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January Articles
| January
Articles: Hello! Welcome to the Orange Villa Veterinary Hospital Newsletter. We hope that you find it interesting, informative, and educational. Remember to Care to Share: We rely on your referrals. Remember when you refer a friend to us to fill out the care to share cards from our office or from the website. This gives your friend a complimentary exam and gives you $10 credited to your account. |
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| Veterinary acupuncture is a non-traditional area of veterinary medicine that is gaining popularity as more of its benefits are being scientifically documented. It has been shown to be helpful in alleviating pain, treating musculoskeletal disease, treating neurological dysfunction, and in emergency resuscitation of small animals. Acupuncture is the act of inserting needles into specific points of the body to cause a desired physiological response. Acupuncture has been practiced on animals in China since around 3000 or 2000 B.C. during the Zang and Chow Dynasties. Unfortunately in the western world of medicine, acupuncture is still not widely accepted as a proven means to treat disease. Until the 1960’s there was little use of acupuncture outside of Asia. By 1974 a group of veterinarians in California formed The National Association of Veterinary Acupuncture (NAVA), which remained active for 4-5 years. At the same time the International Veterinary Acupuncture Society (IVAS) was formed and remains active today. In 1996 the American Veterinary Medical Association (AVMA) published guidelines including acupuncture in its practice act. There are certification courses offered every year through IVAS and Colorado State University if a veterinarian is interested in becoming certified. Currently, Western scientists are undecided as to exactly how acupuncture works, although there is general consensus that in general consensus that it does work. Theories consider neural (nervous system) to humoral (immune system) response to the stimulation. Acupuncture has been used to promote balance in the body’s energy system, or Qi (pronounced Chee), and its ability to heal. It may be used alone or in combination with conventional treatments. In all animal species there are precise locations of acupuncture points on or near the surface of the body. When these points are stimulated, whether by direct needling, laser, heat application, electricity or injection of a fluid, there may be a change in the body’s internal organs and functions. The goal of stimulating these points is to get the patient’s Qi to flow in a smooth and harmonious pattern resulting in return to health or reductiomn of pain. Veterinary acupuncture therapy must involve a patient - centered approach. One treatment protocol may work in one patient, while another protocol may work for a different patient. It is important that the practitioner is willing to try more than one treatment plan and that the client be informed of the idiosyncratic nature of acupuncture. The client must also be informed as to the limits of acupuncture. It may be that the disease or trauma has progressed beyond the point of where conventional medicine or acupuncture can fix the damage already acquired. Acupuncture can be a great means to treat animals without the use of drugs, the stress of surgery or hospitalization, or may be the last resort for many animals with whom conventional medicine has failed. It can also complement or make conventional medicine more effective. Many studies have found that the body responds to acupuncture through the endocrine system and the central nervous system by increasing the levels of endorphin in the brain and spinal cord. Acupuncture also has a direct effect on the production, stimulation and release of body chemicals such as epinephrine, catecholoestrogen, and prostaglandin. Acupuncture has been shown to provide generalized oxygenation (extra high levels of oxygen needed for metabolism) and increased blood flow to areas of treatment. It aids in the production of endogenous (internal) cortisol and other anti-inflammatory chemical mediators and stimulates the immune system. Acupoints, or acupuncture points, are and area just below the skin that contains a neurovascular and lymphatic bundle. Nerves and blood vessels within theses bundles are surrounded by concentric collagen fibers. The spaces between the collagen fibers contain increased extra cellular water, cells, and fat. It is a region of decreased electrical resistance or increased electrical conductivity within the skin. Meridians are pathways, or channels, along which bioelectric and biochemical changes occur. Meridians may follow the route of major nerves, vessels, or cleavage planes between muscles. Meridians are functionally connected to a corresponding organ which is a place where energy, or Qi, is stored, such as the liver meridian or the kidney meridian. The bioelectric energy that flows through points and meridians is actually