Just Ask the Expert: Can laser therapy reduce anxiety in veterinary patients?
Patients undergoing photobiomodulation seem to calm down in the clinic after a few treatments. Whats going on?
Photo courtesy of Dr. Matt BrunkeQuestion: Many of my patients with anxiety in the veterinary clinic seem to calm down after a few laser therapy sessions targeting their sore joints. Are they making positive associations between the pain relief they're experiencing and the clinic environment, causing them to experience less stress in our hospital?
Answer: When we talk about photobiomodulation (laser therapy) in veterinary medicine, we're usually referring to its use for pain relief in sore muscles and arthritic joints. But we're learning about other areas where it may be helpful as well.
Arthritic patients that come into a veterinary hospital may be experiencing pain or having trouble walking. This can make them fearful of slippery floors, of being palpated, or of having to be restrained for nail trims, blood draws and so on. Many of these patients benefit directly from laser therapy. As the laser provides pain relief, we see the patient move better and be more comfortable during future veterinary visits. This alone may allow them to be less fearful of a clinic visit.
Of course, pets also associate places with feelings (we all know the dog that gets super-excited when you pull into his favorite dog park). So as they feel better, yes-they can certainly start to associate the vet office with pain relief and a positive environment.
You may also have patients with less obvious mobility problems. This could be the old dog with diabetes and Cushing's that has poor muscle mass-it may be fearful of falling. These older dogs may not have painful joints, but they may be sore because of their metabolic issues. Treating dogs or cats with laser therapy before or after a potentially uncomfortable procedure can help reduce their fear and anxiety, and it can help them feel better while we address their underlying issues.
Finally, what about those patients with fear and anxiety directly associated with the veterinary clinic? Can photobiomodulation help them-even if they're not in pain? Well, first, researchers have established that we have the potential to evaluate cognitive and behavioral aspects of the canine brain (no studies on cats yet) using functional magnetic resonance imaging (fMRI).1 Knowing that it's possible to evaluate cognitive function, can we work on directly improving it?
That depends on the pathology causing fear and anxiety. Another study has shown the potential for photobiomodulation to improve cognitive function and reduce pain and anxiety in traumatic brain injury patients.2 This at least opens the door for the possibility to try this with dogs and cats (those that don't have a neoplastic process causing their behavior changes) to assist them with behavioral issues. As far as settings, treatment time, frequency and so on? Determining that is the next step.
1. Huber L, Lamm C. Understanding dog cognition by functional magnetic resonance imaging. Learn Behav 2017;45(2):101-102.
2. Morries LD, Cassano P, Henderson TA. Treatments for traumatic brain injury with emphasis on transcranial near-infrared laser phototherapy. Neuropsychiatr Dis Treat 2015;11:2159-2175.
Dr. Matt Brunke is a pain and rehabilitation specialist with Veterinary Orthopedic and Sports Medicine Group in Annapolis Junction, Maryland.