Tablets at the recommended dose level, IVERHART MAX Chewable Tablets are not effective for microflariae clearance. A mild hypersensitivity-type reaction, presumably due to dead or dying microflariae and particularly involving transient diarrhea, has been observed in clinical trials with ivermectin alone after treatment of some dogs that have circulating microflariae. ADVERSE REACTIONS: In clinical feld trials with ivermectin/ pyrantel pamoate, vomiting or diarrhea within 24 hours of dosing was rarely observed (1.1% of administered doses). The following adverse reactions have been reported following the use of ivermectin: depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation. ANIMAL SAFETY: Studies with ivermectin indicate that certain dogs of the Collie breed are more sensitive to the effects of ivermectin administered at elevated dose levels (more than 16 times the target use level of 6 mcg/kg) than dogs of other breeds. At elevated doses, sensitive dogs showed adverse reactions which included mydriasis, depression, ataxia, tremors, drooling, paresis, recumbency, excitability, stupor, coma and death. No signs of toxicity were seen at 10 times the recommended dose (27.2 mcg/lb) in sensitive Collies. Results of these studies and bioequivalence studies support the safety of ivermectin products in dogs, including Collies, when used as recommended by the label. In a laboratory safety study, 12-week-old Beagle puppies receiving 3 and 5 times the recommended dose once weekly for 13 weeks demonstrated a dose-related decrease in testicular maturation compared to controls. HOW SUPPLIED: IVERHART MAX Chewable Tablets are available in four dosage strengths (see Dosage section) for dogs of different weights. Each strength comes in a box of 6 chewable tablets, packed 10 boxes per display box. STORAGE CONDITIONS: Store at 20° C-25° C (68° F- 77° F), excursions permitted between 15° C-30° C (59° F- 86° F). Protect product from light. For technical assistance or to report adverse drug reactions, please call 1-800-338-3659. Manufactured by: Virbac AH, Inc. Fort Worth, TX 76137 NADA 141-257, Approved by FDA IVERHART MAX is a registered trademark of Virbac Corporation. 09/11 ( ivermectin / / praziquantel ) © 2014 Virbac Corporation. All Rights Reserved. 3/14 CONTRAINDICATIONS & PRECAUTIONS TO LASER THERAPY 1 • Always use protective eye gear; furthermore, eyewear should be appropriate for the wavelength of the laser being used. • Never direct the laser into the eye. • Use caution around metal surfaces as they can cause scatter of the laser light. • Use caution with the following: pregnancy, open fontanels, around growth plates, malignancies, and photosensitive areas of the skin. • Darker skin and hair can absorb the laser light and cause excessive heating of the skin. TVP_2014_0506_RecovRehab_LaserTherapy.indd 65 5/23/2014 6:02:12 PM