being conducted through the connective tissue which surrounds the neurovascular (nerve and blood vessel), tendinomuscular (muscle and tendon), and lymphatic structures which are a part of a meridian or acupoint. Collagen, which is the main component of connective tissue, has piezoelectric properties which are responsible for polarization of collagen when it is subjected to an electrical field or mechanical strain. Needle acupuncture is the most commonly known and utilized form of acupuncture. Needles are chosen on the basis of the size of the animal and the depth of the point into which the needle will be inserted. Acupuncture needles can purchased commercially as pre-sterilized disposable needles or as reusable needles that can be sterilized in an autoclave. Usually very little patient restraint is needed for proper needle insertion. The patient should be allowed to sit, stand or lay in a comfortable position and a technician is asked to hold and comfort the patient throughout the treatment. The patient should move as little as possible for the duration of the treatment. All efforts should be made to avoid chemical restraint. It has been shown that acupuncture analgesia is mediated through endogenous opioids. These opioids are responsible for inhibiting the transmission of pain from the source to the brain. By using chemical restraint (sedation) there is a risk of reversing or inhibiting the beneficial analgesic effects of acupuncture. Pain or stiffness may sometimes be exacerbated by needle insertion as well as lethargy. This may last several hours or several days after treatment before benefits are noted. Electroacupuncture is gaining popularity amongst veterinarians as a way to enhance regular needle acupuncture. It involves attaching a device to the needles, which are already in place. The device passes a low voltage current through the electrode and to the acupoint. It provides a control over the amount and quality of stimulation to the acupoint. The patient is restrained in the same manner as used for needle acupuncture. A good electro acupuncture device should provide a steady, stable current intensity. Frequency controls should accurately regulate the pulses per second. There are many different commercial units available. Electroacupuncture has been shown to produce transient changes in white blood cell counts and activity, increase dilation of blood vessels, increase electrical conductivity and excitability of nerve and muscle cells, and provide analgesia. Electroacupuncture should not be used in cases of cardiac arrhythmias, epilepsy, shock, hypotension and pregnancy. Moxibustion is an adjunctive therapy to regular needle acupuncture as well. It is the heating of acupoints by burning an herb, usually mugwort (Artemisia vulgaris), over the acupoints directly or when rolled into a ball and placed on the end of needles that have been inserted into particular acupoints. Direct moxibustion is not commonly used in veterinary medicine because it can be painful due to the thermal burn acquired. However, indirect moxibustion avoids direct contact with the heat source and therefore no thermal burns can occur. A “moxa stick”, which is the mugwort herb formed into a hard cylinder, is lit and then held directly above the needle in the acupoint or 0.5-1 inch above the acupoint. The moxa stick is moved in slow circular motions for 3-15 minutes. The heat is carried through the needle to deeper tissues for therapeutic effect. Moxibustion is time consuming and the fumes can cause humans the discomfort of headache or burning sensations in the eyes. Aquapuncture is the injection of solutions into acupoints with a hypodermic needle and syringe. Vitamin B12, saline, and dimethyl sulfoxide (DMSO) have been used as solutions to be injected. The patient requires more restraint for the injection. However, the patient is not required to remain immobile for the usual duration of the previously described modalities. With aqua puncture there is a longer term, residual stimulation of the acupoints. Caution should be taken to assure that he substances used are appropriate for the tissues into which they are being injected. Treating musculoskeletal disease Musculoskeletal disease is perhaps the most commonly treated indication for acupuncture. Diseases such as hip dysplasia, myositis (muscle inflammation), and degenerative joint disease (DJD) are often treated with analgesics and steroidal and non-steroidal anti-inflammatory such as Rimadyl, and Metacam, However, with such treatments many pets still experience debilitating pain, and inability to perform to their owner’s expectations. With DJD stiffness is caused by hypertonicity of the flexor and extensor muscles around the joint caused by the activation of sensory fibers in the muscles and tendons due to the joint inflammation and local release of inflammatory mediators. This causes the activation of motor neurons leading to shortened muscles with lower elasticity and eventually further joint trauma. Acupuncture activates central endorphin