Written by a Medical Acupuncture for Veterinarians course graduate. Signed release obtained from client/author. A2017025
Abstract: Speedy, a 10-year-old Quarter Horse gelding, presented for a primary complaint of a sore back and trouble picking up the left lead at the canter. Throughout the course of three treatments, Speedy’s lumbar and compensatory brachiocephalicus trigger points resolved and he began to pick up his left lead.
History and Presentation: Speedy, a 10-year-old Quarter Horse gelding, presented for a primary complaint of a sore back and trouble picking up the left lead at the canter. He is a working cow horse. Speedy lives in a stall in a barn and is ridden 4-5 times a week. His diet consists of grass hay and he is not currently on any medications or medical management. On presentation, Speedy was bright, alert, and responsive, and extremely friendly.
Physical Examination and Clinical Assessments: On physical examination, Speedy’s vitals were within normal limits (T: 99.4F, P: 36bpm, R: 18bpm), he has a corneal opacity in his left eye from a historic ulcer, and otherwise has no significant abnormalities. Neurologic examination revealed normal facial expression, musculature, and symmetry, no overt cranial nerve deficits appreciated, and no ataxia appreciated at the walk. He does not show any overt lameness at the walk, can perform small circles in both directions, and backs in a straight line willingly. Myofascial palpation: (6/26) Very nervous during palpation. Sensitive to palpation of the ventral brachiocephalicus bilaterally (threw his head up and took a few steps back) and was tight in his pectoral muscles and forelimb range of motion. Palpation of the caudal thoracic/thoracolumbar/lumbar area of BL 18-25 bilaterally caused muscle fasciculation and he moved away from the gentle pressure. (7/4) Comfortable and calm during palpation. Less sensitivity on palpation of brachiocephalicus m. (7/15) Similar to previous session. Told he was anxious during training yesterday.
Medical Decision Making: Speedy is a relatively nervous, but very friendly horse. He had not received acupuncture before these treatments. His trigger points in his brachiocephalicus and caudal thoracic/lumbar epaxial muscles are likely the result of how he must hold himself and maneuver his body during ranch horse work. To start, I chose LI 16, LU 1, and GB 21 (good initial test points in the horse as well as helpful for the brachiocephalicus trigger points – I made sure to not go directly in the trigger point at first) bilaterally, as well as Bai Hui (centering and balance). I massaged his back and epaxial muscles first to help get him used to the pressure and contact, and then placed bilateral BL 13, 18, 21, and 23. BL 23 placement resulted in a significant lumbar musculature spasm, so after he relaxed once more I chose to stop there as far as the BL points for the first treatment.
Differential and Definitive Diagnoses:
-Athletic stiffness due to profession
Acupuncture Treatments: Please see medical decision making as well. I used Seirin 0.23 x 30mm and 0.25 x 0.30mm with insertion tubes because he is a sensitive horse who has not had acupuncture prior to these treatments.
6/26/17: LI 16, GB 21, LU 1, Bai Hui, BL 13, BL 18, BL 21, BL 23. Speedy was rather nervous during the treatment, but his comfort increased during the course of the treatment after all the needles were placed.
7/4/17: LI 16, GB 21, LU 1, Bai Hui, BL 13, BL 18, BL 21, BL 23, BL 25, BL 27, BL 54. Speedy was much calmer and more comfortable during this treatment. Likely because he knew what to expect and hopefully realized that he enjoyed it last time and felt better afterwards.
7/15/17: LI 16, GB 21, LI 17b, Bai Hui, LU 1, BL 13, BL 21, BL 23, BL 25, Da Feng Men. Speedy was lovely for the placement of his needles and seemed genuinely happy to see me at the start of our appointment. I think he is beginning to associate me with feeling better.
Outcomes, Discussions, and References: Speedy’s comfort with the acupuncture treatments increased dramatically and he was only nervous during the first portion of the first treatment. His trigger points and sensitivity to palpation of his brachiocephalicus muscles and epaxial muscles in the caudal thoracic and lumbar regions improved significantly as well. He also began to pick up his left lead for his owners after the second treatment.