Advanced Surgical and Therapeutic

Modalities are now Possible with the

Pilot Class IV Veterinary Diode

Laser System!

LASERLightAmplification by StimulatedEmission of Radiation

Solid StateNd:YAG –1064 nm, 532 nm(KTP)Alexandrite -755 nm, HoYAG (2100 nm)Ti Sapphire -700 to 1000nmDiode Lasers635 nm,820 nm ,940 nm, 980 nmFiber LasersTypically between 1000nm and 1700 nmDye LasersTypically visibleGas LasersCO2(10,000 nm), Excimer (193 nm, 248 nm)

Laser Types

The Pilot DVM-S/T (Surgical/Therapy) Laser – What Can It Do For Your Practice?

Identifies Your Practice as a State of the Art Technology Veterinarian Care Provider

Immediately Introduce a New Profit Center which Does Not Require the Doctor to Administer Treatment (therapeutic applications)

Allow your Technicians to Become More Valuable Team Members

Delivers More Advanced and Effective Treatments

• No sedation• No clipping hair• 3 - 5 min. treatments per site (based on size of pet) • 6 total treatments for chronic problems• Follow-up treatments required every 3 to 8 weeks• Preset protocols• Client prepays for treatments• Client brings pet to appointment

Benefits of Pilot DVM-S/T Laser Therapy

WavelengthsWavelengths are Measured in Nanometers

The biological effect of laser therapy is related to the wavelength of light emitted by the laser: Different wavelengths target different tissues,

e.g. blood, melanin, water, etc. These Targets are Known as Chromophores

Wavelengths

INFRA-RED

193 nm 400 to 700 visible

532 nm 1064 nm

755 nm 10.2 μm

Wavelengths

• The treatment beam of the Pilot Laser System has a wavelength output of

820nm, proven to be optimal for surgical and therapeutic laser

treatment.

Laser Light is Very Different From Normal Light

Laser light has the following properties:

•Monochromatic•Coherent•Collimated

MONOCHROMATIC

The light emitted from a laser is monochromatic, on other words, one wavelength (color). In contrast, ordinary white light is a combination of many different wavelengths (colors).

LASER PROPERTIES

Laser PropertiesCOHERENT VS. INCOHERENT

LASER PROPERTIESCOLLIMATED

A laser has a very tight beam that is strong and concentrated. A flashlight, by comparison, releases light in many directions, the light is weak and diffuse.

Temporal Formats

•Continuous Wave•Modulated Continuous Wave•Q Switched •(nanosecond pulses)•Long pulsed •(micro or millisecond pulses)

Pulsed Emmissions

The words pulsing and frequency are used interchangeably to describe the same concept, which is the interruption of energy flow on a predetermined basis. Some manufacturers have laid claim to special frequencies, claiming that they produce better clinical outcomes.

Peak Power = pulse energy/pulse x durationA 75 W peak power system with a 1 ms pulse has a pulse energy of 75 mJ… Power = pulse energy x rep rate; 75 mJ laser at 10 Hz = 750 mW

Continuous Wave Emission

Continuous wave emission lasers have no interruption during the delivery of their energy

Laser vs. LED

•A Light Emitting Diode is a semiconductor device that emits incoherent, low intensity light•Laser Light delivers photonic energy deeply and specifically•LED Clusters deliver energy superficially over broader regions

The main difference is coherency

Laser vs. LED

“Whenever LED and lasers have been compared in studies (13 studies found), laser has come out on top.” Jan Tuner @ (www.laser.nu)

Class 1 Class 2

Laser Printers, CD Players Low Power, Diffused Output

Laser Classification

Erchonia LLLT Lasers

Class 3A Lasers Class 3B Lasers

LLLT 500 mW LasersLaser Pointers

Pilot Class IV Laser

Laser Classification

Pilot DVM-T/S Class IV Medical Laser

Surgical and Therapeutic Laser

Surgical Laser: Used to cut, coagulate and evaporate tissues. This type of laser replaces the scalpel.

Therapeutic Laser: Used for the stimulation of cell function. The biological effect is photochemical as well as thermal, unlike surgical lasers.

