Written by a Medical Acupuncture for Veterinarians course graduate. Signed release obtained from client/author. A2017005
Abstract: Squirt is an 8 year old gelding who has had muscle soreness and many trigger points along his pectorals, caudal cervical, cranial thoracic, and thoracolumbar areas. We performed 3 acupuncture treatments on Squirt and his owner reported that his riding began to improve immediately after the first treatment.
History and Presentation: Squirt is an 8 year old Quarter Horse gelding who presented on 5/17/17 for difficulty saddling up and picking up leads while riding. He was bought 2 years ago by his current owner. She mentioned that he had a very heavy owner that rode him previously. The current owner is a veterinary student at and is also massage certified and noticed that he had a good amount of tension in his pectorals and shoulder pain when purchased. She also mentioned that he is a cribber, which she is currently managing. Squirt has been used for light barrel racing and currently more pleasure riding. He is kept out on pasture with another horse. He is fed free choice grass hay and has a salt block and F/C water.
Physical Examination and Clinical Assessments: 5/17/17
Temperature: 100 °F
Pulse Rate: 44 bpm
Respiratory Rate: 24 bpm
Weight: 500 kg (Estimated)
Blood Pressure: Not Examined
Organ System Comments:
General: BAR, BCS 5/9
Integument: Mildly overgrown hooves. No signs of alopecia, crusting, lacerations or erythema. Bay hair coat.
Head/Neck: No masses, lacerations or abnormal swellings around the head or neck.
Eyes-Ears-Nose-Throat: Menace response normal and no corneal opacity observed. External ears with free of debris and no odor. Normal airflow through both nostrils. Mild normal nasal discharge. No signs of ocular discharge. MM are pink and moist. CRT<2 seconds. No signs of vesicles or mucosal trauma.
Cardiovascular: No arrhythmias or murmurs auscultated. Normal synchronous rhythm with pulse.
GI: Normal gut sounds in all 4 quadrants. 2-3 borborygmi/minute.
Respiratory: Normal lung sounds. No crackles or wheezes. Normal tracheal breathe sounds and no tracheal rattle heard on auscultation.
Musculoskeletal: No lameness, warmth or digital pulses palpated on any of the 4 limbs at standing. Lameness exam not performed.
Nervous: No gait abnormalities at a walk. Full neurologic exam not performed.
Hemolymphatic: submandibular lymph nodes bilateral ~1 cm. No swellings observed on peripheral lymph nodes.
- Moderate – Severe resistance on mobility of the Mid- caudal cervical spine to the left and the right. Great mobility of head/cervical movement up and down
- Joint Mobility in all limbs was great with no significant findings.
- Mild-moderate resistance on mobility of the thoracolumbar spine.
- Myofascial tension and trigger points noted at caudal cervical area. Trigger points found at cranial thoracic area (BL13-18), thoracolumbar area, and bilateral pectorals.
Medical Decision Making: Squirt will be started on weekly acupuncture treatments and massage therapy to treat the muscular tension and mobility issues in the caudal cervical, cranial thoracic, and thoracolumbar areas. (Although due to our student schedules, we were not able to perform treatments on a strict weekly basis) There are no other significant findings and Squirt is generally healthy at this time.
Differential Diagnoses: Muscular tension and soreness may be contributed to the previous history of a heavy rider and the cribbing.
Definitive (or Putative) Diagnosis (or Diagnoses): Previous history of a heavy rider and the cribbing
5/17/17: Due to rough weather issues and Squirts first acupuncture treatment, only a few points were chosen.
- Bilateral: LI16, LI17, BL11, BL13, GB21
5/25/17: Today, Squirt enjoyed his acupuncture treatments and many more points were added to his treatment plan. He had mild tension on his left semitendinous/semimembranous muscular area. All other trigger points and myofascial tension remained the same as previously. His physical parameters were within normal limits.
- Bilateral: GB21, LI16, BL10, BL11, BL12, BL13, BL21, BL22, BL25, LU1
- Bai hui
- Left side: GB30, BL54
7/3/17: Due to time constraints with our rotation/externship schedules, this 3rd treatment was delayed. On presentation, Squirt was BAR but had mild bilateral nasal discharge. The Owner mentioned that he had unilateral nasal discharge on 7/1/17, that has now progressed to bilateral. He had an increased heart rate of 52bpm and a fever of 103.3F. She also mentioned that other horses nearby just arrived back from a show, who also had nasal discharge. A viral component is suspected, along with other possible infectious agents. We discussed starting Squirt on Banamine SID for 3 days and re-checking his temperature daily. If he does not improve, an appointment with an ambulatory veterinarian or veterinary clinic is recommended to perform further diagnostics. Acupuncture was performed today as well to assist with immunity and current muscular tension. All muscular trigger points remained the same as the first exam, except for a new trigger point located on his right mid cervical area.
- Bilateral: LI16, LI17, BL11, BL12, BL13, BL14 BL21, BL25, GB21, LI11, LU1
- Bai hui, GV14
- Right: SI16, muscular trigger point mid cervical area
Outcomes, Discussions, and References: Squirt improved after his first and second treatment. The owner mentioned that he picked up his leads without any trouble and saddled better, especially when buckling in the cinch. The plan is to continue his acupuncture treatments and at home massage therapy when possible. With his current potential viral infection, the plan is to continue with treatment of Banamine and monitoring of his temperature daily. When he improves, he can be ridden again.