Since October 2024 I have been very excited and proud to offer referring vets CO2 laser surgery, using the Aesculight Vetscalpel CO2 laser from the USA on a wide range of skin conditions. I am one of only two veterinary dermatologists in England and Wales (there are two in Scotland) to be able to offer this form of surgery, which really comes into its own in treating Chronic Pododermatitis and Interdigital Furunculosis (CPIF), where the laser can be used to safely ablate chronically diseased skin, “false pad” tissue and draining tracts without risking collateral thermal damage to adjacent structures. The Vetsacalpel unit comes with a variety of laser tips and ablation tips including a tubular metal tip that can pass down the working channel of my Karl Storz video otoscope and I have found it superior to my diode laser for removing larger tumours and Feline Cystamatosis lesions and it can even be used to remove severe hyperplastic skin in some Proliferative Otitis cases. It can also be used to ablate multiple skin tumours such as sebaceous adenomas and multiple keratoacanthomas.
I had successfully treated a few cases of CPIF where only a small part of the foot was affected, using my diode laser, but this machine is a real game changer in that there is minimal collateral thermal damage compared to the diode laser so I can now treat all cases of CPIF, even those with large areas of “false pad” development affecting all digits and with multiple interdigital “cysts”, where a combination of the “Superpulse” excision mode to cut out tissue and the “Continous Mode” with an ablation tip can be used to vaporise affected tissue.
Here’s a short video showing its use for treating Feline Cystomatosis:-
CO2 Laser treating Feline Cystomatosis
Here’s another video showing David Duclos, an American dermatologist, who is a pioneer in using CO2 lasers in dermatology, showing the ablation tip to laser away larger Cystamatosis lesions at the opening of the ear canal in a cat. Duclos- CO2 Laser treating Feline Cystomatosis
Chronic Pododermatitis and Interdigital Furunculosis
This was the main reason that I purchased the CO2 laser as there are so many dogs out there suffering with this condition, which is seen particularly in Atopic and food allergic dogs with the added problem of poor conformation leading the haired skin swelling up and becoming in contact with the ground and the follicles becoming plugged, resulting in rupture of the follicles internally leading to a foreign body reaction to keratin and draining tacts /interdigital furuncles appearing on the dorsal surface of the interdigital webs. Prior to the advent of C02 lasers, it was an extremely difficult condition to treat, fusion podoplasty being one surgical technique which was far from ideal, with wound breakdown being common and several altered conformation with the toes unable to spread out. The CO2 laser allows safe ablation of the affected “false pad” tissue which is then allowed to heal by secondary intention over 3-4 weeks.
“False Pad ” in Chronic Pododermatitis and Interdigital Furunculsosis (CPIF)
Squeezing sebum out of “False Pad ” in Chronic Pododermatitis and Interdigital Furunculosis (CPIF)
After lasering off “False Pad” tissue in a case of CPIF
Here is a link to one of David Duclos’s videos in using the C02 laser to ablate cystic tissue in a case of CPIF. The treatment of this condition with the CO2 laser can be a combination of excision and ablation. Either way, the wounds are left to heal by secondary intention and this occurs in 3-4 weeks. In a cases series published by him, 25 about of 28 cases of CPIF were cured.
Here is a link to a case report published in the Vetscalpel Website:-
CO2 Laser use in interdigital pododermatitis
The cost of doing a C02 Laser Podoplasty is around £1200 – £1400 per foot depending on the severity of the CPIF
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