Develop your services with MLS® Class 4 Laser

Are YOU doing enough for your senior and rehab patients?

Dr Caroline Taylor, is a veterinary surgeon with a passion for making sure senior pets have access to the best available treatments and tools to manage long term conditions, to make their golden years the best they can be.

She had the pleasure of talking to Donna Hall recently, a senior Registered Veterinary Nurse at Paragon Veterinary Hospital. Donna set up a rehabilitation service at the hospital a couple of years ago, which has hugely enhanced the care of senior pets in the area. In fact, many new clients have come to the practice, to take advantage of the service and help manage their pets’ osteoarthritis.

Read on to find out how Donna established a successful rehabilitation and senior pet service…

Donna Hall is a qualified RVN, with many years of experience. Just prior to 2020, she looked to enhance her skills in rehabilitation and completed a Diploma in Canine Exercise Rehabilitation. Post COVID, when the practice became busier and busier, she began to offer senior clinics, complementing the vets’ work and supporting owners of elderly pets. This really was the springboard to launching a range of services at the practice she is based at, Paragon Vets.

 

What makes Paragon Vets a bit different from others in the area?

From the outside, Paragon Vets looks like any moderately sized mixed practice, offering a range of services to farm, equine and small animal patients. But what makes it different is its ethos: to encourage all staff members to develop individual expertise and provide unique services within their field of interest. Donna told me "Everyone helps each other. There is flexibility within the Rota, to fit clinics around other interests. While everyone takes their fair share of the standard routine vet work, each team member is encouraged to develop their own expertise. Some nurses have different niches in anaesthesia, or weight management, while I took an interest in post-surgery rehabilitation and senior health care."

 

Before acquiring therapeutic laser – how were you helping osteoarthritic pets and how did the practice support you?

Initially Paragon vets started offering senior health checks, run by nurses, for any pet identified with mobility issues at routine booster or nail clip appointments.

The next step was to offer an education program for owners. We felt this was the best way to disseminate important information to a wider audience and gave us an opportunity to promote our available services. We hosted a series of client evenings. The first involved an educational presentation and free mobility assessment. Everyone was given a free mobility pack including a Home Mobility Questionnaire and leaflets about available services including acupuncture, hydrotherapy and therapeutic laser. The second involved education on what the pet owners could do at home including range of motion and physiotherapy exercises.

Following the success of the senior clinics, we started rehab clinics for patients undergoing surgery. This began as post-surgery rehab exercises, but quickly evolved into a full pre-surgery mobility assessment with exercises recommended where necessary to strengthen the contralateral limb, maintain muscle mass and improve recovery rates. We measure static and dynamic movements with gait analysis, and provide an At Home Exercise Plan for owners, which includes passive and active range of movement exercises, along with advice on ‘What to do/Not do’ to manage the condition.

Even simple steps, like trimming the nails and the hair between the pads for better grip on slippery floors, can help arthritic pets. We also share the Canine Arthritis Management online resource for further tips and support. https://caninearthritis.co.uk/

With the help of Canine Exercise Solutions, which has a library of videos to help show owners the techniques required, we can provide an ‘exercise prescription’ to each pet https://canineexercise.com/

 

How did you assess the response?

We asked owners to complete questionnaires before and after several sessions to assess response rates. Norbrook provide an online pain scoring tool, which is really useful to watch for trends.

 

 

We also took muscle mass measurements regularly, and kept an eye on weight management to maximise impact of treatments given.

It was so successful!

We were then ready to add further treatment options to develop our rehabilitation service further. It was a natural step to combine MLS® Therapeutic Laser clinics with what we were doing already. We began to offer combined mobility assessment and laser therapy sessions at a discounted rate and had an additional client evening to inform our clients of the new service. Those who attended were offered a discount on booking a course of six laser treatments, and we also ran a competition: the prize being a free course of laser therapy!

 

How did MLS® Laser therapy transform your patient treatments?

When using laser to treat post-surgical patients, we noticed an increase in the speed of wound healing and a faster return to weight bearing and normal function. We seemed to have less setbacks after surgery, could reduce the anti-inflammatory medication sooner and the patients could start exercising more quickly.

It also helps to bond the client to the practice with regular check-ups, providing maintenance therapeutic laser sessions every 1-3 months.

We even picked up new clients, with post-surgical pets from other practices in the area that do not offer rehab support.

 

These days we are all so busy. How do you fit in the OA support and Laser sessions into your busy workload?

At the beginning, we started offering the service one day a week, and I reduced my surgical nursing time in theatre. It soon became busier and financially profitable. As a paid for service, often funded as a veterinary treatment within an insurance claim, and given the vast improvements seen in our patients, it made sense to utilise nursing time and develop this side of the business further. We trained more RVNs and also SVNs and ACAs, who sometimes help with the clinics and mobility assessments. We found that the training not only develops a new skill, but also improves the level of confidence of SVNs and ANAs overall when managing client relationships. Many have been more confident running health clinics and communicating with clients. Laser and mobility clinics run by nurses can actually save vets time in practice. The vets can confidently refer clients to us for extended advice consultations and we rely less on regular Cartrophen injections, preferring therapeutic laser as a first line in combination with NSAIDs and other medication as required.  We often successfully manage osteoarthritis with monthly laser sessions at the time of Librela injections. We have had a number of dogs on this protocol for many months, without needing other medications at all.

