Shining a Light on Canine Heroes

Unlike family pets, working dogs require a different level of veterinary care with a particular urgency. If a working dog becomes injured or ill, it often cannot effectively perform its job and may have to be temporarily taken out of service or even retired. That leaves a gap in the service they provide to a community. Photobiomodulation therapy, which includes laser therapy, can help accelerate healing and reduce pain and inflammation helping to speed their return to service.

Laser Therapy and Working Dogs

by Maureen Blaney Flietner

THEY ARE OUR UNSUNG HEROES—HIGHLY TRAINED, HARD-WORKING SPECIALISTS who find the lost, the trapped, the deceased; who subdue criminal suspects and enemy soldiers; who detect narcotics and bombs. They often work through long shifts over multiple days. But away from work, they like time with a chew toy as much as the next dog.

But, unlike the family pet, working dogs require a different level of veterinary care, care that comes with a particular urgency. And that is why modalities such as laser therapy have a role in their recovery.

“When we’re treating working dogs, our goal is often multifactorial,” explained Tracy Darling, RVT, VTS (SAIM), CCRP, CCFT, senior director of canine operations at the National Disaster Search Dog Foundation in Santa Paula, California. The nonprofit, nongovernmental organization rescues and recruits dogs and partners them with firefighters and other first responders to find people buried alive in the wreckage of disasters.

“Our primary goal is to alleviate pain and suffering, just like with any companion animal, but also, working dogs are really valuable. We want to get them back to work, and they want to work. They really don’t like to be couch potatoes. Anything that we do to shorten the duration of an injury or disease or promote mobility to get the dogs back to work quicker makes everybody happy.

“When a working dog becomes injured or ill, they often cannot effectively perform the jobs for which they have been trained and may have to be temporarily taken out of service or, in some cases, they may have to be retired from service,” she explained. “That can create gaps in care or coverage for their handler or the community. Early diagnosis and treatment can be beneficial in reducing the amount of time a dog might need to be out of service.”

Injuries Come with the Jobs

Unfortunately, there is a wide range of injuries seen in working dogs depending on the job they perform.

1.png“Musculoskeletal disease and soft tissue injuries such as wounds, muscle sprains and strains (including cruciate ligament disease), osteoarthritis, lumbosacral disease with lower back pain, and fractures are most often reported in working dogs,” explained Bess J. Pierce, DVM, MS DABVP, DACVIM, DACVSMR, professor of veterinary medicine at Lincoln Memorial University College of Veterinary Medicine in Harrogate, Tennessee. “These dogs tend to be exposed to greater risk for injury in their working environments, and traumatic injuries are relatively common,” Pierce said. “Dermatologic disease such as skin and ear infections and gastrointestinal disorders are also frequently seen in this population of dogs.”

F1_photo_Matthew_Brunke_DVM.jpg
Matthew Brunke,
DVM, DACVSMR, CCRP,
CVPP, CVA

Matthew Brunke, DVM, DACVSMR, CCRP, CVPP, CVA, is the medical director of Veterinary Surgical Centers Rehabilitation, a surgery, physical rehabilitation, and pain management practice with sites in Vienna, Leesburg, and Winchester, Virginia. Brunke sees military working dogs and government-owned single-purpose and dual-purpose canines: patrol alone, patrol/narcotics, or explosives detection from local, state, and federal agencies. He also works with search canines. He said he is “absolutely” aware of the particular chronic or acute injuries common to the type of work the dogs do.

In his experience, acute injuries to the dogs he sees include “lacerations or trauma tears of tendons and ligaments, which, while not common, can occur and cause setbacks in training and working. Acute skin wounds also can occur.”

Brunke said he also sees chronic conditions that come from repetitive stress injuries common in overtrained dogs doing bite work. Those are cervical disk issues, biceps tendinitis, and others.

“We also see issues related to lumbosacral disease that can be degenerative but also from chronic ‘hupping’ (when dogs search high by placing their forepaws on an elevated surface while keeping their hind paws on the ground) and dogs with degenerative osteoarthritis.” A presentation made at the International Working Dog Conference in Sweden in September 2019 by Andrea L. Henderson, DVM, MS, DACVSMR, chief of rehabilitation at the Department of Defense Military Working Dog Vet Service, detailed some of the issues that happen with military working dogs.

Henderson noted that “orthopedic and neurologic injuries represent a large proportion of causes of death/discharge from duty or prolonged recovery of military working dogs.” Contributing factors to these injuries, she reported, were breed/genetics; conformation and drive; kennel environment; cyclic, repetitive loading; hupping; jumping down; traumatic tissue load to failure; jumping from high positions; torque under high strain such as a sudden turn with a limb caught; rapid eccentric load; sudden onset of high-intensity exercise; and navigating hazardous/unstable terrain.

Learn More About Caring for Working Dogs

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Curious about caring for the health of working dogs?
In addition to the 2021 AAHA Guidelines for Working,
Assistance, and Therapy Dogs, practitioners or
hospitals interested in providing care to working dog
populations can take advantage of continuing education
sessions, said Pierce. Three places to check are:

“They highlight the important differences between
working dogs and pet dogs,” said Pierce. “Working dog
veterinary caregivers must be well versed in behavior,
occupational requirements, fitness, nutrition, specific
dental care needs, and preventive care strategies of
these dogs. But there is nothing more gratifying than
helping working dogs.”

Even for dogs returning to duty, orthopedic surgery and rehabilitation can result in three months minimum out of duty and cost a minimum of $5,000 to $7,000 per patient, according to Henderson.

Kick-Starting the Healing

“With pet dogs,” said Darling, “veterinary treatment may often proceed with a strategy of ‘let’s try and see if this helps and if it doesn’t, we will dig deeper.’ With working dogs, it’s important to get to the bottom of things quickly to get them back to full function.”

