by Alex Vitruk, LSN Editor
“Because its (CO2) wavelength is highly absorbed by water, little to no collateral tissue damage occurs when this laser is used properly.”
David Duclos, DVM, board-certified dermatologist, has been our customer for more than 20 years. At his clinic he uses Aesculight AE-3020 (30 Watt CW / 20 Watt SP) CO2 surgical laser on a daily basis.
In a recent Veterinary Practice News article (June 2012), he summarized five key advantages of Aesculight laser system:
- convenience and pinpoint precision of scalpel-like handpieces
- calibration of the distal end laser power
- ability to defocus the beam to switch between incising/excising and large area ablation
- rugged design thanks to all-metal laser tube technology (“In the 22 years I have used these lasers, I have never had a breakdown. One time the
tube had to be recharged”)
- latest-generation laser handpieces use no disposables.
“In most dermatologic surgical procedures using CO2 lasers,” Dr. Duclos says, “no sutures are required and no post-operative care is needed. The pet does not bother the lesions because the nerve endings are sealed by the CO2 laser, and thus little to no pain is present after the surgery. The advantages of minimal hemorrhage, precise control of how much tissue to remove and minimal postoperative swelling make the CO2 laser an invaluable tool in veterinary dermatology.”
In a speech given before his colleagues in San Diego (July of this year), Dr. Duclos identifies numerous scenarios where “laser is the better or only option.” These include Nodular Sebacious Hyperplasia, Apocrine Tumors, Fibrous Tumors, Nevi, Follicular Tumors, Actinic Changes and Viral Tumors. The body sites affected include the animal’s nasal planum, pinnae, ear canal, mouth and feet.
First of all, Nodular Sebaceous Hyperplasia signifies the most common of the aforementioned issues. It has a wide range of malignancy potential and often manifests itself through senile warts, which often bother client and may be irritating to the pet.
An example of a Nodular Sebacious Hyperplasia (1A) and its subsequent removal by Dr. Duclos’ Aesculight laser (1B & C).
Here is another excellent example of Nodular Sebacious Hyperplasia in a dog before (2A) and immediately post-op laser surgery (2B).
Next, Apocrine Tumors exist on the ears, chin, mammary glands and are most common in cats. Here are some pictures of a patient site (cat’s ear) before (3A), immediately after (3B), and 2 weeks post-op laser ablation (3C).
Treating viral lesions is another important aspect of veterinary dermatology. These include Bowen’s (bowenoid in situ carcinoma), canine pigmented viral plaques, warts and equine venereal warts. Here are some pictures, before (4A) and during (4B) laser ablation of a (feline) Bowenoid Carcinoma.
Viral Papillomas arrive in the forms of warts, pigmented viral plaques and equine venereal warts. On the next page is an example of a miniature schnauzer with canine pigmented viral plaques, before (5A) and immediately after (5B) CO2 laser surgery.
For oral papillomas, Dr. Duclos uses Systemic Interferon and his laser as an adjunctive, if needed. Below are several examples, before (6A / 7A) and immediately after laser ablation (6B / 7B) . Systemic Interferon was used for 6 weeks before and 4 weeks after laser ablation
The next representative example is actinic in situ carcinoma – or actinic keratosis – which may progress to invasive squamous cell carcinoma. Here is a 21-yr. old cat where the actinic keratosis was detected early on her nasal planum… Before (8A), immediately after (8B) and 2-months post-laser surgery (8C) pictures follow (on the left).
Plasma cell pododermatitis usually affects the large central pad. It results in the animal having large, soft, spongy footpads. The surface of the footpads often appears white, scaly or silvery. Occasionally one or more will ulcerate. This procession of pictures displays the CO2 laser’s superior ability to treat a patient with plasma cell pododermatitis (9A-9D).
Miscellaneous Tumors include fibromas, nevi, mixed epitheliomas, plasma cell tumors, follicular tumors, gingival tumors and follicular cysts. On the right are some in-surgery pictures of collagenous nevus, before (10 A & B) and immediately after (10C) CO2 laser ablation.
All Images Courtesy of Dr. Duclos