release that results in analgesia like a “runner’s high”. Needling also causes improved circulation to the area where muscles are spastic, resulting in reduced swelling and inflammation. Many modalities of acupuncture are applicable and effective. It is usually the client and practitioner’s personal choice as to the modality used. A treatment protocol usually consists of treatments 1-3 times a week for 3-5 weeks. It is common for the client to be asked to commit to a certain number of treatments to the acupuncture a chance to work. As soon as a desired response is seen, treatments are tapered to as few as needed to keep the animal at the desired level of comfort and function. Hip dysplasia may or may not be a surgically controllable disease. Some clients do not feel that he benefits of surgeries such as total hip replacements, enervations or triple pelvic astronomies, outweigh the risks of those surgeries. In some cases medication is not working at all or not working well enough to improve their pet’s pain and mobility. In these cases acupuncture may be a great adjunctive or single therapy. Analgesia is the main goal of acupuncture. With analgesia there will eventually be increased mobility. The most important concept to remember when dealing with treating musculoskeletal disorders is that a proper diagnosis must be reached first, in order to assure that proper treatment protocols are being used. It is also important to let clients know that in cases of chronic disease, continued acupuncture treatments will be needed and that acupuncture cannot cure nor stop the progression of the disease. Treating Neurological Disorders As for any other condition, before attempting acupuncture the
lesion must be localized. Neuropathies varying from facial paralysis
to epilepsy can be treated with acupuncture. Especially in cases
where surgery is not an option and the patient is faced with long-term
steroid use as an alternative. Idiopathic epilepsy is defined by
recurrent seizures with normal metabolic function and normal brain
structure. Most veterinarians choose to try potassium bromide and
Phenobarbital administration to control seizures before adding
acupuncture to the treatment regimen. Treating Canine Lameness The first step in treating canine soft tissue association lameness
is to isolate the muscles and meridians needed to diagnose the
primary lameness. The longitudinal muscle - channel system is an
anatomically based system used to find a treatment strategy for
canine lameness. Muscle channels are similar to organ meridians
in that they connect muscle groups to their meridians. The body
is classified into four regions: cervical (neck), forelimb, thoracolumbar
(trunk), and hind limb. It is important to identify the muscle
channel involved and treat the associated points. Analgesic Affects of Acupuncture Surgical analgesia has been obtained with the use of acupuncture. However, restraint of an awake patient through a procedure can be difficult and a hindrance. Any kind of pain can be treated with acupuncture. It is known to affect the central nervous system by activating the body’s endogenous pain modulatory systems thereby causing decreased perception of pain (nociception). Treating Intervertebral Disc Disease In most cases of intervertebral disc disease (IVDD) surgery is the first treatment option. Surgery can relieve the compression on the spinal cord and eliminate the pain and possibilities of paralysis. However, there may be some patients who are nor good surgical candidates or clients who simply cannot afford the surgery. In these cases acupuncture may be helpful in relieving pain and returning mobility to the patient. It is thought to work through the abolishment of pain which in turn stops muscle spasms, decreases local inflammation, edema, and therefore the cycle of pain. It is also thought to activate the re-growth of damaged axons in the spinal cord. The patient still needs strict confinement and good supportive care until the final level of return to function is reached which may take weeks. Emergency Resuscitation Using Acupuncture A point in the middle of the nasal philtrum, or the line connecting the nasal pad to the upper lip is used by veterinarians to bring an apneic patient back to normal breathing. Strong needling of the point was found to bring 90-100% of simple cases back within 10-30 seconds. This point has been shown to enhance cardiac output and brain perfusion, raise blood pressure and has sedative effects on convulsing animals. Conclusion Veterinary acupuncture
is becoming more widely used, respected and understood throughout
the profession. It has many applications
that may be used in conjunction with traditional medicine or alone.
Acupuncture has been shown to reduce pain, treat various conditions
and aid in emergency resuscitation. Adding veterinary acupuncture
to one’s repertoire can give your clients and patients alternatives
when traditional medicine is not effective or too expensive.
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