One way to help these dogs who may suffer certain conditions and injuries is with laser therapy. Trupanion, a pet insurance provider based in Seattle, Washington, that includes working dogs among its insured, noted that the most common illness and injury claims it receives that include laser therapy as part of treatment are lameness and limping, CCL tears, masses, and arthritis. Laser therapy is most useful as an adjunctive therapy with other treatment modalities such as rehabilitation and acupuncture and is a series of treatments of varying frequency, usually over months, according to Caroline Wilde, DVM, staff veterinarian at Trupanion.

Laser therapy is also known as cold laser or low-level laser therapy. That is meant to distinguish it from the more powerful Class 4 lasers that can lead to heating of the tissue and cause burns when improperly applied, explained Pierce.

“Laser therapy appears to stimulate cellular function, leading to production of compounds such as nitrous oxide, increased adenosine triphosphate production, and enhanced gene transcription that ‘kick-start’ the cell, promoting cell proliferation, migration and healing,” she said.

Pierce also noted that laser therapy “inhibits the production of inflammatory compounds. Pigments within the tissue such as melanin and hemoglobin absorb light at wavelengths shorter than 600 nanometers, which is the reason that laser therapy utilizes red to near-infrared light. Haircoat, pigmentation, and thickness of tissue can affect the absorption of light and will determine the effectiveness of the therapy.”

Laser therapy is a form of photobiomodulation, which is the preferred scientific term, according to Brunke. It was added to the Medical Subject Headings (MeSH) thesaurus of the National Library of Medicine in 2016 to distinguish nonthermal therapies from those using light-based devices that rely on thermal effects. Besides laser therapy, photobiomodulation includes light-emitting diode (LED) arrays. Their power was first discovered in a NASA-funded research project to treat chronic pain.

Wavelengths are in the spectrum of red to near-infrared light (600–1,070 nanometers), explained Pierce. In these therapies, light energy is converted to chemical energy and produces downstream molecules at the cellular level. The photochemical effects triggered have been compared by some to the process of photosynthesis in plants. Brunke said photobiomodulation “can be very WOW.” He uses the therapy for its pain-relieving effects and the ability to help with wound healing.

More Well-Designed Studies Needed

Pierce said it’s always gratifying to see a positive response to therapy when the dog is experiencing pain or dysfunction. She said she finds the therapy to be most useful and best supported by the scientific literature for treating skin lesions, incisions, and wounds.

“I also use laser therapy as an adjunctive therapy for osteoarthritis, particularly in working dogs that are at greater risk for gastrointestinal NSAID-related adverse effects. Most working dogs tolerate the treatment sessions well, which can be a challenge in this high-drive population,” she noted.

When used appropriately, this therapy is considered to be safe with few adverse effects. It is important to learn the theory and apply the principles of laser therapy in calculating and delivering doses to the patient, Pierce cautioned. “Don’t rely solely on the preprogrammed settings on the unit. As always, it is the practitioner’s responsibility to make adjustments for individual patient differences and needs. Adhere to safety protocols to protect the patient, owner, and therapist during treatment sessions.”

AAHA Working Dog Guidelines

The 2021 AAHA Guidelines for Working, Assistance, and Therapy Dogs discuss recommendations for dogs trained for protection, odor/ scent detection, service functions for people with diagnosed disabilities or physical limitations, emotional support, and therapeutic intervention.

They also note that to the extent that is reasonable and possible, the medical care rendered to the service/ working dog merits the highest priority and highest capability available. Read and download the full guidelines at aaha.org/workingdog.

Pierce noted that while laser therapy has been promoted as an effective treatment for a wide variety of diseases, there is a lack of well-designed, controlled studies in both the human and veterinary fields to support many of the claims and to determine appropriate and effective doses and protocols.

But the therapy does look promising.

“In humans, it has been shown to promote healing in chronic wounds such as diabetic ulcers that have not responded adequately to other therapies, and we see a similar positive response in our veterinary patients,” she said.

“There is emerging evidence for its use in decreasing inflammation and providing pain relief through modification of nociceptive pathways. It continues to show promise as an appropriate modality to treat a variety of inflammatory conditions such as osteoarthritis, dermatitis, and gingivitis.”

There has been ongoing interest in examining it as a treatment for drug-resistant skin infections such as methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus pseudintermedius (MRSP). Preliminary studies have shown laser therapy to be effective in reducing numbers of pathogenic bacteria in these chronic infections. Other areas of interest are on bone healing and intervertebral disk disease, said Pierce. Brunke, too, sees promise for the therapy. He noted that he had seen recent papers about how higher doses of photobiomodulation therapy were safer and more beneficial than lower doses for elbow arthritis and for the treatment of degenerative myelopathy.

Darling, who remotely monitors the veterinary care of about 80 search dogs across the country, said that her best advice to veterinary hospitals is to follow the evidence and utilize measurable outcomes to guide therapy. “Patients should be monitored regularly for response to therapy, and adjustments should be made to ensure the modality is providing the expected benefits. In some cases, the dose, frequency, or technique may need to be adjusted to maximize therapeutic benefit. That being said, not every dog or every injury will benefit, and clinicians should choose the therapeutic modality or modalities most appropriate for the individual patient,” she noted.

 

Maureen Blaney Flietner
Maureen Blaney Flietner is an award-winning freelance writer living in Wisconsin.

 

Photo credits: Photo courtesy of Search Dog Foundation, RichLegg/E+ via Getty Images. Photo courtesyBess Pierce. Photo courtesy of Matt Brunke, Photo courtesy of Search Dog Foundation, RichLegg/E+ via Getty Images.

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