Use of CO₂Laser as an Adjunctive Treatment for Caudal Stomatitis in a Cat

Abstract

Lasers have become a popular tool in veterinary practice, particularly the carbon dioxide (CO2) laser. In humans, the CO2 laser is used most commonly in oral and maxillofacial soft tissue surgery due to its favorable interactions with oral soft tissues. Other types of lasers are better suited for use on hard tissues such as enamel and dentin. This article reviews the history of laser use, physics of laser-tissue interaction, delivery systems, and laser types used in dentistry and oral surgery. This is followed by a case report describing the use of CO2 laser as an adjunctive treatment for therapy of refractory caudal stomatitis in a cat.

Therapeutic Management of Feline Chronic Gingivostomatitis: A Systematic Review of the Literature

“…The most common reasons for study exclusion were manuscripts focusing on species other than cats (i.e., humans) as well as articles discussing treatment of other feline diseases, such as feline immunodeficiency virus, and mentioning stomatitis as a clinical sign or sequela. After assessing the included 16 studies, 4 were assigned an EDG of I ( 12 , 28 , 36 , 37 ), 3 were assigned an EDG of II ( 10 , 11 , 38 ), 3 were assigned an EDG of III ( 39 – 41 ), 1 was assigned an EDG of IV ( 42 ), and 5 were assigned an EDG of V ( 43 – 47 ). Seven studies (43.8%) were prospective clinical trials, three studies were retrospective (18.7%), and six studies were case reports presenting the outcome of one or two cats (37.5%).…”

“…There were 10 forms of medical management evaluated in these studies: Zincreo germicidal astringent obtundent ( 43 ), local paramunization with PIND-ORF (parapoxvirus ovis) ( 38 ), thalidomide ( 44 ), lactoferrin ( 37 , 44 ), cyclosporine ( 12 , 40 ), recombinant feline interferon omega ( 28 , 42 , 46 ), prednisolone ( 28 ), diet ( 36 ), piroxicam ( 37 ), and autologous mesenchymal stem cells ( 10 ). There were six studies that focused on surgical management, discussing efficacy of dental extractions ( 11 , 36 , 39 , 41 , 45 ) and use of carbon dioxide laser treatment as an adjunct to dental extractions ( 47 ). The reported mechanism of action of these treatments is as follows: local paramunization ( 38 ), thalidomide ( 44 ), lactoferrin ( 37 , 44 ), cyclosporine ( 12 , 40 ), recombinant feline interferon omega ( 28 , 42 , 46 ), and autologous mesenchymal stem cells ( 10 ) elicit immunomodulatory effects; prednisolone ( 28 ) and piroxicam ( 37 ) reduce inflammation; lactoferrin ( 37 , 44 ) inhibits bacterial growth; recombinant feline interferon omega ( 28 , 42 , 46 ) impedes viral replication; diet ( 36 ) accelerates healing and reduces inflammation; carbon dioxide laser ( 47 ) removes proliferative tissue and stimulates fibrosis; and dental extractions reduce immune stimulation via eliminating plaque ( 11 , 36 , 39 , 41 , 45 ).…”

“…There were six studies that focused on surgical management, discussing efficacy of dental extractions ( 11 , 36 , 39 , 41 , 45 ) and use of carbon dioxide laser treatment as an adjunct to dental extractions ( 47 ). The reported mechanism of action of these treatments is as follows: local paramunization ( 38 ), thalidomide ( 44 ), lactoferrin ( 37 , 44 ), cyclosporine ( 12 , 40 ), recombinant feline interferon omega ( 28 , 42 , 46 ), and autologous mesenchymal stem cells ( 10 ) elicit immunomodulatory effects; prednisolone ( 28 ) and piroxicam ( 37 ) reduce inflammation; lactoferrin ( 37 , 44 ) inhibits bacterial growth; recombinant feline interferon omega ( 28 , 42 , 46 ) impedes viral replication; diet ( 36 ) accelerates healing and reduces inflammation; carbon dioxide laser ( 47 ) removes proliferative tissue and stimulates fibrosis; and dental extractions reduce immune stimulation via eliminating plaque ( 11 , 36 , 39 , 41 , 45 ). The mechanism of action of Zincreo germicidal astringent obtundent was not directly reported ( 43 ).…”

Dental and Oral Diseases

“…71 In severe cases the inflamed tissues become from complete resolution of inflammation (60%), minimal residual inflammation, and no oral pain (20%); to initial improvement requiring continued medical therapy to control clinical signs (13%); to no improvement (7%). 67 The CO 2 laser is used in excision and ablation modes. 50 Laser surgery may be used as an adjunct in patients with refractory stomatitis not responding to extractions and medical therapy.…”

NonsuturedHotz–Celsus technique performed byCO2laser in two dogs and two cats

“…Different CO 2 laser applications have been reported in small animal surgery: resection of a mast cell tumor of the upper lip and nasal planum in a dog, resection of the soft palate in dogs with brachycephalic airway obstructive syndrome, treatment of feline ceruminous cystomatosis, dental applications, in oral, and maxillofacial soft tissues. and multiple dermatological applications, such as removal of sebaceous adenomas, keratoacanthomas, hemangiomas, or cutaneous angiomas. Additionally, infected tissue can be vaporized in lesions caused by papilloma virus, herpes dermatitis and sarcoids and the recurrence rates of these decreased .…”