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.
Pets with neurological disease are usually treated weekly unless they have
marked dysfunction or pain, then they are treated twice weekly. Needling and
electroacupuncture are the most common modalities used. Patience is needed
when treating neurological disorders. The cumulative effects of the treatments
take time to develop.
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.
Most of the time, three treatments a week for a three week interval is agreed
upon as the starting protocol and treatments are tapered or continued according
to the amount of analgesia and return to mobility that is accomplished.
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.
Here at Orange Villa Veterinary Hospital we offer acupuncture treatments for
pain alleviation associated with musculoskeletal disorders. Needling is the
only modality currently being used here until Dr. Slaton takes the necessary
courses to become certified. At this time her training consists of an internship
under a certified acupuncturist and DVM, along with 3 years of practical application
as a veterinarian. She currently requires that the client agrees to 3 sessions
a week at 1 hour per session, for 3 weeks to determine if treatment is working.
Each session costs $75.
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