Written by a Medical Acupuncture for Veterinarians course graduate. Signed release obtained from client/author. A2017005
Abstract: Aida is a 9 year old FS yellow Lab who was diagnosed with hip dysplasia when she was a puppy. As she has gotten older she has had signs of pain and weakness in her hind limbs bilaterally. She refuses to go on the long walks that she used to go on and her primary veterinarian has prescribed NSAIDS to help with the inflammation and pain. We performed 3 acupuncture treatments on Aida.
History and Presentation: Aida is a 9 year old FS yellow Lab who presented with decreased desire to attend her daily walks. When Aida was a puppy she was diagnosed with Hip Dysplasia with radiographs with her primary veterinarian. She is not limping, but her owner does notice her hips drop when she gets very excited and her hips sway side to side. She was adopted as a puppy and has been with her owner since. She is doing great at home, great appetite and no diarrhea or vomiting. She is playful and happy and has had no changes in behavior or lethargy. She is given NSAIDS on occasion when she is refusing to walk.
Physical Examination and Clinical Assessments:
Temperature: 98.6°F Axillary
Pulse Rate: 88 bpm
Respiratory Rate: 28 bpm
Weight: kg (Estimated)
Blood Pressure: Not Examined
Organ System Comments:
General : Bright, alert, responsive. BCS 5/9, euhydrated.
Skin: Clean coat; no lesions, crusts, or ectoparasites visualized.
EENT: Ears clean with mild external debris AU. Eyes clear and visual OU without any abnormal discharge. Nasal planum clean, no abnormal discharge visualized.
Respiratory: Eupneic. Clear bronchovesicular lung sounds over all lung fields, no crackles or wheezes appreciated.
Cardiovascular: CRT <2 sec. Moist, pink mucous membranes. Normal heart rate and rhythm with strong, synchronous pulses. No arrhythmias or murmurs auscultated.
Gastrointestinal: Soft and comfortable upon palpation, no ascites or organomegaly appreciated. Moderate plaque on maxillary and mandibular premolars and molars.
Genitourinary: No urethral discharge
Mammary: Normal without any masses palpated or visualized.
Musculoskeletal: Mild muscle atrophy of hind limb lateral thigh sand gluteal muscles bilaterally; No masses or abnormalities observed on palpation
Nervous: No ataxia noted, normal CPs x 4, no cervical/spinal pain, normal cranial nerves
Hemolymphatic: Mandibular, superficial cervical, axillary, and popliteal lymph nodes all palpated soft and small, WNL
– There is no lameness at a walk or a trot
– Bilateral severe resistance on hip extension and hip abduction
– Bilateral mild gluteal muscle atrophy and semimembranosus and gastrocnemius taut muscles
– Taut iliopsoas muscle bilaterally with a painful response on palpation
– Sensitive on palpation of the thoracolumbar and lumbosacral spine
Medical Decision Making:
– Aida’s owner did not want to pursue radiographs and further diagnostics since she knew the diagnosis Aida had and did not want to pursue any surgical treatment. The decision was made to continue to medically manage Aida with NSAIDS and add on Acupuncture and massage.
Differential Diagnoses: Top differential: Hip dysplasia/osteoarthritis; Other differentials: Spondylosis, cauda equina syndrome, achondroplasia, and less likely due to her age hypertrophic osteodystrophy and Legg-Calve-Perthes disease.
Definitive (or Putative) Diagnosis (or Diagnoses): Hip dysplasia (diagnosed as a puppy)
5/26/17: Baihui, Bilateral: BL 23, BL25, BL54, GB29, GB30, BL60/KI3
9/21/17: GV14, Baihui, Bilateral: BL15, BL23, BL25, BL54, GB29, GB30, BL60/KI3
9/23/17: GV14, GV20, Bauhui, Bilateral: BL14, BL15, BL25, BL23, BL54, BL36, BL40, BL60/KI3, GB29, GB30
– E-stim: BL23-25 at ~4Hz at level 4 for 10 minutes bilaterally
– E-stim: BL36-40 at ~4Hz at level 5 for 10 minuets bilaterally
Outcomes, Discussions, and References:
Aida’s muscle relaxation seems to be doing better after the treatments and her owner reports that she is walking a little more and seems less stiff. We will continue to work with Aida since she has been benefiting from the treatments and see how she does in the future. Due to time, location and my school schedule the treatments were spread out but we will continue to help Aida when our schedules match up.