Laser-Tissue Interaction

PHOTO-THERMAL long pulses, biological effect due to heating, hair removal, most surgical lasers

PHOTO-MECHANICALShort-pulsed (q-switched) lasers cause ablation tattoo removal

PHOTO-CHEMICAL laser causes chemical change or response-pain relief

Photo ChemicalA photo-chemical treatment is where the light has a chemical impact on the tissue being treated.

Examples include:

Photo Dynamic Therapy (PDT) Cancer treatment, ophthalmic treatments

Laser Therapy pain relief

Important Parameters

•The right wavelength for absorption •The right depth of penetration•The right amount of light or dosage

AbsorbtionCellular action spectra has been determined to be from 500 nm to 1100 nm

The Chromophore (photoreceptor)is believed to be Cytochrome C Oxidase, which is in the mitochondria and is instrumental in cellular respiration.

Important FactorsFor effective penetration, light needs to avoid scattering and surface absorption.

ScatteringA beam of light focused on tissue may be reflected, absorbed, or scattered.

Scattering is wavelength dependent. Longer wavelengths have less scattering.

Scattering in tissue broadens the incident beam, decreasing the effective fluency in the intended target area.

Doubling the spot size will increase the effective volume by a factor of eight.

The Importance of Power

The main reason cited for negative findings in therapeutic laser studies have primarily been because of the use of very low dosages.

The Power of the Pilot DVM Laser

Power = Energy/Time 1 Watt = 1 Joule/Second

Your 9 watt Pilot DVM Therapy Laser™ delivers 9 joules/sec.

Over a period of one minute your laser delivers 9 joules/sec x 60 sec/min = 5400 Joules/min.

Power Density vs. Energy Density

Power Density (irradiance) The power of the laser per unit areaIrradiance (PD) = W/cm2

Energy Density (fluence)The power density multiplied by the exposure time, measured in Joules/square centimeterFluence (ED) = Joules/cm2

Power Comparison

The Erchonia 3LT™ laser PL3000 5mW laser delivers 0.005 joules/sec. Over a period of one minute this device delivers 0.005 joules/sec x 60sec/min. = 0.3 joules /min.

The Respond 2400XL500P™ has a 500mW head delivering .5 joules/sec. Over a period of one minute this device delivers .5joules/sec x 60 sec/min. = 30 joules/min.

The Pilot DVM Therapy Laser™ delivers 540 joules/min

Spot Size & Power DensitySpot SizeThe advanced solid state technology and the innovative hand-piece of the Pilot Therapy Laser™ safely delivers a high dose of photons over a large area

Power DensityIndicates the degree of concentration of the power output. It is measured in watts per centimeter squared (W/cm2).

PD = W/cm2

Conclusion

Energy Density is the dosage of energy applied to a specific

anatomical area

THE AMOUNT OF ENERGY DELIVERED DETERMINES THE MAGNITUDE OF THE LASER INTERACTION WITHIN THE TISSUES AND EVEN THE INDIVIDUAL CELLS

Physics Summary

Results

The Pilot DVM Laser delivers:

LARGE SPOTBEST WAVELENGTHHIGH POWERSAFEST and FASTEST APPLICATION

Which Means You Have the Safest, Fastest, and Most Effective Therapeutic Laser Currently Available

Current Nomenclature

LLLT: Low-Level Laser TherapyLILT: Low-Intensity Laser TherapyCLT: Cold Laser TherapySoft Laser Therapy Low Reactive Laser TherapyLow Power Laser TherapyLight Emitting Diode TherapyLow Energy Photon Therapy

Bio-stimulation LaserTherapeutic LaserBio-regulating LaserMedical LaserPhototherapyClass III Laser TherapyClass IV Laser TherapyHPLT: High Power Laser Therapy