We can also save time by combining laser sessions with other regular checks, such as blood sampling or monitoring concurrent issues. Many senior pets have multiple problems being managed at the same time. We often do split consults - the vet checks the pet over first, we collect and run the blood sample and perform the laser treatment whilst the vet sees another client, then the results can be checked and reported at the end of the visit. It all works very efficiently!

 

Do you have any recent cases examples of Laser making a difference?

We recently had a Bichon Frise with a cranial cruciate rupture, whose owner declined surgery, so he had to be managed conservatively. Despite physiotherapy exercises and 6 weeks of rest he continued to limp intermittently and he was bunny hopping, and required regular doses of meloxicam

We started MLS® Laser and after six sessions over 3 weeks, he stopped bunny hopping, and was able to jump onto the sofa again. We now give a maintenance dose of laser treatment every 2-4 weeks, without needing any NSAID medication.

 

Did you see any unexpected benefits in your patients?

Sometimes our patients improve far more than expected. We recently treated a Belgian German Shepherd with really severe OA, who exacerbated the issue by jumping out of a car. He became non-weight bearing and all we could hope for was to make him comfortable enough to improve his quality of life. MLS® Laser dramatically helped his comfort levels, and after the 4^th session he was fully weight bearing. We hadn’t expected such a quick and dramatic response.  We have shared some videos of his progress on the CelticSMR website for you to see the difference: https://www.celticsmr.co.uk/news/veterinary-news-items/

We also notice an improvement in the behaviour of some dogs. Some of our patients are quite nervous and anxious attending the practice, after several visits for x-rays and surgery. After just a couple of MLS® Laser sessions, they love coming in, wagging their tail and happily settling down for the treatment. We treated a young collie who was scared of everything, and initially we needed to hide the laser head under a sleeve. He began to allow us to treat from a distance and within 2 weeks, he was not scared to visit anymore and now loves coming in to see us.

 

What else do you treat with laser on a regular basis that improves outcomes?

The laser is brilliant at treating pain and inflammation in all sorts of conditions in small animals. As well as post-orthopaedic surgery, we use it after wart removal and on hot spots. It’s great at reducing the amount of excess licking and seems to improve comfort levels. One of the staff members used the device on their horse with a huge haematoma, and it was amazing at bringing down the swelling.

 

What extra training did you complete in order to offer rehabilitation at Paragon vets?

I completed a two-year, online program to gain a Diploma in Canine Exercise Rehabilitation with the Animal Rehabilitation and Health Academy https://animalrehabhealth.academy/course/diploma-in-canine-exercise-rehabilitation/ They also offer a Certificate for qualified veterinary nurses, that can be completed in 12 weeks, with 12 hours study per week.

The additional training has given me the confidence to set up the mobility clinics, that now work in tandem with the treatments the vets are offering.

 

What would be your advice to a practice thinking of offering laser treatments to their patients?

Do It! Definitely do it!

Do your research into the various Therapy Lasers on the market. We chose the MLS® unit for several reasons:

• It is a Class 4 laser unit with high peak powers and short treatment times
• It is the only Class 4 Laser on the market that is designed to prevent too much energy being delivered to the tissue. This means that we can hold the handset still and provide targeted treatment and we don’t have to worry about burning our patients.
• The price!
• Celtic SMR provided full training and continue to support us when we need it

It is vital to have full training on all aspects of therapeutic laser and specific device training to ensure you are delivering the most effective protocols safely to your patients. The support and guidance from CelticSMR has been fantastic.

It’s great to know that ASA, the manufacturer of the MLS® Laser machines (M-Vet and Vet Blue), continue to perform a huge variety of clinical trials in both humans and animals to continue to improve the protocols and knowledge surrounding laser therapy. They also have a comprehensive library of cases online, providing details of settings, protocols and concurrent therapies used. I recently looked up treatment for a biceps tear in a dog, that successfully resolved with laser treatment without the need for surgery.

 

It was my pleasure to talk to Donna Hall RVN, Veterinary Rehabilitation Therapist, based at Paragon Vets, near Carlisle.

If you would like to know more about the MLS® Class 4 Laser devices and what they could offer your patients or organise a free trial then contact: sales@celticsmr.co.uk.

Dr Caroline Taylor BSc (Hons) BVetMed PGCert (SAM) MRCVS is a passionate Veterinary surgeon with a number of interests. As well as keeping her hand in, as a small animal veterinary locum in the North West, she provides ultrasound and laser training, on behalf on CelticSMR, in the North of the UK. Last year she has set up an online support program for owners to help with weight loss in dogs: www.theslimpetvet.co.uk. She also loves teaching and has recently joined Harper Keele Vet School as a Clinical Teaching Fellow. When not travelling around the country, you will find her walking her Stabyhoun, or trying to keep up with the family on their bikes.