Current Alternatives in CKD Using Photobiomodulation Therapy (Red Light Therapy) in Dogs and Cats update 11/23

It has been nine years since we initiated a pilot study integrating Photobiomodulation Therapy (PBMT, previously known as Low Level Laser Therapy and now commonly known as Red Light Therapy) into a mainstream Chronic Kidney Disease treatment group.(click here) The study subjects were canine and feline, all suffering from Late Stage III and Stage IV Chronic Kidney Disease (CKD). Three canines and nine felines, all were placed on protein and phosphorous restricted diets, hypertensive medications when indicated and appetite stimulants if needed. In addition, these patients received PBMT at the Brockton Animal Hospital in Brockton, Massachusetts on a regular schedule. At the conclusion of the one-year trial, ten of the twelve patients had survived with what was assessed as a very good to excellent quality of life. We presented the results at the ASLMS (American Society of Laser Medicine and Surgery) in Boston, Massachusetts in 2016. Since this initial study, we have treated nearly two hundred patients in our hospital. Many other pets have been treated remotely utilizing Telemedicine, home therapy units and outside veterinary facilities. Though no double blinded, sham study has been completed at an academic institution, our results have been compelling. Improvement in both the quality of life and likely the longevity of these patients is significant when PBMT is added to traditional treatment. Two other private veterinary facilities have replicated our initial work with similar results.

Because of a great variation in available Red-Light Therapy devices and a lack of education among veterinary professionals in the field of Photobiomodulation, treatment of patients outside of our control varies greatly. Some patients receive both in-hospital and at-home light therapy while others are limited to at-home treatment only. Often the advertised light parameters are unknown or unreliable. The following summarizes our various protocols as we continue to treat patients in our hospital and consult with other remote clients and their care providers. Comments made below are strictly based on our opinion and/or clinical impressions at this juncture. They may change as we experience additional patient populations, data acquisition and patient progression.

Protocol 1 (in and outpatient treatment at the Brockton Animal Hospital)

This is the precise regimen followed in the Pilot study. These patients received in-hospital PBMT using THOR Laser and LED devices https://www.thorlaser.com/ twice daily for the initial 2 to 3 days of hospitalization, then twice weekly as outpatient therapy for two weeks, once weekly for two weeks and then every other week for the duration of the study. Post study, we varied frequency with some patients when the client desired to prolong the treatment interval to every 3 or 4 weeks. In these cases, creatinine appeared to increase more rapidly than those continuing the two-week protocol. Currently we feel that every other week therapy in a clinic only environment is optimum.

Protocol II (addition of home device)

Same as above with the addition of a Luma device from MedcoVet for twice weekly home treatment in addition to the bi-weekly clinic treatment. Though it is unclear if these patients do better than the first group, there is scientific logic and laboratory research that supports the concept of more frequent treatment in ongoing inflammatory conditions.

Protocol III

This protocol updates a previous at home protocol in that these patients are strictly treated at home by the pet owner with the MedcoVet Luma device. The pet is presented for in clinic exam and blood work at the Brockton Animal Hospital every 3 to 4 months. Also during this visit we can closely assess the pet’s health status and the client’s ability to accurately locate treatment points. These patients seem to do well as long as the pet owner is vigilant with the treatment schedule and repeat hospital visits for laboratory evaluation and treatment refinement.

Protocol IV (Telehealth patients)

Initial laboratory and patient assessment are identical to the above, but at the client’s own veterinary or urgent care facility. Treatment is limited to at home therapy using the Luma device only. We have not yet completed any studies using this protocol. As these are remote patients, attempts to follow up are difficult. Several of these patients seem to do well during the first month communication period but then tend to go quiet. In three very complex CKD patients with cardiac disease co-morbidity we have had very positive feedback. Though no news is generally thought of as good news, this may not be an accurate assessment in other cases. We encourage all clients to monitor biochemical parameters (BUN, creatinine, phosphorous, blood pressure, U/A etc.) the same as in our in-house patients.

The integration of Photobiomodulation (Red Light Therapy) into the mainstream treatment approach of Chronic Kidney Disease appears to be of significant benefit. Which of the above protocols is utilized will be based on access to specific veterinary resources, client resources and personal choice. We will continue to recommend a combination of in-clinic and home therapy as our current “Best Practice”. Training of the client is important in order that the correct placement locations are utilized when using the MedcoVet device. PBMT in one or more forms is of obvious benefit in the treatment of Chronic Renal Disease. It has been quite rewarding to see such significant improvement in a disease that is so widespread and devastating.