How Laser Therapy Works

Laser Therapy

Physiological Effects of Photobiostimulation

•ANTI-INFLAMMATORY, ANALGESIC, AND ANTI-EDEMATOUS

•INCREASED MICROCIRCULATION

•INCREASED SYNTHESIS OF ATP, RNA AND DNA

•INCREASED TISSUE OXYGENATION AND NUTRITION

•INCREASED RATE OF TISSUE REGENERATION

Biological Effects of Therapeutic Laser Applications

• ACCELERATED TISSUE REPAIR AND CELL GROWTH

• FASTER HEALING OF ANY INJURY I.E. WOUNDS, TENDONS

• REDUCED FIBROUS TISSUE FORMATION

• ANTI-INFLAMMATORY

Biological Effects of Therapeutic Laser Applications

• IMPROVED RATE OF NERVE REGENERATION

• IMMUNE STIMULATION

• STIMULATION OF ACUPUNCTURE POINTS AND TRIGGER POINTS

• ANALGESIA THROUGH THE RELEASE OF ENDORPHINS, BRADYKININS ETC.

• IMPROVED VASCULAR ACTIVITY

• INCREASED METABOLIC RATE WITHIN THE TISSUES

Acute Inflammation Reduction

How does Photobiomodulation reduce inflammation?

Stabilization of the Cellular Membrane

•Ca++, Na+ and K+ concentrations, as well as the proton gradient over the mitochondria membrane are positively influenced. This is accomplished in part by the production of beneficial Reactive Oxygen Species aka (ROS).

•These ROS’s modulate intracellular Ca++ concentrations and laser therapy improves Ca++ uptake in the mitochondria.

Acute Inflammation Reduction

Stabilization of the cellular membrane

Enhancement of ATP Production and Synthesis

ATP production and synthesis are significantly enhanced, contributing to cellular repair, reproduction and functional ability

Photonic stimulation of Cytochromec Oxidase, a chromophore found on the mitochondria of cells, plays a major role in this rapid increase in production and synthesis of ATP.

Acute Inflammation Reduction• Stabilization of the cellular membrane• Enhancement of ATP production and synthesis

Stimulation of Vasodilation

Vasodilation is stimulated via an increase in Histamine, Nitric Oxide (NO) and Serotonin levels, resulting in reduction of ischemia and improved perfusion

Laser-mediated vasodilation enhances the transport of nutrients and oxygen to the damaged cells and facilitates repair and removal of cellular debris.

Acute Inflammation Reduction

• Stabilization of the cellular membrane• Enhancement of ATP production and

synthesis• Stimulation of vasodilation

Acceleration of Leukocytic Activity

Beneficial acceleration of leukocytic activity results in enhanced removal of non-viable cellular and tissue components, allowing for a more rapid repair and regeneration process.

Acute Inflammation Reduction

Increased Prostaglandin SynthesisProstaglandins have a vasodilating and anti-inflammatory action

• Stabilization of the cellular membrane• Enhancement of ATP production and synthesis• Stimulation of vasodilation• Acceleration of leukocytic activity

Acute Inflammation Reduction• Stabilization of the cellular membrane• Enhancement of ATP production and synthesis• Stimulation of vasodilation• Acceleration of leukocyticactivity• Increased prostaglandin synthesis

Reduction in Interleukin 1Laser irradiation has a reducing effect on this pro-inflammatory cytokine that has been implicated in the pathogenesis of rheumatoid arthritis and other inflammatory conditions.

Acute Inflammation Reduction• Stabilization of the cellular membrane• Enhancement of ATP production and synthesis• Stimulation of vasodilation• Acceleration of leukocyticactivity• Increased prostaglandin synthesis• Reduction in interleukin 1

Enhanced Lymphocyte ResponseIn addition to increasing the number of lymphocytes, laser irradiation mediates the action of both lymphatic helper T-cells and suppressor T-cells in the inflammatory response. Along with laser modification of beta cell activity, the entire lymphatic response is beneficially affected by laser therapy.

Acute Inflammation Reduction• Stabilization of the cellular membrane• Enhancement of ATP production and synthesis• Stimulation of vasodilation• Acceleration of leukocyticactivity• Increased prostaglandin synthesis• Reduction in interleukin 1• Enhanced lymphocyte response

Increased AngiogenesisBoth blood capillaries and lymphatic capillaries have been clinically documented to undergo significant increase and regeneration in the presence of laser irradiation.

