Veterinarians have no shortage of options when it comes to Class IV therapy lasers. Although you should certainly consider your budget when comparing the options, your primary concern should be the needs of your practice.
Which types of animals and injuries do you currently treat? Which do you plan to treat in the future? How do specific features of a particular laser improve its usability, versatility, or efficacy?
The answers to these questions will help you identify the best therapy laser for your practice. Below, we’ve listed eight things most practices need in a therapy laser—and eight things that you can go without.
What You Do Need in a Therapy Laser?
- Class IV Power to Treat Large and Deep-Seated Injuries in a Short Amount of Time
Veterinary therapy lasers are available in two power classes: Class III and Class IV, with the distinction between the two be a power threshold below/above 500 mW (1/2 Watt). Class IV lasers can deliver up to 1,500 times more energy than Class III lasers and, as a result, they reduce treatment times and offer greater penetration (10 cm2 compared to about 0.5–2 cm2). Although both classes of lasers are effective on small, superficial wounds, you need Class IV power to treat large wounds and deep-seated injuries.
- Wavelengths That Penetrate and Target Biological Chromophores
The therapeutic benefits of light are attributed to its absorption by key chromophores within tissues and constituent cells in the body. These materials, such as the mitochondria of cells and hemoglobin in the blood, have been shown to absorb in the visible-to-near-infrared light spectrum. Fortunately, in this portion of the spectrum, there is also a window of translucency (between 800nm and 950nm) where the barriers of penetration (like melanin and water) do not absorb very well, allowing for significantly deeper penetration of therapeutic light.
- Variable Frequencies That Span the Range of Tissues in the Body
We now know that each of the tissue-types in the body respond differently to laser therapy, and that the method of delivery and frequency used are two primary factors that determine the effects of laser therapy on a particular tissue-type. Bone and soft tissue are on opposite ends of this spectrum, so it is important that your therapy laser is capable of spanning this therapeutic range—from 1 Hz up to 15,000 or even 25,000 Hz. Because most injuries involve multiple tissue-types, each protocol should employ several frequencies to have the highest probability of targeting each of the tissues present in the treatment volume.
- A Quick and Easy Way to Get a Tailored Protocol
The appropriate parameter-sets (power, pulse, and wavelength) and delivery method for a particular laser treatment depend on the type of animal, the color of the animal, and the specific condition and tissue-types being treated. Despite this variation, you should not have to touch the screen 11 times to get a tailored protocol. Your laser should be programmed to reduce the number of button-touches required to get a protocol, but gathering enough information to differentiate a small, post-surgical wound from the hip dysplasia of a large, light-colored dog from the shoulder arthritis of a dark-haired cat.
- Consistency from Treatment to Treatment
Achieving the best patient outcomes with laser therapy requires the use of appropriate parameters and the right treatment technique. Consistency of treatments comes with proper training and understanding of the principles of laser therapy. This comes in the form of on-going training (either on the device itself or in easy-to-access supplemental material) giving advice on all of the above as well as on how often to treat and how to modify treatments based on the patient response. This improves both consistency and efficacy of treatment.
- Consistency from Tech to Tech
The last thing you want is a pet owner requesting a particular technician to treat an animal. Your business is built on delivering consistent patient outcomes regardless of which technician is attending to the patient. Proper training is the key to this consistency, but your technicians need more than a one-time, three-hour training session; they need ongoing instruction and guidance through each treatment phase until they have mastered laser therapy.
- Real-Time Advice on Treatment Technique
Therapy lasers are not magic wands. As any experienced laser therapist will tell you, there is an art in the technique with intricacies that normally take months or even years to master. Some laser companies only spend one to two days on initial training, and they expect techs to refine their technique through lots of trial-and-error and online videos. You need more.
- A Long-Term Warranty to Back Your Investment
Investing in a new modality is about more than improving patient outcomes; it’s also about boosting your practice’s revenue. Beware of laser companies that do not offer a warranty to back up their technology. You’ll be using this modality for a long time, so be sure to find a therapy laser from a company that offers a long-term warranty to give you peace of mind.
What You Don’t Need in a Therapy Laser
- 15 Watts of Power
The pain threshold for laser therapy is about 1–2 watts/cm2 of power density. The typical treatment size for most Class IV therapy lasers is about 10 cm2. As such, delivering 15 watts of power would fall dangerously close to, if not above, the pain threshold. Although higher power can shorten treatment times, there are virtually no pre-set protocols that employ 15 watts of power, because if the tech becomes distracted or pauses over a single area for just a moment, it can inflict immediate pain in the patient.
- A Wavelength above 960 nm
Laser therapy will not be effective if the light is absorbed by water and converted into heat. Wavelengths in the range 960nm –980 nm coincide with a peak of water’s absorption of light, which leads to a quicker conversion of light into heat. This inhibits penetration and leads to local thermal accumulation which, beyond simply heating the tissue, does not have much therapeutic benefit. The key chromophores that are stimulated by laser therapy exponentially decrease in absorption efficiency when the wavelength is higher than 940 nm.
- 11 Five-Second Phases per Treatment
When delivering each “phase” of treatment, there must be enough time to target the intended tissue-type. If there are too many phases within a fixed treatment time, then the individual “phase” time is only a few seconds, which is not nearly enough time to cover the entire treatment area. For example, 11 phases on a two-minute treatment is only 11 seconds per phase.
- To Touch the Screen 11 Times to Treat a Dog and Then Have to Do It Again to Repeat the Treatment
On most commercial lasers, there are only three virtual “knobs” to turn (power, frequency, and time). Yet, techs are often required to make 10 selections before getting a tailored protocol. This false façade of complexity is meant to provide a sense of confidence in the precision of the therapy. Upon further inspection, though, you would notice that only a couple of the protocol selections actually change any meaningful output parameters. For example, opting between arthritis and tendonitis of the same joint makes no change at all, so you should not be forced to do so.
- On-Board Database to Store Default Protocols Just with Different Names and Timestamps
Currently, there is no therapy laser that can fully integrate with any practice management software (PMS)—mostly because there are so many different PMS systems out there. As such, having the capability of storing default protocols should not be a concern when comparing therapy lasers. Rather, it is best practice to store all your diagnostic and treatment information in one place—your PMS—instead of having to enter the data in both your PMS and laser therapy system.
- Complex Modification of Default Protocols
There are only three instances when substantial protocol modification is necessary:
1. When the pre-set protocols are not comprehensive
2. When you are treating a rare injury
3. If you have years of experience and you are certain that a particular modification would benefit the patient
- iPad App with Pretty Graphics and Generic Summaries
In an attempt to appear innovative, some laser companies provide marketing materials with fancy graphics and less-than-useful educational brochures. The best way to demonstrate the benefits of laser therapy to your clients is to use it on their pets.
- Extra Brochures and an iPad Thrown in at Point of Sale
In order to close a sale, some laser companies throw in marketing giveaways that have perceived, yet empty, value. Instead, shift the focus to the more important issues at the point of sale: alternate treatment heads and iron-clad, long-term warranties that ensure optimal equipment performance for years after your initial investment.