Lasers Offer Major Benefits for All Pets

by Christopher Forsythe, DVM

I decided to purchase my Co2 surgical laser five years ago, and little did I know then what a step up I was taking for my practice, my patients, and myself. This one piece of equipment has enabled me to transform my practice into a “scalpel-free” veterinary hospital that now delivers an even higher quality surgical experience for my patients. In this month’s column, I want to discuss the benefits of lasers and a few of their uses in small animal medicine.

A laser is a device that generates an intense beam of light at a specific wavelength. The word “laser” is an acronym for Light Amplification by the Stimulated Emission of Radiation. Since its medical use in the early 1960’s, lasers have been jokingly referred to as a “tool in search of an application.” Over the years, medical lasers have been bulky, expensive and difficult to maintain. However, recent technological breakthroughs have made portable, affordable and reliable lasers available to veterinarians.

How does the laser work?

You don’t have to love Star Trek to understand the how the laser works and is applied in veterinary medicine. The way a particular laser works is determined by the specific wavelength of light that it produces. Of the lasers currently on the market (Argon, KTP, Diode, Co2), the Co2 is the most commonly used. It produces an invisible beam of light that vaporizes water normally found in skin and other soft tissue. Because your veterinarian can precisely control it, only a thin layer of tissue is removed leaving the surrounding areas unaffected. The carbon dioxide energy of various amounts from 0-30 watts that it emits is delivered through a “waveguide” which has a pencil-like handle on the end and a small tip protruding from it through which the laser sends the energy onto the pet. Holding the sterile handle, the surgeon steps on a foot peddle, engaging the laser energy and delivering it with pinpoint accuracy to the patient. The laser energy delicately slices the tissue open as the carbon dioxide from the laser interacts with the water in the tissue. As the surgeon delicately passes the tiny tip over the surface of the patient’s tissue, it “unzips” as if being sliced by a scalpel.

What types of surgeries can I do with a laser?

The laser is very useful for any type of soft-tissue surgery, so I use it for everything from spays/ neuters to tumor removal to soft palate resections in short-faced breeds of dogs. Among the most successful uses for the laser at my practice include:

• complete removal of tumors on the eyelid margins (meibomian tumors)
• entropion surgery (eyelid margin enhancement)
• nasal tumor/lip/oral tumor removal
• skin and body tumors (sometimes with a local anesthetic)
• feline declaws with less trauma, much less pain.

Why did I choose laser for my patients?

Lasers cut the tissue with a beam of light, which seals the noci (pain) receptors so there is usually very little pain when pets wake up. The day I got my laser, I performed six surgeries on various pets, most of whom were seniors with soft tissue masses requiring removal. I was most impressed that all the pets seemed to wake up with less vocalization and moaning. The process of surgery seemed to me to be less traumatic to them, like they hadn’t been through World War III. Granted, this was just my subjective observation, but it is very reassuring to see that especially senior patient come out of surgery relaxed, beginning to wag her tail and quickly getting back to normal.

Another huge benefit is that laser technology seals blood vessels as it cuts so there is much less blood loss during surgery. Whether the procedure is a routine spay/neuter or a limb amputation, less blood loss during surgery makes operations cleaner, easier, and much better for the patient.

Lasers also seal lymphatic skin vessels, which nearly eliminates any swelling after surgery, thus making healing and recovery quicker and easier. Lasers cut without actually touching (the tip of the laser is held a few millimeters away from the tissue as the energy penetrates the patient) which eliminates much of the trauma associated with standard surgical techniques.

What does it mean for my pet?

Since we autoclave (sterilize) the laser handle and tips each time, the part of the laser I handle is completely sterile, just like a scalpel or electrocautery unit would be. The laser also sterilizes as it removes diseased tissue, thus killing bacteria that cause infections. This suggests laser use may reduce risk of infection at the surgical site.

Lasers are also very precise. The surgeon is able to move a tiny pencil-point beam around the surface of a mass or into a small area in order to perform complex surgeries with wonderful dexterity. Because of the laser’s precision the doctor can remove unusually shaped masses from difficult locations where a scalpel would be not only dangerous but prohibitive. Since the laser can remove unhealthy tissue while minimizing adverse affects to healthy surrounding tissue, it has provided a wonderful aid to veterinarians who operate on soft tissue masses on any part of a pet’s anatomy.

I have used the laser for five years now, and by far the most common feedback I get from clients is that they are happy with how quickly their pets returned to normal activity and how little discomfort they had after surgery. Now it is almost hard to remember the days when I used a scalpel, but when I do I become aware of the rather remarkable post-op recovery differences, I am really glad that I made the investment in my patients. I would never go back now that I have seen so many happy tailwagging dogs on their way out the door.

Sing Fat

He was the perfect candidate for laser surgery at my office. He was big, bold, beautiful, with a physique like Atlantis. Perfect fur, perfect features. Just with a glance at him, female dogs swoon, veterinarians’ hearts begin to palpate quickly, and people flee the sidewalk. That’s right. Sing Fat was a sight to behold. At 90 lbs, he commanded any place he went. An imposing Pit Bull with a head the size of a basketball, an attitude like a prizefighter, but the demeanor of a third grader just wanting another Tootsie Roll, you had to admire him for the picturesque bold beauty he is.

The trouble was that he had lump on his chest that resembled a breast implant of the “C” cup variety, and it was getting bigger by the week.

His human, Bess, decided the best surgery for Singy was to knock him out as he entered the building and “wake him up when the groomer shows.” This attitude shows her undying affection and unyielding desire to make all things in Sing Fat’s world trouble free, comfortable, and painless. In short, this was an owner after my own heart!

Sing Fat received all the appropriate pre-surgical screening, including blood work, sedation, and catheter. During the procedure, I used the Co2 laser to make a straight skin incision over the baseball sized mass on his breast area and expose the underlying tissue. Using a careful dissection technique, I exposed the mass and removed it in one big jiggly piece. Routine closure with humangrade dissolving suture followed, and Sing Fat woke up a few minutes later, apparently oblivious to his somewhat remarkable physical state. With very minimal bruising, his mother was able to take her stately and magnificent creature home that afternoon so he could begin his healing process and get back to doing what he does best, beautifying the town of Sonoma.