Acute Inflammation Reduction• Stabilization of the cellular membrane• Enhancement of ATP production and synthesis• Stimulation of vasodilation• Acceleration of leukocyticactivity• Increased prostaglandin synthesis• Reduction in interleukin 1• Enhanced lymphocyte response• Increased angiogenesis

Temperature ModulationAreas of inflammation typically demonstrate temperature variations with the inflamed portion having an elevated temperature. Laser therapy has been shown to accelerate temperature normalization, demonstrating its beneficial influence on the inflammatory process.

Acute Inflammation Reduction• Stabilization of the cellular membrane• Enhancement of ATP production and synthesis• Stimulation of vasodilation• Acceleration of leukocyticactivity• Increased prostaglandin synthesis• Reduction in interleukin 1• Enhanced lymphocyte response• Increased angiogenesis• Temperature modulation

Enhanced Superoxide Dismutase (SOD) LevelsLaser stimulated increases in cytokine SOD levels interact with other anti-inflammatory processes to accelerate the termination of the inflammatory process.

Acute Inflammation Reduction• Stabilization of the cellular membrane• Enhancement of ATP production and synthesis• Stimulation of vasodilation• Acceleration of leukocyticactivity• Increased prostaglandin synthesis• Reduction in interleukin 1• Enhanced lymphocyte response• Increased angiogenesis• Temperature modulation• Enhanced superoxide dismutase (SOD) levels

Decreased C-reactive Protein and Neopterin LevelsLaser therapy has been shown to lower the serum levels of these inflammation markers, particularly in rheumatoid arthritis patients

Acute Inflammation CascadePilot DVM Therapy Laser Treatment

Cytochrome Activation

Cell Membrane Changes

ATP Increase

Increased Leukocyte Activity

Angiogenesis

Proton Gradient Change

Enhanced Lymphocyte Response

SOD Production

Ros Production

Ca, Na, K Ion Changes

IL-1 Decrease

Temperature Modulation

Vasodilation PG Synthesis

AnalgesiaHow Does Photobiomodulation with the

Pilot DVM Therapy Laser™ Reduce Pain?

Increase in beta endorphins

The localized and systemic increase of this endogenous peptide after laser therapy irradiation has been clinically reported in multiple studies with subsequent pain reductions.

Analgesia

• Increase in Beta Endorphins

Increased Nitric Oxide Production

Nitric oxide has both a direct and indirect impact on pain sensation. As a neurotransmitter it is essential for normal nerve cell action potential in impulse transmission activity and, indirectly, the vasodilationeffect of nitric oxide can enhance nerve cell perfusion and oxygenation.

Analgesia

• Increase in beta endorphins• Increased nitric oxide production

Decreased Bradykinin LevelsSince Bradykinins elicit pain by stimulating nociceptive afferents in the skin and viscera, mitigation of elevated levels through laser therapy can result in pain reduction.

Analgesia• Increase in beta endorphins• Increased nitric oxide production• Decreased bradykinin levels

Ion Channel NormalizationPhotobiomodulation promotes normalization in Ca++, NA+ and K+ concentrations, resulting in pain reduction as a result of these ion concentration shifts.

Analgesia

• Increase in beta endorphins• Increased nitric oxide production• Decreased bradykininlevels• Ion channel normalization• Blocked depolarization of C-fiber afferent nerves

Increased Nerve Cell Action PotentialsHealthy nerve cells tend to operate at about -70 mV, and fire at about -20 mV. Compromised cell membranes have a lowered threshold as their resting potentials average around this -20 mV range. That means that normal non-noxious activities produce pain. Laser therapy can help restore the action potential closer to the normal -70 mV range.

Analgesia

• Increase in beta endorphins• Increased nitric oxide production• Decreased bradykinin levels• Ion channel normalization• Blocked depolarization of C-fiber afferent nerves• Increased nerve cell action potentials

Increased Release of AcetylcholineBy increasing the available acetylcholine, Laser Therapy helps in normalizing nerve signal transmission in the autonomic, somatic and sensory neural pathways.

Analgesia• Increase in beta endorphins• Increased nitric oxide production• Decreased bradykinin levels• Ion channel normalization• Blocked depolarization of C-fiber afferent nerves• Increased nerve cell action potentials• Increased release of acetylcholine

Axonal sprouting and nerve cell regenerationSeveral studies have documented the ability of laser therapy to induce axonal sprouting and some nerve regeneration in damaged nerve tissues. Where pain sensation is being magnified due to nerve structure damage, cell regeneration and sprouting may assist in pain decrease.

Mechanisms Behind Tissue Healing• One of the truly unique characteristics of THE PILOT DVM THERAPY LASER™ is

that it has the ability to actually promote and enhance healing, not just treat symptoms.

• The irradiation by therapeutic laser light accelerates and enhances healing activities carried out by the body.

• THE PILOT DVM THERAPY LASER™ mediated reduction in inflammation and pain frees the body’s natural ability to repair and heal itself.

• As wound healing progresses through the stages of inflammation, proliferation, remodeling and maturation, laser therapy presents the opportunity to impact each of these phases in positive and beneficial ways.

• THE PILOT DVM THERAPY LASER™ can provide the following beneficial impacts in both open surface wounds and closed connective or soft tissue injuries as follows:

Mechanisms Behind Tissue HealingEnhanced Leukocyte Infiltration

The PILOT DVM THERAPY LASER™ stimulates activity involving neutrophils, monocytes and lymphocytes.

Mechanisms Behind Tissue Healing

Enhanced leukocyte infiltration

The PILOT DVM THERAPY LASER™ accelerates macrophage activity in phagocytosis, growth factor secretion and stimulation of collagen synthesis.

Mechanisms Behind Tissue Healing• Enhanced leukocyte infiltration• Increased macrophage activity

Increased Neovascularization•The significant angiogenesis that occurs with laser therapy promotes revascularization with subsequent improvement in perfusion and oxygenation

•Endothelial cell regeneration is accelerated

Mechanisms Behind Tissue Healing• Enhanced leukocyte infiltration• Increased macrophage activity• Increased neovascularization

Increased Fibroblast Proliferation The PILOT DVM THERAPY LASER™ stimulation increases fibroblast numbers and fibroblast mediated collagen production.

• Enhanced leukocyte infiltration• Increased macrophage activity• Increased neovascularization• Increased fibroblast proliferation

Keratinocyte ProliferationThe beneficial synthesis activities and growth factor ability of keratinocytes are enhanced by proliferation secondary to the PILOT DVM THERAPY LASER™.

Mechanisms Behind Tissue Healing

Mechanisms Behind Tissue Healing• Enhanced leukocyte infiltration• Increased macrophage activity• Increased neovascularization• Increased fibroblast proliferation• Keratinocyte proliferation

Promotion of Early EpithelializationLaser light stimulated acceleration of epithelial cell regeneration speeds up wound healing, minimizes scarring, and reduces infection opportunities.

Mechanisms Behind Tissue Healing• Enhanced leukocyte infiltration• Increased macrophage activity• Increased neovascularization• Increased fibroblast proliferation• Keratinocyte proliferation

Promotion of Early EpithelializationLaser light stimulated acceleration of epithelial cell regeneration speeds up wound healing, minimizes scarring, and reduces infection opportunities.

Mechanisms Behind Tissue Healing• Enhanced leukocyte infiltration• Increased macrophage activity• Increased neovascularization• Increased fibroblast proliferation• Keratinocyte proliferation• Promotion of early epithelialization

Growth Factor IncreasesTwo to five fold increases in growth-phase-specific DNA synthesis in normal fibroblasts, muscle cells, osteoblasts and mucosal epithelial cells irradiated with infrared light are reported.

Mechanisms Behind Tissue Healing• Enhanced leukocyte infiltration• Increased macrophage activity• Increased neovascularization• Increased fibroblast proliferation• Keratinocyte proliferation• Promotion of early epithelialization• Growth factor increases

Enhanced Cell Proliferation and DifferentiationLaser induced increases in nitric oxide, ATP, and other compounds that stimulate higher activity in cell proliferation and differentiation into mature cells.

Mechanisms Behind Tissue Healing• Enhanced leukocyte infiltration• Increased macrophage activity• Increased neovascularization• Increased fibroblast proliferation• Keratinocyteproliferation• Promotion of early epithelialization• Growth factor increases• Enhanced cell proliferation and differentiation

Greater Healed Wound Tensile StrengthIn both soft tissue and connective tissue injuries, the PILOT DVM THERAPY LASER™ can increase the final tensile strength of the healed tissue. By increasing the amount of collagen production/synthesis and by increasing the intra and inter-molecular hydrogen bonding in the collagen molecules, laser therapy contributes to improved tensile strength.

Healing CascadePILOT DVM THERAPY LASER™

Increased Leukocyte Activity

Increased Vascular Regeneration

Early Cell Regeneration

Increased Tensile Strength

Increased Macrophage Activity

Increased Fibroblast Proliferation

Enhanced Cell Differentiation

Accelerated Wound Healing

REDUCED HEALING TIMES

Laser SafetyFOLLOW ALL OF THE

MANUFACTURERS RECOMMENDATIONS

AND WARNINGS!

Laser SafetyTHE NUMBER ONE SAFETY CONCERN WITH ANY CLASS III OR IV LASER USE IS PROTECTION OF THE EYES

The PILOT DVM THERAPY LASER™ emits both visible and invisible radiation

Laser SafetySafety training begins with YOU!!!

Protective eyewear is necessary for everyone in the treatment area including the animal!

Laser Safety• Laser safety eyewear, is not a primary mode of protection. • Safety eyewear is not designed to protect against the primary

beam.

• Do not shine the laser beam toward anyone’s eyes, even if they are wearing protective eyewear.

• Limited protection is provided by proper protective eyewear against the primary beam and in general, full protection, against a reflected beam.

• The protective eyewear that came with your laser is manufactured specifically for the wavelengths emitted by the Pilot laser.

• Do not use protective eyewear from other manufacturers as they will not provide the appropriate level of protection.

Laser SafetyREFLECTIVE SURFACES

• Jewelry (Rings, Watches, Bracelets)• Metal fixtures such as nameplates• Muzzles, Harnesses, Leashes • Snaps and other fixtures

Laser SafetyGENERAL SAFETY SUGGESTIONS

• Keep extraneous people out of the area.• Post a warning sign when possible.• When not using laser, keep in standby or

OFF mode.• NEVER look into the laser probe or into

the direct path of the laser beam.

ContraindicationsContraindications for the PILOT DVM THERAPY LASER™ are often based on anecdotal evidence as well as scientific or clinical data.

Contraindications are presented as precautionsfor safe and effective treatment and care.

ContraindicationsLaser therapy should not be administered in the following situations:

• Hemorrhaging• Eyes• Testicles• Corticosteroids• Photosensitive Medications• Epiphysitis• Melanomas and Sarcoids • Pregnancy• Cardiac Conditions

Therapy ProtocolsGENERAL THERAPY PROTOCOLS

• DUE TO THE POWER AND PENETRATION, THERAPY TIMES ARE BOTH EFFICIENT AND EFFECTIVE

• WHENEVER POSSIBLE, TREAT LARGE AREAS

• THERAPY IS MEASURED IN JOULES ADMINISTERED

Therapy ProtocolsGENERAL THERAPY PROTOCOLS

ImproperPlacement

ProperPlacement

• SAFETY FOR ALL• PLACEMENT OF THE

PROBE• POWER• RECORD THE AMOUNT

OFJOULES ADMINISTERED

Therapy Protocols

• Maintain control of the probe with a firm grip.

• Keep the probe perpendicular to the dermis whenever possible

• Keep the end of the probe just off the dermis at all times

• Utilize a slow “erasure” type movement when administering therapy

• Administer the therapy in a 50%/50% technique

Therapy ProtocolsPILOT DVM THERAPY LASER™

•THE MOST EFFECTIVE PHYSICAL THERAPY •IDEAL MODALITY WAVELENGTH•IDEAL POWER•IDEAL PENETRATION

•SAFE & EFFECTIVE•EXCELLENT ADDITION TO ANY PRACTICEADDING STATE OF THE ART MEDICAL TECHNOLOGY•INCREASING THE VALUE OF STAFF MEMBERS

•PROVIDES EFFECTIVE PAIN RELIEF•REDUCTION IN INFLAMMATION•ACCELERATED HEALING